How Effective Is Propecia Or Finasteride For Hair Loss?
There are many hair loss treatments that promise to be the answer for hair loss. So how do we know which treatment really works and what is right for us? Before we explore, it is important to understand the causes of hair loss. The most common type of hair loss is Androgenetic Alopecia. In men, this is often referred to as Male Pattern Hair Loss. This condition can impact on confidence and self-esteem.
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So what does Male Pattern Hair Loss mean?
Male Pattern Hair Loss is caused as a result of the effect of the male hormones androgens on the hair follicles mainly a hormone known as dihydrotestosterone (DHT). DHT is responsible in the sexual development of the individual at the foetal stage as well as puberty. DHT is a by-product of the male hormone testosterone which is also found in women. DHT is produced as a result of the binding of testosterone to an enzyme called 5-alpha reductase. We all have DHT and, in the right amount, it does not affect hair loss. However, during puppetry, the amount of testosterone may increase leading to a greater chance of binding to 5-alpha-reductase thereby resulting in the formation of more DHT.
This process will, in turn, result in an imbalance of DHT in the hair follicles. androgenetic alopecia is the most common type of baldness which is characterised by hereditary thinning of the hair that is induced by androgens in genetically susceptible individuals. The transformation of large terminal follicles into miniature ones is triggered by the binding of (DHT) to androgenic receptors in the hair follicles of the scalp. Resulting in the hair follicles to continue to shrink and weaken during every growth cycle to produce hairs that are short, thin and fragile which eventually fall out.
Androgenetic alopecia seems to follow a distinct pattern that is confined to specific areas that include the front hairline, the crowns and top of the scalp whilst the sides and the back of the head remains. As Androgenetic alopecia is of genetic in nature, it is not possible to reverse the effect. No one can really predict when it will begin and how long it will take to fully impact. Therefore the earlier the treatments are started the more hair can be recovered.
One of the most effective treatments in male pattern hair loss is Finasteride.
What is Finasteride?
Finasteride is a drug is available in two strengths 5mg and 1mg. It works by inhibiting the enzyme 5-alpha reductase that is responsible for the conversion of testosterone to DHT reducing its level. At 1mg dose, Finasteride can reduce the levels of DHT by 60-70% and therefore, it is a powerful drug in the treatment of male pattern hair loss.
How often is Finasteride taken?
Finasteride comes in a tablet format 1mg dose. It is taken daily. The tablet is conveniently swallowed whole with plenty of water with or without food preferably at the same time each day. It should not be crushed or chewed.
Are there any side effects?
All medications carry a degree of risk, therefore, it is important to ensure that correct and accurate information is given on the medical questionnaire.
Side effects from Finasteride are not very common. Less than 2% of individuals experience side effects. Finasteride has a minimal effect on sexual dysfunction such as lowered libido or difficulty in achieving an erection. These sexual adverse effects should not affect prescribing practices. However, if any side effects are experienced then please get in touch with us as we will be able to assist.
How safe is Finasteride?
Finasteride has a proven safety profile and studies have shown that the side effects can wear off with continued use. Finasteride has a half-life of 7 hours which means that it is cleared from the body fairly quickly and within days. However, if the side effects continue then stopping the medication will also result in the reversal of side effects. It is important to get in touch with us and GP should you experience any side effects or planning to stop the medication.
Can Finasteride be taking when trying for a baby?
Traces of Finasteride may remain in the semen and therefore it is advisable to stop Finasteride one week before trying to conceive as well as during pregnancy of the partner. If the decision to continue using finasteride whilst the partner is pregnant then it is important to use barrier contraception and ensure that the partner does not handle the tables.
Can Finasteride increase the risk of prostate cancer?
There is not enough evidence to suggest that Finasteride increase the risk of prostate cancer. However, taking Finasteride may alter the PSA test results and therefore it is important to get in touch with us and the GP.
Can Finesteride increase the risk of breast cancer?
Side effects relating to the changes in the tissues of the breast are not common. However, we advise you to get in touch with us and the GP should you experience any changes in breast tissue.
Can Finasteride cause infertility?
The side effects of Finasteride are less than 2% and in most cases ware off. However, sometimes persistent side effects may occur but unlikely to be permanent. Persistent side effects are also experienced when individuals continue to use the medication despite the side effects. It is important to get in touch with us and the GP should any side effects. It is also vital to read the patient information leaflet.
Can finasteride cause depression?
Some studies have indicated that there may be an increase in depressive symptoms after using the Finesteride for up to 2 months; however, the overall effects were minimal. It is important to provide accurate information when requesting the medication in order for you to receive the best possible advice regarding your treatment. Also to get in touch with us and GP if any side effects are experienced.
Can blood be donated when using Finasteride?
It is advisable to stop taking Finasteride one month before donating blood.
Will Finasteride affects the hair in other areas?
Finasteride is not known to affect hair growth in other areas.
Can the tablets be stopped when the desired effects are reached?
As male pattern hair loss is a genetic condition it is not possible to stop genetics and therefore stopping the tablet will reverse the effects as genetics will continue to proceed.
Conclusion
- Finasteride 1mg seems to be the best medication with effects available to treat androgenetic alopecia to address the root of the issue.
- Finasteride 1 mg daily promotes the conversion of hairs into the anagen phase. Finasteride 1mg treatment results in favourable effects on hair quality that contribute to the visible improvements in hair growth.
- Studies have shown the safety of finasteride 1mg when used over long a long period of time. At 1mg, the side effects are not common and are reversible.
- Finasteride 1mg is an effective and safe drug for the treatment of male pattern hair loss when used in accordance prescriber’s instructions and the patient information leaflet. However, it is important to get in touch with us and the GP should if side effects are experienced.
- The use of finasteride for the treatment of male pattern hair loss has recently been the focus of media and internet attention for potential irreversible sexual dysfunction and severe depression. The purpose of this study was to perform a critical review of the recent studies reporting prolonged sexual dysfunction and depression with the use of finasteride for the treatment of male pattern hair loss. A literature search was performed using PubMed to review the literature pertaining to any potential adverse effects with the use of finasteride and its treatment of male pattern hair loss. The authors conclude that the reports of potential irreversible sexual dysfunction and severe depression do raise concerns about the safety of finasteride; however, these studies are wrought with significant bias. Therefore, larger, randomized, double-blind, controlled trials are warranted to further ascertain the true potential risks or confirm long-term safety profile of finasteride use.
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References:
- Kaufman KD, Olsen EA, Whiting D, et al. Finasteride in the treatment of men with androgenetic alopecia. Finasteride Male Pattern Hair Loss Study Group. J Am Acad Dermatol. 1998;39:578–589.
- Leyden J, Dunlap F, Miller B, et al. Finasteride in the treatment of men with frontal male pattern hair loss. J Am Acad Dermatol. 1999;40(6 Pt 1):930–937.
- Mayoclinic.org. (2017). [online] Available at: http://www.mayoclinic.org/documents/mc1402-50-pdf/doc-20228419 [Accessed 11 Dec. 2017].
- Mysore, V. (2012). Finasteride and sexual side effects. Indian Dermatology Online Journal, [online] 3(1), p.62. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3481923/ [Accessed 12 Dec. 2017].
- Singh MK, Avram M. Persistent Sexual Dysfunction and Depression in Finasteride Users for Male Pattern Hair Loss: A Serious Concern or Red Herring? The Journal of Clinical and Aesthetic Dermatology. 2014;7(12):51-55.
- Van Neste D, Fuh V, Sanchez-Pedreno P, et al. Finasteride increases anagen hair in men with androgenetic alopecia. Br J Dermatol. 2000;143:804–810.
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