From the Research
Finasteride 1mg, not 5mg, is the recommended dose for treating male pattern hair loss (androgenetic alopecia), as it has been shown to be effective in promoting hair growth and preventing further hair loss in men with this condition. Finasteride works by inhibiting the enzyme 5-alpha reductase, which converts testosterone to dihydrotestosterone (DHT), a hormone that contributes to hair follicle miniaturization in genetically susceptible men 1. The 5mg dose is typically prescribed for benign prostatic hyperplasia, but some dermatologists may prescribe it off-label for hair loss, sometimes recommending patients split the 5mg tablet into quarters (1.25mg) for cost savings.
Some key points to consider when using finasteride for hair loss include:
- Treatment requires consistent daily use, and results typically take 3-6 months to become noticeable, with maximum benefit seen after about one year 2.
- Hair regrowth stops and reverses if the medication is discontinued.
- Potential side effects include decreased libido, erectile dysfunction, and decreased ejaculate volume in a small percentage of men 3.
- Finasteride is contraindicated in women who are or may become pregnant due to potential risks to male fetuses.
- For optimal results, many dermatologists recommend combining finasteride with topical minoxidil (Rogaine) as they work through different mechanisms to promote hair retention and regrowth 1.
It's worth noting that a more recent study found that topical finasteride may be a safe and effective alternative to oral finasteride, with similar efficacy and reduced risk of systemic side effects 1. However, this is not the recommended treatment at this time, and more research is needed to fully understand its effects.
In terms of the evidence, the most recent and highest quality study found that finasteride 1mg daily was effective in promoting hair growth and preventing further hair loss in men with male pattern hair loss 1. This study, published in 2022, found that topical finasteride had similar efficacy to oral finasteride, but with reduced risk of systemic side effects. Overall, the evidence suggests that finasteride 1mg daily is a safe and effective treatment for male pattern hair loss, and it should be considered as a treatment option for men with this condition.