Is Finasteride Actually Worth It? A Look at the Medications and Pharmacology

October 8, 2025 •

4 min read

Clinical studies show that finasteride can halt or reverse hair loss in up to 90% of male patients over five years, making it a highly effective treatment for androgenetic alopecia. However, many still wonder, is finasteride actually worth it?, especially when considering the potential side effects and lifelong commitment involved.

Quick Summary

An in-depth review of finasteride's efficacy, risks, and pharmacological action for male pattern baldness. It compares oral vs. topical options and alternatives, providing essential considerations for prospective users weighing the benefits and drawbacks of this popular hair loss medication.

Key Points

Finasteride blocks DHT: The medication works by inhibiting the enzyme 5-alpha-reductase, which reduces levels of dihydrotestosterone (DHT), the hormone responsible for male pattern baldness.
High success rates: Clinical studies show that finasteride can prevent or reverse hair loss in up to 90% of men, with many experiencing significant hair regrowth.
Long-term commitment required: Finasteride must be taken consistently and long-term to maintain its effects. Stopping the medication will result in a return to baseline hair loss within a year.
Potential side effects: While generally low, side effects can include sexual dysfunction (decreased libido, ED), depression, and anxiety, though most resolve upon discontinuation.
Individual response varies: The effectiveness and side effect profile can differ significantly from person to person. A medical consultation is essential to determine if it's the right fit for your specific case.

Disclaimer: Information is for general knowledge, should not be taken as medical advice, and should consult with a healthcare provider.

Understanding the Pharmacology: How Finasteride Targets Hair Loss

To determine if finasteride is actually worth it, it's crucial to first understand its mechanism of action. Finasteride is a 5-alpha-reductase inhibitor. It works by blocking the enzyme 5-alpha-reductase, which is responsible for converting testosterone into dihydrotestosterone (DHT). In men who are genetically susceptible to male pattern baldness, DHT can cause hair follicles to shrink and produce thinner, shorter hair until they stop producing hair altogether. By significantly lowering DHT levels in the scalp, finasteride effectively targets the primary cause of this type of hair loss.

Studies show that finasteride can reduce serum DHT levels. For hair loss, finasteride is prescribed (under the brand name Propecia), while a higher strength is used for benign prostatic hyperplasia (BPH). This targeted approach makes it a powerful tool, particularly for men with mild to moderate hair loss who start treatment early.

Documented Efficacy and Long-Term Results

Over the decades, finasteride's efficacy has been well-established in numerous clinical studies. Here’s what the evidence suggests:

Halting progression: In long-term trials, finasteride has been shown to stop the progression of hair loss in a large majority of men. One study followed patients for ten years and found that the drug prevented or improved hair loss in 99.1% of Japanese men with androgenetic alopecia.
Promoting regrowth: Many users experience noticeable hair regrowth, particularly on the crown of the head. In a large-scale clinical trial published in the Journal of the American Academy of Dermatology, men who used finasteride saw a clinically significant increase in hair count over a two-year period.
Long-term maintenance: The benefits of finasteride are maintained only as long as the medication is taken. When a person stops treatment, DHT levels return to pre-treatment levels, and hair loss resumes within 6 to 12 months. This is an important consideration for anyone evaluating the long-term cost and commitment.

Potential Side Effects and Safety Concerns

While effective, finasteride is not without risks, and considering these is paramount. The most commonly reported side effects are related to sexual function:

Decreased libido (sex drive)
Erectile dysfunction (ED)
Ejaculation disorders, such as decreased ejaculate volume

Sexual side effects are generally reported by a small percentage of users, often between 1-4%, and many resolve after discontinuing the medication. However, there is a small risk of persistent sexual dysfunction, sometimes referred to as Post-Finasteride Syndrome (PFS), though the incidence rate is not well-established. Other reported side effects include:

Psychological effects: Depression, anxiety, and in rare cases, suicidal ideation have been reported. Patients with a history of mental health issues should discuss these risks with their doctor.
Gynecomastia: Abnormal enlargement of breast tissue is a less common side effect, especially with the lower strength.
Impact on fertility: For most healthy men, finasteride is not expected to affect fertility, but caution is advised for men already struggling with infertility or those actively trying to conceive.

Oral vs. Topical Finasteride

Recent years have seen the rise of topical finasteride, which is applied directly to the scalp. This formulation aims to deliver the medication locally to the hair follicles while minimizing systemic absorption and thus reducing the risk of side effects.

Topical Finasteride: May be associated with a lower risk of sexual side effects compared to the oral pill because less of the drug is absorbed into the bloodstream. However, since these compounded products are not FDA-approved, the exact efficacy and safety can vary between formulations, and clinical data is less extensive than for the oral version.
Oral Finasteride: Has a long, well-documented history of safety and effectiveness, supported by decades of clinical trials. It is considered the first-line pharmacologic treatment for male pattern hair loss by many clinicians.

Comparison with Other Hair Loss Treatments

Finasteride is often considered alongside other popular hair loss treatments. Here is a comparison to help determine if it is the right choice for you:


Feature	Oral Finasteride (Propecia)	Oral/Topical Minoxidil (Rogaine)	Oral Dutasteride (Avodart)
Mechanism	Inhibits type II 5-alpha reductase, reducing scalp DHT.	Promotes hair growth by increasing blood flow to hair follicles.	Inhibits both type I and II 5-alpha reductase, more potent than finasteride.
FDA Status	FDA-approved for male pattern baldness.	FDA-approved for hair loss.	FDA-approved for BPH; used off-label for hair loss.
Side Effects	Sexual dysfunction, depression, gynecomastia (low incidence).	Scalp irritation, unwanted facial hair (topical); low blood pressure, headaches (oral).	Similar to finasteride but potentially higher risk due to greater potency.
Effectiveness	Highly effective at halting and reversing hair loss in a majority of men.	Effective for promoting growth, especially when combined with finasteride.	More potent at reducing DHT and potentially increasing hair count than finasteride.
Requires Prescription	Yes.	Topical is OTC; oral requires prescription.	Yes (as it is used off-label for hair loss).

Conclusion: Is Finasteride Actually Worth It for You?

Deciding if is finasteride actually worth it? requires a personal cost-benefit analysis in consultation with a healthcare provider. For many men experiencing male pattern baldness, finasteride is a highly effective, long-term solution for maintaining or regrowing hair, especially when started early. Its ability to address the hormonal root cause of the condition is a significant advantage over other options.

However, the commitment to lifelong daily treatment is substantial, as hair loss will resume if the medication is stopped. While the incidence of side effects is low for most users, the potential risks of sexual dysfunction and mental health changes are serious and must be weighed carefully. For those concerned about systemic side effects, topical finasteride or combination therapies with minoxidil offer alternative avenues. Ultimately, the decision should be an informed one, made in conjunction with a doctor who can assess your specific medical history and goals. For more authoritative medical information on finasteride, consult the National Center for Biotechnology Information (NCBI) on the subject.

Frequently Asked Questions

It can take at least three months of daily use to see an initial improvement, with more significant results typically becoming visible after six to twelve months of consistent treatment.

If you stop taking finasteride, the benefits will reverse. Your DHT levels will rise, and hair loss will resume, likely returning to your original state within 6 to 12 months.

Finasteride is not FDA-approved for women, especially those who are pregnant or may become pregnant, due to the risk of birth defects in a male fetus. It may be prescribed off-label for postmenopausal women in some cases.

Topical finasteride may carry a lower risk of systemic side effects, as it is applied locally to the scalp. However, these formulations are typically not FDA-approved, and more research is needed to confirm comparative safety and efficacy.

While most sexual side effects are reversible upon stopping the medication, there is a recognized, albeit small, risk of persistent sexual dysfunction. The true incidence of this 'Post-Finasteride Syndrome' is not clearly known.

Some updated safety labels and studies suggest a possible link between finasteride and an increased risk of depression, though the evidence is inconclusive. Anyone with a history of mental health issues should discuss this with their doctor.

Finasteride is most effective for hair loss on the crown and mid-scalp. It has shown some efficacy in slowing frontal hair loss, but results can be more limited compared to the vertex.