Using finasteride for hair loss

How Does Finasteride Work?

If you’re reading this post, you probably have some experience with hair loss. Whether it’s you, a family member or a loved one, you can see the sands of the hourglass slowly (or perhaps quickly) running out. And you’ve probably seen it all around you too – roughly two thirds of men will have started losing their hair by the age of 35.1 While some have accepted their fate and decided to let nature run its course, others are desperately looking down every avenue for a potential cure, with hundreds of companies out there promising you a miracle. We’re here to tell you there’s no magical silver bullet to hair loss, but there have been some advancements in the science of hair loss that truly offer hope to those not quite willing to part ways with their luscious locks.

Today the best way to treat male pattern hair loss (MPHL, also known as androgenetic alopecia) is to do so proactively and consistently. Once you get past the myriad snake-oil salesmen promising their holy grails (with little more than anecdotal evidence to support their efficacy) you’ll find that there are only a few compounds with strong scientific evidence (multiple randomised control trials and systematic reviews) to support their ability to curb hair loss. Two of these compounds, minoxidil and finasteride, are the only FDA-approved treatments for the prevention of further hair loss and the promotion of hair regrowth. This post is dedicated to exploring finasteride – the science behind it, its efficacy and the potential side effects.


Finasteride was first approved by the FDA for the treatment of MPHL in 1997. In South Africa it is commonly prescribed as a 1mg tablet taken orally for MPHL, however, a 5mg tablet is available which is used in the treatment of prostate enlargement. It was first approved for medical use in 1992 and has a mountain of evidence behind it supporting its efficacy in the treatment of hair loss.

How does it work?

Finasteride works by inhibiting the 5-alpha reductase enzyme, which is responsible for converting testosterone into dihydrotestosterone (DHT), a natural by-product of testosterone metabolism and a more potent form of testosterone. It is has been shown that high levels of DHT results in MPHL.2 Understanding exactly how high levels of  DHT results in hair loss requires an understanding of the cycle of hair growth, but the simple explanation is that DHT overstimulates the androgen receptors in your hair follicles causing a disruption of your cycle of hair growth which causes your hair follicles to weaken, shrink, and eventually die in a process known as follicular miniaturisation. By inhibiting the 5-alpha reductase enzyme, finasteride decreases the amount of DHT produced and puts a stop to the miniaturisation process.

Less miniaturization = less hair loss and more hair regrowth.

In a study of more than 3000 men over a 3-year period, taking finasteride resulted in hair growth for 87% of participants, with reported adverse effects in only 0.7% of participants.3 Recently there have been studies discussing the use of finasteride as a topical solution (applied directly to the affected areas of your scalp) however as this is technically an off-label use we cannot comment on its safety, quality or efficacy in accordance with South African Health Products Regulatory Authority (SAHPRA) law. You can find links to the studies mentioned below.4,5

Side effects

So what are the adverse effects that less than 1% of those that use finasteride may experience? Let’s bring out the usual suspects:

  • Decreased libido or sex drive
  • Erectile dysfunction
  • A decrease in the volume of ejaculate

These side effects are uncommon and will usually subside within a few months of stopping the finasteride. As mentioned above, these side effects have largely been reported in those men taking oral finasteride, and while once again we cannot comment on whether the topical solution will have the same side effect profile, we have included a link to a systematic review below.5

Topical vs oral

While the oral route of administration is the on-label, conventional and well-studied area, topical finasteride shows good promise in the literature and where we think the future of treating MPHL lies. Unfortunately, there is no such thing as a blanket solution for MPHL, so while some men may respond well to the topical solution, others may require oral finasteride (or its newer cousin dutasteride, also a 5-alpha reductase inhibitor) for effective hair regrowth to occur.

The &BAM solution

The &BAM medical hair loss solution is a convenient all-in-one topical formulation with active pharmaceutical ingredients that you can simply apply directly to the affected areas of your scalp and leave on while the meds work their magic. It’s important to note that the positive effects of using finasteride (and minoxidil) persist only while you continue to use the treatment! Once you stop using the treatment, your regrowth will stop and hair loss will resume. Proactive and consistent use of these medications over a minimum treatment period of 6 – 12 months will show the best results, with improvement continuing the longer the medications are used.

Feel like you could use a helping hand with your hair loss? Take our online hair consult, which will be reviewed by a medical doctor and is 100% confidential.



If you have any medical questions or concerns, please talk to your doctor. The articles and posts on any &BAM website or channel are not a substitute for professional medical advice, diagnosis, or treatment.

  1. Why Do Men Go Bald and What Can You Do About it?  
  2. Serum Levels of Androgen-Associated Hormones Are Correlated with Curative Effect in Androgenic Alopecia in Young Men. 
  3. Evaluation of efficacy and safety of finasteride 1 mg in 3177 Japanese men with androgenetic alopecia. 
  4. Comparing the therapeutic effects of finasteride gel and tablet in treatment of the androgenetic alopecia. 
  5. A Systematic Review of Topical Finasteride in the Treatment of Androgenetic Alopecia in Men and Women