Advantages and Disadvantages of Finasteride

Overview of AGA and Finasteride

Androgenetic alopecia (AGA) is a common form of hair loss associated with inherited susceptibility and hair-follicle sensitivity to dihydrotestosterone (DHT).

Finasteride is a medication that blocks the action of an enzyme called 5-alpha-reductase. By doing so, it reduces the conversion of testosterone into dihydrotestosterone (DHT), a hormone linked to hair loss, leading to significantly lower DHT levels in the body.

Types of Finasteride

1-Oral Use

Finasteride is available in both 1 mg and 5 mg oral tablet forms, each prescribed for different medical purposes. When used for hair loss, it often takes 6 to 12 months of consistent treatment to see noticeable results.

2-Topical Finasteride

Topical finasteride is another formulation designed to treat AGA by delivering the active ingredient directly to the scalp, while aiming to reduce systemic absorption and potential side effects.

Advantages of Finasteride

1-Effectiveness in Reducing Hair Loss

Finasteride has been clinically shown to slow down and even reverse male pattern hair loss by lowering levels of DHT. Many patients notice reduced shedding and improved hair density with consistent use over several months.

2-A licensed treatment option

Oral finasteride 1 mg is FDA-approved for male pattern hair loss in the United States and is authorised in various European countries. Approval does not mean it is suitable for everyone or free of side effects.

3-Potential for Combination Therapy

Finasteride can be combined with other treatments, such as minoxidil for a more comprehensive approach to hair restoration.

Disadvantages of Finasteride

1-Sexual Side Effects

Finasteride can cause reduced sex drive, erectile difficulties or ejaculation problems. Some people have reported sexual symptoms continuing after treatment stops. Discuss any change with your prescriber so the benefits and risks can be assessed for you.

2-Hormonal Findings

Finasteride reduces the conversion of testosterone to DHT. Findings from laboratory or animal studies do not establish the same effects, or their frequency, in people. Your medical history matters when assessing individual treatment risks.

3-Mood Shifts

In its 2025 review, the European Medicines Agency confirmed suicidal thoughts as a side effect of finasteride 1 mg and 5 mg tablets, with frequency unknown. If you take 1 mg finasteride for hair loss and develop a depressed mood, depression or suicidal thoughts, stop taking it and seek medical advice. Seek urgent help if you may harm yourself. Mood changes during treatment and symptoms reported to persist after stopping are related concerns, but are not interchangeable terms.

4-Patient Considerations

Tell your prescriber about your medicines, medical conditions and any history of depression or suicidal thoughts. Starting or continuing finasteride should follow an individual assessment of its expected benefits and risks.

Conclusion

Finasteride is an option for managing androgenetic alopecia. It can help preserve existing hair, but continued treatment is usually needed to maintain its benefit. The decision to use it should account for both expected improvement and possible side effects.

Hair transplantation may be considered for suitable candidates who want to improve hair coverage. It does not stop ongoing loss of existing hair or automatically remove the need for medication. Donor supply, the pattern of hair loss and your expectations should guide the plan.