Is Fenestiride (Finasteride) effective for hair growth?

Finasteride is Effective for Hair Growth in Androgenetic Alopecia

Finasteride 1 mg daily is effective for promoting hair growth and preventing further hair loss in a significant proportion of men with androgenetic alopecia, with studies showing durable improvements over five years of treatment. 1

Mechanism of Action and Efficacy

• Finasteride is a 5-alpha-reductase inhibitor that blocks the conversion of testosterone to dihydrotestosterone (DHT), the androgen responsible for male pattern hair loss in genetically predisposed individuals 2
• Long-term studies demonstrate that finasteride leads to progressive hair regrowth and prevents further hair loss in 87.1% of men with androgenetic alopecia 3
• In clinical trials, finasteride showed significant improvement in hair count and overall appearance compared to placebo:
  • 48% of men with vertex hair loss showed improvement at 1 year and 66% at 2 years (versus 7% with placebo) 2
  • 83% of finasteride users had no further hair loss after 2 years (versus 28% with placebo) 2

Treatment Protocol

• The standard dosage for androgenetic alopecia is 1 mg orally daily 2
• A 12-month trial is typically needed to assess stabilization of hair loss, with hair regrowth potentially taking 2 years or longer 4
• Finasteride is often used as part of a combined therapy approach with:
  • Topical minoxidil for enhanced efficacy
  • Multivitamin supplements as adjunctive therapy 5

Safety Profile

• Finasteride is generally well tolerated with a low incidence of adverse effects 1, 2
• Sexual function disorders (decreased libido, ejaculation disorder, erectile dysfunction) occur in approximately 3.8% of men (versus 2.1% with placebo) 2
• These sexual adverse events typically reverse upon discontinuation of therapy and many resolve even with continued treatment 2
• Long-term studies over 5 years have not identified any new safety concerns with continued use 1

Special Considerations

Topical Finasteride

• Topical finasteride formulations are being investigated as an alternative to oral administration 6
• Preliminary results show significant decreases in scalp DHT with topical application, without significant changes in serum testosterone 6
• This approach may potentially reduce systemic side effects while maintaining efficacy 6

Use in Women

• Finasteride has shown limited efficacy in female pattern hair loss in controlled studies 4
• It is contraindicated in pregnant women due to the risk of hypospadias in male fetuses 2
• Women of childbearing potential must use reliable contraception while taking finasteride 4

Monitoring and Expectations

• Patients should be evaluated after one year of treatment to assess response 5
• The response rate improves with increasing duration of treatment, with best results seen with long-term use 3
• Discontinuation of treatment will lead to gradual reversal of hair growth benefits within 12 months 2

Common Pitfalls and Caveats

• Patients must understand that finasteride requires continuous use to maintain benefits; discontinuation leads to reversal of hair growth 2
• Setting realistic expectations is crucial - not all patients will experience significant regrowth, but most will at least prevent further hair loss 3
• Finasteride may be ineffective in patients without enlarged prostates according to some guidelines, which could impact treatment decisions in certain populations 7
• Patients should be informed about potential sexual side effects before initiating treatment, though these are relatively uncommon and often reversible 2