Finasteride Dose for Hair Loss

The treatment options for thinning hair or hair loss can seem endless and overwhelming. Plenty of hair loss treatment products promise amazing results, but there are relatively few medications that have FDA approval and a well-established record of being safe and effective for most users.

Among that select group is finasteride, a medication that’s available in oral tablets and topical sprays and serums. Finasteride is from a class of medicines called alpha-5 reductase inhibitors. Finasteride works on the hormones that cause male pattern hair loss; specifically, it targets the alpha-5 reductase enzyme to help prevent the conversion of testosterone into dihydrotestosterone (DHT). 

DHT can not only interfere with healthy hair growth, especially as you get older, but it can also lead to an enlarged prostate, a condition known as benign prostatic hyperplasia (BPH). High DHT levels are also associated with a higher risk of prostate cancer. Finasteride (sold for BPH under the brand name Proscar) may help slow or reverse prostate enlargement and treat some BPH symptoms. A urologist or your primary care doctor should be able to advise you whether you should take finasteride for prostate health.

As for the treatment of male pattern hair loss, it’s important to talk with a dermatologist or other healthcare provider who specializes in hair regrowth and hair restoration. Finasteride may not be right for everyone, but with solid medical advice, you can determine whether it’s something you want to try and what dose will be safe and effective for you.

Finasteride is used to treat androgenetic alopecia, better known as male pattern baldness. Men with androgenetic alopecia have higher DHT levels in their scalp and smaller hair follicles. If you are among the men dealing with androgenetic alopecia, you are in good company: An estimated 30% to 50% of adult men experience male pattern baldness.

If you currently have a healthy head of hair, taking finasteride to help prevent male pattern hair loss may not be worth it, and it may not be effective. Hair loss, including a receding hairline, isn’t always the result of too much DHT. Certain genetic factors may predispose you to premature hair loss. The same is true for certain hair styling practices or harsh hair products. Finasteride may not be effective for hair loss unrelated to DHT levels.

The recommended oral finasteride dose for hair loss, according to the FDA, is a 1 milligram tablet. For best results, finasteride tablets should be taken daily. Ideally, you should take the medication at about the same time every day. It can be taken with or without food.

Topical finasteride products include sprays and serums that are worked into the scalp to stimulate new hair growth in existing hair follicles. One study found that a 0.25% topical solution of finasteride applied just once a day was effective at improving hair count compared to a placebo, and was well-tolerated.

Topical finasteride is especially effective when used in combination with minoxidil, a medication that helps restore hair loss as a result of inherited male pattern baldness. For people who don’t like taking pills, topical finasteride may be a better option.

Missing an occasional dose of finasteride shouldn’t be problematic. Rather than take the medication as soon as you remember, let it go and simply resume taking finasteride at your next scheduled time and resume your usual medication regimen. Taking too much finasteride could lead to potentially serious side effects and complications.

Finasteride is available through prescription only. There is not yet an over-the-counter version of the medication. 

Oral finasteride is usually available in 1 mg tablets to treat hair loss. For BPH, your doctor may prescribe a 5 mg tablet. A 5 mg tablet is not recommended for treating hair loss. Generic finasteride and the brand medication (Propecia) are sold in 1 mg tablets.

Topical finasteride should be applied in small amounts to the scalp follicles experiencing hair loss. You don’t need to apply more than is needed, especially in areas with healthy hair growth. 

Choosing oral or topical finasteride may come down to personal preference. A 2022 study in the Journal of Dermatological Treatment found that individuals who took oral finasteride saw similar hair growth compared with those who used the topical version.

Finasteride is generally well-tolerated by most people. You may be able to take it safely for months or years and experience robust hair growth without any problems. However, new hair growth that occurs after you start finasteride may be lost within a year or so after stopping the medication.

And like any powerful medication, finasteride can cause some potentially serious side effects. 

Oral finasteride, in particular, can produce some unwanted side effects, such as:

• Chills

• Cold sweats

• Dizziness and/or lightheadedness

Less common side effects can include bloating, weight gain, or swelling in the face, hands, and elsewhere in the body. Hives, redness, or other skin rashes may also develop.

Finasteride may also cause erectile dysfunction and a reduced sex drive. You may also notice less ejaculation volume, though these side effects often fade as your body gets used to the medication. While there is little research on the topic, you may find that taking a lower dose may still restore hair growth while reducing the severity of side effects.

If you experience adverse effects with oral finasteride, you may want to try the topical version. Research suggests that men who make that switch still experienced desired improvements in hair density without the side effects. Using a combination of finasteride and minoxidil also proved to be especially helpful with hair regrowth.

Some drug interactions involving finasteride and other prescription medications or supplements are possible, so be sure to consult your healthcare provider or a pharmacist to avoid any adverse effects or complications. It’s always smart to keep your doctor updated with all the medications and supplements you take.

While you may be especially anxious to restart hair growth in a hurry, keep in mind that finasteride is not an overnight solution. Hair growth takes time. The effects of finasteride may take three or four months to produce the results you want.

Everyone’s hair growth timeline is different, of course, but if you don’t see results within 12 months, that may be a sign that the medication isn’t going to help, and you may want to consider other hair restoration options.

Keep in mind that finasteride doesn’t lead to a complete reduction of DHT levels, but it can often be effective in slowing and reversing some hair loss.