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Propecia (finasteride) Review

Bottom Line

According to clinical studies, doctor-prescribed Propecia is more effective at growing hair back than minoxidil, and it works for most men. It's not approved for women and can cause serious birth defects for pregnant women who even handle the tablet. A small percentage of users suffer sexual side effects, but those disappear if Propecia is discontinued. Propecia must be taken daily, and it can take up to a year for results to take effect.

Performance

Pros

  • Stops progression of hair loss for most men
  • Sold in tablet form -- no messy application

Cons

  • Treatment must be continued for rest of patient's life
  • Risk of sexual side effects for men
  • Not approved for women
  • Requires prescription
Our Analysis
Specs
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Side effects

Side effects go away with discontinued use. Experts warn that a small percentage of men will experience sexual side effects, namely loss of libido, but suggest that all side effects disappear completely when treatment is discontinued. Propecia is not safe for women who are or may become pregnant, as even handling the tablets can result in serious birth defects. The 5 percent concentration of the drug isn't FDA approved for women, but a 2013 study published in the International Journal of Trichology found it to be a safe and effective solution for hair loss in postmenopausal women.

Our Sources

A. Rossi et al., 2011

This study assesses the efficacy of a 1 mg daily dose of finasteride among male AGA patients over a 10-year period. Most patients improved or maintained hair growth they achieved in the first year of treatment. Twenty-one percent of the patients achieved better results after continuing treatment for five years.

R. Oliveira Soares et al., January 2013

This study probes the efficacy of finasteride treatment for postmenopausal women with female pattern androgenetic alopecia (AGA). (Finasteride has not earned FDA approval for treatment of women.) The researchers concluded that a dosage of 5 mg per day is "effective and safe for the treatment of female AGA in postmenopausal women in the absence of clinical or laboratory signs of hyper-androgenism."

A. Sato et al., January 2012

This study, which tested the safety and efficacy of a daily dose of finasteride among Japanese men with AGA, enrolled 3,177 subjects for three years. Researchers observed hair regrowth in 87 percent of patients, with improving response rates as the duration of treatment increased.

E. Arca et al., 2004

This study compares 5 percent minoxidil (the active ingredient in Rogaine), applied twice daily, to one daily dose of 1 mg oral finasteride (the active ingredient in Propecia). Results show that finasteride is superior to minoxidil and produces better hair growth over a 12-month period.

E.A. Olsen et al., December 2006

The study reported in this journal shows dutasteride to be more effective than finasteride at regrowing hair in men with androgenetic alopecia. Dutasteride, the active ingredient in Avodart, has not yet been approved by the FDA for treatment of AGA.

Editors of American Hair Loss Association, Not Dated

The American Hair Loss Association discusses the discovery of finasteride, the active ingredient in Propecia, as an effective treatment for hair loss. The report explains how treatment works and suggests Propecia as a first line of defense for treating male-pattern baldness.

Holly C. Corbett, Not Dated

Frederick Joyce, M.D., founder of Rejuvenate! Med Spa and member of the International Society for Hair Restoration Surgery, recommends Propecia for men looking for a reliable, FDA-approved solution to hair loss, but he warns that the drug is "a lifetime commitment." Joyce says, "Once you stop using Propecia, any hair loss that you would have had if you weren't taking the medication will happen within three to eight months."

Contributors to Drugs.com, As of March 2014

About 8 reviewers who have AGA give finasteride a combined score of 7.9 out of 10. Ten other reviewers used the drug to treat benign prostatic hyperplasia, bringing its overall score down to 5.8 out of 10. Most of the responses are positive, although two reviewers say they have experienced a decrease in sex drive.

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