Hair Loss - Learn more about Finasteride

Finasteride works by blocking the receptor from dehidrotestosterone, causing the hair loss process to stop. In some cases, depending on which phase of miniaturization the hair follicle is at, finasteride may thicken the hair, creating the impression that the hair has grown (see photos below).

So, we must first determine if the hair loss is androgenetic or not, that is if it has a hereditary component. This may only be determined under microscopic analysis of the scalp, which shows the percentage of hair follicles that are in the telogen phase or miniaturization phase.

Should androgenetic hair loss have begun, independent of the patient’s age, clinical treatment is recommended. The purpose is to DELAY THE EVOLUTION AND PROGRESSION OF HAIR LOSS, since hairs that are genetically predisposed will fall out one day, regardless of the treatment.

It is important to understand that finasteride “works” for 87% of the patients who take it, while 13% do not respond to its treatment.

As results may only be perceived after three to four months of taking finasteride, the only way to be certain if you are among the 87% who respond to its treatment is to take it for four months and then return to your doctor for a new microscopic and photographic analysis. Upon comparing the new images to the old it can be determined if finasteride is working for you.

If finasteride does work for you, continue to use it until it no longer has an effect. Finasteride’s effect lasts on average from four to five years. After this time, it will stop working and the hairs will fall out.

Finasteride is an important complement to hair transplant surgery. Imagine the following: You undergo surgery in which 5000 hairs are transplanted. Those hairs will never fall out, however those hairs that are genetically coded for hair loss will fall out.

If in one year you lose 5000 hairs, when you return for post-operative photographs, you will have the impression that the surgery “did not work” and had no effect, therefore finasteride should be taken independent of surgical treatment.

Surgery will provide volume and finasteride will stave off the progression of hair loss, therefore delaying the need for further surgical sessions.

See the following cases:

Case 1: Clinical treatment only with finasteride for one year. Note that there was no further hair loss and there was slight improvement in the region indicated.

Case 2: Clinical treatment only for one year. There was significant improvement in the vellus (thinning) area, but note that the bald regions continue to be bald.

Cases 3 and 4: Finasteride and hair transplant surgery, three and six months, respectively, following surgery. Note that the areas that have been marked did not receive hair transplants, only the central region of the crown. Finasteride helped to “close in” the crown and halted the progression of hair loss.

Case 5: Finasteride and hair transplant surgery. One year following surgery (two years after uninterrupted finasteride treatment).

ADVERSE REACTIONS – MYTH AND FACT

Much is said about adverse reactions to finasteride, and among them, without a doubt the most feared, is sexual impotency. Let it be made clear, finasteride does not cause sexual impotency.

In a very small percentage of patients (around 2%), finasteride causes a reduction in libido, in other words, in sexual desire. This percentage gains strength in a psychosomatic manner when the patient reads the prescription information, is influenced by friends, or thinks “this could happen to me”. However, even if a reduction in sexual desire occurs, it is totally reversible in 100% of the cases. Once the patient stops taking the medication, within 48 to 72 hours the effect will have ended.

For these patients there is yet another alternative, which is to use finasteride for topical use, which is not absorbed into the body and does not cause any adverse reaction. The problem is the cost, not to mention the lack of practicality as most patients do not become accustomed to applying a product on the scalp every day. Finasteride for oral consumption is priced reasonably, is easy and practical to consume (just one pill per day), and rarely interacts with other medication. Further, finasteride consumed orally is four times more efficient than finasteride for topical use only*.

* Never take any medication that has not been prescribed by a specialist. The medication that worked for your neighbor, relative or friend may, not only, not work for you as it may not be appropriate for your case, but in some cases may cause undesirable adverse reactions.