Using Finasteride to Stop Hair Loss: Dosage, Side Effects & Result

I: Understanding Finasteride

Finasteride is a commonly prescribed oral medication used to treat androgenetic alopecia (male-pattern hair loss) in men. It works by blocking the enzyme 5-alpha-reductase, which converts testosterone into dihydrotestosterone (DHT). DHT is the primary hormone responsible for miniaturizing and thinning hair follicles in the scalp, which leads to progressive hair loss. By lowering DHT levels, finasteride can help stabilize hair loss and regrow hair in men suffering from male pattern baldness.

The typical dosage of finasteride used for hair loss treatment is 1 mg, taken orally once per day. Lower doses around 0.5 mg may also be effective for some men to lower DHT while potentially reducing the risk of side effects. Finasteride begins working to lower DHT levels within hours of the first dose, but it can take 3-6 months to see visible improvements in hair regrowth. To maintain benefits, continued daily use is necessary, as hair loss will resume about 6–12 months after stopping treatment. 

The U.S. Food and Drug Administration (FDA) has approved finasteride at dosages of 1 mg per day for the treatment of hair loss. It has been rigorously tested and prescribed to millions of men for over 25 years. Clinical studies have shown finasteride is highly effective at slowing hair loss progression and re-growing hair. However, response varies based on individual factors like genetics, age, dosage adherence, lifestyle, and duration of baldness.

In clinical studies, finasteride was most effective at re-growing hair in the vertex of the scalp area. Efficacy was less significant in re-growing hair along the frontal hairline. However, with continued use, finasteride can maintain hair along the hairline and is more effective than medications like minoxidil alone. Those with a shorter duration of hair loss often respond better. Finasteride works best at growing back thinner, miniaturized hair rather than re-growing where follicles have already died. 

Around 2 out of 3 men maintain their hair or experience regrowth with finasteride treatment. However, it does not work for everyone. Lack of improvement within 12 months signals it may not be effective for an individual. Discussing alternative treatments with your doctor is recommended in such cases. 

Potential side effects like sexual dysfunction, breast tenderness, mood changes, or allergic reactions have been reported in a small percentage of men using finasteride. Most resolve when treatment is stopped. But proper precautions, close monitoring, and open discussions with your physician can help minimize risks.

II: Optimizing Finasteride Dosage

The most common dosage of finasteride used for treating hair loss is 1 mg, taken orally once per day. However, finding the lowest effective dose is key to optimizing results from finasteride while reducing the chances of side effects. 

Your prescribing doctor may start you at 1 mg daily but later suggest trying a lower dose around 0.5 mg or 0.25 mg to see if it remains effective for you personally at lowering DHT and regrowing hair. The difference in results between 1 mg and 0.5 mg of finasteride is generally small, but lower doses provide decreased systemic DHT reduction that may decrease the incidence of side effects.

Some doctors also recommend spacing out finasteride by taking it three times a week rather than daily. Absorption studies show taking 1 mg of finasteride every other day or every third day is enough to maintain stable levels of the drug in the body. This intermittent dosing may help reduce side effects. So, for example, 1 mg could be taken on Monday, Wednesday, and Friday. Discuss optimal dosing frequency with your doctor.

Topical finasteride formulas have also grown in popularity in recent years as a way to further lower systemic exposure compared to oral dosing. Applying finasteride solutions directly to balding areas of the scalp allows for targeted delivery and absorption. Reduced doses of around 0.1 mg of finasteride via topical solution may provide hair benefits while decreasing side effects compared to higher oral doses.

Compounded finasteride is an additional option where the medication is custom-formulated to your specific dosage needs by a specialty pharmacy. This allows maximum flexibility in prescribing more precise doses like 0.25 mg or 0.5 mg. Compounded topical finasteride formulas are also available. Discuss such options with a knowledgeable hair restoration physician. 

Using finasteride along with minoxidil, an over-the-counter topical solution for regrowing hair, can also boost results. Using finasteride with adjunct treatments like microneedling at 0.5mm to 1mm depth has been shown to enhance the absorption and efficacy of topical finasteride formulations.

But introducing combination therapies should be done carefully. Start with only finasteride, monitor your response and side effects, and then add additional treatments one by one to properly gauge results. Finding a minimalist routine that provides maximum hair regrowth with minimal side effects is key.

III: Managing Expectations with Finasteride

Some men are hesitant to start finasteride treatment due to fear of potential side effects like sexual dysfunction, gynecomastia (breast development), and mental fogginess. However, extensive clinical studies have shown such side effects occur in less than 5% of men using finasteride for hair loss. Despite this low risk, such fears can trigger a nocebo effect. 

The nocebo effect is when negative expectations of treatment can cause or worsen issues through the power of suggestion. Men who take finasteride while constantly worrying about and expecting side effects are more likely to experience problems, even without physiological reasons.

That's why having realistic expectations about finasteride results and potential side effects is important. Focusing on the high probability of positive gains in halting hair loss rather than the miniscule risks of side effects helps reduce anxiety. Open discussions with your doctor can also provide reassurance.

It also takes time to see the full effects of finasteride treatment. Continued daily use for at least 6 to 12 months is recommended before assessing efficacy. Hair growth is a slow, cyclical process, so dramatic regrowth does not happen overnight. Tracking progression with photos over several months helps better evaluate the true response.

Some shedding and thinning may occur in the first few months as hair follicles enter the new growth phase. But this should stabilize in 6 months and improve in 12 months. Have patience through the ups and downs, and discuss any concerns with your doctor along the way. Managing expectations about this gradual process with finasteride can help you stay motivated and consistent with treatment.

IV: Lifestyle Recommendations

Leading an overall healthy lifestyle helps maximize results from finasteride treatment. While genetics play a big role in hair loss, certain lifestyle factors can support your hormonal balance and hair health.

Eating a nutritious diet with adequate protein, iron, zinc, and vitamins A, C, and B-complex provides the building blocks for healthy hair growth. Increase your intake of nuts, eggs, spinach, citrus, avocados, legumes, and fatty fish. Avoid crash dieting and extreme calorie restriction.

Regular scalp massage and exercise improve blood circulation for optimal nutrient delivery to follicles. Aim for 30–60 minutes of cardio and resistance training most days per week. Getting 7-9 hours of quality sleep per night supports hormone and stress regulation. 

Chronic stress can aggravate hair loss by raising cortisol and inflammatory cytokines. Adopt relaxation practices like meditation, yoga, or deep breathing. Nurture supportive relationships and engage in hobbies you enjoy to support your emotional health. Seek counseling if you are dealing with anxiety, depression, or trauma.

Avoid behaviors that can impede hair growth, like smoking, excessive alcohol, recreational drugs, and misuse of medications. Discuss any new supplements with your doctor, as interactions with finasteride are possible. Inform your provider about major life or health changes.

V: Side Effect Management

Finasteride can have negative effects in a small percentage of people despite being generally well-tolerated. Understanding the risks and proactively monitoring side effects allows for prompt management if any occur. 

Sexual side effects like decreased libido, erectile dysfunction, and reduced ejaculate volume are most common, affecting around 1-5% of men on finasteride. Symptoms generally recur after stopping the medication but can take several weeks to fully resolve. Your doctor may advise adjusting dosage, temporarily discontinuing, or prescribing erectile dysfunction medications to counteract issues.

Gynecomastia, or breast enlargement with tenderness, has been reported rarely. Taking finasteride with medications like spironolactone may increase this risk. Switching or stopping causative medications typically resolves breast changes. Estrogen inhibitors like tamoxifen may help reverse gynecomastia.

Mood changes, mental fogginess, fatigue, and long-term depression represent other uncommon psychological side effects. Dosage adjustments often improve such symptoms. Underlying mental health disorders may also require treatment. Discuss severe or persistent emotional changes with your doctor promptly.

Allergic reactions to finasteride manifesting as a skin rash, itching, swelling, wheezing, or anaphylaxis are very rare but serious. Discontinue finasteride and seek immediate medical care if any signs of an allergy develop. Monitoring for side effects helps detect intolerances early.

VI: Assessing Continued Use

Periodically assessing your response to finasteride treatment helps determine if it remains effective or if exploring alternative options may be preferable. Evaluating progress photos, re-examining genetics and lifestyle factors, and discussing progression with your doctor allows for an informed decision about continued use.

Look for stabilization of hair loss and signs of regrowth around the 12-month mark. Miniaturized hairs should thicken and increase in number. If your hair continues to decline after treatment, finasteride may not be beneficial for you.

Trying other medications like dutasteride or hair restoration procedures may produce better results. Minoxidil and microneedling can augment finasteride's effects. But if unsatisfactory after 12–18 months of diligent treatment, discontinuing finasteride may be appropriate. 

Work on gradually accepting hair loss as a natural part of aging. Counseling helps if you are struggling with self-esteem. Prioritize meaningful aspects of life beyond cosmetic concerns. Discuss all options thoroughly with your prescribing doctor.

VII: Future Outlook

Several exciting avenues of research are underway to enhance finasteride's effectiveness. Novel topical delivery methods aim to target application and optimize dosage. Combining finasteride with emerging therapies like JAK inhibitors, PRP, or laser light shows promise for boosting results compared to finasteride alone.

Hair cloning to stimulate the growth of new follicles and gene therapies to counteract genetic causes of baldness offer hope of more permanent cures in the future. But major challenges remain in translating these pioneering technologies into viable human treatments.

For now, oral finasteride taken daily remains one of the most proven medical therapies for combating genetic hair loss in men. Used properly under medical guidance, it can help stabilize progressive balding and regrow hair in the majority of individuals. Being consistent with treatment, tracking results, and managing expectations are key to optimizing the benefits of finasteride.

While not a cure, finasteride provides a powerful option to slow down male pattern baldness as part of a comprehensive treatment plan. Combining it with a healthy lifestyle, alternative therapies, and a positive mindset can help you make the most of the available options to enhance your self-image. Stay patient and persistent in working with your doctor to navigate the realistic ups and downs of finasteride treatment.

FAQ

Finasteride for Hair Loss: Frequently Asked Questions

What is finasteride?

Finasteride is an oral medication used to treat male-pattern hair loss (androgenetic alopecia). It works by blocking the enzyme 5-alpha-reductase to lower DHT levels in the scalp. DHT causes the thinning of hair follicles, so reducing levels allows hair to regrow.

What is the typical dosage? 

The standard dosage for hair loss is 1 mg taken daily. Doses of 0.5 mg or 0.25 mg may also be effective for some individuals. Topical solutions are also available at lower doses.

How long until I see results?

It takes at least 3–6 months to see initial results, with improvements continuing up to a year or more. Have patience, as the process is gradual. Take photos consistently and track progress with photos.

What are the side effects?

Potential side effects include sexual dysfunction, breast tenderness, mood changes, allergic reactions, and fatigue. These occur in less than 5% of men and often resolve with discontinuation. 

Will it work for me?

Response varies based on genetics, age, and other factors. About 2/3 of men maintain or regrow hair with finasteride. It may not work for all types of baldness. Discuss your options with a doctor.

What happens if I stop?

Hair loss will likely resume within 6–12 months of stopping. You need to take it long-term to maintain its benefits. Temporary discontinuation may help if side effects develop.

Can I get finasteride online?

You need a prescription from a licensed provider. Do not order from unregulated sites, as product quality and safety cannot be verified. See a reputable doctor or telehealth service.

Does insurance cover it? 

Many insurance plans cover finasteride with a standard copay, especially if prescribed for an enlarged prostate. But specific coverage depends on the plan. The cost is relatively low, at around $10–30 for a month's supply.

Can it cause depression?

Mood changes have been reported rarely, but no evidence shows finasteride causes depression when used under medical supervision. Discuss any mental health concerns with your doctor.

Is topical or oral better?

Topical finasteride may reduce systemic side effects, but oral finasteride remains the gold standard for proven efficacy. Lower oral doses can also minimize side effects. Combining approaches may be beneficial.

Can I take finasteride if I'm trying to conceive? 

Finasteride lowers male fertility, so it should be avoided when trying to conceive. It may take several months to clear your system and normalize sperm levels after stopping.

Is finasteride safe long-term?

Yes, studies have shown long-term daily treatment with finasteride at recommended doses is generally safe and well tolerated. Monitoring with a doctor helps minimize risks.

How does finasteride compare to other hair loss treatments?

Finasteride is more effective than minoxidil alone. Hair transplants offer permanent results but are costly and invasive. Discuss all options thoroughly with your doctor.

Should I take any supplements with it?

A general multivitamin to support hair health may be beneficial, but check for any ingredient interactions first. Saw palmetto and pumpkin seed oil could potentially interfere.

Can I prevent hair loss before it starts?

Using finasteride as a preventive measure is not recommended. Lifestyle factors like diet, exercise, and stress management help maintain healthy hair. Treat hair loss when it occurs.

How can I reduce the side effects of finasteride? (how to reduce side effects of finasteride).

There are several strategies that can help minimize side effects from finasteride:

• Start at a low dose, like 0.5mg or 0.25mg and increase slowly if needed
• Take the medication less frequently, such as 2-3 times per week instead of daily
• Switch to a topical finasteride formulation 
• Use a compounded formula to customize the optimal dose
• Take the dose at night before bed to avoid side effects
• Stay well hydrated and limit alcohol intake
• Manage stress and get regular exercise
• Add medications like Viagra if sexual side effects occur
• Adjust or discontinue use if intolerable side effects persist

Do side effects go away if I stop taking finasteride?

In most cases, side effects will gradually go away after stopping finasteride. It can take a few weeks to a few months for hormones and sexual function to normalize again. A doctor should assess persistent symptoms.

Will lowering my finasteride dose help with side effects?

Yes, in many cases, taking a lower dose can provide the same hair regrowth benefits while reducing the incidence of side effects. Try alternating doses of 0.5mg and 1mg or taking 0.5mg three times a week.

Can I switch from oral to topical finasteride? 

Switching to a topical finasteride solution may help reduce systemic absorption and side effects. Apply a 0.1-mg finasteride solution daily to balding areas instead of taking an oral dose.

Does taking finasteride every other day reduce side effects?

Taking finasteride intermittently instead of daily, such as every other day or every third day, allows your body a break from the medication, which can minimize side effects for some men.

What supplements help with finasteride side effects?

Saw palmetto, pumpkin seed oil, and zinc supplements may help counteract sexual side effects from finasteride. Ginkgo biloba and ginseng are also beneficial. However, discuss any supplements with your doctor first.

Does finasteride lower testosterone levels?

Finasteride does not directly lower overall testosterone levels in the body. It blocks the conversion of testosterone into DHT. However, this can cause a compensatory rise in testosterone levels by 15–25% above baseline in some men.

In a small subset of men, temporarily lowered testosterone levels may occur in the first few months after starting finasteride. But studies show levels normalize back to baseline within 6–12 testosterone levels months with continued treatment.

The risk of persistent testosterone suppression while on finasteride is very low and unsupported by scientific evidence. Only isolated case reports exist. Monitoring hormone levels with a doctor can provide reassurance.

If symptoms like low energy, reduced libido, or erectile dysfunction develop, checking testosterone levels may be prudent to rule out other causes besides finasteride. But most men maintain normal testosterone levels on the medication.

Discuss any concerns about the interpretation of the potential effects of finasteride on your hormones openly with your prescribing physician. They can advise if monitoring testosterone levels is recommended in your case and interpret results appropriately.