From the Guidelines
The standard dosage of finasteride for treating male pattern hair loss is 1 mg taken orally once daily. This dosage has been shown to be effective in reducing dihydrotestosterone (DHT) levels, which contribute to hair follicle miniaturization and eventual hair loss, as supported by a study published in the Journal of Clinical Oncology 1. According to this study, a 1-mg dose of finasteride had an effect similar to 5 mg (50% decrease) at the 1-year follow-up date for men age 50 years and older.
Key Points to Consider
- Results typically take 3-6 months to become noticeable, and maximum benefits may require 1-2 years of consistent use.
- Potential side effects include decreased libido, erectile dysfunction, and decreased ejaculate volume, though these occur in less than 5% of men and often resolve with continued use.
- Finasteride is only FDA-approved for men and is contraindicated in women who are or may become pregnant due to risks of birth defects in male fetuses.
- A prescription is required, and regular follow-up with a healthcare provider is recommended to monitor effectiveness and any side effects.
Important Considerations
- It's essential to understand that finasteride only works while you're taking it; if discontinued, hair loss will resume within 6-12 months.
- The effects of finasteride on PSA levels should be taken into account when judging the significance of a PSA level, as it can lower the PSA by 50% after 12 months of therapy 1.
From the Research
Finasteride Dosing for Hair Loss
- The standard dosage of finasteride for the treatment of androgenetic alopecia is 1 mg per day 2.
- Studies have shown that finasteride 1 mg/day significantly increases total hair count compared to placebo after 24 weeks and 48 weeks 2.
- The efficacy of finasteride has been compared to other treatments, including minoxidil and low-level laser light therapy, and has been found to be effective in promoting hair growth in men with androgenetic alopecia 3.
Alternative Finasteride Formulations
- Topical finasteride has been evaluated as a potential alternative to oral finasteride, with studies showing similar efficacy to oral finasteride in promoting hair growth 4.
- Topical finasteride may reduce the risk of systemic side effects associated with oral finasteride, such as sexual dysfunction 4.
- However, topical finasteride is not FDA-approved and may have localized side effects, such as scalp pruritus and irritation 4.
Combination Therapies
- Combination therapies, such as topical minoxidil and topical finasteride, may enhance efficacy in treating androgenetic alopecia 4, 5.
- Clinicians must weigh the benefits and risks of each treatment option, including combination therapies, to determine the best course of treatment for individual patients 5.
Treatment Considerations
- Treatment selection for androgenetic alopecia involves ethical, evidence-based decision-making and consideration of each individual patient's needs, compliance, budget, extent of hair loss, and aesthetic goals 6.
- Clinicians must consider the efficacy, side effect profiles, and practicality of treatment options, as well as the patient's individual circumstances, when selecting a treatment regimen 6.