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FDA approved for more than 25 years
Finasteride is a medication designed to encourage hair growth, yet some men report accelerated hair loss when they begin using it. This is understandably concerning — no one wants a medication that does the opposite of what it’s supposed to.
So, does finasteride cause shedding? Yes, it can in the early stages, but it’s actually nothing to worry about.
Finasteride shedding is a common experience — some people briefly shed more hair than usual in the early stages of finasteride use. This is a sign the medication is working, and the phase usually passes in a short time. It’s not permanent.
Curious how hair loss on a medication intended for hair growth can be a good thing? Read on for the science behind hair shedding with finasteride, when it starts, when it goes away, and what happens if it doesn’t go away.
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Does finasteride cause hair loss? No. It’s complicated, but finasteride can cause temporary shedding at first.
During the first few months of treatment with finasteride, some men see more hair loss than normal — a phenomenon known as finasteride shedding or Propecia® shedding (finasteride is the generic version of Propecia).
As a treatment for androgenetic alopecia, or male pattern baldness, finasteride works by reducing levels of the androgen (male hormone) dihydrotestosterone (DHT) throughout the body. This, in turn, shields hair follicles from the effects of DHT.
Finasteride works well as a long-term treatment for male pattern hair loss. A 10-year study on finasteride found that more than 99 percent of men who use it experience no further progression of their hair loss.
However, results from finasteride typically aren’t immediate. It usually takes three to four months before any results are visible. And the “final” results from finasteride (how good it’s gonna get) are typically visible after about one year of consistent use.
Before that, finasteride may cause a stutter in your hair’s internal clock, specifically its growth cycles. We’ll explain why this happens below.
Though experts aren’t totally sure why finasteride often causes temporary hair shedding, some believe it may be related to the hair growth cycle.
Every hair on your body goes through a multi-phase hair cycle involving distinct hair growth periods, regression, rest, and shedding.
During one phase of this cycle, the anagen phase (or the growth phase), hair grows to its full length before resting and falling out.
The anagen phase for hair on your scalp typically lasts several years. It’s much shorter for your body hair, which is why the hair on your arms, legs, and torso naturally grows to a shorter length than the hair on your scalp and face.
Roughly 90 percent of the hairs on your scalp are in the anagen phase at any given time, with other hairs in different phases of the hair growth cycle (catagen, telogen, or exogen).
Finasteride works by inhibiting the 5-alpha-reductase enzyme that converts testosterone into DHT. DHT can attach to receptors in tissue throughout your body, including hair follicles on your scalp.
Over time, DHT-related damage to hair follicles can result in hair follicle miniaturization, which leads to thin, damaged hairs.
When DHT binds to receptors in the scalp and damages hair follicles, it can shorten the anagen phase so much that new hairs eventually stop growing out from the scalp. Finasteride can cause hair to abruptly exit the telogen phase, resulting in lots of shedding at once.
After you start using finasteride, your DHT levels drop significantly. In fact, research shows that a typical dose of finasteride lowers the amount of DHT freely circulating throughout your body by more than 70 percent.
By blocking DHT, finasteride can promote hair follicles to enter the anagen phase, where they can actively grow.
Due to this decline in DHT levels and sudden promotion of hair growth, hair follicles in the regression and resting phases of the hair cycle may become active again.
This could cause temporary hair loss as some hair follicles shed old hairs to replace them with new ones. This may seem jarring, but it’s actually a good thing — it makes room for new, healthy hair to grow in place of the damaged ones.
When does Finasteride shedding start? It depends, but if you experience it at all, you’ll typically see these results within one to three months of use (many people don’t notice it).
Here’s what to expect from a finasteride shedding timeline:
Finasteride shedding in month one. You probably won’t see shedding this early on, as the hair growth cycle is in flux.
Finasteride shedding at two to three months. This is when people most notice taking finasteride notice shedding. It seems contradictory, but you may also notice new hair growth during this period.
Finasteride shedding at six months. Finasteride shedding usually resolves within six months. By then, you should be seeing some new healthy hair growth over balding areas.
Finasteride shedding after a year. You shouldn’t be seeing hair loss due to finasteride at this point. If you’re still seeing noticeable hair loss after a year on the medication, it’s best to check in with a dermatologist or another healthcare provider to find out what’s going on.
Finasteride shedding generally lasts two to four weeks and should resolve independently.
Men experience different volumes of hair shedding when starting out with finasteride, but it’s generally common to see about double the normal amount of shedding.
Many men can shed 50 to 100 hairs per day or more as part of the natural hair growth cycle. This level of hair loss is so insignificant that it’s usually not even noticeable (particularly if your hair is cut short), but as it doubles, you might take notice.
Finasteride shedding can be severe if you also apply minoxidil (a topical medication designed to stimulate hair growth) to your scalp.
Though its mechanism of action still isn’t fully understood, minoxidil is believed to work by encouraging hair follicles to enter into the anagen phase of the growth cycle. It also improves blood circulation to the scalp, which may give your hair follicles more nutrients for healthy hair growth.
Like finasteride, minoxidil is known for causing temporary hair loss during the first few weeks or months of use, as inactive strands of hair shed before entering the anagen phase.
If you start to experience hair shedding after you start using finasteride (either alone or with minoxidil) it’s important to stay the course.
Finasteride does work for many men, and the hair shedding you might experience during the first few months of treatment is most often temporary.
Keep using finasteride as prescribed. After three to four months, you should notice real improvements in your hair density and general growth.
Finasteride shedding is a temporary issue that lasts only a few months. After starting treatment with finasteride, you may notice some regions of your scalp have slightly less hair coverage than before, especially under bright lighting or when your hair is wet.
In a clinical trial published in the European Journal of Dermatology, experts found that men with hair loss who used finasteride showed improvements in hair density after six months of use.
In other words, after six months, any shedding from finasteride has been more than made up for with new hair growth.
Similarly, shedding from minoxidil is generally a temporary issue that completely reverses within the first few months.
If you notice shedding after you start using finasteride, don’t panic. Stay focused on the long term and keep using your medication daily. Over time, you’ll likely notice thin areas filling back in with new, healthier hair as your follicles become active once again.
Finasteride shedding after six months could mean something else is wrong. Finasteride shedding after one year is both unusual and a sign that something besides finasteride may be causing hair loss. In those cases, it’s best to consult a medical provider.
While finasteride is effective on its own, it’s even more effective when combined with other hair loss treatments and good hair care habits.
We’ll go over several tips to improve your finasteride results and help you better maintain any hair growth you experience while using this medication.
One of the best ways to improve your results from finasteride is to use minoxidil at the same time.
Minoxidil is available over the counter as a topical solution (liquid) and a foam. It promotes hair growth locally at the scalp level, allowing you to simultaneously treat hair loss and potentially stimulate hair growth from more than one angle.
In one study, researchers compared the effectiveness of finasteride and minoxidil alone to a combination of the two medications.
They found that 59 percent of men who only used minoxidil and about 84 percent of those who only used finasteride experienced improvements in hair growth after 12 months.
In comparison, a significantly higher 94 percent of men who used both hair loss medications together experienced improvements in hair growth.
We offer minoxidil solution and minoxidil foam online, allowing you to add this treatment to your hair loss prevention toolkit easily. You can also try our Hair Hybrids, which combine finasteride with minoxidil in a convenient chewable form.
In addition to using minoxidil with finasteride, washing your hair with a hair loss shampoo like our Thick Fix Shampoo may help prevent further hair loss and keep your hair in optimal condition.
Helpful ingredients to look for in a hair loss shampoo include ketoconazole and saw palmetto, both of which have been linked to reduced DHT and improved hair growth in scientific research.
It’s worth noting that although these ingredients appear to be effective, the scientific evidence for them isn’t as strong as it is for finasteride or minoxidil.
Vitamin B7, or biotin, plays a critical role in the growth process for hair, skin, and nails. Plenty of other vitamins also help promote consistent hair growth and ensure your strands remain healthy.
While vitamins don’t seem to have any significant role in preventing male pattern baldness, they may help keep your hair in optimal condition.
Consuming plenty of vitamin-rich foods that promote hair growth or taking a vitamin supplement like our biotin gummies are good places to start.
Finasteride can take up to one year to produce significant results. This means you’ll generally need to use the medication for some time before your hair loss stops and new growth occurs.
To keep yourself motivated, it can help to take photos of your hairline and scalp to stay on top of any changes that occur in your hair.
Our guide to taking finasteride before-and-after photos explains how you can keep track of new hair growth while using finasteride.
Smoking isn’t just harmful to your heart and lungs — it can also damage your hair follicles and contribute to hair loss.
A study carried out in Taiwan found that regular cigarette smoking was associated with an elevated risk of developing moderate or severe hair loss in men.
If you’re a smoker, consider quitting. Not only can kicking the habit improve your general health — it may also help you grow thicker, stronger hair.
Along with minoxidil, finasteride is one of two medications approved by the FDA (U.S. Food and Drug Administration) to treat male pattern baldness. It’s highly effective, with most men noticing a reduction in hair loss and a significant increase in hair growth after around one year of consistent use.
Here’s what to keep in mind about finasteride shedding:
Shedding can be one of the early side effects of finasteride. It’s common and normal to experience some diffuse hair loss or finasteride shedding when you first start using the medication.
For most men, any temporary hair loss from finasteride reverses within a few months, revealing a thicker, fuller head of hair and fewer worries about male pattern baldness.
The shedding phase won’t last forever. But for some guys, it may take up to a year to start seeing noticeable results with finasteride.
Combining finasteride treatment with minoxidil might give you faster, more noticeable results with hair regrowth.
We offer finasteride as part of our range of hair loss medications, following an online consultation with a licensed healthcare provider who’ll determine if a prescription is appropriate.
You can also find out more about your options for stopping hair loss and promoting regrowth in our detailed guide to preventing hair loss.
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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.
Dr. Knox Beasley is a board certified dermatologist specializing in hair loss. He completed his undergraduate studies at the United States Military Academy at West Point, NY, and subsequently attended medical school at Tulane University School of Medicine in New Orleans, LA.
Dr. Beasley first began doing telemedicine during his dermatology residency in 2013 with the military, helping to diagnose dermatologic conditions in soldiers all over the world.
Dr. Beasley is board certified by the American Board of Dermatology, and is a Fellow of the American Academy of Dermatology.
Originally from Nashville, TN, Dr. Beasley currently lives in North Carolina and enjoys spending time outdoors (with sunscreen of course) with his wife and two children in his spare time.
Bachelor of Science, Life Sciences. United States Military Academy.
Doctor of Medicine. Tulane University School of Medicine
Dermatology Residency. San Antonio Uniformed Services Health Education Consortium
Board Certified. American Board of Dermatology
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