What it is
Finasteride is a prescription oral medication classified as a 5-alpha reductase inhibitor. It was originally developed for benign prostatic hyperplasia (BPH) and later approved by the FDA at a lower dose (1 mg) for the treatment of androgenetic alopecia in men. It is one of the most extensively studied hair loss treatments available.
Who it's commonly prescribed for
Finasteride is typically prescribed for adult men experiencing early-to-moderate androgenetic alopecia (male-pattern hair loss), particularly those with thinning at the crown or recession at the temples. It is not approved for use in women or children. A licensed clinician will consider your medical history before prescribing.
Pregnancy warning and handling
Finasteride labeling includes a pregnancy warning: because it can affect development of a male fetus, women who are or may become pregnant should not handle crushed or broken finasteride tablets. If you see topical finasteride products, note that compounded topical finasteride is not FDA-approved and the FDA has issued an alert about potential risks and systemic exposure; ask a clinician about pregnancy-related precautions for any topical product.
Typical timeline
Hair loss treatments require consistency. With daily finasteride use, most patients begin to notice reduced shedding within 3 months. Visible improvement in density or coverage generally becomes apparent between 6 and 12 months. Maximum results are typically observed around 24 months of continuous use. Discontinuation leads to gradual loss of benefit over 6 to 12 months.
Common side effects
As with any medication, finasteride carries potential side effects. The following have been reported in clinical trials and post-marketing surveillance. Most are uncommon and generally resolve upon discontinuation.
- Decreased libido
- Erectile changes
- Reduced ejaculate volume
- Breast tenderness (rare)
- Mood changes (reported infrequently)
- Skin rash (uncommon)
Questions to ask a clinician
If you are considering finasteride, these questions can help guide a productive consultation with your prescribing clinician.
- Is finasteride appropriate given my specific pattern of hair loss?
- Are there any interactions with medications I currently take?
- What monitoring, if any, do you recommend while on this medication?
- What should I do if I experience side effects?
- Is a lower dose or less frequent dosing schedule a reasonable starting point?
- How will we evaluate whether the treatment is working?
Compounded topical finasteride
Some clinics offer compounded topical finasteride (sometimes combined with minoxidil). Compounded topical finasteride is not FDA-approved, and the FDA has issued an alert about potential risks associated with compounded topical finasteride. If you are considering a compounded product, ask your clinician what ingredients and concentrations are included and what side effects to watch for.