Propecia (Finasteride)

Propecia, or finasteride, is an oral medication that has a very high success rate in stopping the progression of male pattern baldness. The medication works by decreasing the male hormone DHT (dihydrotestosterone), which causes a shortening of the hair growth cycle eventually leading to baldness in those who are genetically predisposed. DHT is different from testosterone, and the reduction in DHT is not associated with a reduction in testosterone.

Originally finasteride was approved by the FDA as a treatment for enlarged prostates, under the brand name Proscar. As men began taking Proscar they noticed hair growing on bald areas of their scalps. Test were done with various dosages, and in the late 90's the FDA approved 1mg/day doses of finasteride under the brand name Propecia.

Studies have shown that up to 90% of men taking Propecia are able to stop further hair loss, and near 50% are able to regrow hair previously lost. The earlier you begin taking Prpecia, the better it works, since hair loss will have occurred more recently and is more likely to be remedied. As with Rogaine, Propecia will only work as long as you continue to take it. If it's discontinued, you'll quickly lose hair as if you had never taken the medication. Also similar to Rogaine, you should expect to wait at least 6 months before noticing significant results.

Propecia is not FDA approved for women, and studies on women have had mixed results. This may be because hair loss in women typically follows a different progression.

The most common side effect of Propecia is sexual dysfunction including a decrease in desire and erectile dysfunction. However, these side effects were noted in only 2% of men, so the chances of occurrence are slim. Additionally, when men who noticed sexual side effects stopped taking Propecia, the side effects also ceased. A very small percentage of men also experienced breast enlargement and tenderness while taking Propecia, but no more than in the control group, therefore this is not considered a normal side effect.

Propecia/finasteride has been shown to be far more effective than Rogaine, but a combination of the two is the most effective way to treat male pattern baldness.