A drug famous for stopping hair loss, Finasteride has its pros and cons. Despite being considered the gold standard in the treatment of male androgenetic alopecia, its list of side effects can be discouraging. Learn more about this medicine and alternative treatments.
Although countless products promise to fight baldness, the top drug and food regulatory body in the United States, the FDA (Food and Drug Administration), approves only three treatments for hair loss that can be safely performed at home: topical use of minoxidil, photobiomodulation (or LEDtherapy and LLLT – Low Level Light Therapy) and the popular Finasteride (oral medication).
This medicine is the most famous method to stop hair loss and, according to trichologist Dr. Mabe Gouveia, a member of the International Dermatoscopy Society, is considered the gold standard in the treatment of male androgenetic alopecia, especially from 18 to 35 years old. Despite this, always remember: every treatment for hair loss should start with a visit to a dermatologist or trichologist (Dermatology area that specializes in hair). As we will see below, Finasteride may not be indicated in many situations and its side effects are extensive.
What is the action of Finasteride?
First of all, it is necessary to understand basically why hair loss occurs. According to dermatologist Dr. Claudia Marçal, a member of the Brazilian Society of Dermatology, androgenetic alopecia is the result of the stimulation of hair follicles by male hormones that start to be produced in adolescence (testosterone). “When it reaches the scalp of patients with a genetic tendency to baldness, testosterone undergoes the action of an enzyme, 5-alpha-reductase, and is transformed into dihydrotestosterone (DHT). It is DHT that will act on the hair follicles promoting its progressive decrease with each hair growth cycle, which will become smaller and thinner, until baldness ”, he says.
Finasteride is a medicine designed to inhibit hair loss and recover some areas that have already suffered rarefaction (emptying of threads). “It has a mechanism of action to decrease the action of the enzyme 5-alpha-reductase (which is responsible for converting the hormone testosterone into dihydrotestosterone or DHT) and through its blocking or reduction of action, this conversion does not occur, which it is the main cause of male pattern hair loss ”, says the tricologist. “Finasteride lowers DHT levels and, in this way, helps to reverse the baldness process, leading to increased hair growth and the prevention of additional hair loss”, adds Dr. Mabe Gouveia.
Despite being a medication, Finasteride can be purchased without a prescription. But this is definitely not a good deal, since hair loss can be caused by other factors, such as Vitamin D deficiency or iron deficiency anemia, for example; in addition, there is an extensive list of adverse effects, which should be discussed in the doctor-patient relationship.
Does Finasteride have side effects?
Yes and there are many, although rare. According to Dr. Mabe Gouveia, the side effects are: decreased libido, erectile dysfunction, decreased ejaculate volume, pain in the testicles, increased breast sensitivity, gynecomastia (increased breast growth), lip edema, skin rashes , depression, memory loss, decreased muscle mass and anxiety. According to the drug’s own package insert, a small number of men (occurring among less than 10% of patients using this drug) may feel less desire to have sex and / or difficulty in obtaining an erection. “An even smaller number (between 0.1% and 1% of patients using this medication) may have a reduction in the amount of semen released during sexual intercourse (this does not seem to interfere with normal sexual function).
Although there is no way to prevent these adverse effects, especially in relation to the loss of libido, the trichologist says that the doctor should request a spermogram and total and free PSA before starting the medication, just for control.
Can women use Finasteride?
Weird that the post so far only talks about “male androgenetics” and adverse effects related to men? Well, this medicine is contraindicated for women. “Finasteride should not be used in women in a fertile period, as there is a risk of fetal malformation and ambiguous genitalia”, says the tricologist. In addition, pregnant women or women who wish to become pregnant should suspend contact with the drug, that is, it is not indicated to handle the drug or have sex with men who consume it.
The contraindication information for women and children is even included in the package insert. “But there is an off-label use for postmenopausal women, although the results for them are not as encouraging as in men,” says Dr. Mabe.
According to a study published in January 2018 in the International Journal of Trichology, female doses should be higher (5mg / day while men use 1mg / day) and one in five pre-menopausal patients who used the medication had side effects three months after the start of Finasteride, among them: reduced libido, mastalgia (pain in the breasts) and hirsutism (increased amount of hair in women in places common to men).
Should I use Finasteride?
Although it is a medication used for many years to fight baldness, many people have sought other treatment methods in conversation with doctors. And one of the most successful alternative methods for the treatment of hair loss is LEDtherapy or LLLT (Low Level Light Therapy), a low intensity LED light, which can be used alone, together with Finasteride and / or Minoxidil or other treatments. And the best: at home.
Equipment like the Capellux cap or the Capellux i9 helmet, in less than 15 minutes daily, help in the treatment of hair loss by emitting red light, which provides energy to the cells – which directly contributes to the nutrition and health of the follicles, stimulating hair growth. This 660 nanometer red light provides energy, as the cell structure located in the membranes of the mitochondria (lungs of cells) is stimulated to produce more ATP (energy). “With more energy and nutrients, the cells operate in optimized conditions in the performance of their functions, which promotes an increase in the quantity and volume of the wires, which also become thicker”, explains dermatologist Dr. Jardis Volpe, a member of the Brazilian Society Dermatology. The procedure is comfortable and there is no heating of the skin.
If you suffer from hair loss, see a doctor: the sooner you do this, the better the results will be.