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Rob (PHH)

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Finasteride is one of two FDA-approved treatments for hair loss, and comes under a class of drugs called type 2 5α-reductase inhibitors. These drugs inhibit the enzyme type 2 5α-reductase which catalyzes the conversion of testosterone to dihydrotestosterone. The overactivity of this enzyme causes an increase in dihydrotestosterone which is associated with the emergence of androgenetic alopecia. Finasteride is probably the most well-studied hair loss treatment, and comes in both oral and topical forms, although only the oral form is FDA-approved. 

Key insights:

  • The in vitro evidence shows that finasteride is an effective 5α-reductase inhibitor which is beneficial for people with male pattern baldness.
  • The in vivo evidence shows that oral finasteride administered at 0.5 or 2 mg/day alone or in combination with topical minoxidil can produce a similar reduction in serum dihydrotestosterone (DHT) in adult male stump tail macaques.
  • 1mg/day of oral finasteride has been found to be an effective dose in male pattern hair loss, with men showing a 68.4% reduction in serum DHT levels after one year. Furthermore, treating men with androgenetic alopecia with 0.2 – 5 mg/day of finasteride for 4-6 weeks can reduce DHT levels by up to 65% in the scalp. 
  • Some people may experience sexual side effects from taking finasteride, so it is important to consult your doctor to potentially change the dose if you start to experience these.
  • Finasteride is an easy-to-use product with high rates of success, and as such, may be a good choice for some hair loss sufferers.
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