Does the thickness of hair strands decrease in men with androgenic alopecia? Can finasteride help to recover it?

When we think of androgenic alopecia, we usually imagine an extreme scenario: the total absence of hair. This perception can lead to hasty decisions in the search for treatments such as finasteride, without fully understanding the process of the condition and how it evolves in each person. However, androgenic alopecia is not a sudden event, but a progressive process where hair is not only lost in quantity, but also changes in thickness and quality before disappearing completely.

Understanding these changes is crucial to making informed decisions about the available treatments. Not all people experience the same progression or respond equally to medication. Therefore, before resorting to a treatment such as finasteride, it is important to know how androgenic alopecia affects hair and how this drug can influence the recovery of hair thickness.

What is androgenic alopecia and how does it affect hair?

Androgenic alopecia is a genetic condition that affects both men and women, characterized by progressive hair loss in specific patterns. This condition is mainly due to the action of dihydrotestosterone (DHT), an androgen derived from testosterone. DHT binds to the receptors of susceptible hair follicles, causing their gradual miniaturization. This process reduces the size and functionality of the follicles, resulting in finer and shorter hair, and eventually, the disappearance of the affected follicle.

What are the physical effects of androgenic alopecia?

In addition to the reduction in the amount of hair, androgenic alopecia causes a progressive miniaturization of the hair follicles. This process implies that the affected follicles produce thinner and more fragile hairs. Over time, these follicles may stop producing hair altogether, leading to bald patches. Miniaturization is due to the action of DHT, which shortens the anagen (growth) phase of the hair cycle and prolongs the catagen (transition) and telogen (resting) phases, resulting in lower hair density and smaller diameter hairs.

Yes, but what is a hair follicle?

The hair follicle is the structure in the skin responsible for hair production. Each follicle acts as a "factory" that creates and regenerates hair in a cyclical manner. In people with androgenic alopecia, hair follicles gradually miniaturize, resulting in thinner, weaker hair. It is through this process that finasteride attempts to intervene, reducing the action of the hormone responsible for miniaturization (DHT) and promoting the production of thicker, healthier hair.

How does hair thinning manifest in men with androgenic alopecia?

Hair thinning in men with androgenic alopecia initially manifests as a progressive thinning of the hair strands, especially in the frontal and upper areas of the scalp. This thinning is due to the miniaturization of the hair follicles, where the follicles become smaller and produce finer, weaker hairs. Over time, this process can lead to the appearance of thinner, less dense hair. In advanced stages, a noticeable recession of the hairline and more extensive bald areas may be observed.

How does finasteride help with hair thickness?

Finasteride is a specific inhibitor of the enzyme 5-alpha-reductase type II, responsible for the conversion of testosterone into DHT. By reducing DHT levels, finasteride decreases its negative impact on hair follicles, slowing down the miniaturization process and allowing the follicles to produce thicker and stronger hair. This effect contributes to improving hair density and thickness in men with androgenic alopecia.

Studies confirming finasteride improves hair thickness

Several studies support the efficacy of finasteride in the treatment of androgenic alopecia, such as a randomized, double-blind, placebo-controlled clinical trial that included men with androgenic alopecia who received finasteride 1 mg/day or placebo for 2 years. The results After one year, 48% of patients treated with finasteride showed hair growth, compared to 7% in the placebo group. After two years, this percentage increased to 66% in the finasteride group. In addition, 87% of patients saw hair loss stop within the first year of treatment. Although the results are promising, the study focused primarily on hair density, and did not provide detailed data on individual hair thickness. In addition, the duration of the study was limited to two years, so long-term efficacy beyond this period is unknown.

Another study involved men with androgenic alopecia who were assigned to receive finasteride 1 mg/day or placebo for 2 years. Patients treated with finasteride showed a significant improvement in hair count and hair quality compared to the placebo group. Efficacy was superior when treatment was maintained for 2 years.

It is important to note that the studies do not specify whether the improvement observed translates into a direct increase in hair thickness or is simply reflected in greater density. However, both studies show a comprehensive recovery of the hair growth process in the long term. Therefore, although thickness was not specifically measured, it is reasonable to infer that this would also benefit. However, more literature is required that specifically delves into the impact of finasteride on hair thickness.

Experiences and oh's

The Community generally agrees that Finasteride helps maintain and increase hair thickness, especially when combined with Minoxidil and Microneedling. Many users report that shedding stops within a few months, and thicker hair regrowth follows over time. One user shared that after 90 days on Finasteride, their hair loss completely stopped, and they expected further thickening in the coming months. Another long-term user who started losing hair at 22 years old maintained thick hair into their 40s by consistently using Finasteride, Minoxidil, and Ketoconazole for over two decades Additionally, users experimenting with topical Finasteride have reported noticeable thickening, especially in the crown area, after around 9 months. While results vary, the overall sentiment is that Finasteride helps prevent further thinning and can lead to thicker hair over time, particularly when combined with other treatments.

sources

Reddit. (2023, June 30). 90 days progress so far on 5% topical minoxidil. Reddit. https://reddit.com/r/tressless/comments/14m9jmc/90days_progress_so_far_on_5_topical_minoxidil/

Reddit. (2023, June 8). I started rapidly diffuse thinning at 22, I'm 42 now. Reddit. https://reddit.com/r/tressless/comments/fcae0j/i_started_rapidly_diffuse_thinning_at_22_im_42/

Reddit. (2023, July 10). About 9 months on topical finmin. Reddit. https://reddit.com/r/tressless/comments/ohl9ef/about_9_months_on_topical_finmin/

León, R. (n.d.). ¿Qué es la alopecia androgenética? Renacimiento León. https://renacimientoleon.com/que-es-la-alopecia-androgenica/

Universidad Nacional de Rosario. (2023). Estudio sobre la alopecia y su tratamiento en medicina familiar. Rephip. https://rephip.unr.edu.ar/server/api/core/bitstreams/b1a52cc1-af6a-4b0e-8828-eeb390d34a1a/content?utm_

Fernández, A., García, R., & Martínez, M. (2023). Alopecia androgenética y su manejo en medicina familiar. Medicina Familiar Semergen, 40(3), 167-173. https://www.elsevier.es/es-revista-medicina-familia-semergen-40-pdf-S0213925104728920?utm_

Sociedad Chilena de Dermatología. (2021). Guía sobre el diagnóstico y tratamiento de la alopecia androgenética. Revista Chilena de Dermatología, 31(1), 21-27. https://www.sochiderm.org/web/revista/31_1/21.pdf