Finasteride, commonly known as Propecia® and Proscar®, is a widely used medication for the treatment of hair loss in men. It does a great job at maintaining existing hair and re-growing hair in a large percentage of guys dealing with androgenetic alopecia and is one of many non-surgical hair restoration treatments we offer at the Hair Transplant Institute of Miami.
What is Finasteride?
The U.S. Food and Drug Administration (FDA) approved finasteride as an oral medication over 20 years ago. Its effectiveness is not in dispute: 83% of men studied were able to retain their initial follicle count, while 64% experienced re-growth after two years.
Finasteride gets these results by inhibiting the body’s production of dihydrotestosterone (DHT), a naturally occurring derivative of testosterone which helps with sexual development in males during fetal development and puberty. The problem is that DHT has been linked to hair loss, so reducing DHT levels can be the key to stopping hair loss in men.
In recent years the drug was introduced in a topical form, much like Rogaine. Since finasteride as a topical treatment is of fairly recent origin, many patients who are exploring hair loss treatment options hear conflicting reports or misinformation about the medication’s use in this form.
We’d like to clear up some of the most common topical finasteride myths so you can make a more informed decision about whether or not to consider this form of the drug in your efforts to combat hair loss. Of course, you should always consult with an experienced hair loss physician before making any decisions about how to proceed (and you’ll need to if you want finasteride in any form since it is prescription only).
Here are the top three finasteride myths we hear floating around:
Topical Finasteride is FDA Approved
As noted, oral finasteride was approved by the FDA for the treatment of hair loss over two decades ago. But the FDA has yet to approve the drug in topical form for this purpose, primarily because of a lack of data not because of any specific concerns about its safety. That said, finasteride’s effectiveness as a topical solution is being widely studied, and there are reports that the Swiss pharmaceutical company Polichem is working towards obtaining FDA approval in 2020.
Even though the FDA has yet to approve topical finasteride for the treatment of hair loss, it is still available in the U.S. for that purpose as an “off-label” prescription.
Topical Finasteride Has No Side Effects
DHT does much more than contribute to hair loss, which means that reducing DHT levels can have unwanted side effects. Since DHT plays a crucial role in male sexual development and mood regulation, reducing the amount of it in the body can impact these aspects of a man’s life in unwanted ways and cause:
Lower sex drive
Difficulty achieving orgasm
Gynecomastia (male breast development)
The good news is that that these side effects only appear in a small minority of men (about one out of every hundred) who take finasteride orally and if any issues do arise with sexual functioning, they are almost always temporary and will return to normal after discontinuing the drug.
But some have claimed that applying finasteride as a topical treatment gets rid of these risks. While this is untrue, it is likely that the possibility of side effects from the topical application will be less than oral ingestion due to the way the body absorbs the drug.
Topical Finasteride Can Actually Cause Hair Loss
Some men using finasteride report an increase in shedding soon after they begin using it, making them worry that the drug is doing more harm than good. The reality is that this mild shedding is normal and necessary for new hair to grow. Finasteride actively stops the current hair growth cycle and begins a new one. Any hair that is in mid-cycle will fall out and be replaced by healthier, stronger hair.
As with any medication, you should discuss with your hair loss physician whether DHT blockers or other pharmaceutical treatments offer a viable and effective option for addressing your hair loss issues.
If you’re ready to do something about your hair loss, contact the Hair Transplant Institute of Miami online or call our office directly at 305-925-0222 to receive a personalized evaluation and treatment plan.