The Question of Trump's Medication
In February 2017, Dr. Harold Bornstein, who served as Donald Trump's personal physician for decades, revealed that Trump takes finasteride [1.2.1, 1.7.4]. This disclosure confirmed that the medication was used to treat male pattern hair loss, with Dr. Bornstein noting, "He has all his hair" [1.2.2]. Finasteride is also credited by the doctor for his own long hair [1.2.5]. In addition to finasteride, Dr. Bornstein mentioned Trump was taking antibiotics for rosacea and a statin for high cholesterol [1.7.1]. This information was volunteered by the doctor in interviews with The New York Times [1.7.3].
Understanding Finasteride: Pharmacology and Mechanism of Action
Finasteride belongs to a class of drugs known as 5-alpha reductase inhibitors [1.3.1]. Its primary function is to block the action of the Type II 5-alpha reductase enzyme, which is responsible for converting testosterone into a more potent androgen called dihydrotestosterone (DHT) [1.2.3, 1.3.6]. DHT is a key factor in androgenetic alopecia, or male pattern baldness, as it can cause hair follicles to shrink and eventually stop producing hair [1.2.5]. By inhibiting this enzyme, finasteride significantly lowers DHT levels in the scalp, which can slow hair loss and, in some cases, stimulate new hair growth [1.3.5].
This same mechanism explains its use in treating benign prostatic hyperplasia (BPH), or an enlarged prostate. DHT also causes the prostate gland to grow, and by reducing DHT levels, finasteride can shrink the prostate, alleviating urinary symptoms associated with BPH [1.3.2].
Dosage and Brand Names
Finasteride is marketed under two main brand names, which correspond to different dosages for different conditions:
- Propecia® (1 mg): This lower dose is FDA-approved specifically for the treatment of male pattern hair loss [1.3.6, 1.4.5]. Daily use for at least three months is typically required to see a benefit [1.4.5].
- Proscar® (5 mg): This higher dose is used to treat the symptoms of BPH [1.3.2].
Dr. Bornstein's report also noted that Trump's use of finasteride explains his low levels of prostate-specific antigen (PSA), a marker that can be used to screen for prostate cancer [1.2.3, 1.2.5]. The medication can lower PSA readings [1.3.5].
Potential Side Effects and Considerations
While many men tolerate finasteride well, it is associated with a range of potential side effects [1.2.1]. The most commonly discussed are sexual in nature and can include decreased libido (sex drive), erectile dysfunction, and problems with ejaculation, such as a decreased volume of ejaculate [1.4.1, 1.3.7].
Other potential, less common side effects include:
- Testicular pain [1.3.1]
- Breast tenderness or enlargement [1.4.1]
- Rash, itching, or hives [1.3.1]
- Depression or mood changes [1.3.4, 1.4.7]
In rare cases, some men report persistent side effects that continue even after stopping the medication, a controversial condition sometimes referred to as Post-Finasteride Syndrome (PFS) [1.3.5, 1.4.7]. It is also important to note that taking finasteride may be associated with an increased risk of developing a high-grade form of prostate cancer [1.3.1]. Because the medication can be absorbed through the skin and can cause birth defects, pregnant women or women who may become pregnant are advised not to handle crushed or broken tablets [1.3.6].
Comparison of Hair Loss Treatments
Finasteride is one of two FDA-approved medications for hair loss, but several other alternatives exist, ranging from other medical treatments to natural supplements and procedures [1.5.4].
| Treatment | Type | Mechanism of Action | Key Considerations |
|---|---|---|---|
| Finasteride (Propecia) | Oral Medication (Prescription) | Blocks the conversion of testosterone to DHT [1.3.6]. | Systemic effects; potential for sexual and mood-related side effects [1.4.1]. Requires continuous use [1.3.2]. |
| Minoxidil (Rogaine) | Topical Solution/Foam (OTC) | Vasodilator; increases blood flow to hair follicles and prolongs the growth phase [1.5.4]. | Applied directly to the scalp; can cause scalp irritation. Does not affect DHT [1.5.5]. |
| Dutasteride (Avodart) | Oral Medication (Prescription, off-label for hair loss) | A more potent 5-alpha reductase inhibitor, blocking two types of the enzyme [1.5.6]. | Potentially more effective than finasteride but may have a higher risk of similar side effects [1.5.3]. |
| Saw Palmetto | Natural Supplement | Thought to inhibit the 5-alpha reductase enzyme, similar to finasteride but less potent [1.5.4]. | Evidence of effectiveness is less robust than for FDA-approved drugs. Generally well-tolerated [1.5.3]. |
| Low-Level Laser Therapy (LLLT) | Device-Based Therapy | Light energy is thought to stimulate hair follicles to re-enter the growth phase [1.5.4]. | Non-invasive and can be done at home with helmets or combs. Efficacy studies are ongoing [1.5.4]. |
| Platelet-Rich Plasma (PRP) | Medical Procedure | Injections of a patient's own concentrated platelets into the scalp to stimulate follicles [1.5.6]. | In-office procedure; can be expensive and requires multiple sessions [1.5.6]. |
Conclusion
Based on public statements from his then-physician Dr. Harold Bornstein, Donald Trump does take finasteride to combat male pattern hair loss [1.7.2]. This medication is a well-established pharmacological treatment that works by reducing levels of DHT, the hormone primarily responsible for shrinking hair follicles [1.3.6]. While effective for many in slowing hair loss and promoting regrowth, it carries potential side effects that warrant discussion with a healthcare provider [1.4.1]. The existence of numerous alternatives, from topical minoxidil to natural supplements and procedures, provides a range of options for individuals seeking to address androgenetic alopecia.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Consult with a qualified healthcare professional before making any decisions about medications or treatments.
Authoritative Link: Finasteride: MedlinePlus Drug Information
