Finasteride (or Propecia) is an FDA-approved medication, employed in the treatment of androgen-related hair loss. It has proven to be effective, but users report heavy and unusual hair shedding, also referred to as finasteride shedding.
Various studies done over the years have continually proved the beneficial effects of this drug against hair loss, specifically in men [1].
Its use leads to an overall improvement in hair count and growth, while successfully deterring any further progression of alopecia.
Relevant reads on Finasteride:
- Finasteride Is Not Working: What To Do?
- Finasteride vs Minoxidil: Worth It?
- Finasteride: Before And After Results (With Pictures)
How does Finasteride work?
A hormone called DHT causes the dormancy of hair follicles in androgenic alopecia. Finasteride hinders the conversion of testosterone into DHT by inhibiting the enzyme, 5 alpha-reductase. It also accelerates the shift of hair follicles from the telogen or resting phase into anagen or growing phase [2]. This results in a rapid boost in hair growth and a setback of alopecia. Although in premenopausal women, the use of Finasteride is still considered controversial and lacks research [3].
Why does Finasteride cause hair shedding?
As mentioned above, our hair has to go through the sequential phases of anagen and telogen. Normally, the anagen phase takes around 3 to 8 years while the telogen phase is 2 to 3 months long [4]. When the telogen (resting) phase ends, the preceding hair falls out and makes space for new hair growth. In people suffering from alopecia, hair remains in the resting stage for longer. Finasteride induces growth in these dormant follicles that can prompt the old hair to start shedding quickly.
How long does Finasteride shedding last?
Hair shedding caused by Finasteride use usually appears 3 to 4 months into treatment. It can last from 2 to 4 weeks and can be a harrowing experience for people suffering from an already existing hair loss condition. It is important to be vigilant about the timeline of any acute hair shedding period and identify its connection with the use of antiandrogens. Contact your doctor immediately if the shedding continues for longer than expected.
Can Finasteride shedding be reduced or stopped?
Finasteride shedding can only be stopped by ceasing its use. Although, doing that would deprive a person of reaping the full benefits of this drug against alopecia. Acute hair shedding in the early stage is an indication that Finasteride is working, so it should not be discontinued.
What are the alternatives to Finasteride that doesn’t cause hair shedding?
Some treatments helpful in alopecia, that does not cause acute hair shedding, the most popular Finasteride alternatives are listed below:
- Herbal remedies (Caffeine, pumpkin seed oil, etc)
- Spironolactone
- Microneedling
- PRP (platelet-rich plasma therapy)
- Stem cell therapy
- Low-level laser light therapy
- Hair transplantation
Remember that Finasteride is an FDA-approved drug extensively studied for hair loss. Substituting it with other options to get the same benefits might not work and any such decision should be first discussed with a doctor.
If you want to, read the full list of all alternatives you can take instead of Finasteride.
Conclusion
Finasteride is an effective remedy for people combating alopecia. It can prompt acute hair shedding upon initial administration, which can be frustrating and seems counterintuitive, but resolves on its own. It is important to keep in mind that increased growth can be observed in around six months to a year with patience and continued use of this drug.
However, it is advised to contact a specialist in case of sustained or unexplainable hair shedding.
References
- Shapiro J, Kaufman KD (2003) Use of finasteride in the treatment of men with androgenetic alopecia (male pattern hair loss). J Investig Dermatol Symp Proc 8:20–23
- Van Neste D, Fuh V, Sanchez-Pedreno P, et al (2000) Finasteride increases anagen hair in men with androgenetic alopecia. Br J Dermatol 143:804–810
- Iorizzo M, Vincenzi C, Voudouris S, Piraccini BM, Tosti A (2006) Finasteride treatment of female pattern hair loss. Arch Dermatol 142:298–302
- Malkud S (2015) Telogen Effluvium: A Review. J Clin Diagn Res 9:WE01–3
