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Advice would be helpful - finasteride


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  • Regular Member

Hi all.

Finally took the plunge and started taking finasteride mid June. Started off by taking 0.25mg twice a week for a week, then went up to 0.25mg 4 times a week, then to 0.5mg 4 times a week and now taking 0.5mg Monday and Sunday and also 1mg Wednesday and Friday. I’m pretty sure I’ve gone through a shed as I’m quite below baseline when I look back at pictures from July. Temples have receded more, crown has thinned out and hair generally feels thinner all over. Only been taking 3mg a week for around 3/4 weeks now as I’ve read this can be enough of a dosage and minimise sides. Honestly thought I’d start seeing something positive by now but if anything my hair is the worst it’s ever been. Still shed around 5/6 hairs in the shower. Really My question is should I stick to 3mg a week or start taking more? Part of me feels like what’s the point. Built up the courage to take it and it’s just getting worse even quicker

Should probably add I’ve got NW3 hairline with crown thinning but I’m also diffusing all over.

Sorry for the long write up 

All advice is welcome. Thanks in advanced.

Edited by Ab93
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  • Senior Member

If you aren't experiencing sides, then you are lucky as it is the best defence available against hair loss progressing, and you should continue to persevere if you feel comfortable in doing so. Your strategy of upping the dosage incrementally is smart, and if you are ok side wise, you could consider upping it gradually to aim to reach 1mg per day. It can take as long as 12-24 months to start to see true results,
 

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3 months is nowhere near enough - I myself have been taking it for 2 years and have seen no real change; no sheds ever and no noticeable improvements, but I've got temple recession in a NW3ish pattern where the hair was too far gone in these areas with the rest of my scalp being absoltely fine, so it was to be expected. I am happy to just maintain and these were always my expectations, so I never felt 'what's the point'. 

Anyway, if you have experienced a shed, then this is a result of your hairs being pushed into a telgoen state and as such they will be dormant for the next 3 months or so. You're not going to see any difference for a while until they come back in. Check out the data from the 10 year Japanese study, where everyone NW4 and above essentially saw some improvement from baseline up until year 7 or so, with any noticeable difference only really being obvious after the first year (an MGPA score of +1 roughly).

https://www.oatext.com/Long-term-(10-year)-efficacy-of-finasteride-in-523-Japanese-men-with-androgenetic-alopecia.php

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  • Senior Member

The med is intended for retention.  Typically you start noticing this after a few weeks.  If you are going to experience enhancement - that takes about 1 year.  The intended dose is 1mg tab per day.  But since Merck lost the patent, Proscar is only available in 5mg by quartering you get about 1.25.  I say "about" since the tab is not pre-scored so this can vary.  Now Finasteride is also available in 1 mg.  So try to get that to avoid the hassle.

There is a difference between shedding and hair loss.  Most believe 100 hairs a day is the norm.  The follicle gets tired of producing hair so it takes a vacation, (dormant period). That hair will return.  Hair loss is different, you don't see it.

Under a bright light look at the hairs on your temporal areas.  Notice each strand. Some thick and some not so much.  Some you can't hardly see.  We refer to this process as miniaturization.  Eventually the hair withers and disappears. That's hair loss.  So, if you do experience enhancement, it is those very fine hairs that will start thickening.  Seems like regrowth - but it's not.  

Patient Consultant for Dr. Arocha at Arocha Hair Restoration. 

I am not a medical professional and my comments should not be taken as medical advice. All opinions and views shared are my own. 

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@LaserCaps

Thanks for the response. I am aware of the difference between hair loss and hair shedding. My main takeaway is the fact the my hair loss has gotten worse over the past three months when if anything i expected it to at least maintain. 

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You need to wait at least 6 months to a year before evaluating whether you feel your hair loss has slowed down or stabilized (a very subjective judgment call I know). Personally I would wait until two years. All you should be concerned about at this stage is the fact that so far you are not experiencing side effects which is great. I think starting off incrementally is the best way to start. All the best! 

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@Gatsby thanks for the response. I know waiting at least 6 months is the thing to do but when it’s thinned out more in 3 months whilst on fin than it did 3 months previous whilst not on fin it really doesn’t fill me with much hope.

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  • Senior Member
On 9/14/2021 at 11:25 AM, Ab93 said:

@LaserCaps

Thanks for the response. I am aware of the difference between hair loss and hair shedding. My main takeaway is the fact the my hair loss has gotten worse over the past three months when if anything i expected it to at least maintain. 

If it was worsened, despite the med, perhaps the med is just not doing anything for you.  Before putting the meds to rest and allow MPB to take over, you may want to look into adding other modalities to the mix.  Rogaine, PRP and laser.  Good luck.

Patient Consultant for Dr. Arocha at Arocha Hair Restoration. 

I am not a medical professional and my comments should not be taken as medical advice. All opinions and views shared are my own. 

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