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What is finasteride?
Finasteride is a prescription treatment that blocks the enzyme 5-alpha reductase type II. 5-alpha reductase turns testosterone into dihydrotestosterone (DHT).
Why is finasteride part of my treatment plan?
Your genetics indicate that your steroid-reductase type II activity is high. This will lead to increased levels of DHT, which impairs hair growth.
Are topical and oral finasteride effective for alopecia?
Oral finasteride is FDA-approved to treat androgenic alopecia. Finasteride has proven to be effective in increasing hair counts and density compared to placebo. The placebo treatment arms had worsened hair loss. Patients in trials reported improved appearance of their hair as well.1,2
Why does Nimbus use low doses of oral finasteride?
Oral finasteride has the potential to cause significant side effects. By lowering systemic levels of DHT, you reduce the level of the most potent forms of testosterone. Unfortunately, this can lead to decreased libido, erectile dysfunction, adverse sexual experiences, nipple discharge, prostate cancer, and male breast cancer. Finasteride is also associated with changes in mental health, such as depression, anxiety, and brain fog. Side effects usually resolve after medication discontinuation but may persist in rare cases. Stop taking finasteride immediately and contact your physician if you experience any of these side effects.
Finasteride is category X in pregnancy as it causes birth defects in a male fetus. The use of finasteride in pregnancy-eligible women is contraindicated unless reliable forms of contraception are used in conjunction. The risk of adverse effects can be lessened by using topical finasteride.2 One study compared topical finasteride 1% with 1 mg finasteride tablets and found no difference in the therapeutic effect.3 We believe in using low doses of oral finasteride to reduce the likelihood of systemic side effects that can occur. Topical therapy is our preferred choice, given the improved safety profile.
Are there any adverse effects while using topical finasteride?
Topical finasteride is well tolerated. Redness and irritation have been reported at the application site.2 Other rare adverse events include low blood pressure, breast tenderness/enlargement, high-grade prostate cancer, allergic reactions, and leg swelling.4
Why do I need to keep taking finasteride?
Finasteride should be used once or twice a day as prescribed by your physician. Continuous use for four months is recommended before evaluating treatment response. Hair shedding may occur at the initiation of treatment as hair follicles are being stimulated to reenter the growth phase, but this frequently subsides within two months. Hair growth usually occurs within four to eight months and stabilizes over 12 to 18 months. Hair loss will occur over several months if treatment is stopped because of the nature of the hair growth cycle. Finasteride is not a cure for hair loss; it is a treatment.
Drug Summary: Finasteride
References
1) Kaufman KD, Olsen EA, Whiting D, et al. Finasteride in the treatment of men with androgenetic alopecia. Finasteride Male Pattern Hair Loss Study Group. J Am Acad Dermatol. 1998;39(4 Pt 1):578-589. doi:10.1016/s0190-9622(98)70007-6
2) Shapiro J, Kaufman KD. Use of finasteride in the treatment of men with androgenetic alopecia (male pattern hair loss). J Investig Dermatol Symp Proc. 2003;8(1):20-23. doi:10.1046/j.1523-1747.2003.12167.x
3) Caserini M, Radicioni M, Leuratti C, Terragni E, Iorizzo M, Palmieri R. Effects of a novel finasteride 0.25% topical solution on scalp and serum dihydrotestosterone in healthy men with androgenetic alopecia. Int J Clin Pharmacol Ther. 2016;54(1):19-27. doi:10.5414/CP202467
4) Hajheydari Z, Akbari J, Saeedi M, Shokoohi L. Comparing the therapeutic effects of finasteride gel and tablet in treatment of the androgenetic alopecia. Indian J Dermatol Venereol Leprol. 2009;75(1):47-51. doi:10.4103/0378-6323.45220