Efficiency of finasteride for long term

[SoSoz]

If a person starts finasteride at 25 and is nw3. After 10 years of finasteride, will the person be still nw3, or he will be still progressing to nw4/5 but more slowly? 

Edited September 1, 2022 by SoSoz

[GoliGoliGoli]

I think the best answer is that mileage will vary person to person. Some people will slow their hair loss a little bit, some people will slow their hair down a lot. I don't think anyone claims it will completely halt their hair loss though. 

[NARMAK]

1 hour ago, SoSoz said:

If a person starts finasteride at 25 and is nw3. After 10 years of finasteride, will the person be still nw3, or he will be still progressing to nw4/5 but more slowly? 

The problem with this is as posted above, everybody is generally different and genetically you may have hit Norwood 3 and got on Finasteride and end up in a situation like @MazABhas and don't progress because of you having positive response to medication despite having a family history headed towards Norwood 6/7. However, if the genetics are such that DHT affects your follicles enough, even blocking it with Dutasteride and higher dosages won't stop it.

Bottom line is that it's worth a try imo. A common misconception is that Finasteride stops working. Actually, it doesn't. The 10 year Japanese long term study showed it continue to work and improve the situation of people who were responding to the medication positively. What actually happens is your hair loss progresses past the rate that Finasteride was able to hold off the loss for when people typically say they're "Losing ground on Finasteride" and that's why we see them switch to Dutasteride to block more DHT. 

[LookMaxx]

Your hairs aren’t bacteria that get resistant to finasteride so yes fin will work until you die

[Al - Moderator]

8 minutes ago, LookMaxx said:

yes fin will work until you die

This is not true. There have been plenty of cases, myself included, where finasteride worked the first few years and then hair started falling out again. Now perhaps you can claim that it's still working in that the hair is falling out slower than it would have without fin, but I think most people would consider it no longer working if their hair loss starts up again.

 

[LookMaxx]

32 minutes ago, BeHappy said:

This is not true. There have been plenty of cases, myself included, where finasteride worked the first few years and then hair started falling out again. Now perhaps you can claim that it's still working in that the hair is falling out slower than it would have without fin, but I think most people would consider it no longer working if their hair loss starts up again.

 

Did you lose a Norwood level? 

[Al - Moderator]

1 hour ago, LookMaxx said:

Did you lose a Norwood level? 

 I was a NW 7 when I started, but you are missing the point. You said hair isn't bacteria that gets resistant to finasteride. No. It's not getting resistant to finisteride. It's that the enemy genetic forces are eventually able to break though the finasteride wall.

Look at it like you're fighting an enemy army. You are on the follicle side and you are fighting DHT. If the DHT is only using bows and arrows then a finasteride wall can maybe hold off that DHT enemy for the rest of your life. But if the DHT enemy is using cannons, a finasteride wall can hold them back for a while, but eventually they will break though and kill all your follicles.

So basically if you have very aggressive hair loss you are probably going to lose no matter when you started. If you have mild loss you can hold off the loss a lot longer, maybe the rest of your life for some people.

Not everyone will be a NW 7 even at 100 years old while others are NW 7 before 30. Finasteride is going to have a much better effect on the ones who aren't headed to NW 7 too early in life.

 

 

Edited September 2, 2022 by BeHappy

[LookMaxx]

35 minutes ago, BeHappy said:

 I was a NW 7 when I started, but you are missing the point. You said hair isn't bacteria that gets resistant to finasteride. No. It's not getting resistant to finisteride. It's that the enemy genetic forces are eventually able to break though the finasteride wall.

Look at it like you're fighting an enemy army. You are on the follicle side and you are fighting DHT. If the DHT is only using bows and arrows then a finasteride wall can maybe hold off that DHT enemy for the rest of your life. But if the DHT enemy is using cannons, a finasteride wall can hold them back for a while, but eventually they will break though and kill all your follicles.

So basically if you have very aggressive hair loss you are probably going to lose no matter when you started. If you have mild loss you can hold off the loss a lot longer, maybe the rest of your life for some people.

Not everyone will be a NW 7 even at 100 years old while others are NW 7 before 30. Finasteride is going to have a much better effect on the ones who aren't headed to NW 7 too early in life.

 

 

Studies show fin works long term though as fas ahead as 10 years getting better every year 

https://pubmed.ncbi.nlm.nih.gov/11809594/#:~:text=Results%3A Treatment with finasteride led,identified during long-term use.
 

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

 

It makes perfect sense because levels of DHT drop as we age and hairs recover the damage they receive. 

I don’t know why people think fin will stop working, it’s thrown around as an established fact when it’s a clear lie. 

[Al - Moderator]

43 minutes ago, LookMaxx said:

Studies show fin works long term though as fas ahead as 10 years getting better every year

 

I think I mentioned somewhere else that there are a lot of issues I have with the 10 year study.

1. They are all Japanese men who generally lose hair very slowly throughout their adult life, usually in a diffuse type of pattern, so it should be easier for finasteride to maintain results for a longer time period than say White men simply because their hair loss is slower to begin with.

2. It doesn't say how old any of the men are or how long they have been losing hair. They only give an age range of 20 to 69, but there could be one 20 year old and everyone else over 30. We don't know. If all of the NW 3 and NW 4 men are 45 and up and have been losing hair for 20+ years (see #1 above) then that could make a significant difference if they were all under 30 and losing that much hair in only the last 5 years.

3. They don't give any idea of how much hair the men would have lost without being on finasteride. For example showing family history and rate of baldness.

4. The study claims that the cutoff is NW3 and past that more of the men began losing hair again after the first few years. That totally negates what you are trying to say about how it continues to work... and that is in the study. Put that with #1 and #2 and it is pretty much useless as proof that it continues to work.

5. Out of 532 men only 37 were NW 5, 6,7 while 332 were NW 1, 2, 3, 4, again indicating that there could be a large number of men who lose hair very slowly over a lot of years. I mean why even have NW 1s in the study unless you want to make the overall results look better?  These guys aren't even losing hair to begin with. Think about it. If you had few Brad Pitts and Tom Cruises in a study like this the past 10 years then of course you'd show good results.

6. The study was 10 years. While this is a decent length of time, it isn't the rest of your life for someone who starts on finasteride at 21. We still don't know if it will work the same for 30 years, so saying it will work for you forever when you only show a study for 10 years, isn't being honest.

7. This one is where I have a real issue. The rest is all OK, but just doesn't necessarily prove anything, but when they said there were no serious adverse reactions and that all 532 men continued in the study for the entire 10 years.... do you really believe that? Not one person out of 532 had to drop out for erection problems, depression, brain fog, etc? NOT ONE?

 

 

 

[Al - Moderator]

1 hour ago, LookMaxx said:

I don’t know why people think fin will stop working, it’s thrown around as an established fact when it’s a clear lie.

 

So I'm lying when I say it worked the first few years and I think I may have grown back a bit of hair, but then after around the 3 or 4 year mark I started losing hair again? I was on finsasteride for 11 years. I stopped because I was losing hair anyway. I've seen other people on this forum write similar things. What makes you sure we must be liars?

 

[Mike10]

The truth is most men will continue to lose ground on Fin in the long term, albeit slowly. For some (around 10 %) Fin will not work at all and for some others (mostly men with aggressive MPB) Fin will stop working. 

[LookMaxx]

3 hours ago, BeHappy said:

 

So I'm lying when I say it worked the first few years and I think I may have grown back a bit of hair, but then after around the 3 or 4 year mark I started losing hair again? I was on finsasteride for 11 years. I stopped because I was losing hair anyway. I've seen other people on this forum write similar things. What makes you sure we must be liars?

 

It wasn’t directed at you, just generally. My bad

[NARMAK]

8 hours ago, BeHappy said:

This is not true. There have been plenty of cases, myself included, where finasteride worked the first few years and then hair started falling out again. Now perhaps you can claim that it's still working in that the hair is falling out slower than it would have without fin, but I think most people would consider it no longer working if their hair loss starts up again.

 

Just to clarify this a bit, Finasteride doesn't lose efficacy and i refer you to my post near the start. It's just that hair loss is progressive and Finasteride is more like a dam trying to hold water back. Eventually more and more water (hair loss) will happen if the water is stronger than what the dam can hold back. That's why people find success switching to Dutasteride which is the equivalent of reinforcing the dam. 

Overall though, Finasteride or Dutasteride is all about slowing hair loss, only a very few lucky people aren't affected by hair loss progressing at a noticeable rate once on it. 

[Rahal Hair Transplant]

SoSoz,

The truth is, everybody responds differently to finasteride. So to attempt to predict how long finasteride will work for an individual is essentially impossible. Assuming you’re a good responder to the medication, it should last for quite some time and possibly as long as you continue taking it. That said, I don’t believe it’s going to stop hair loss completely but it will likely slow it down so much that it will likely take many, many years (possibly even decades) for you to lose some of the hair that you would have lost quickly otherwise. 

Now, I’ve spoken to many hair restoration physicians about this very topic but it’s been years since I’ve had this discussion.  The truth is, I don’t know at this point if there are long-term studies on finasteride to truly answer this question with certainty.  I will however, speak with Dr. Rahal to garner his opinion on this and see if there are any recent studies that I haven’t seen yet regarding long-term use of finasteride, its efficacy and potential long-term side effects.

Best wishes,

Rahal Hair Transplant