A Long, Hard and Honest Look at Propecia - Is It Worth the Risk? (2023)

You’ve visited the hair loss forums. And you’ve heard the horror stories about Propecia. Now, you’re scared and I don’t blame you! You want to keep your hair, but not if it costs you your manhood.

In this post, I’ll review the facts about Propecia/finasteride, while attempting to separate the truth from the fiction. I’ll also:

  • Review some of the key studies on Propecia, in plain English with no medical jargon.
  • Describe the basic facts about the drug, its effectiveness, and how it works.
  • Discuss the possibleside effects of Propecia.
  • Examine the controversy behind this medication — again, striving to rely only on facts.
  • Review what prominent doctors and hair loss experts think about Propecia.
  • Explain the Nocebo Effect, which may be one of the reasons why self-reported side effects are on the rise.
  • Go over the alternatives to Propecia, along with supplementary treatment options.
  • Give my take on finasterideafter spending countless hours reviewing the research and data.
  • Summarize the drug’s risks and benefitsat the end of the article — and much more.

I cite my sources throughout this post, and I encourage you to review some of the data for yourself.

Disclaimer: I’m not a doctor. If you’re suffering from hair loss and wish to do something about it, I suggest you seek treatment from a qualified professional. Let’s get started.

Propecia for Hair Loss – The Basics

What is Propecia?

Propecia, along with its generic equivalent finasteride, is the only medication available that effectively targets the root cause of male pattern baldness, a hormone called DHT.

It was originally formulated as a treatment for BPH (an enlarged prostate). Researchers noticed that patients on the drug also regrew hair; Propecia was officially approved by the FDA as a hair loss treatment in 1997.

A Long, Hard and Honest Look at Propecia - Is It Worth the Risk? (1)

Finasteride before and after photos from a Japanese study. The bottom photo was taken 10 years after the first one!

How it Works

Propecia blocks the conversion of testosterone to DHT. It reduces DHT levels in the body by about 70% and can dramatically slow, stop, and even partially reverse hair loss in some men. DHT is essential to male development during puberty, but it’s generally thought not to yield many tangible benefits after puberty. Some disagree, of course. More on that later.

Who It’s For

Propecia is FDA-approved to treat hair loss in men only, though it is sometimes prescribed to women for “off-label” use. See my article on female hair loss for more info.

How Effective is Propecia?

It’s very effective. According to the American Academy of Dermatology, Propecia or generic finasteride slows hair loss in 88% of men. It stimulates regrowth in about 66% of men as well (1). So there’s an excellent chance Propecia can, at the very least, help you maintain the hair you have.

A Long, Hard and Honest Look at Propecia - Is It Worth the Risk? (2)

Long-Term Propecia Studies

The initial studies on Propecia found that the drug was safe and effective. Side effects were rare, reported in about 2% of patients. Now, I’ll go over two of the most pertinent, long-term studies on Propecia, in plain English! No jargon or convoluted, hard-to-follow sentences.

Five Year Propecia Study

This was perhaps the most significant, long-term study on Propecia. It was double-blinded, placebo-controlled, and involved 1,553 men. Hair counts, before-and-after photos, patient self-evaluations, and investigator assessments were all conducted as part of the study. The results were as follows:

  • By the end of the fifth year, in a one-inch diameter area of the scalp, men on Propecia had an average 277 more hairs than the placebo group.
  • 65% of the patients on Propecia either improved or maintained their hair counts compared to their counts at the start of the study.
  • In their photo analyses, dermatologists found that 90% of the men on Propecia showed no further, visible hair loss at the study’s conclusion, compared to 25% in the placebo group.
  • Overall satisfaction ratings were much higher in the treatment group than the placebo group — 63% to 20%, respectively. Men were treated with Propecia reported higher satisfaction with their hair’s appearance on their vertexes (59% vs. 13% on the placebo) and on their frontal hairlines (48 percent vs. 7 percent). Men in the Propecia group were also more likely to notice shrinking bald spots (61% vs. 20%), increased hair growth (75% vs. 40%) and a slower rate of hair loss (90% vs. 67%).
  • Physician investigators found that 77% of patients on Propecia had increases in scalp hair, compared to 15% of patients in the placebo group (2).
  • Side effects were rare. A few of the most common ones included less desire for sex (1.8% vs.1.3% on placebo),difficulty in achieving an erection (1.3% vs. 0.7% on placebo), and a decrease in semen upon ejaculation (.8% vs .4%).
  • All sexual side effects reportedly went awayin men who discontinued treatment.

A Long, Hard and Honest Look at Propecia - Is It Worth the Risk? (3)

Before-after results from one of Propecia’s clinical trials.

10-Year Study

This Italian study is the longest Propecia study I’m aware of. It tracked 118 men on Propecia for 10 years. The patients were evaluated at baseline and then after 1, 2, 5, and 10 years of treatment. This wasn’t a double-blinded or placebo controlled study. Here are a few of the pertinent results:

(Video) WATCH: How one man said hair loss drug ruined his life

  • After 10 years, only 14% patients experienced a worsening of hair loss.
  • 86% benefited from the treatment, and its effectiveness was not found to diminish significantly over time in most of the patients.
  • About 48% of the patients saw improvements over time.
  • 7 subjects (5.9%) experienced side effects, and some of those patients stayed in the study because of the benefits they reported.

Prostate Cancer Prevention Trial(17,000+ Participants)

Finasteride is believed to lower the risk of certain types of prostate cancer, especially in older men. This 7-year study included over17,000participants. It was double-blinded and placebo-controlled. Researchers used the study as an opportunity to evaluate the sexual side effects of finasteride.They utilized a comprehensive Sexual Activity Scale, ranging from 1 to 100; higher numbers indicated a higher degree of sexual dysfunction.

Keep in mind, finasteride is typically prescribed at a much higher dosage for prostate cancerprevention (5 mg’s, vs. only 1 mg for hair loss).

In the study, researchers found:

  • Finasteride increased sexual dysfunction only slightly in the control group, and that its effects diminished over time.
  • The average Sexual Activity Scale score in the finasteride group was 3.21 points higher than the placebo group at the first assessment; It was only 2.11 points higher (again, on a 100 point scale) at the study’s conclusion.
  • The researchers concluded that finasteride’s impact on sexual function is minimal in most men, and should therefore doctors should not alter their prescribing practices.

In a 2014 article,Meena K. Singh, MD and Marc Avram, MD state that this particular Prostate Cancer Prevention Study was “the most informative trial specifically analyzing the effect of finasteride and sexual functioning” (3). They conclude that based on the data of hundreds of controlled, randomized trials, finasteride should still be regarded as a safe and well-tolerated medication.

A Long, Hard and Honest Look at Propecia - Is It Worth the Risk? (4)

Trusted by Doctors and Leading Hair Loss Organizations

There are doctors who have prescribed Propecia for going on 20 years, to thousands of patients, who assert that it’s safe and have no issues prescribing it to themselves or members of their immediate families. Dr. Alan Bauman, a prominent Florida hair restoration surgeon, had prescribed it to 8,000 patients as of 2011 and says it’s safe (4).

Dr.’s Rassman and Pak of Balding Blog have both taken Propecia, as have members of their families, with no side effects (5). Dr. Julian Mackay-Wiggan, a dermatologist at Columbia University, has her husband on Propecia (6).

The American Hair Loss Association, one of the world’s leading hair loss organizations, recommends Propecia as the bestfirst-line of attack against androgenic alopecia, or male pattern baldness.

Propecia works. And, that’s undoubtedly one of the top 10 reasons you MAY want to give Propecia a chance.

About the Risks and Sexual Side Effects of Finasteride

There are (at least) several studies and surveys that Propecia skeptics claim call into question the drug’s safety profile. None of these studies were nearly as large or exhaustive as the initial, FDA studies. But they’re worth looking at, nevertheless.

2015 Northwestern University Study

This study was essentially a review of 34 finasteride trials. It concluded that not one of those 34 published finasteride trials “provided adequate information about the severity, frequency or reversibility of sexually adverse effects.” Researchers found that adverse effects were not sufficiently graded in terms of their toxicity. According to the study’s lead authorDr. Steven Belknap, “people who take or prescribe the drug assume it’s safe, but there is insufficient information to make thatjudgment.”

Potential Problem with this Study – The lead researchers received direct funding from the Post-Finasteride Syndrome Association.

2011 Journal of Sexual MedicineSurvey

This study essentially went viral in 2011 and really put Propecia’s safety profile into question.

It’s very controversial, primarily because the study’s lead researcher, Dr. Michael Irwig of George Washington University, recruited his subjects from an online Propecia support group.

In other words, the overwhelming majority of men involved in his survey were already having serious issues with the drug (or perhaps other, psychologicalproblems). So while the statistics are somewhat shocking at face value, they’re really not all that surprising. Irwig found that:

  • 94% suffered low libido
  • 92% experienced erectile dysfunction
  • 92% had decreased sexual arousal
  • 69% developed problems with orgasm
  • Side effects lasted an average of 40 months after treatment had been discontinued

Second 2015 Study

This study compared the safety of finasteride totamsulosin; tamsulosin, like finasteride, is used to treat BPH and is a 5α-reductase inhibitor. The researchers in this study concluded that long-term finasteride use lowered testosterone levels and resulted in the worsening of ED symptoms. They also stated that ED symptoms did not worsen among patients who tooktamsulosin.

Finasteride and Depression

Mental side effects, primarily depression, have also been reported. This 2006 study involving 128 men found that finasteride might induce depressive symptoms; it should be noted that in the study, those symptoms resolved after the medication was discontinued. The possibility of mental side effects, by the way, is one of the 10 things I personally hate about Propecia.

Dr. Michael Irwig also conducted a study, comparing the rates of depression among former finasteride users to balding, non-finasteride users. He concluded that the rate of depressive symptoms was considerably higher in the finasteride group — 75% vs. 10% among non-finasteride users (7).

Researchers have noted their concerns with Irwig’s findings, citing the implicit biases among the participants in his study. Again, many of them were recruited from an online support group for men suffering from long-term side effects as a result of using finasteride. In their 2014 article, Dr.’s Meena K. Singh and Marc Avram state that based on Irwig’s studies, “we cannot conclude that finasteride is definitively linked to persistent sexual dysfunction and depression” (8).

Other Finasteride Side Effects

As is the case with any prescription medication, Propecia has many potential side effects. Some of the serious side effects include chills, cold sweats, confusion, dizziness, and lightheartedness. Allergic reactions have also been reported, including rashes, hives, and swelling of the lips and face. Sexual side effects, as discussed above in detail, are also possible. If you’re looking for an exhaustive list of Propecia’s possible side effects, you can review thisdrugs.com medication profile.

(Video) Propecia (finasteride): a Q&A with a dermatologist|Dr Dray

Propecia and Prostate Cancer

In the aforementioned Prostate Cancer Prevention study, researchers found that finasteride reduced the overall risk of prostate cancer by 25%; however, it increased the risk of high-grade prostate cancers (more serious cancers) among the participants by 27%. Finasteride itself wasn’t the reason for the uptick in high-grade cancer diagnoses, according to the researchers.

The drug is known to shrink the prostate. And, according to Dr. Otis Brawley, chief medical officer for the American Cancer Society, doctors are more likely to diagnose prostate cancer in men with smaller prostates. He says, “this drug wasn’t causing more prostate cancer. It’s causing more prostate cancer to be diagnosed” (9).

Finasteride and Infertility

This is another somewhat touchy/unresolved subject. From what I’ve gathered, most doctors contend that there isn’t a direct link between Propecia and fertility (or infertility). That said, according to a 2013 paper, which reviewed the effects of finasteride on fertility in 4,400 men, the drug can reduce sperm counts significantly, even at small doses. Upon discontinuing the medication, average sperm counts increased fourfold. So in other words, the effects on infertility, if applicable, are generally reversible (10).

The Belagravia Centre of England advises their patients to discontinue Propecia a week before attempting to conceive (11).

Dr. William Rassman says that using Propecia while trying to have a baby is generally safe, but he still typically advises his patients to stop taking the drug for a 2-week cycle while attempting to conceive. He notes Propecia’s short half life, the fact that the drug is out of the bloodstream within 24 hours, and that it’s out of the tissue within a few days (12),

A Changing Tide?

I don’t think there’s any question that opinions are starting to shift on Propecia, primarily among hair loss sufferers and, to a much lesser extent, in the medical community. It used to be a no-brainer almost: when someone noticed they were losing their hair and wanted to fight it, they got on the drug and that was that. People believed the statistics, that only about 2% of men experienced side effects.

Now, it appears that the rate of side effects may have been under-reported in the studies, and a very small percentage of men do experience serious, long-term side effects after they stop using the drug. Nevertheless, the majority ofhair loss experts stand behind the drug and continue to prescribe it.

OnThe “Nocebo” Effect

In recent years, there’s definitely been an uptick in men reporting sexually adverse effects from Propecia. Some people attribute the increase in perceived side effects to the so-called “nocebo” effect. When patients expect negative results or side effects from any medication, those side effects often noticed — hence the name.

Here’s an interesting New York Times article on the Nocebo effect,which mentions finasteride. It cites a study where finasteride was administered to two groups of men to relieve the symptoms of prostate enlargement. The first group was informed that finasteride could cause erectile dysfunction, and the second group wasn’t told about that particular side effect.

In the informed group, 44% of the patients reported experiencing erectile dysfunction, compared to only 15% in the uninformed group. It should be noted that patients who take finasteride for prostate enlargement generally take it at higher does than men who use the drug to treat male pattern baldness; that could be the reason for the high rate of side effects.

“My Biggest Regret is not Starting on Propecia Sooner”

I’ve heard this refrain from regretful men countless times. Their stories usually go something like this:

First, they become paralyzed by fear after reading the Propecia horror stories online. So they decide not to take it. Then, eventually as their hair loss worsens — and it almost always worsens — they start taking the drug, almost out of desperation. They don’t have any side effects, and their hair loss stops. A significant percentage of them report noticeable regrowth, too. But they still have considerable hair loss, which may have been prevented to some degree had they started on the medication sooner.

I’m not saying using Propecia doesn’t come with risks. It certainly does. There are risks and benefits to practically every medication. But the the amount of fear mongering and misinformation being passed around with regard to Propecia is troubling, to say the least. People on YouTube, who have never taken the drug and frankly know nothing about it, are making anti-Propecia propaganda videos — and they’re generating thousands upon thousands of views.

My Take on Propecia

In this op-ed, I state the reasons why I personally wouldn’t use Propecia without trying alternatives first. So no, I’m not a shill for the pharmaceutical companies.

I believe the research indicates it’s safe and well-tolerated by the vast majority of its users. In my opinion, the nocebo effect is real, and it’s likely a major reason why self-reported side effects appear to be on the rise. I see little compelling evidence to suggest that a significant percentage of men experience long-term side effects after stopping Propecia.

Still, I also believe opinions are starting to shift on the drug to some degree. Some doctors are more cautious about prescribing it, and patients are exponentially more hesitant to take it today than they were 10 or even 5 years ago. Better, safer medications will hopefully be available in the not-too-far distant future.

A Vocal Minority

The Propecia critics are a loud and dominant group. I don’t want to criticize them, because I know some of them are genuinely suffering. All that said, I believe the relatively silent majority of men on Propecia tolerate the drug without any major issues.

Most Effective Option for Aggressive Hair Loss

Time is of the essence in cases of early, aggressive hair loss. The sooner you start treatment, the better your prognosis will be. And Propecia is the only treatment option that has been proven, time and time again, to effectively treat and even partially reverse cases of aggressive, early-onset hair loss.

If you’re a young, balding man with an extensive family history of hair loss, Propecia is likely going to be, by far, the most potent treatment option for you. Whether or not it’s worth the risk is entirely your call.

Supplementary Treatments and Finasteride Alternatives

Propecia is most frequently used in conjunction with minoxidil. They seem to have a synergistic effect when used together, as they effectively treat hair loss both internally and externally. Propecia, minxoidl, and Nizoral shampoo collectively form the “Big 3” hair loss treatment cocktail. Nizoral has its skeptics, but evidence does seem to suggest that it can help prevent androgens from attaching to hair follicles.

(Video) Risks and Recovery of Possible Sexual Side Effects from Finasteride

As far as Propecia alternatives go, many young men look to natural remedies such as Saw Palmetto and Pumpkin Seed Oil, both of which show promise as reasonably effective, natural treatments for hair loss.

Do these natural remedies work as well as Propecia? No, certainly not. But the early research shows some potential.

Pumpkin Seed Oil Study – Before-After Photos

A Long, Hard and Honest Look at Propecia - Is It Worth the Risk? (5)

Copyright © 2014 Young Hye Cho et al. Click to view the original. You can read my full pumpkin seed oil review here.

PRPandlaser therapy for hair loss are also options, both of which are among the top 7 hair loss treatments available at this time.

Topical Finasteride & RU58841

Since I first wrote the initial draft of this post a few years ago, topical finasteride has become a more popular treatment option. In 2015, Swiss researchers found that the topical version of the medication reduced DHT levels by about 25%. Comparatively, oral finasteride reduced DHT by around 75%, leading the team to speculate that topical finasteride may yield less side effects.

They also concluded that the topical treatment was more effective overall (13). It was a small study with only 18 participants, but other research has indicated that topical finasteride may be a viable alternative to the pill.

As far as new and trendy hair loss treatments go, RU58841, the “for-research” only topical, seems to be gaining traction. In animal studies, RU58841 targeted DHT locally without reducing serum (blood) DHT levels. It has a questionable safety profile. Nevertheless, some RU users have reported exceptional results anecdotally.

Low-Dose Finasteride

Since my initial draft of this article, low-dose finasteride has become increasingly popular. When you see these stats I’m about cite, you’ll likely understand why:

  • A .5 milligram dose of finasteride — half the standard dose — is about 80% as effective as the standard dose.
  • .25 milligrams of finasteride — a quarter dose — delivers 1/2 the DHT-lowering benefit as the 1 mg capsule.

In theory, the lower your dose, the lower your risk of side effects will be.

But before you jump on the low-dose finasteride bandwagon, consider the following:

  • No significant studies have been done to test the long-term effectiveness (or safety) of low-dose finasteride.
  • 50% less finasteride doesn’t necessarily mean 50% less side effects. The numbers don’t correlate directly.
  • 1 MG is the standard dose that’s been proven, time and time again, to help effectively treat hair loss in 9 out 10 guys.
  • Most doctors still prefer to prescribe the standard dose, at least as a starting point. If a patient develops side effects, they can adjust the dose accordingly.

Which version of finasteride should you take? That’s coming up in the next section.

Propecia vs. Generic Finasteride

Most men opt to take the generic finasteride, as it can be purchased for around $10 per month. Propecia typically costs $50-$60 per month. Insurance will not cover these medications.

The men who choose to spend extra money on Propecia usually do it for one reason and one reason only: consistency. You know exactly what you’re getting with Propecia, every time, as it’s manufactured to the same standards without deviation.

On the other hand, there are many different generic versions of finasteride available, which are manufactured throughout the world.

The active ingredient is the same, of course. And it’s unlikely, in my view, that your results will be dramatically different, whether you go with the generic or the name-brand Propecia.

But if you do use a generic and have positive results, it would probably be wise to stick with the same version of that genericmedication for as long as possible to ensure consistency. Consult with your doctor and/or pharmacist about this if you have any questions or concerns.

Tips for Using Propecia Safely

First off, you should talk to a dermatologist or hair loss specialist. Obviously. Aside from doing that, there are a number of things you can do to minimize your risks if you’re considering using Propecia.

Get a medical evaluation before starting treatment.

You could have a medical issue you aren’t aware of, which could jeopardize your safety while on the drug. Getting a full check-up could be a wise move on your part, including some blood and hormonal tests, if possible.

Dr. Jeffrey Rapaport, MD likes to test prostate-specific antigen (PSA) levels in his patients before prescribing Propecia (14). Dr. William Rassman of BaldingBlog offers optional DHT testing to all of his patients prior to going on finasteride — and if they have low DHT levels, he may not recommend the drug to that person (15).

Proceed with caution if you have a mental health issue.

(Video) Side Effects of Finasteride

Patients with certain mental health problems may be more likely to notice side effects. Before you begin treatment, if you’re having a mental health issue, you may want to talk to a counselor or therapist, along with your doctor.

Stay positive and have an open mind.

If you expect negative side effects, there’s a good chance you’ll have negative side effects.

Propecia Positives

A Long, Hard and Honest Look at Propecia - Is It Worth the Risk? (6)

1. Best First-Line of Attack – The American Hair Loss Association recommends Propecia as the first-line treatment option for male pattern hair loss. It can dramatically slow and partially reverse hair loss for a high percentage of men.

2. Generally Well-Tolerated – Propecia has been used as a hair loss treatment since 1997. It’s FDA approved and considered safe by the two of the world’s leading hair loss organizations, the International Society of Hair Restoration Surgeons and the American Hair Loss Association.

3. Trusted by Doctors – Based on my research, it appears that the overwhelming majority of hair loss specialists and dermatologists believe Propecia is, by and large, a safe and highly effective treatment for androgenic alopecia.

4. Can Work for Years, Even Decades – Propecia is the most effective, long-term hair loss treatment option on the market today.

5. Easy to Use as Directed– Taking a pill every day is no big deal for most people. On the other hand, compliance may be an issue with a hair loss treatment like minoxidil, where the solution must be rubbed into the scalp twice daily.

6. Affordable – Generic finasteride especially is a budget-friendly hair loss treatment and can often be purchased for $100 or less per year.

The Risks and Downsides

A Long, Hard and Honest Look at Propecia - Is It Worth the Risk? (7)

1. Side Effects may be more common than we realized.

2. The very small risk of persistent sexual side effects and/or post-finasteride syndrome.

3. If you stop taking it, you’ll lose any hair you kept or regrew with the drug within about 12 months.

4. The unknown is another downside, given that Propecia is still a relatively new medication. The general consensus in the medical community is that it’s a safe and well-tolerated medication for the most part, but that could change in the future.

Propecia for Hair Loss – Closing Thoughts

So do the benefits outweigh the risks? That’s entirely up to you. Propecia is a proven, highly effective treatment for male pattern hair loss, approved by the FDA and trusted, by and large, by the medical community. It stops hair loss in many men, and can promote some regrowth in up to 2/3 of its users.

Men are becoming more hesitant to use it for a variety of reasons — but primarily due to the risk of long-term sexual side effects. Again, the side effects went away in all men who experienced them in the large, FDA trials, but newer studies and reviews appear have put Propecia’s safety profile into question, at least to some degree. Some men look to alternatives like minoxidl, laser therapy, pumpkin seed oil, PRP, and saw palmetto; but none of those treatments are likely to yield better results than Propecia, either in the short-term or the long-term. Topical finasteride perhaps is the one exception to the rule.

If you have any questions or comments or a personal experience with Propecia/finasteride, feel free to leave a comment.

Robert Price

Robert Price is a writer, consumer advocate, and hair loss nerd with thousands of hours of experience in the field. His goal is to keep you out of the hair loss rabbit hole, underworld, or whatever you want to call it. He founded Hair Loss Daily, the unbiased hair loss blog, in 2016. You can learn more about Robert in the my story section of this website.

(Video) Is Finasteride/Propecia really that Bad?



Is it worth it to take Propecia? ›

Research shows that finasteride works, often very well. In long-term, placebo-controlled clinical trials published in the Journal of Investigative Dermatology Symposium Proceedings, 90 percent of men with hair loss who used finasteride either maintained their hair or saw improvements in hair growth.

Is finasteride worth risk? ›

Finasteride is generally safe to take for a long time. Many people take it for many months or even years without any problems. However, there have been reports of breast cancer in some men taking finasteride, but this is rare.

What are the risks of taking Propecia? ›

Although commonly prescribed, finasteride is a drug with side effects far more serious than the diseases it treats. Side effects may be irreversible and include persistent erectile dysfunction, depression, suicidal tendencies, loss of libido, anxiety, and other neurological issues (ie.

Does Propecia have long term side effects? ›

Are finasteride side effects permanent? Large-scale studies have not found Propecia side effects to be permanent. There are anecdotal examples of people experiencing persistent sexual dysfunction even after taking the drug, and some small studies that find this as well.

Is Propecia still the best? ›

Yes! Finasteride does work if you take it continuously. Scientific research and evidence point to finasteride as the most effective treatment for hair loss in males. It can also be used in combination with Regaine, a product that contains the ingredient Minoxidil, another proven hair loss treatment.

Can you still go bald on finasteride? ›

By Blocking DHT, Finasteride Often Stops Hair Loss

Research shows that the overwhelming majority of men who use finasteride experience no hair loss during treatment.

What percentage of people regrow hair with finasteride? ›

Clinical evidence for Propecia (finasteride)

Over 80% of the men taking finasteride found that their hair loss stopped within 6 to 12 months, and 66% even reported regrowth. In contrast, the entire placebo group experienced hair loss.

Do I have to take finasteride forever? ›

Finasteride isn't a lifetime cure — instead, it's a hair loss treatment that you need to keep taking if you want to continue to stop hair loss.

Is finasteride a lifetime commitment? ›

Bear in mind that the treatment of alopecia with finasteride is a lifelong commitment and that “lifelong'” means a long time for young men. Will these patients be protected from prostate cancer, or are they at greater risk of serious disease?
Grade 7–10 cancers2371280
2 more rows

Does Propecia affect the brain? ›

"Brain fog" has been reported in rare instances among finasteride users as dr. Rassman suggests. However, the post finasteride syndrome Foundation describes these cognitive side effects. They are memory and recall impairment, Slowed thought and Decreased comprehension.

Can Propecia make hair loss worse? ›

Answer: It is possible for both finasteride (Propecia) and minoxidil (Rogaine) to accelerate the hair cycle, resulting in temporary increased hair loss/shedding. This phenomenon typically lasts just a few months and usually resolves by approximately 9 months.

Who should not take Propecia? ›

Women and children should not use this medicine. Women who are pregnant or may become pregnant should not handle crushed or broken tablets. Finasteride can be absorbed through the skin and cause birth defects in male babies.

Can you take Propecia for 20 years? ›

To continue blocking DHT formation, you need to keep taking finasteride for life. Finasteride is a long-term drug, unlike minoxidil which can have its effects wane if you keep taking it. I have patients who have been on finasteride for over 20 years.

Does finasteride work after 10 years? ›

One thing is certain- there is a 90% chance you will have more hair on your head in 10 years if you use finasteride than if you do not. You still may lose after 5-10 years but you'll likely be way better off.

Does Propecia stop working after 10 years? ›

A: In many patients we have found finasteride to hold on to a patient's hair for at least 15 years. We don't have much longer data than that since it was approved for hair loss in 1998. Although finasteride will usually continue to work as long as you take it, it may lose some of its efficacy over time.

Is there anything better than Propecia? ›

Dutasteride has been shown to be 3 times more potent than finasteride at inhibiting type II 5AR and more than 100 times at inhibiting type I 5AR. Furthermore, oral dutasteride decreases serum DHT concentrations by up to 90% while finasteride only reduces DHT by 70%.

Is there a better drug than finasteride? ›

Studies have found that dutasteride is more effective at treating male pattern baldness. This medication is not only shown to be potentially more effective at treating hair loss but also shows the same rate and types of side effects as finasteride. That means you likely won't be trading efficacy for more side effects.

Is Rogaine better than Propecia? ›

While Propecia might slow down hair loss and balding, and Rogaine might slow down balding and stimulate minor hair regrowth, neither is effective for advanced-stage hair loss. In addition, as soon as you stop taking either medication, your hair loss is likely to continue.

When is it too late for finasteride? ›

As long as your hair follicles aren't entirely dead, you can start using Finasteride, also known by its brand name Propecia. The trick is that you have to start Finasteride treatments when you initially notice that you're losing hair before the problem gets worse.

How many years of balding can finasteride reverse? ›

By blocking DHT, finasteride can slow, stop, or even reverse hair loss. In clinical trials, finasteride stopped hair loss in 83% of people with male pattern baldness who took it for two years (Shapiro, 2003). But you can see results from finasteride within as little as three to four months.

Why am I losing more hair with finasteride? ›

When you start using Finasteride, follicles in the resting or telogen phase skip ahead to the growth phase, and begin to produce new hair. But before new hair can grow, these resting follicles must shed any existing hair. By doing this, they make way for healthy new hair in your dormant follicles.

Does finasteride work after 40? ›

A: Propecia (Finasteride 1 mg) can hold on to hair at any age, but works best to re-grow hair in those who are younger. The reason is that finasteride works to reverse miniaturization (the thinning and shortening of hairs due to DHT).

Do actors take finasteride? ›

Who Uses Finasteride in Celebrities? Many people in the world who are well-known and admired have used this drug to prevent hair loss. Bradley Cooper, Justin Bieber, Ashton Kutcher, Dax Shepherd, Rob Lowe, as well as many famous names in this way prevented hair loss.

Does Propecia actually regrow hair? ›

Propecia is a brand name for the generic drug finasteride, which is a prescription-only oral tablet taken daily to slow down hair loss in men. It's important to know that the drug cannot prevent male pattern hair loss, and it cannot regrow hair that has been permanently lost — instead, it stops hair loss in its tracks.

Does finasteride make you pee more? ›

Among men with symptoms of urinary obstruction and prostatic enlargement, treatment with finasteride for four years reduces symptoms and prostate volume, increases the urinary flow rate, and reduces the probability of surgery and acute urinary retention.

Is it okay to miss a day of finasteride? ›

If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Does finasteride lower blood pressure? ›

Finally, less-common adverse effects, generally observed in less than 1%-2% of patients taking finasteride, include: Runny nose. Skin rash. Low blood pressure.

Can finasteride cause brain fog? ›

Adverse cognitive effects in former finasteride users were also reported in this study. Such cognitive effects include memory problems (71/131), attention difficulties (93/131), slowed thought processes (93/131), and mental cloudiness or brain fog (95/131) [30].

Can I take finasteride for 5 years? ›

Conclusions: In men with MPHL, long-term treatment with finasteride 1 mg/day over five years was well tolerated, led to durable improvements in scalp hair growth, and slowed the further progression of hair loss that occurred without treatment.

Can finasteride cause brain tumor? ›

Finasteride is an FDA-approved medication for the treatment of benign prostate hyperplasia and androgenic alopecia. However, in recent years, a few studies have suggested that finasteride shows some potential as a new glioblastoma drug [30,31].

Does finasteride affect the heart? ›

This medicine can cause serious side effects in patients with heart problems.

What percentage of Propecia users have side effects? ›

How common are finasteride side effects? Fortunately, finasteride's side effects aren't very common. During Propecia's clinical trials, only 3.8% of men taking the drug experienced side effects, versus 2.1% of men taking a placebo (Mcclellan, 1999).

Does Propecia cause mental problems? ›

Patients taking finasteride had 4 times the risk of experiencing depression and anxiety, as well as an increased risk of reporting suicidal feelings.

Does finasteride cause wrinkles? ›

Wrinkles is not a recognised side effect of finasteride. Acquiring wrinkke is a natural part of the aging process but can be accelerated by sun damage. Keeping well hydrated and using regular moisturisers can improve their appearance.

Will Propecia thicken my hair? ›

Clinical studies have found that finasteride stops hair loss for 90% of men, and 65% will also benefit from increased hair growth and thickening of existing miniaturized hairs. One study from 1998 showed a significant increase in hair count after 2 years of finasteride 1mg daily.

Can Propecia take 2 years to work? ›

Although finasteride starts working immediately, your hair follicles need time to begin producing new hairs. This means that you'll usually need to wait for three to six months before seeing any changes in your hairline or hair thickness after starting treatment with finasteride.

How many days can you miss finasteride? ›

As you know, finasteride 1mg is meant to be taken once per day. When you miss a dose, you should just continue to take your tablet as normal - again, only one per day - the next day.

Can you develop erectile dysfunction a year after taking finasteride? ›

In March 2017, a Northwestern Medicine study found that some men who took finasteride suffered persistent erectile dysfunction in which they were not able to have normal erections for months or years after stopping the medication.

How can I make finasteride more effective? ›

Minoxidil is the number one way to increase Finasteride results. Minoxidil comes in the form of a topical solution applied to the scalp - which increases blood flow oxygen in your blood vessels and revitalises shrunken or damaged hjourlaair follicles in your scalp.

What happens when you stop using Propecia? ›

Finasteride has a relatively short half-life. So, once you stop taking the tablet, its effects should be out of your system within seven days and you can expect to see your usual rate of hair loss (what you experienced prior to taking the medication) return.

Does finasteride cause weight gain? ›

Weight gain is not a known side effect of finasteride (Propecia).

What do dermatologists think about finasteride? ›

Dermatologists considered treatment with 1 mg/day finasteride to be the most efficacious treatment for AGA, as reflecting by its long-term (5 years) prescription.

Is Propecia safer than finasteride? ›

Because brand name Propecia and generic finasteride contain the same active ingredient, they both cause side effects at an equal rate.

Is Propecia better than Rogaine? ›

While Propecia might slow down hair loss and balding, and Rogaine might slow down balding and stimulate minor hair regrowth, neither is effective for advanced-stage hair loss. In addition, as soon as you stop taking either medication, your hair loss is likely to continue.

Is there anything better than finasteride? ›

Dutasteride has been shown to be 3 times more potent than finasteride at inhibiting type II 5AR and more than 100 times at inhibiting type I 5AR. Furthermore, oral dutasteride decreases serum DHT concentrations by up to 90% while finasteride only reduces DHT by 70%.

Who should not use finasteride? ›

Women and children should not use this medicine. Women who are pregnant or may become pregnant should not handle crushed or broken tablets. Finasteride can be absorbed through the skin and cause birth defects in male babies.

Can I take finasteride for 20 years? ›

To continue blocking DHT formation, you need to keep taking finasteride for life. Finasteride is a long-term drug, unlike minoxidil which can have its effects wane if you keep taking it. I have patients who have been on finasteride for over 20 years.

Does finasteride work after 50? ›

A: Propecia (Finasteride 1 mg) can hold on to hair at any age, but works best to re-grow hair in those who are younger. The reason is that finasteride works to reverse miniaturization (the thinning and shortening of hairs due to DHT).

Can I take finasteride for 10 years? ›

In summary, long–term (10-year) AGA treatment with finasteride 1 mg/day demonstrated a high efficacy and safety based on subjective and objective evaluations in Japanese men. Specifically, the N-H classification of AGA patients improved by approximately 1 grade after 10 years of treatment with finasteride.

Is there a safer alternative to finasteride? ›

Many of our patients report the same benefits using saw palmetto as using Finasteride, such as thickening of her hair. It does seem to create a reduced likelihood of side effects than Finasteride, although this may be a placebo effect.

Should I avoid finasteride? ›

Currently, studies show that finasteride treatment is safe in the long term. For example, a clinical study from the Prostate Cancer Prevention Trial of almost 19,000 men who had taken finasteride for seven years concluded that there is “little need to worry” about any long-term consequences from finasteride.

Can Propecia make your hair worse? ›

Answer: It is possible for both finasteride (Propecia) and minoxidil (Rogaine) to accelerate the hair cycle, resulting in temporary increased hair loss/shedding. This phenomenon typically lasts just a few months and usually resolves by approximately 9 months.

Do Celebrities use Propecia? ›

Who Uses Finasteride in Celebrities? Many people in the world who are well-known and admired have used this drug to prevent hair loss. Bradley Cooper, Justin Bieber, Ashton Kutcher, Dax Shepherd, Rob Lowe, as well as many famous names in this way prevented hair loss.

What's safer minoxidil or finasteride? ›

Finasteride Side Effects. Minoxidil and finasteride are both safe, effective medications for most people. Both drugs have been studied extensively, with clinical trials showing that side effects are usually mild, transient and rarely severe.

Is Propecia hair growth permanent? ›

It is important to remember that Propecia is a hair loss treatment, not a cure. Once you stop taking Propecia your testosterone will start converting into DHT as before. Gradually your hair loss will resume, and it is likely that you will lose any hair that you have gained within 12 months of stopping the treatment.


1. Finasteride (Propecia) For Hair Loss
(Dr. Gary Linkov: City Facial Plastics)
2. UPDATE - Side Effects of Propecia / Finasteride
(David DiMuzio)
3. Post-Finasteride Syndrome
(The Hair Loss Show)
(More Plates More Dates)
6. Finasteride: Experiencing side effects after the 1st tablet?
(The Hair Loss Show)
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