Finasteride Is Not Working: What To Do?
Written by
Morgan German
Medically approved by
Dr. Andrea Ortega M.D.

Finasteride is not working for you! You thought that this drug will help you get rid of hair loss! Find out what you can do to support Finasteride or what other options do you have?

Finasteride was a medication initially indicated for benign prostatic hyperplasia through inhibition of the enzyme alpha-5-reductase, the main testosterone converter. It was discovered that it could also be helpful in hair loss by inhibiting testosterone transformation into dihydrotestosterone (DHT).

Since then, Finasteride has been a cornerstone in treating male pattern hair loss (androgenic alopecia) with many positive clinical outcomes. But does it work in all cases? Let's find out.

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What is Finasteride?

DHT is a metabolite of testosterone that, like any hormone, acts in many parts of the body, including hair follicles. It easily attaches to the hair follicle and reduces its size and growth when levels exceed, causing androgenic-induced baldness.

Finasteride is a type II inhibitor of the 5-alpha-reductase enzyme, which converts testosterone into DHT. It acts by inhibiting this conversion, preventing high levels of DHT and, therefore, complete hair growth cessation.

When DHT levels remain high for a long time, the scalp hairs become thinner and fall out, decreasing hair volume. The opposite happens in the body; the beard increases, and body hair grows due to DHT stimulation. This is called male pattern hair loss.

Male pattern hair loss is related to your genes and male sex hormones. It's thought to be caused by genes passed down in families that make you more or less prone to baldness. We speak of a pattern because it is the same for all men: more visible crown, fading hairline, losing more hair every day, or your usual hairstyle ''does not fit you anymore''.

The fading hairline is probably the most common sign you should look out for to know if you're going bald but usually the hardest to notice at the beginning. The other notable sign is when the crown becomes more visible.  

Once you feel that your hair has thinned a lot, that your crown is more visible than ever before or that you need a ''new hairstyle'', all because of the shedding hair, you probably need hair loss treatment with Finasteride, one of the most effective of all.

Finasteride as the leading treatment for male hair loss

male pattern hair loss due to finasteride not working

Finasteride is one of the best-known pharmacological treatments to stop hair loss. It is an anti-androgenic drug from non-hormonal steroids that prevents DHT production

In people genetically predisposed to alopecia, the follicles are reduced in size due to testosterone. With this miniaturization, the hair becomes thinner and shorter by speeding up its growth cycle until it finally disappears. When Finasteride decrease DHT, hair turnover stops to returns its normal growth cycle.

Finasteride is currently approved by the FDA (Food and Drug Administration) for male androgenetic alopecia at a dose of 1 mg sold as Proscar® and Propecia®.

Studies confirm that it stops hair loss in at least 86% of men who take it. However, there is a percentage where it does not work or takes longer than usual.

Many wonder if it is possible to go bald while taking Finasteride, and the answer is yes. This is where you seek to take action. Although Finasteride is highly effective in stopping DHT and thus hair loss, it does not work the same way in everyone. All bodies are different, and not all men may respond in the same way to treatment.

Although this is possible, most men notice significant improvements within a few months of treatment.

How long does Finasteride take to work?

female worried about hair loss

It usually takes three to four months to see any benefit and may take up to a year to see maximum results. Side effects are few but can occur.

The medication acts immediately, but results become visible over time. This is one of the reasons why many men give up on the treatment before seeing results because it can take from months to a year to see results.

Check out our before and after Finasteride article here!

What causes Finasteride to stop working?

Finasteride is intended to be effective in all individuals. However, either branding issues, distribution of products falsely sold as Finasteride or non-compliance with the treatment regimen may cause it not to work, or cases of severe baldness where little or no hair remains.

The effectiveness of Finasteride in delaying or slowing hair loss is the same in all scalp areas as long as there is some hair in it. Besides human reason, not all people react in the same way to medication.

How to speed up and see finasteride results faster?

Remember that you should consult your physician as soon as possible if the finasteride therapeutic regimen prescribed is not working even after 6 months of treatment. 

There are things you can do that can increase the effectiveness of Finasteride.

Minoxidil

minoxidil

Minoxidil (commonly sold as Rogaine) is another anti-baldness drug but topically applied. It consists of a vasodilator that expands the blood vessels, allowing more nutrients to flow through the bloodstream, causing the hair follicle to be healthier and full of good ingredients.

Since Minoxidil boosts blood flow and Finasteride is taken orally daily, the former allows Finasteride to be distributed better and faster throughout the body and scalp, increasing its effect.

Minoxidil must be used once or twice a day on dry hair to allow the liquid to act more deeply on the scalp.

How does Finasteride get stronger with Minoxidil?

The effects are enhanced since both acts in different ways but with the same purpose: to stop hair loss. Finasteride modifies hormones and blocks baldness progression from inside, while Minoxidil acts outside by increasing blood flow.

Some 40% of men experience hair regrowth when using Minoxidil, and studies state that using the two together is more effective in fighting hair loss than one alone.

It is critical to use both constantly; if you discontinue, you will likely reverse hair growth, and male pattern hair loss will continue.

What to pick between Finasteride and Minoxidil?

We understand that sometimes both aren't an option - therefore, we made this guide comparing Finasteride vs. Minoxidil.

Low-level laser therapy (LLLT)

doctor

Low-level laser therapy is a safe form of light/heat treatment for various health conditions. It consists of an innovative treatment method. A low-intensity laser is applied to the scalp for 15 - 30 minutes to stimulate the follicular cells and the blood microcirculation that nourishes them.

This circulation allows a better arrival of nutrients and oxygen to the hair follicle.

What are the benefits of low-level laser therapy?

  • Increased scalp hair thickness
  • Prevents hair loss 
  • Stimulates new hair growth
  • Increases hair density
  • Prevents cellular aging
  • Eliminates oily dandruff and toxins

When combined with Finasteride, it dramatically improves the drug's performance because it also stimulates the whole pilosebaceous unit.

Vitamin D

vitamin D sunlight

Supplementing your nutrition with low vitamin D levels can relieve hair loss patterns. It is a star in stress processes, as happens in the telogen effluvium that following hair loss.

Vitamin D is taken naturally from the sun and some foods such as eggs and milk. However, not all people metabolize it the same way, and many have some vitamin D deficiency without even knowing it.

If your hair has thinned quickly without any apparent cause, you likely need daily vitamin D supplementation.

Saw palmetto

saw palmetto

The Saw palmetto extract or oil is rich in essential fatty acids, including lauric, myristic and oleic acids, and phytosterols. You can further stimulate Finasteride effects with saw palmetto since beta-sitosterol and fatty acids also inhibit the alpha-5-reductase, both working at the same time with the same goal.

The recommended intake, according to experts, is 320mg/day.

Pumpkin seed

pumpkin seeds

Recent studies show that a supplement containing pumpkin seed oil can work with Finasteride and delay hair loss on its own. This is because pumpkin seed has, like saw palmetto, phytosterols and lipids that also inhibit alpha-5-reductase.

Pumpkin seed is a perfect alternative not only for when Finasteride does not work but also for other diseases. The recommended daily intake is 400 mg for about 24 weeks to see results.

Massage your scalp

scalp massager

Massage therapy has long been a beneficial technique for many conditions, including hair loss. 

Scalp massages relieve daily stress on the scalp, improve blood circulation, relax the muscles, and relieve anxiety. This gentle circular movement stimulates and strengthens hair growth while making it more flexible. 

In addition, massages not only improve circulation but also relieve headaches induced by muscle tension. It is not uncommon to have stressful days filled with stress, and your muscles clench tightly. When this happens, blood flow will also decrease, and headaches will occur.

Benefits of hair massage:

  • Dilate vessels and improve capillary blood flow
  • It helps alleviate headaches
  • Relieve stress (which is a factor in hair loss)
  • Prevents hair loss
  • Improves mood

Because of these benefits, scalp massagers like our Scalp Stimulating Massager are among the most frequently purchased product.

How to massage your scalp?

  1. Apply the product (such as our hair growth routine) as usual and distribute them throughout the scalp and/or hair.
  2. While holding the massager in your palm, gently press the silicone tips to the scalp with medium pressure and massage in a circular motion.
  3. Repeat on all areas of the scalp for a minimum of 4 minutes.

Conclusion

Finasteride is an excellent drug preventing, delaying and stopping hair loss, especially in men. There are many ways to speed up its action. However, you have to consider that each person reacts differently to the same medication, and there is a time interval between the initial treatment and the results.

When Finasteride does not work, some treatments act the same way and enhance its effect for better results. Such is the case of saw palmetto and pumpkin seed; both works in inhibiting the same enzyme that Finasteride inhibits.

If you still do not see results despite having tried these tips, then it is time to consult a healthcare provider.

Frequently Asked Questions

What's the difference between Finasteride and Propecia?

Well, it's only in the brand name, everything else is the exact same. You can see more detail in our comparson guide here.

Are there any alternatives to Finasteride?

There are many alternatives to Finasteride:

References

  1. Adil, A., & Godwin, M. (2017, July). The effectiveness of treatments for androgenetic alopecia: A systematic review and meta-analysis. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28396101
  2. Hugo Perez, B. S. (2004). Ketocazole as an adjunct to finasteride in the treatment of androgenetic alopecia in men. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/14729013
  3. American Hair Loss Association. (n.d.). Retrieved from https://www.americanhairloss.org/men_hair_loss/treatment.html
  4. Almohanna, H. M., Ahmed, A. A., Tsatalis, J. P., & Tosti, A. (2019, March). The Role of Vitamins and Minerals in Hair Loss: A Review. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380979/
  5. English, R. S., & Barazesh, J. M. (2019, March). Self-Assessments of Standardized Scalp Massages for Androgenic Alopecia: Survey Results. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/30671883
  6. Zgonc Škulj, A., Poljšak, N., Kočevar Glavač, N., & Kreft, S. (2020). Herbal preparations for the treatment of hair loss. Archives of Dermatological Research, 312(6), 395–406.
  7. Padois K, Cantiéni C, Bertholle V, Bardel C, Pirot F, Falson F. Solid lipid nanoparticles suspension versus commercial solutions for dermal delivery of minoxidil. Int J Pharm. 2011;416:300-304.
  8. Rossi, A., Mari, E., Scarno, M., Garelli, V., Maxia, C., Scali, E., Iorio, A., & Carlesimo, M. (2012). Comparitive effectiveness of finasteride vs Serenoa repens in male androgenetic alopecia: a two-year study. International Journal of Immunopathology and Pharmacology, 25(4), 1167–1173.