Below are the most frequently asked questions about finasteride for hair loss, answered with data from clinical trials and the current medical literature.
General Questions
What is finasteride and how does it work?
Finasteride is an oral prescription medication that blocks the enzyme 5-alpha reductase type II. This enzyme converts testosterone into dihydrotestosterone (DHT), the hormone responsible for miniaturizing hair follicles in men with androgenetic alopecia. By reducing scalp DHT levels by approximately 70%, finasteride slows and often reverses the miniaturization process.
What is the standard dosage?
The FDA-approved dose for hair loss is 1mg daily, taken orally. The drug is available as brand-name Propecia or as a generic. Some physicians prescribe 5mg tablets (Proscar, approved for prostate) to be split into quarters as a cost-saving measure.
Does it work for everyone?
No. Finasteride halts further loss in 80-90% of men and produces regrowth in roughly 65%. Approximately 10-15% of men see minimal benefit. It only works for androgenetic alopecia (male pattern baldness) and is not effective for alopecia areata, telogen effluvium, or other non-DHT-related hair loss types.
Results and Timeline
When will I see results?
Reduced shedding is typically the first sign, occurring within 1 to 3 months. Visible hair thickening and regrowth appear between months 6 and 12. Full results require 12 to 18 months of continuous daily use.
What happens if I stop taking finasteride?
Hair loss resumes. Without the DHT-blocking effect, follicle miniaturization restarts. Most men who discontinue finasteride return to their pre-treatment hair loss trajectory within 6 to 12 months. Any regrowth gained will gradually be lost.
Does finasteride work better at certain Norwood stages?
Yes. Men at earlier stages respond better because more follicles are still viable:
| Norwood Stage | Grafts Equivalent | Expected Response |
|---|---|---|
| N2 | 800-1,500 | Excellent: high regrowth potential |
| N3 | 1,500-2,200 | Very good: strong stabilization + regrowth |
| N4 | 2,500-3,500 | Good: stabilization with moderate regrowth |
| N5 | 3,000-4,500 | Moderate: primarily stabilization |
| N6-N7 | 4,000-7,500 | Limited: transplant likely needed alongside |
Side Effects and Safety
What are the side effects?
Sexual side effects occur in 2-4% of users. These include decreased libido, erectile difficulty, and reduced ejaculate volume. In clinical trials, these effects were reversible upon discontinuation in all participants.
Are side effects permanent?
In controlled clinical trials, all sexual side effects resolved after stopping finasteride. Reports of persistent effects exist in medical literature, but no controlled study has established a permanent causal link. Discuss any concerns with your prescribing physician.
Can women take finasteride?
Finasteride is not FDA-approved for women. Women who are or may become pregnant must not handle crushed or broken finasteride tablets due to the risk of birth defects in male fetuses. Some dermatologists prescribe finasteride off-label for postmenopausal women, but this is a specialized decision requiring careful medical evaluation.
Combining with Other Treatments
Can I use finasteride with minoxidil?
Yes. This is the most recommended combination. Finasteride blocks DHT (80-90% halt loss) while minoxidil stimulates growth through vasodilation (40-60% regrowth). They work through different mechanisms and do not interfere with each other.
What about finasteride and PRP?
Finasteride and PRP ($500-$2,000 per session) complement each other well. Finasteride reduces the hormonal driver of loss while PRP delivers concentrated growth factors to follicles, increasing density by 30-40% in clinical studies.
Should I take finasteride before a hair transplant?
Most surgeons recommend starting finasteride 6 to 12 months before a transplant. This stabilizes ongoing loss, establishes your true baseline, and may reduce the number of grafts needed. After FUE surgery (7-10 day recovery, 90-95% graft survival), continuing finasteride protects the native hair surrounding your transplanted grafts.
Cost and Access
How much does finasteride cost?
Generic finasteride 1mg costs $5 to $30 per month. Brand-name Propecia runs $60 to $90 monthly. Most insurance plans do not cover finasteride for hair loss, but prescription discount programs like GoodRx can significantly reduce out-of-pocket costs.
Do I need a prescription?
Yes. Finasteride is a prescription-only medication in the United States and most countries. You can obtain a prescription from a dermatologist, primary care physician, or licensed telehealth provider.
Determine your treatment starting point. Use the free AI assessment at myhairline.ai/analyze to identify your Norwood stage and understand which treatments apply to your situation.
Medical disclaimer: This article is for informational purposes only. Finasteride is a prescription medication. Consult a licensed healthcare provider before starting any hair loss treatment.