What is finasteride and what is it used for?

Finasteride belongs to a group of medications called 5-alpha-reductase inhibitors. These medications work by limiting the amount of testosterone converted to dihydrotestosterone.

DHT has been linked to genetic hair loss conditions, such as androgenetic alopecia. It binds to androgen receptors in hair follicles, causing them to shrink over time and, eventually, hair loss.

Finasteride is available in oral or topical forms. There are two dosages: 1 mg and 5 mg. The 5 mg dose is used to treat an enlarged prostate gland due to benign prostatic hyperplasia, while the lower dose is generally prescribed for men with thinning hair, hair loss, and baldness.

Finasteride is an effective treatment for preventing hair loss, and numerous studies have shown impressive results. In one study, up to 80% of subjects saw an improvement in their hair loss. In another, it was found that after two years of finasteride treatment, 83% of men saw an increase in hair growth.

Why look for alternatives to finasteride?

Before exploring best alternatives to finasteride, it's helpful to understand the motivation behind this research. While this medication is effective for many patients with androgenetic alopecia, approximately 3% of them experience side effects such as decreased libido or erectile dysfunction. Over time, other problems, such as depression, confusion, and breast enlargement, can also occur.

It's also important to remember that finasteride is specifically designed for male pattern baldness. Therefore, people suffering from other types of hair loss, a situation that can be isolating, may require different solutions. People suffering from hair loss due to conditions such as alopecia areata or female pattern baldness do not benefit from medication. For these individuals, exploring alternative treatments offers the hope of regaining hair density and growth without worrying about side effects or pre-existing health issues.

Finally, some patients simply want to avoid long-term drug dependence and opt for natural solutions combining ointments, massage, improved diet, stress reduction, and dietary supplements. These alternatives contain beneficial herbs and nutrients that gently balance the hormones associated with hair production, thus facilitating hair growth.

How does finasteride work?

Basically, finasteride acts as a DHT blocker, preventing the hormone from reaching hair follicles. Generally, low DHT levels result in increased hair growth.

DHT isn't entirely harmful: during male fetal development and puberty, it's the hormone that develops male characteristics, such as facial hair and a deeper voice. But later on, the androgen can bind to receptors in hair follicles, causing gradual hair loss in those genetically susceptible to its effects.

Medical Alternatives

For those seeking scientifically based and safe hair loss solutions, there are several pharmaceutical alternatives to finasteride, including:

Minoxidil Treatment

This over-the-counter lotion delivers an ingredient directly to the hair root to prolong the growth phases and prevent hair loss. Powerful yet gentle, it works by increasing blood circulation and nutrients in men and women suffering from hereditary or age-related hair loss, unlike finasteride. Many claim that this easy-to-use solution regenerates hair over time if applied correctly to thinning areas, slowing, stopping, or sometimes reversing hair loss without a prescription.

Dutasteride

In addition to traditional hair loss pills, there is an advanced oral medication, dutasteride, which appears to be more potent according to laboratory tests. Early research shows that lower doses than alternatives stop genetic hair loss for longer periods. However, the powerful compounds involved also increase the risk of sexual, mental, or glandular side effects.

Home Treatments for Hair Loss

Home treatments are convenient, and many are available without a prescription. With studies showing the effectiveness of the following treatments, your dermatologist may include one in your home treatment program.

Microneedling:

  • A microneedling device contains hundreds of tiny needles. Some studies have shown that it can stimulate hair growth. In one study, men aged 20 to 35 with mild to moderate hereditary hair loss were treated with:
  • 5% minoxidil twice daily
  • 5% minoxidil twice daily plus microneedling once a week
  • After 12 weeks of treatment, patients treated with minoxidil and microneedling experienced significantly faster hair growth.
  • Other studies have shown that using microneedling in combination with another treatment, such as platelet-rich plasma or a corticosteroid applied to the affected area, helps improve hair growth.
  • Although a microneedling device is available without a prescription, it is advisable to consult a dermatologist first. Microneedling can aggravate certain conditions. It's also important to choose the right microneedling device. Devices used for hair loss contain longer needles than those used for skin treatment.

At-home laser treatment:

  • You can purchase laser helmets and combs to treat hair loss at home. Although few studies have analyzed these devices, the results are promising.
  • In one study, more than 200 men and women with hereditary hair loss were given either a laser comb or a device simulating a laser comb. The patients used the device three times a week for 26 weeks.
  • Researchers found that some patients who used the laser rather than the sham device experienced thicker, fuller hair.
  • It's important to understand that not everyone who used the laser experienced hair regrowth.
  • Further studies are needed to determine who is most likely to benefit from this treatment and whether these devices cause long-term side effects.

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