Do You Have to Take Finasteride Forever? A Deep Dive into Long-Term Use

October 7, 2025 •

3 min read

Affecting up to 50% of men by age 50, androgenetic alopecia is a common concern. This leads many to ask: for treatments like finasteride, do you have to take finasteride forever to maintain results?

Quick Summary

To maintain the hair growth benefits of finasteride, continuous, long-term use is necessary. The medication works only while active in your body, and stopping it will lead to a reversal of its effects.

Key Points

Long-Term Commitment: To maintain its hair-preserving effects, finasteride must be taken continuously for as long as results are desired.
Mechanism of Action: Finasteride works by inhibiting the enzyme 5-alpha reductase, which significantly lowers levels of DHT, the hormone responsible for male pattern hair loss.
Reversal Upon Cessation: If you stop taking finasteride, DHT levels return to normal within about two weeks, and hair loss typically resumes, with benefits lost within a year.
Proven Efficacy: Long-term studies, some lasting up to 10 years, have shown that finasteride is highly effective at preventing further hair loss and can increase hair growth for most men.
Potential Side Effects: While generally well-tolerated, finasteride can cause side effects, most commonly sexual, in a small percentage of users. These usually resolve after stopping the drug.
Post-Finasteride Syndrome (PFS): A rare and controversial condition where sexual, physical, and mental side effects persist after discontinuing the medication has been reported.
Doctor Consultation is Crucial: Before starting or stopping finasteride, it is essential to consult with a healthcare provider to discuss the benefits, risks, and long-term commitment involved.

Understanding Finasteride and Its Mechanism of Action

Finasteride is an oral medication primarily used to treat male pattern hair loss (androgenetic alopecia) and benign prostatic hyperplasia (BPH). It belongs to a class of drugs called 5-alpha reductase inhibitors. Its effectiveness stems from its ability to block the action of the Type II 5-alpha reductase enzyme. This enzyme is responsible for converting testosterone into a more potent androgen called dihydrotestosterone (DHT). In genetically predisposed individuals, DHT binds to receptors in scalp hair follicles, causing them to shrink in a process known as follicular miniaturization. This shortens the hair growth phase (anagen), leading to progressively shorter, finer hairs and eventual hair loss. By inhibiting the enzyme, finasteride can significantly reduce serum and scalp DHT levels, thereby slowing hair loss and, in many cases, promoting regrowth.

The Core Question: Do You Have to Take Finasteride Forever?

For individuals using finasteride to combat hair loss, the answer is unequivocally yes—lifelong commitment is necessary to maintain the results. Finasteride is a treatment, not a cure. It only works as long as the drug is active in your system and suppressing DHT levels.

What Happens When You Stop Taking Finasteride?

Once you stop taking finasteride, the 5-alpha reductase enzyme is no longer inhibited. Your body resumes converting testosterone to DHT at its normal rate. DHT levels typically return to their pre-treatment baseline within about 14 days of cessation. Consequently, the protective effect on your hair follicles is lost. The hair loss process that was paused will restart, and any hair that was gained or preserved due to the treatment will typically be lost over the following 9 to 12 months. You can expect your hair to return to the state it would have been in had you never started the medication.

Long-Term Efficacy, Safety, and Potential Side Effects

Clinical studies have demonstrated finasteride's long-term safety and efficacy for many years, with some studies following patients for a decade. One 10-year study found that a large percentage of men using finasteride saw a prevention of further hair loss progression. However, long-term use is associated with potential side effects. The most commonly reported are sexual in nature, including decreased libido, erectile dysfunction, and reduced ejaculate volume, affecting a small percentage of users (roughly 2-4%). For most men, these side effects cease upon discontinuing the drug.

A Note on Post-Finasteride Syndrome (PFS)

A controversial and rare condition known as Post-Finasteride Syndrome (PFS) has been reported by a small number of men. PFS is characterized by the persistence of sexual, neurological, and physical side effects for at least three months after stopping the medication. Symptoms can include erectile dysfunction, depression, anxiety, and cognitive issues, sometimes referred to as 'brain fog'. The exact cause and prevalence of PFS are not well understood, and it remains a subject of ongoing research and debate within the medical community. Patients should be aware of these reported risks and discuss them thoroughly with a healthcare provider.

Finasteride vs. Other Hair Loss Treatments

When considering a long-term treatment for hair loss, it's useful to compare finasteride with other common options.


Treatment	Mechanism of Action	Application	Prescription Required?
Oral Finasteride	Inhibits 5-alpha reductase to block DHT production systemically.	Oral Pill	Yes
Topical Minoxidil	Vasodilator; improves blood flow to follicles and may prolong the growth phase.	Topical Liquid/Foam	No (OTC)
Oral Dutasteride	Inhibits both Type I and Type II 5-alpha reductase, leading to more significant DHT suppression.	Oral Pill	Yes (often off-label for hair loss)
Topical Finasteride	Inhibits 5-alpha reductase locally in the scalp to reduce systemic absorption and side effects.	Topical Solution	Yes

Conclusion: A Lifelong Commitment for Lasting Results

Finasteride is a clinically proven and effective long-term treatment for male pattern baldness, capable of halting hair loss and promoting regrowth in a majority of men. However, its benefits are entirely dependent on continuous use. The decision to start finasteride should be seen as a long-term, potentially lifelong, commitment. Discontinuation will lead to a reversal of its positive effects on hair. Prospective users must weigh the proven efficacy against the ongoing cost, the daily commitment, and the potential for side effects, including the rare but serious reports associated with Post-Finasteride Syndrome. A thorough consultation with a qualified healthcare professional is essential to make an informed decision tailored to your individual health profile and goals.

For further reading on the pharmacology of finasteride, consult authoritative resources such as the National Center for Biotechnology Information (NCBI).

Authoritative Link

Frequently Asked Questions

Consult with your healthcare provider for guidance on what to do if you miss a dose of finasteride. They can provide instructions based on your specific prescription and circumstances.

Noticeable improvements, such as slowing of hair loss or some regrowth, can typically be seen after several months of consistent daily use. Peak effects are often observed after a year or more.

For most men, side effects are temporary and resolve after stopping the medication. However, there are rare reports of a condition called Post-Finasteride Syndrome (PFS), where symptoms persist after cessation.

No, the hair loss is not immediate. Hair shedding typically resumes within a few months, and any hair gained is usually lost within 9 to 12 months after stopping the treatment.

Topical finasteride is an alternative that aims to reduce systemic side effects by acting locally on the scalp. Studies suggest it can be similar in effectiveness to oral finasteride but with markedly lower systemic exposure and less impact on serum DHT levels.

Propecia and Proscar are brand names for finasteride. Propecia is typically prescribed for male pattern hair loss, while Proscar is often prescribed for benign prostatic hyperplasia (BPH), or an enlarged prostate. The dosage of finasteride differs between these two medications and indications.

Yes, you can drink alcohol while taking finasteride as there are no known direct interactions that would make it unsafe.