Finasteride for Androgenetic Alopecia

January 1998 in “ NEJM Journal Watch ”

Neil H. Shear

TLDR Finasteride increases hair count in men with hair loss, but the effect isn't permanent and hair loss returns if treatment stops.

Finasteride, an inhibitor of type II 5α-reductase, has been found to be effective in reducing the conversion of testosterone to dihydrotestosterone (DHT) in hair follicles and the prostate. Two one-year, double-blind, randomized, controlled trials were conducted with 1,553 men with androgenetic alopecia. After one year of treatment with finasteride, scalp hair counts increased by about 80% from baseline, while those on placebo experienced a decrease of about 20%. Hair counts remained stable in men who continued finasteride for the second year, and those who switched from placebo to finasteride saw a 50% increase in hair counts. The treatment was well-tolerated, with only a small percentage of men experiencing decreased libido or erectile dysfunction. However, it is important to note that hair loss returns to baseline within six months of stopping finasteride, indicating that it is not a permanent solution.

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Research cited in this study

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in Research/Science 140 upvotes 4 months ago

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in Finasteride/Dutasteride 72 upvotes 2 years ago

Topical Finasteride doesn't directly reduce 5ar enzyme on scalp and has the same mechanism as oral, needing to go through the liver. Users debate the accuracy of this information and discuss various studies and experiences.

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in Research/Science 230 upvotes 1 year ago

Finasteride can impact neurosteroids, potentially causing depression and other side effects in some users. Despite these concerns, many continue using it for hair loss, with some switching to topical applications to mitigate side effects.

community 30-Min Dermatology Visit – Best Questions to Ask About Balding? ( 175$ )

in Treatment 6 upvotes 8 months ago

The conversation discusses hair loss treatments, focusing on finasteride, minoxidil, and other options like PRP and ketoconazole. It highlights the importance of asking specific questions during a dermatology visit to determine the cause of hair loss and appropriate treatments.

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in Finasteride/Dutasteride 156 upvotes 1 year ago

The conversation discusses the effectiveness of hair loss treatments, specifically finasteride and dutasteride. The conclusion is that dutasteride significantly reduces DHT levels and may be more effective than finasteride for long-term hair retention, with some users reporting personal experiences and side effects.

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