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Finasteride (Propecia®)

Finasteride – better known as the brand name Propecia® – is a prescription-only drug used to treat androgenetic alopecia, or male pattern baldness. Finasteride is a DHT blocker that prevents testosterone from being converted into Dihydrotestosterone (DHT), which is widely believed to be one of the main causes of male hair loss.



Testosterone is a steroid hormone that plays a key role in the development of male reproductive tissues, as well as muscle, bone mass and body hair growth. The enzyme 5-alpha reductase converts testosterone into DHT, which is another hormone. When DHT accumulates in susceptible hair follicles, blood circulation decreases and causes follicular miniaturization, transforming strong hair into increasingly finer and thinner hair. The follicle may eventually stop growing new hair at all. Propecia blocks the 5-alpha reductase from converting testosterone into DHT, thus drastically slowing (or even stopping) the loss of hair, and stimulating the growth of stronger, darker, and thicker hair. To date, Propecia is the only DHT blocker approved by the FDA for use in hair loss prevention.

History

In 1992, Merck, the makers of Finasteride, were given FDA approval to offer 5g oral tablets of the medication for the treatment of benign prostate enlargement.  Since prostate enlargement is believed to be exacerbated by the same elevated levels of DHT at the root of male hair loss, Merck decided to test Finasteride as a possible treatment. The Finasteride study was conducted over five years, and concluded that two (2) out of every three (3) patients taking a 1mg daily dose of the medication experienced some level of hair growth. It was also discovered that three (3) out of every four (4) patients hair loss, even if some did not experience any re-growth. Finasteride appeared to be most successful in the treatment of vertex baldness, with the greatest results seen in the crown area.

In 1997, Merck was given additional FDA approval for Finasteride as a treatment for male pattern baldness. Since then, Finasteride has been marketed as a hair loss prevention treatment under its better known brand name, Propecia.

Procedure

Propecia’s active ingredient is Finasteride and is a prescription-only oral medication taken once daily, with or without food. The simplicity of taking a pill once a day is one of the medication’s biggest advantages. Although Propecia begins to work immediately, results are usually seen within three (3) to six (6) months from the beginning of treatment. This timing is due to the length of the hair growth cycle.

Results are most often seen on the crown or back of the scalp. Men who participated in Merck’s initial studies noticed overall improvement in the thickness, strength and texture of their hair during the first year of treatment. The test subjects either maintained or increased the number of visible scalp hairs on the crown. Propecia appears to stop hair loss, although it generally will not grow back all of the hair an individual has lost. There’s very little evidence that Propecia helps stop temporal hair loss (receding hairlines).

As with all hair loss treatments, Propecia requires a long-term commitment from the user, as the effects will last only as long as the medication is taken. Any benefits that a user gains from taking Propecia will be reversed within 12 months of discontinuing use of the medication.

Accessibility

Propecia is medication prescribed for men only. Ideal candidates for Finasteride are males who are in the earlier stages of vertex hair loss, who are in otherwise good health and who have had the necessary blood tests done to determine their suitability for a DHT blocker.

Although Finasteride, under the brand name Proscar, is prescribed at a much higher dosage for treating an enlarged prostate (5mg for prostate issues versus 1mg for hair loss treatment), Propecia users should still consult with a physician before beginning treatment. They should remain in contact with their physician until it is determined that Propecia has had no effect on the prostate.



Unlike many other hair loss treatments, Propecia has been shown to have some effectiveness in older (42-60 year-old) men, although the results were not as dramatic as they are in younger (18-41 year-old) men. Unless they are in a very advanced stage of androgenetic alopecia, older men can still enjoy some of Propecia’s benefits. However, because the results are not as drastic in older men, it’s best to consult with your physician or a hair loss specialist to ensure that the Propecia’s benefits are worth the cost and possible side effects.

A one-month, 30-pill supply of Propecia varies from pharmacy to pharmacy, but can be purchased for as little as $64. Generic Propecia, which is just as effective, can sometimes be purchased for less.

Side Effects

Not all men who use Propecia experience side effects, but of those who did report them, the most common ones were dizziness, unusual weakness, drowsiness, speech issues, blurred vision, and runny nose.

Some users have experienced severe allergic reactions such as skin rash, itching, hives, swelling, wheezing or difficulty breathing and swallowing. If a user experiences any of these, they should stop taking the medication and consult a physician immediately.

A small number of Propecia users have reported sexual and emotional side effects such as loss of libido, reduced ejaculation and semen volume, testicular pain, erectile dysfunction, and depression.  In some of these cases, the symptoms persisted even after the medication stopped being taken. For more information on the sexual side effects associated with Propecia, check out these two reports – one from USA Today, and the other from eMedTV. Although these side effects do not occur often, they still warrant a thorough discussion with a physician or hair loss specialist in order for the benefits and drawbacks of Propecia to be fully explored.

Pregnant women or women who may become pregnant are warned not to come into contact with Propecia. If the tablet’s protective coating has been broken, the active ingredients can be absorbed through the skin. Exposure sure as this has been known to cause birth defects in undeveloped male infants. If a pregnant woman comes into contact with a broken or crushed Propecia tablet, and is exposed to Finasteride, she should consult her doctor immediately.

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