An increasing number of young men are taking medicines to prevent hair loss, raising concerns that the oral medications cause rare but potentially long-term side effects.
The number of men in the United States being prescribed finasteride has increased by nearly 200% in the past seven years, according to a report conducted by Epic Research for NBC News.
“In my clinic, it’s like water,” says Dr. Jerry Shapiro, a dermatologist at NYU Langone Health. “I prescribe it all the time.”
While Epic’s report looked at men over 25, Dr. Shapiro and his colleagues say they are also seeing an increase in younger men seeking treatment, including those in their late teens, who are seeking treatment before their hair loss begins or gets worse.
Part of the increase in prescriptions may be linked to telemedicine companies such as Hims, Keeps & Ro, which promote the drug on billboards and online ads, said Dr. Maria Colavincenzo, an associate professor of dermatology at Northwestern Feinberg School of Medicine who has worked in the work for 10 years.
Social media influencers are promoting finasteride with videos about hair loss and regrowth while taking the drug, and finasteride has also been heavily promoted in popular Reddit communities. Unbundled.
“We’re seeing more people become interested in getting treatment a little younger than they used to,” Colavincenzo says.
Doctors say the daily pills are safe, but once you start taking them, you need to keep taking them for as long as you want to avoid hair loss. And the drug is controversial because erectile dysfunction can continue even after you stop taking it.
What is Finasteride and does it work?
Finasteride, also known by the brand name Propecia, was originally developed as a treatment for benign prostatic hyperplasia and has been approved by the U.S. Food and Drug Administration to treat hair loss for nearly 30 years.
It’s a medication taken daily to slow the progression of male pattern baldness, also known as male pattern baldness, which affects about half of all men by age 50.
There’s no conclusive evidence that men who start taking the medication before hair loss begins will never go bald, but doctors say the risk appears to be low.
In this type of alopecia, which is characterised by a receding hairline and thinning hair at the back of the head, two main changes occur in the hair follicles, says Colavincenzo.
These include the miniaturization, or shrinkage, of hair follicles and a slowing of the hair growth cycle, both of which lead to a decrease in hair thickness.
Finasteride inhibits 5-alpha reductase, preventing the conversion of testosterone to dihydrotestosterone (DHT), lowering DHT levels in the body. DHT is the hormone primarily responsible for facial and body hair. Meanwhile, high DHT levels are thought to shrink scalp hair follicles and shorten the hair growth cycle, leading to hair loss.
“If you block the signal to shrink your hair, it might not shrink, or it might shrink a little less,” she says. “That’s what finasteride does.”
Why some people have high DHT levels but don’t go bald ultimately comes down to genetics, and is an area of active research, she said.
The good news is that the majority of men who take finasteride seem to be successful in slowing their hair loss.
the study “This drug shows promise for preventing about 80 to 90 percent of hair loss from progressing,” Shapiro said, adding that because the drug is so preventative, the earlier you start, the better. But once you start, it’s a lifelong medication.
“Most medications are lifelong,” said Shapiro, who also serves as a medical adviser to online drug seller Keepus Inc. “If you have high cholesterol, you’re on medication for the rest of your life. If you have high blood pressure, you’re on medication for the rest of your life.”
Dr. Carolyn Goh, a dermatologist at UCLA Health, said that while long-term data on the drug’s effectiveness is limited, the data shows that the drug’s effects are maintained over time. Published A study published in the Journal of Dermatology found that over a five-year follow-up period, nearly 100% of men saw the same or greater hair growth as before they started taking the drug.
“It’s very effective,” she says. “It doesn’t necessarily make your hair grow, it just keeps it from getting worse, but it’s pretty effective.”
a Another study Italian researchers followed more than 100 patients who took finasteride for 10 years and found that 86% of the men saw no change in their hair.
Although finasteride is very effective at preventing further hair loss, it is not as effective at regrowing hair that has already fallen out, which is why finasteride is often used in combination with minoxidil, a topical medication applied directly to the scalp to stimulate hair growth.
Colavincenzo said some patients followed for about 10 years have benefited from the drug, although he can’t necessarily tell if it’s helping them.
“The hard part is you often don’t know how well it’s working,” she says. “Even if your hair isn’t getting worse, that’s still a success.”
Finasteride is not typically covered by insurance because male pattern baldness is considered a cosmetic problem. It has been available as a generic drug since 2006 and can usually be purchased for less than $100 per month.
What are the side effects of Finasteride?
In 2022, after patient advocacy groups urged the FDA to remove the drug from the market, Prescription labels warn of possible suicidal behavior For men taking medication.
More recently, a paper published in the International Journal of Impotence Research in 2023 found that Energizing online discussions Regarding the phenomenon known as Post-finasteride syndromeThe syndrome is associated with decreased libido, erectile dysfunction, and even cognitive impairment.
The most commonly reported side effects of finasteride are decreased libido, difficulty maintaining an erection, and decreased semen volume. These adverse sexual side effects are typically seen in less than 5% of men taking the drug.
It’s also been linked to mental health effects such as depression, but it’s unclear how common this is and whether the drug itself is the cause.
“Certainly the vast majority of my patients don’t have those side effects, they’re fine, they’re doing pretty well,” Colavincenzo said.
If men are already experiencing sexual problems, Coravincenzo warns against using the drug.
“I would be very cautious if someone told me they had problems with sexual function,” she says. “I would usually say, I don’t think this is a good idea and I don’t recommend it.”
Shapiro said the risk of permanent side effects is “very rare.”
“I’ve treated thousands of patients and I’ve never seen anyone like this,” Shapiro said.
