Hair Loss & Restoration Article: Propecia (Finasteride) and Hair Loss

Propecia (Finasteride) and Hair Loss

Large Clinical Trial Confirms Effectiveness of Finasteride in Stopping Hair Loss Due to Male-Pattern Alopecia

Medical treatment of hair loss with an oral drug such as Propecia (finasteride) or a topical agent such as Rogaine (minoxidil) is one of the options a man with male-pattern baldness (androgenetic alopecia) may be offered by a hair restoration doctor (See Nonsurgical hair loss treatment options for more information on these hair regrowth agents).

A recently completed five-year extension of a controlled clinical trial provides additional and significant support for the efficacy of finasteride in halting hair loss on the vertex (top of the head) in men whose hair loss is due to male-pattern baldness.

Headline Results

At the end of the fifth year of the five-year extended trial:

Hair Count:In the one-inch diameter circle on top of each man’s scalp that was assessed for efficacy of finasteride, men taking finasteride had an average 277 more hairs than the men taking an inactive placebo. At the start of the study, baseline hair counts for all men in the study was 876 hairs in the one-inch diameter circle. At the end of the fifth year of the study, 65% of the men taking finasteride maintained or improved their hair count compared to the baseline count. All of the men on placebo lost hair compared to the baseline count.

Before-and-after photos:A panel of dermatologists reviewed before-and-after photographs of the scalps of the men taking finasteride and placebo. At the end of the five-year extended study the panel of dermatologists rated 90% of the finasteride-treated men as having no additional visible hair loss compared with baseline; 25% of the men on placebo were rated as having no additional visible hair loss.

Patient questionnaires:At the end of the five-year extended study, both groups of men received a questionnaire asking them to rate their satisfaction with their hair appearance. Men who received finasteride indicated a higher level of satisfaction compared to those who received placebo:

Investigator assessments:Physician researchers who evaluated the men at the end of the five-year extended study determined that 77% of the men who received finasteride had increases in scalp hair, compared with 15% of the men who received placebo.

Finasteride is an oral drug given in pill form. It is the only oral drug approved by the U.S. Food and Drug Administration for treatment of male-pattern hair loss. Finasteride is not approved for use in women, and should not be used by women or children.

The clinical trial was conducted over a five-year period, enrolling 1,553 men aged 18 to 41 years who had mild to moderate male-pattern androgenetic alopecia as assessed by a physician. Half of the group of men received finasteride and half received a placebo (an inactive agent or "sugar pill"). The study was conducted in double-blind design, meaning that neither the physician researchers nor the men in the study knew who received finasteride and who received placebo until the end of the study period. The first year of the study established safety and efficacy of finasteride. The study was extended in one-year increments for the next four years, with the men in the study offered the opportunity (1) to remain in the study, and (2) to stay on the same regimen. The five-year data focused on the results of men who stayed in the study for five years and on the same regimen for five years: 284 men on finasteride, and 15 on placebo.

The five-year extended study showed efficacy of finasteride in stopping hair loss due to male-pattern androgenetic alopecia on the top of the head. The efficacy of finasteride in treating hair loss in the templar area (the sides of the frontal scalp) has not been assessed.

Finasteride is manufactured by Merck & Co., Inc., and is available only by prescription. It should be used only under the direction of a physician hair restoration specialist. It may be used alone to slow hair loss, or may be used in combination with a surgical approach to hair restoration.

For a related article, see 5-Alpha-Reductase Inhibitors For Hair Loss. The ISHRS wishes to acknowledge Merck & Co. as a sponsor of this website.