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Reviewed by Kristin Hall, FNP
Written by Our Editorial Team
After years of noticing your hairline slowly receding and your hair shedding, you’ve decided to take the leap and gave finasteride (the active ingredient in Propecia®) a try.
You’ve followed your healthcare provider’s recommendations to a T and paired your finasteride prescription with the topical medication minoxidil to maximize your results.
While you were skeptical at first, a few months later you’ve noticed that the hair loss medications are working.
Not only do you find fewer hairs on your pillow and in your hair brush, but your hair is becoming noticeably thicker and stronger. It’s everything you hoped for. But now what do you do?
After you’ve started using finasteride and minoxidil, it can be difficult to work out what to do next to maintain your hair.
Below, we’ve explained how finasteride and minoxidil work, as well as how you can take these medications over the long term for sustained results.
We’ve also listed other actions that you can take to get the most from your hair loss treatments and enjoy thicker, better looking hair throughout your life.
Male pattern baldness, also referred to as androgenetic alopecia, is the most common form of hair loss for men.
Research shows that about 16 percent of men aged 18 to 29 and 53 percent of men in their 40s have moderate to extensive male pattern baldness.
This form of hair loss is caused by a combination of your genes and the effects of the hormone dihydrotestosterone, or DHT.
DHT is created as a byproduct of the hormone testosterone. If you’re generally predisposed to male pattern baldness, DHT can bind to receptors in your scalp and, over time, cause your hair follicles to become smaller and less capable of producing new hairs.
The effects of DHT on your hair aren’t immediate, which is why it often takes years or decades for baldness to develop. Our guide to DHT and male pattern baldness discusses this process in more detail.
When it comes to treating male pattern baldness, acting fast is important. The earlier you begin to treat your hair loss, the more likely it is that you’ll be able to stop further hair loss and protect your existing hair from DHT-related damage.
Finasteride is a prescription drug that’s used for the treatment of male pattern baldness. It’s sold as a generic medication and under the brand name Propecia.
As a treatment for hair loss, finasteride works by blocking an enzyme called 5-alpha reductase, which is responsible for converting a small percentage of the testosterone produced within your body into DHT.
This reduces the amount of DHT inside your body, shielding your hair follicles from DHT-related damage and allowing the hair growth process to resume its normal course.
Numerous studies have found that finasteride is effective at slowing down and stopping hair loss caused by male pattern baldness.
For example, a study published in the Journal of the American Academy of Dermatology in 1998 found that men who used finasteride for a period of two years experienced a clinically significant increase in hair count.
The same study also found that men who used a non-therapeutic placebo over the same period continued to experience hair loss.
Other research has found that 83 percent of men who use finasteride experience no further hair loss after two years of treatment.
In order to achieve results like this, finasteride needs to be taken on a consistent basis over the long term.
The standard dosage for finasteride is 1mg per day. While finasteride starts working as soon as it’s absorbed by your body, it may take three to four months before you start to see a difference in your hair’s thickness, coverage and general appearance.
As for the “final” results for finasteride, it may take one year or longer before you begin to see a significant change in your hair.
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“I’m a 34-year-old father of two and have been using Hims for over a year now. My hair is back to what it was in my mid-twenties.”
So, how long should you keep using finasteride? If you’ve seen improvements in your hair, or if you’ve noticed that your hair loss seems to have stabilized, you shouldn’t stop using finasteride unless advised by your healthcare provider.
Finasteride works by blocking the production of DHT. If you stop taking finasteride, the amount of DHT in your body will return to its normal level.
This means that your hair will once again be exposed to DHT-related damage.
Studies have found that finasteride is both safe and effective when it’s taken over the long term as a hair loss treatment.
In a long-term study carried out in Japan, researchers looked at the effectiveness of finasteride in men with male pattern baldness over the course of 10 years.
The study found that 99.1 percent of the men who used finasteride over a 10-year period saw no worsening of their hair loss.
Interestingly, more than 91 percent of the men experienced an improvement in hair growth during their 10 years of finasteride use.
Throughout the 10-year study period, no serious adverse reactions were recognized, although 6.8 percent of the men reported mild and temporary side effects.
In short, finasteride keeps working, even after several years. If you’ve stopped your hair loss or regrown some of your hair, it’s best to keep using finasteride to maintain your progress.
Minoxidil is a topical medication for hair loss. It’s available as a generic medication or under the brand name Rogaine® and comes as a liquid solution or foam.
Unlike finasteride, minoxidil doesn’t appear to have any effect on your body’s production of DHT or other hormones.
Instead, it treats hair loss by moving hair follicles into the anagen, or growth, phase of the hair growth cycle.
Minoxidil also appears to increase blood flow to your scalp, which may help to supply your hair follicles with the nutrients they need to produce hair growth.
Like finasteride, minoxidil is backed up by a lot of scientific research showing that it can reduce hair loss and improve hair growth.
In a study published in the Journal of the American Academy of Dermatology, experts looked at the effects of minoxidil on men’s hair growth over the course of 12 months.
Of the men that participated in the study, 62 percent had a smaller area of hair loss following 12 months of treatment with minoxidil.
A further 35.1 percent of the men didn’t show improvement in hair growth, but experienced no further hair loss while using minoxidil.
In total, 84.3 percent of the men who used minoxidil rated it as either “very effective,” “effective” or “moderately effective” at treating hair loss.
Minoxidil is designed to be applied directly to the areas of your scalp with hair loss -- a process we’ve explained in our guide to applying minoxidil for hair growth.
Although minoxidil starts working as soon as it’s absorbed by your skin, its effects on your hair aren’t immediate.
Like with finasteride, you’ll usually need to wait for three months or longer to see any improvements in your hair’s thickness and coverage after you start using minoxidil.
Due to its effects on your hair’s growth cycle, it’s common to notice hair thinning during the first few months of treatment with minoxidil. This is a normal effect that will pass with time.
Similar to finasteride, minoxidil is only effective while you actively use it, meaning you’ll need to keep applying it to your scalp if you want to maintain your results.
What happens if you stop minoxidil? If you stop applying minoxidil to your scalp, you’ll gradually lose any hair that you’ve regrown as a result of the medication.
Minoxidil is a well-studied medication that’s safe to use for the long term.
If you notice that your hairline looks more full or your hair looks thicker after using minoxidil, you can continue using it for years to maintain your results over time.
Although finasteride and minoxidil both treat hair loss from male pattern baldness, they do this through different mechanisms and don’t “compete” with each other within your body.
This means that you can safely use finasteride and minoxidil at the same time.
In fact, studies have found that using these medications together will likely give you better results than using just one medication to treat hair loss.
In a study published in the journal Dermatologic Therapy, researchers compared the effects of finasteride, minoxidil and both medications as treatments for hair loss.
Their research showed that after 12 months, 80.5 percent of men who used finasteride and 59 percent of men who used minoxidil experienced improvements in hair growth.
In comparison, 94.1 percent of the men who used both medications showed improvements.
Another study found that a combined treatment of finasteride and minoxidil outperformed either medication used on its own.
However, this study used a topical form of finasteride rather than the more common oral medication.
Put simply, research shows that finasteride and minoxidil are more effective at treating hair loss when used together than when either medication is used alone.
As such, if you’re aiming to get the best possible results from your hair loss protocol, you’ll want to use both medications to target your hair loss from different angles.
In addition to using finasteride and minoxidil together, there are several other steps that you can take to better protect your hair and stimulate hair growth:
Use a hair loss shampoo. These contain active ingredients such as saw palmetto and ketoconazole, which may help to block DHT on your scalp. Our Thickening Shampoo is designed to reduce scalp buildup while promoting volume and moisture.
Consider taking a biotin supplement. Biotin, or vitamin B7, is a vitamin that plays an important role in the hair growth process. Although it won’t stop male pattern baldness, it’s important for healthy growth of your hair, skin and nails. Our Biotin Gummy Vitamins contain biotin and other important vitamins for optimal hair growth.
If you smoke, quit. Research shows that smoking can damage your hair and contribute to hair loss.
Take steps to minimize stress. While stress doesn’t cause male pattern baldness, it is linked to a form of hair loss called telogen effluvium. Try to reduce your stress levels by avoiding sources of stress and practicing stress management techniques.
Unfortunately, while finasteride treats male pattern baldness, it doesn’t cure it. This means that you’ll need to continue using medication to maintain your results.
If you stop taking finasteride at any time, you may start to lose any hair that you’ve grown back since starting treatment.
It’s important to understand that while most men experience some degree of hair regrowth after starting finasteride, this isn’t a guaranteed benefit.
While you may notice some level of regrowth in areas of your scalp that are thinning rather than completely bald, finasteride isn’t a miracle pill.
As such, it’s rare to experience regrowth in areas where your hair has completely stopped growing.
This is why men who start taking finasteride shortly after noticing their hair loss typically see the greatest benefits.
Even if finasteride isn’t effective at regrowing your lost hair, it may be effective at slowing down the hair loss process and protecting the hair you still have.
It’s important to remember that finasteride isn’t a “cure” for baldness. Male pattern baldness is closely linked to a number of genetic and environmental factors.
Right now, we don’t have any proven cure that addresses all of these.
Finasteride addresses the specific mechanism that causes hair loss, but it doesn’t address the underlying factors that lead to male pattern baldness.
This is why you can expect your hair loss to resume if you stop taking the medication.
However, since hair loss restarts when you stop taking finasteride and scientific research shows that finasteride is safe to use over the long term, why would you ever quit?
Although finasteride is one of the only proven medications for treating male pattern baldness, it is a prescription medication and, as such, comes with a risk for side effects.
In clinical trials, 1.4 percent of men who used finasteride stopped taking their medication due to side effects.
To put this in perspective, 1.6 percent of men who used a non-therapeutic placebo also stopped due to side effects.
Other reported side effects of finasteride include testicular pain and depression.
Although rare, finasteride may cause more severe side effects, such as hives, itching, rash, changes in breast size, swelling that affects the lips and face and/or difficulty breathing or swallowing.
If you experience any of these side effects, it’s important to contact your healthcare provider immediately.
Minoxidil can also cause side effects, including itching, dryness, scaling, burning, irritation and flaking of your scalp.
These side effects usually occur in the first few weeks of treatment and may disappear over time.
If you’ve been successful in treating your hair loss with finasteride, do yourself a favor and stick with it!
As long as you aren’t experiencing any negative side effects and you’re pleased with the results, you have no reason to quit.
Generic for Rogaine®, this FDA-approved over-the-counter version of topical minoxidil is used for regrowth on the crown of the head.
This is the FDA-approved dynamic duo. When used together, men saw better results in clinical trials compared to using either alone.
If you’re looking for something effective but don’t want too many steps in your routine, this once-a-day pill could be right for you.
Clinically proven to regrow hair in 3-6 months, no pills required.
Hair loss is a common issue that affects many guys during their 20s, 30s and 40s.
The sooner you catch it by identifying the signs of baldness, the better equipped you will be to protect your hair and stop your hair loss from getting worse.
As we mentioned above, finasteride and minoxidil are currently the most effective medications for treating and preventing hair loss.
You can purchase both of these medications online in our Hair Power Pack, following a private consultation with a healthcare provider who will determine if a prescription is appropriate.