The Science of Propecia & Finasteride

The Science of Propecia & Finasteride

Many of us like to know we are getting our money’s worth in the things we buy and why shouldn’t we? Indeed, we would expect that a new fridge would work in keeping our food chilled, or assume that a kettle would boil our water and so it can be further extrapolated that people want their medicines to work in the way they are intended also. However, this can be more challenging than one might initially assume as the actual science of how well a medicine works is often difficult to find or impossible to understand considering the amount of medical jargon it usually contains. Therefore, in this article, the effectiveness of Propecia is summarised and is entirely backed up with the research surrounding it in a way that is quick and easy to understand.

Propecia-1-84Finasteride is the drug contained within Propecia. Propecia is a drug produced by Merck and approved for use by the Food and Drug Association in 1992. Propecia appears as a tan, octagonal tablet, marked with a ‘P’ on one side and ‘PROPECIA’ on the other. Propecia is used to treat the symptoms of the common hair loss condition known as Male Pattern Baldness (MPB), a condition which affects around half of men over fifty to some degree.

Looking briefly at hair loss and how this happens we must consider the constant cycle that hair participates in. Indeed, hair starts in an anagen phase, known also as the growth phase, whereby in the end a hair comes out from the hair follicle as a mature, pigmented and overall healthy hair strand. This phase happens constantly for around two to four years after which the hair enters a telogen phase known also as the resting phase during which the hair is released and subsequently falls out. Each hair follicle is independent and will be in different stages of this cycle at different times; otherwise, all your hair would fall out at once! It is at this point it is important to remember that it is completely normal to lose some hair every day and it is only when its someone is losing around 100 hairs or more is there any cause for concern.


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In the case of MPB, it is thought that the receding hairline and thinning of the hair are caused by a combination of genetic factors and a particular hormone known as dihydrotestosterone (DHT).
In relation to this, hair follicles contain type ⅱ5α-reductase and this is perfectly normal, however, in abnormal scenarios of hair loss such as MPB there are increased levels of DHT. This causes the hair to become miniaturised and un-pigmented and present symptoms of MPB such as a receding hairline and thinning of the hair on the crown of the head.
Propecia can be used to decrease scalp and serum levels of DHT as it acts as a competitive and specific inhibitor of type ⅱ5α-reductase. Indeed, its mechanism of action blocks the conversion of testosterone to androgen DHT. This can help reverse the balding process and alleviate symptoms of MPB.

According to the official product literature, this reduction of DHT is significant in as little as 24 hours from the first dosing of Propecia.
Now, to get to the facts regarding efficacy and there is no better place to look than the clinical trials which surround the use of Propecia.
Indeed, looking at a clinical study involving 1879 men aged 18 to 41 who all had mild to moderate, but not complete, vertex hair loss from the frontal to mid sections of the scalp, the true effect of Propecia was compared to a simple placebo. In the two studies performed 16 men taking a placebo were assessed for differences in comparison to another 290 men who took Propecia treatment at the standard dose of one 1mg tablet a day for the duration of five years. The efficacy of Propecia treatment was measured using the following parameters;

I. Hair count within a defined scalp area of 5.1cm2
II. The patient self-assessment questionnaire
III. Investigator assessment using the seven-point scale (a seven-point scale starting with ‘Completely Disagree’ to ‘Completely Agree’)
IV. Photographs of the scalp examined by an independent panel of dermatologists

From the experiment, it was shown that participants who took Propecia had shown a higher level of hair growth compared to initial baseline levels of hair and also to volunteers taking the placebo medication. These positive effects were reported by investigators as early as three months into the trial. Furthermore, at the two-year point, it was found that within the defined 5.1cm2 area of the scalp which was used to assess efficacy there was an increase of 88 hairs from the initial baseline hair count taken at the beginning of the experiment. Five years later the same area of scalp was examined again and it was shown that there were 38 additional hairs compared to the baseline measurement taken at the start of the trial. This is significant in comparison the placebo group who at the two-year analysis had a reported loss of 50 hairs compared to the baseline value and subsequently 239 hair decrease at the five-year point.

Hair DifferenceIn addition, photographs showed that 48% of men treated with finasteride for five years were rated as ‘improved’, and an additional 43% were rated as ‘unchanged’ meaning there was no further deterioration in their hair loss symptoms. Comparing this to the placebo group it was found that just 25% of the participants were classified as either ‘improved’ or ‘unchanged’. It can be concluded from this study that men who started treatment with Propecia over the five-year study experienced a solid stabilisation of their hair loss and the associated symptoms of MPB in comparison to the men taking a placebo.

Furthermore, clinical data has shown that Propecia actively promotes the conversion of hair follicles into the growth phase. This is important because, as mentioned above, it is a decline in the growth phase that causes the symptoms of MPB in the first instance. In a 48 week, placebo-controlled study involving 212 men, the effectiveness of Propecia was determined at each stage of the hair cycle. To measure this hair counts were done on a 1cm2 target area of the scalp during the anagen phase (growing phase) and telogen phase (resting phase). At 48 weeks into the study, it was found that anagen hair counts were much higher (27 hairs was the average count) in the men taking Propecia compared to the men on placebo medication who actually lost hair while in the anagen phase. This research shows how Propecia can promote hair while in this growing phase which is essential to relieve the hair loss associated with the MPB condition.

In conclusion, it can be seen there has been a great deal of lengthy and detailed research that has gone into the investigation of how well Propecia works and on the whole, it has been extremely promising. Indeed, no longer is MPB a curse that cannot be solved with anything other than a pricey hair transplant; now sufferers have the option of Propecia. In addition, at Assured Pharmacy patients can fill in a quick and simple questionnaire from our UK registered doctor and have the medication delivered hassle-free to their home conveniently and discreetly. Now armed with this information, feel free to give it a go and experience the benefits for yourself.


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Assured Pharmacy is not liable for the currency or accuracy of the information contained in this blog post. For specific information about your personal medical condition, please contact our doctors or pharmacists for advice on [email protected].