Should You Start Taking 1 mg Finasteride for Hair Loss?
Yes, you should consider starting 1 mg finasteride daily for male pattern hair loss, as it is an effective FDA-approved treatment with generally mild and reversible side effects that occur in only 2-4% more patients than placebo. 1
Efficacy and Expected Results
Finasteride 1 mg daily produces durable improvements in scalp hair growth over 5+ years, with visible improvement typically beginning by 12 weeks and maximal benefit at 1-2 years. 1, 2
Treatment leads to measurable increases in hair counts and slows progressive hair loss that would otherwise occur without treatment. 2
Better responses are observed in patients under 26 years old, particularly those with higher baseline DHT levels, which predict good treatment response. 3, 4
Hair loss resumes if treatment is discontinued, so plan for long-term therapy to maintain benefits. 1
Side Effects: Common and Reversible
Sexual Side Effects
Sexual dysfunction occurs in approximately 2-4% more patients compared to placebo, including decreased libido, ejaculation disorders, and erectile dysfunction. 1
The overall incidence of sexual function disorders is not significantly different between finasteride and placebo when properly analyzed. 1
These side effects are reversible and uncommon after the first year of therapy, and they resolve with discontinuation of the drug. 5, 6
Only 6% of patients in long-term studies reported side effects, and some continued treatment due to excellent hair growth results. 3
Other Considerations
Finasteride reduces PSA levels by approximately 50% after 12 months, which must be considered if you undergo prostate cancer screening. 1, 7
No clinically meaningful effects occur on cortisol, prolactin, thyroid hormones, lipid profiles, or bone mineral density. 7
Testosterone levels increase by approximately 10-20% but remain within normal physiologic range. 7
Important Precautions
If you are approaching prostate cancer screening age (>40-45 years), consider obtaining a baseline PSA before starting treatment to properly interpret future screening results. 1
The drug is generally well tolerated with no new safety concerns identified during long-term use up to 10 years. 2, 3
Maximum plasma concentration occurs 1-2 hours after dosing, with DHT suppression maintained throughout the 24-hour dosing interval. 7
Discontinuation results in return of DHT levels to pretreatment values in approximately 2 weeks. 7
Bottom Line
The evidence strongly supports that finasteride 1 mg daily is safe and effective for male pattern hair loss, with side effects that are mild, uncommon (only 2-4% above placebo rates), and fully reversible upon stopping the medication. 1, 6 The American Academy of Dermatology recommends this treatment for men aged 18-60 years seeking medical treatment for hair loss. 1