Ask An Expert: Does Propecia Really Prevent Balding
Earlier this year, the web was atwitter about claims that Donald Trump was taking hair regrowth drug Propecia. Its a drug that decreases the conversion of testosterone to dihydrotestosterone, which in turns prevents hair from falling out . It wouldn’t be surprising if Trump takes Propecia that wispy, discolored mop looks anything but natural. Or perhaps, like Samson the Israelite, Trump’s power is somehow linked to his flowing locks. It makes total sense that he would do whatever possible to prevent balding.
This bit of gossip aside, it’s a big question for guys in their late twenties and early- to mid-thirties: How far will you go to prevent hair loss? Are you going to move to Nova Scotia because you read somewhere that pollution causes male pattern baldness? Or will you embrace it and shave your hair as closely as possible?
Hormone-altering drugs like Propecia have numerous potential side effects. Many of the outlets blogging about this Trump item pointed out that Propecia can cause mental confusion and impotence in rare casesthough most guys see no negative side effects at all.
If youre thinking about taking Propecia , its imperative to educate yourself about your chances of a positive outcome and the potential harms. To help you sift through all the noise, we asked three dermatologists to tell us exactly what they tell their patients before prescribing anything.
What Are The Typical Results When Using Finasteride
Finasteride has been studied extensively for its effects. A meta-study reviewed 12 studies to determine the safety and effectiveness of finasteride in male pattern baldness both in short-term and long-term . The total number of subjects from the studies comprised 3,927 men suffering from androgenic alopecia with outcome measures that included hair count, clinical assessment, and self-assessment. The meta-study found that those who had used finasteride showed a statistically significant improvement in scalp hair compared to placebo groups in both short- and long-term studies. Finasteride therapy also resulted in an increase in average hair count compared to placebo groups. Self-assessment and investigator clinical assessments also improved, particularly in the short-term.1
Speaking To Your Doctor
As mentioned, finasteride is prescription only. That means you need to consult a physician to begin treatment and determine the right dosage for you.
If you are concerned that the 1mg dosage might be too much for you, discuss this with your doctor. Together, you can decide on a lower dosage regimen, which will most likely be around 0.2mg.
Finasteride pills are not available in strengths lower than 1mg. This means that if you want to take a lower dosage, your doctor can advise you on a) either skipping the pill on certain days or b) cutting the pill into smaller pieces with a pill cutter.
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Common Side Effects Of Oral Finasteride
Finasteride is effective in reversing the hair loss caused due to male pattern baldness and has a high success rate. It is prescribed by the dermatologist between three months to one year before you actually see results. However, it has some side effects as well which are mentioned below
How Long Do Side Effects Of Finasteride Last?
Does Propecia Actually Work
With the sheer number of products promoted as hair loss solutions marketed to those suffering from male pattern baldness, its perfectly understandable that people would question the efficacy of finasteride.
The good news is, finasteride is very effective in the majority of people who take it to treat their male pattern baldness.
Study after study totaling thousands of men observed over a period of up to five years has shown that Propecia not only slows the process of hair loss, but it actually helps regrow some of the hair the person has already lost.
In fact, clinical trials showed that the progression of hair loss stopped in 86% of participants. Furthermore, 65% experienced a substantial increase in hair growth. Theres even evidence to suggest that finasteride is more effective in year five of use than in year one.
Because of its efficacy in such a large portion of those who take it, finasteride is often the first recommendation doctors give to patients experiencing male pattern baldness who are interested in seeking treatment even before over-the-counter treatments like minoxidil.
Its important to note that finasteride is most effective in those with mild to moderate hair loss. Frankly, theres less ground to cover if the person is earlier on in the hair loss process. If the patient has lost too much hair, the effects will barely be noticeable.
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Study: Lack Of Efficacy Of Finasteride In Postmenopausal Women With Androgenetic Alopecia
This first study, performed in Portugal and published in 2000, consisted of 137 postmenopausal women with diagnosed AGA .
The study was carried out over one year, and it can be classified as a double-blind, placebo-controlled, randomized, multicenter trial.
The women were split into two groups, of which one received a daily dose of 1mg finasteride and the other received a placebo. This continued for 12 months, and the methods used for evaluation included:
- Scalp hair counts
- Assessment of global photographs by a blinded expert panel
- Histologic analysis of scalp biopsy specimens
How did the women fare?
According to the study, after 1 year of therapy, there was no significant difference in the change in hair count between the finasteride and placebo groups. In fact, both groups showed significant decreases in hair count in the frontal/parietal scalp.
Even further, the scalp biopsy analysis did not demonstrate any improvement in slowing hair thinning, increasing hair growth, or improving the appearance of the hair.
This study very clearly demonstrated that the women did not benefit from finasteride therapy, but a few later studies say otherwise.
At What Age Can You Start Taking A Dht Blocker
Considering how important DHT is during puberty and the development of physical male characteristics, finasteride and other DHT blockers should only be used by adult men.
One study aimed to determine the efficacy of finasteride on men age 18 to 60 with male pattern hair loss. The double-blind, randomized study split groups of men age 18 to 41 and age 41 to 60 into groups given a placebo or 1 milligram per day of finasteride. The researchers then evaluated the effectiveness based on clinical photographic reviews of the vertex, anterior, and middle scalp as well as the front and temporal hairlines over the course of 24 months.
While all men showed improvements in hair loss, only the younger group showed reduced hair loss in all areas of the scalp and hairline. Older subjects showed reduced hair loss only in the vertex and anterior regions of the scalp. This suggests that finasteride and other DHT blocker ingredients may be more effective in younger men than in older men.5
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Does Finasteride Work For Everyone
For the majority of users, Finasteride is an extremely successful treatment for treating hair loss.
Of course, everyone is different and individuals can react to the same medication in different ways, so in some rare circumstances, Finasteride may not be as effective. Finasteride also works best at treating hair loss where there is a receding hairline and thinning in areas of complete hair loss, it will not work as well.
In terms of who can use Finasteride, any man over the age of 18 can use this medication irrespective of height, weight, or age, and will most likely see positive results from their treatment.
However, Finasteride isnt suitable for use by children and adolescents younger than 18. Women are advised not to take Finasteride either, because of the way that it interacts with female hormones.
Mechanism Of Finasteride In Female Pattern Hair Loss
Because FPHL is a complex disease, the mechanism by which finasteride improves hair loss is not well established. A study in mice proposed that DHT may downgrade insulin-like growth factor-1 expression by inhibiting the release of calcitonin gene-related peptide that interacts with the androgen receptors, thereby preventing hair growth. These findings suggested that finasteride might be associated with increasing IGF-1 production in the dermal papillae by decreasing DHT levels. Rushton et al found that finasteride administration resulted in increased mean hair density without insignificant changes of vellus hair counts. The observed hair regrowth in FPHL may be supported by reactivating telogen/kenogen follicles into anagen follicles rather than vellus-to-terminal hair transformation. Further studies are needed to determine the mechanism of finasteride in FPHL. Concerning contradictory efficacy in pre-existing literatures, oral finasteride may be served as an alternative modality in FPHL patients who fail minoxidil treatment. We suggest using finasteride in postmenopausal women to avoid potential teratogenic effects.
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How Does The Dht Blocker Finasteride Work
Finasteride is one of the few FDA-approved medications for preventing hair loss and promoting hair growth. It is a DHT blocker, it blocks DHT by inhibiting the production of DHT by the enzyme 5-alpha reductase . Blocking 5-AR prevents the conversion of testosterone into DHT, which regulates the levels of both hormones and can help to prevent male pattern baldness at the source. The medication has been found to reduce DHT levels in the blood by up to 70 percent and in the scalp specifically by up to 60 percent.2
How Does Finasteride For Hair Loss Treatment Work
Finasteride belongs to a class of medications called 5 alpha-reductase inhibitors, or 5-ARIs. It works by inhibiting the action of the 5 alpha-reductase enzyme, which is involved in converting testosterone into the hormone dihydrotestosterone .
DHT plays a central role in male pattern baldness. If youre genetically prone to hair loss, DHT can bind to receptors in your hair follicles and cause them to miniaturize, resulting in a gradual loss of hair around your hairline, crown or across your scalp.
Our guide to DHT and male hair loss discusses the effects of DHT on your hair follicles in more detail.
Research shows that a typical dose of finasteride lowers serum DHT levels by more than 70 percent.
This can result in your hair loss slowing, or even stopping completely. Many men even notice a significant degree of hair regrowth in areas of the scalp affected by male pattern baldness after starting treatment with finasteride.
So, does finasteride produce results? For most men, absolutely. Numerous studies have found that finasteride can slow down or stop hair loss from male pattern baldness, and even stimulate hair growth.
In one study involving two one-year clinical trials, researchers found that finasteride produced a more than 15 percent increase in hair count at the vertex scalp in men with male pattern baldness.
In short, finasteride works, with most men experiencing improvements in their hair growth and density with treatment.
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Is More Better With Finasteride When It Comes To Hair Improvements
Researchers have concluded that the 1mg strength of Finasteride and the 5mg strength produce similar hair improvements, so taking more than the recommended 1mg Finasteride strength to help improve your hair will likely not give you much better results.
Also, there is a small risk of potential side effects with Finasteride, including erectile dysfunction, ejaculation disorder, decreased ejaculate volume, decreased sperm counts, and a reduced sex drive.
So, if you take a higher strength of Finasteride than recommended by your doctor for hair loss, you will likely not see more hair improvements, but you may be at a higher risk of developing unwanted side effects.
âBottom Line: More is not always better, and higher doses may increase your risk of side effects. Always follow the instructions from your doctor and pharmacist when it comes to dosing and never change your dose or regimen without consulting with a doctor first.
Stay Consistent With Your Finasteride Treatment
âLong-term, Finasteride should now be considered your hair maintenance medication, and you must continue with Finasteride in order to maintain your regrowth.
The patient package insert notes that if the medication is stopped, there will likely be a reversal of the effect within 12 months.
Finasteride is a long-term medication to keep any hair benefits, so that should be considered before launching into a treatment regimen.
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Potential Side Affects Of Finasteride Use
Each person metabolizes medications differently and therefore has a different risk/benefit profile. Scheduling a consultation with a licensed physician at Invigor Medical provides an opportunity to discuss how your diet, supplement intake, medications, medical conditions, and medical history can increase or decrease your risk of side-effects from finasteride.
Finasteride For Women: Can Women Use Finasteride For Hair Loss
Medically reviewed by Kristin Hall, FNP
While hair loss is usually associated with men, its far from uncommon for women to experience hair shedding and even permanent hair loss at some point in life.
If youve looked into treatments for hair loss, you may have heard of finasteride a medication thats often used by men with male pattern baldness.
Currently, the FDA hasnt approved finasteride for women.
However, research into its effects in women is ongoing and its possible that a form of finasteride could be approved as a treatment for female pattern hair loss at some point in the future.
Below, weve discussed what finasteride is, as well as how it works as a treatment for hair loss in men.
Weve also looked at the most recent research into the effects of both oral and topical finasteride in women.
Finally, weve listed the other treatment options that are currently available if youre losing hair due to female pattern hair loss.
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