Taking finasteride correctly is straightforward: 1mg once daily, every day, for as long as you want to maintain results. But the details matter. Missed doses, incorrect expectations, and poor progress tracking are the most common reasons men abandon finasteride before it has time to work.
Step 1: Get the Right Prescription
Finasteride for hair loss is available in two forms:
- Finasteride 1mg (brand: Propecia, or generic): The FDA-approved hair loss dosage
- Finasteride 5mg (brand: Proscar, or generic): Approved for BPH, sometimes prescribed off-label and split into quarters for cost savings
Your prescribing physician will determine which is appropriate. For most men, generic finasteride 1mg is the standard starting point. The 5mg split-tablet approach can reduce monthly costs from $5-$30 down to $4-$15, though dosing is less precise.
Where to Get a Prescription
- Dermatologist: Ideal for a comprehensive hair loss evaluation and diagnosis confirmation
- Primary care physician: Can prescribe after reviewing your history
- Licensed telehealth provider: Convenient for straightforward cases; many offer combined consultation and medication delivery
Step 2: Establish Your Dosing Routine
Dosage
Take one 1mg tablet daily. This is the only dosage studied and approved for hair loss.
Timing
There is no medically superior time of day. Choose a time that fits your existing routine. Many men take it:
- With breakfast
- At bedtime
- Alongside another daily medication
The key is consistency. Taking finasteride at roughly the same time each day maintains steady DHT suppression.
With or Without Food
Finasteride can be taken with or without food. Absorption is not significantly affected by meals.
What If You Miss a Dose?
If you miss a single dose, take the next dose at your regular time. Do not double up. Finasteride's DHT-blocking effect does not disappear from one missed dose because the enzyme inhibition builds up over time. However, frequent missed doses will reduce efficacy. If you miss more than 3 days per week regularly, the drug will not perform as clinical trials demonstrated.
Step 3: Understand the Timeline
Setting correct expectations prevents premature discontinuation. Here is what the clinical evidence shows:
| Period | What to Expect |
|---|---|
| Weeks 1-4 | No visible change. Drug is building up in your system. |
| Months 1-3 | Possible increased shedding (normal). Weak, miniaturized hairs fall out as the growth cycle resets. Shedding slows by month 3. |
| Months 3-6 | Reduced daily hair fall. Some men notice early thickening. |
| Months 6-12 | Visible improvement in density for most responders. Hair appears thicker and covers more scalp. |
| Months 12-18 | Maximum results. Clinical trials measure peak efficacy at this point. |
| Year 2+ | Maintained results. 80-90% of men continue to hold their gains. |
The initial shedding phase (months 1-3) causes some men to panic and stop treatment. This shedding is a sign the drug is working. Weak, miniaturized hairs are being replaced by stronger ones. Pushing through this phase is essential.
Step 4: Track Your Progress
Subjective assessment is unreliable. You look at your hair every day and small changes are invisible to your own eyes. Use objective tracking instead.
Photo Documentation Protocol
Take standardized photos every 4 weeks using these guidelines:
- Same lighting: Natural daylight or a consistent artificial light source. Overhead bathroom lighting is acceptable if you use the same fixture every time.
- Same angles: Front (hairline straight-on), top (camera directly above), crown (use a second mirror or phone timer), and both temples.
- Dry hair: Wet hair looks thinner. Always photograph dry hair in the same state (unstyled).
- Same distance: Mark a position on the floor or use the same mirror distance.
Hair Count Method
For a more objective measure, count the hairs in your sink, shower drain, or on your pillow over a 7-day period once per month. Track the weekly total. You should see this number decrease over the first 6 months.
Norwood Stage Check
Reassess your Norwood stage every 6 months using the free AI tool at myhairline.ai/analyze. This provides an objective comparison of your pattern over time.
Step 5: Manage Side Effects If They Occur
Sexual side effects (decreased libido, erectile difficulty, reduced ejaculate volume) occur in 2-4% of finasteride users. If you experience them:
- Continue for 2-4 weeks if effects are mild. Some men report that side effects diminish as the body adjusts.
- Contact your prescribing physician if effects persist or are bothersome. Your doctor may recommend:
- Reducing frequency to every other day (off-label adjustment)
- Switching to topical finasteride (lower systemic absorption)
- Discontinuing and switching to an alternative treatment
- Do not adjust the dose on your own. Cutting to 0.5mg or taking every other day without medical guidance may reduce efficacy without reliably eliminating side effects.
Side effects resolve upon discontinuation. Finasteride has a half-life of 5-6 hours and clears the system within 1-2 weeks.
Step 6: Know When Finasteride Alone Is Not Enough
Finasteride is most effective at Norwood stages 2 through 4. At these stages:
- N2 (800-1,500 grafts equivalent): Finasteride alone frequently sufficient
- N3 (1,500-2,200 grafts): Finasteride often sufficient, adding minoxidil improves results
- N4 (2,500-3,500 grafts): Combination therapy recommended; transplant may be needed for restoration
At Norwood 5 through 7 (3,000-7,500 grafts), finasteride serves as a maintenance tool alongside surgical restoration. A hair transplant (FUE recovery: 7-10 days, 90-95% graft survival) restores density in areas where follicles are beyond medication's reach, while finasteride protects the remaining native hair.
Common Mistakes to Avoid
| Mistake | Why It Matters |
|---|---|
| Stopping during initial shed (months 1-3) | Shedding is normal; quitting prevents seeing the regrowth phase |
| Inconsistent dosing | Irregular use reduces DHT suppression below therapeutic levels |
| No progress tracking | Without photos, you cannot objectively assess whether the drug is working |
| Expecting immediate results | Clinical results take 6-12 months; patience is required |
| Not telling your doctor about side effects | Adjustments exist; suffering silently or quitting are not the only options |
| Ignoring advanced stage needs | Finasteride alone at N5+ sets unrealistic expectations |
Start with Your Baseline
Effective finasteride use starts with knowing your current Norwood stage. Your stage determines whether finasteride alone is likely sufficient or whether you should plan for combination therapy from the start. Get your free assessment at myhairline.ai/analyze.
Medical disclaimer: This article is for informational purposes only. Finasteride is a prescription medication. Consult a licensed healthcare provider before starting, adjusting, or discontinuing any hair loss treatment.