Finasteride- It’s
use for hair loss- by
Dr. Robert Jones
Merck developed
this drug in 1992 for the treatment of an enlarged
prostate gland. As with Minoxidil, some patients
taking Finasteride grew hair on their head. Soon
afterwards, it was released as a prescription
medication for hair loss treatment.
The main cause of
hair loss is DHT (dihydrotestosterone). Finasteride
works by stopping the conversion of testosterone to
DHT, reducing DHT levels by up to 75%.
The well-known
Finasteride product is Propecia. In a study, over
80% of the balding individuals who used it
experienced rejuvenated growth, and about 5%
commented that their improvement was dramatic.
As well as
increasing the number of hairs, Propecia increases
the shaft diameter of existing hairs. Most of the
improvement, taking Finasteride, will come in the
first year of use. Since the main purpose of this
drug is to prevent further hair loss, I usually
suggest it as a first-line treatment for younger
patients, for whom maintaining the hair they have is
of prime importance.
The
studies mentioned above did show that there are some
limited side effects. A very small number (less than
2%) showed erectile dysfunction and decreased
libido, although the same complaints were found in
about 1% of patients taking placebos. These effects
are completely reversible if the drug is
discontinued, and over half of patients who
continued the drug with these side effects saw them
disappear.
Finasteride has
been around for over 14 years, and has not shown any
long-term side effects.
Women should
not use Finasteride.
The drug acts on testosterone and will not have any
effect on women, even in women with high
testosterone levels. It has also been shown to cause
defects in the sexual organs of male infants, so it
is advised that pregnant females not take, or even
handle, this drug. If the male is taking
Finasteride, Merck feels confident that the trace
amounts found in the semen do not put the fetus at
risk. I sometimes hear this concern from patients,
and suggest they use condoms during the pregnancy to
completely eliminate the risk of Finasteride
entering the woman’s
bloodstream.