Finasteride Q+A

Summary

In Episode 17 of The Hair Loss Show, Dr. Vikram Jayaprakash and Dr. Russell Knudsen answer common questions about hair loss treatments. They discuss the optimal dosage of Finasteride, which can be as low as 0.5-1 mg three times a week, and its combination with Minoxidil for enhanced results. The doctors clarify that hair loss treatments don’t need to be expensive, and they emphasize the importance of minimal side effects with proper dosing. They also address the safety of Finasteride for men and the considerations for women, along with explaining that blood tests aren’t required before starting treatment.

Takeaways

• 😀 Finasteride is most effective at doses between 0.5mg and 1mg per day, with a recommended schedule of taking 1mg three times a week for better results and fewer side effects.
• 😀 Combining Finasteride (a DHT blocker) and Minoxidil (a hair stimulator) can provide superior results, as both complement each other in preventing hair loss and promoting growth.
• 😀 Generic versions of Finasteride are affordable and work just as effectively as branded versions, with no significant quality concerns in regulated markets like Australia.
• 😀 Finasteride is generally well tolerated, with very few patients experiencing side effects, and it works best when taken consistently and within the recommended dosing schedule.
• 😀 It is unnecessary to conduct blood tests for testosterone or DHT levels before starting Finasteride, as these levels don't determine the effectiveness of the treatment.
• 😀 Finasteride can sometimes regrow hair, but only if the hair follicles are still alive and not completely shriveled. It works best on thinning areas rather than areas with no hair.
• 😀 Finasteride is not safe for women who are pregnant or trying to conceive, but it is generally safe for men in these situations when they take precautions.
• 😀 For men planning to conceive, it is advised to stop taking Finasteride a month before trying to conceive, as it has a long-lasting effect in the system.
• 😀 Finasteride is not necessary for everyone, especially if someone isn't actively losing hair; it is more effective when used by those with noticeable male pattern baldness.
• 😀 The dosing schedule for Finasteride can vary from person to person, but regularity is important; a simple approach like taking it with a toothbrush can help ensure consistency.

Q & A

What is the optimal dose of Finasteride for hair loss?

The recommended dose of Finasteride is 1 mg per day. However, the most effective dose is between 0.6 to 0.7 mg. Taking a 1 mg tablet and cutting it in half can still provide good results. The optimal frequency for taking Finasteride is 3 times a week, with 1 mg per dose, which provides stability with minimal side effects.

Can Finasteride be taken every day, or is it better to reduce the frequency?

It is not necessary to take Finasteride every day. In fact, it stays in the system for about a month, so taking it 3 times a week (1 mg per dose) is just as effective. This schedule helps ensure minimal side effects while maintaining efficacy.

Can Finasteride and Minoxidil be used together for hair loss?

Yes, Finasteride and Minoxidil can be used together. Finasteride is a blocker that works systemically, while Minoxidil is a topical stimulant. Using both enhances results, as they work through different mechanisms. In practice, Finasteride is typically taken orally, while Minoxidil is applied topically.

Is it expensive to use Finasteride and Minoxidil together?

No, it's not expensive. Taking Finasteride 3 times a week costs around $5 in Australia, while using Minoxidil once a day costs around $1.50. When compounded, the combined cost for both medications is still affordable, usually around $5-6 a week.

Does taking Finasteride come with a financial benefit for the doctors prescribing it?

No, the doctors do not receive any financial benefit from prescribing Finasteride. They are not paid by the manufacturer, Merck, and do not have any vested interest in promoting it. The prescription is based purely on scientific evidence and patient need.

Do you need to take blood tests before starting Finasteride?

No, blood tests are not required before starting Finasteride. Measuring testosterone or DHT levels in the blood is not relevant because the medication works at the follicular level, blocking the conversion of testosterone into DHT, which is a local effect.

Can Finasteride regrow hair in areas where it has completely fallen out?

No, Finasteride cannot regrow hair in completely bald areas. It is effective in thickening existing hair, but once the hair follicle has completely miniaturized (more than 50% reduction in diameter), regrowth is not possible. It works best in areas of thinning hair rather than in fully bald spots.

Is Finasteride safe to use during pregnancy?

No, Finasteride is not recommended for use during pregnancy. It has not been tested in women of childbearing age. However, men can take it without concern during their partner's pregnancy. For women who are planning to conceive, it is advisable to stop taking Finasteride a few months before trying to conceive for peace of mind.

Does Finasteride have any side effects?

Finasteride can have side effects, but they are generally rare and mild. These may include sexual side effects such as reduced libido or erectile dysfunction, but these side effects are usually temporary and resolve once the medication is stopped. The dosing schedule recommended (3 times a week) helps minimize side effects.

Why does Finasteride work better for hair loss at the crown than at the hairline?

Finasteride tends to work better in the crown because the enzyme levels responsible for hair loss (DHT) are typically lower in the crown than at the hairline. People usually seek treatment after their hairline has significantly receded, making the crown area more responsive to treatment.