Before Finasteride treats male pattern baldness, it causes the remaining hair on your head to fall out. This phenomenon is known as Finasteride shedding, and it can be very alarming – your hair loss medication should be encouraging the growth of new hair, not shedding that which remains, after all! In this article, we cover everything that there is to know about Finasteride shedding so that you can rest assured that this side-effect is simply part of the process of achieving a full head of healthy, new hair. 

What is Finasteride?

Finasteride is an oral medicine that is used to treat hair loss and balding. It comes in the form of a tablet or capsule, and it should be taken once a day, preferably alongside a meal. The tablets must be taken whole, and should not be broken or crushed. In the UK, it is sold under the brand names Propecia and Proscar, and it can only be accessed via a private prescription – which means that it is not available on the NHS. 

Finasteride fights hair loss by reducing the production and supply of dihydrotestosterone (DHT) in the body. DHT is an androgen or sex hormone, which means that it is responsible for the onset of male sex characteristics during puberty,  such as the growth of body hair, increase in muscle mass, or the deepening of the voice. Unfortunately, however, the hormone can also cause hair loss in some men, as it can attach itself to the hair follicles in the scalp and force them to shrink, which prevents them from producing thick, healthy hair. 

The body produces DHT from another sex hormone called testosterone, and Finasteride prevents hair loss by impeding this process: it stops the body from converting testosterone into DHT.

Who can use Finasteride?

Patients must always consult a medical professional before they begin taking Finasteride to ensure that they are an appropriate candidate for the medicine. Generally speaking, however, men over the age of 18 who suffer from male pattern baldness are suitable for this treatment.

Finasteride is not suitable for women experiencing female pattern baldness. This is because the medicine works by preventing the production of DHT – a male sex hormone – in men, and so it will not be able to prevent hair loss in women. 

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Does Finasteride produce permanent results?

No, the new hair growth prompted by Finasteride is not permanent. The medicine will only produce results when it is being taken consistently. This means that, when you stop taking Finasteride, hair loss will resume, and you will begin to lose the new hair that the medicine has produced within a few months of stopping the treatment. 

Does Finasteride cause hair shedding?

Yes, Finasteride can cause hair shedding in the first few months of use. Most patients will experience shedding approximately 2 to 3 months after they first start using the medicine, though this will vary from person to person. 

This is referred to as Finasteride shedding, and it can cause some patients to panic since the hair loss medication appears to be causing more hair loss than usual. However – whilst it may seem odd – Finasteride shedding is actually a sign that the medicine is working properly. 

How does Finasteride cause shedding?

Your hair grows according to a cycle, known as the hair growth cycle. This cycle has four stages, called the anagen, catagen, telogen, and exogen phases. The first stage (the anagen phase) is when new hair begins to grow. After this, the hair enters the catagen (or ‘transition’) phase, which is when the hair detaches itself from the body’s blood supply and ceases to grow any further, becoming what is known as ‘club hair’. 

After two or three weeks, the club hair enters the telogen phase, which is when new hair begins to form beneath it. The club hair neither falls out nor grows any further during the telogen phase; instead, it simply hangs from the head, which is why this is sometimes referred to as the ‘resting’ stage. Finally, the hair enters the exogen phase of the cycle, which is when it detaches from the scalp and falls out. 

When you start taking Finasteride, the medicine encourages hair growth by speeding up the hair growth cycle. Consequently, the hair follicles that are in the telogen phase skip forwards and return to the anagen (or ‘growth’) phase. However, before new hair can grow, the existing hair must be lost – which is why shedding occurs. 

Finasteride Results Timeline:

The results timeline below lets you know what to expect in the first year after you start taking Finasteride, and details when Finasteride hair shedding begins and how long it lasts. 

After 1 to 3 months:

Finasteride shedding begins after approximately 1 to 3 months have passed since you started taking the medicine. Whilst this can be quite alarming, remind yourself that hair shedding is a part of the process of regrowing your hair, and it will not last forever. 

After 3 to 4 months:

After roughly 3 to 4 months have passed since you began taking Finasteride, the shedding will slow down. Some new hair will start to sprout on the scalp during this time, too. 

After 5 to 6 months:

Finasteride shedding will stop at some point during this period. There will also be a clear improvement in the appearance of your hair: bald spots will be considerably smaller, and the hairline will start to move forwards. 

After 6 to 9 months:

After 9 months have passed since you began taking Finasteride, there will be a considerable amount of new hair. In fact, you may notice that – though the hairs are still not as strong or thick as you would like them to be – you have now achieved full coverage of the scalp, as there are no bald spots. 

After 9 to 12 months:

After approximately one year has passed since you started taking Finasteride, there will be a visible improvement in the strength and colour of your new hair. The sides and crown of the head will be covered by thick, healthy hair, and the hairline will have come forwards considerably. 

Patients who do not notice any improvement in the appearance of their hair after 12 months of taking Finasteride every day are unlikely to benefit from the medicine and should consult their doctor regarding alternative solutions for hair loss. 

What Can I Do to Improve the Results of this Treatment?

It takes patience to see results from Finasteride: the medicine must be taken every day for one year to see the final result (and then the medicine must continue to be taken to maintain this result). Similarly, patients must remain positive and patient throughout the Finasteride shedding phase (which is often the most challenging stage of the process), as they wait for new hairs to begin to grow.

Unfortunately, there is not much that patients can do to quicken this process, and patients must simply remind themselves that the results will be worth it in the end. However, there are some lifestyle changes that patients can make to improve the results of this medicine once they do begin to appear:

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1. Massage the Scalp Every Day

Massaging the scalp increases blood circulation to the hair follicles. Your blood carries oxygen and vital nutrients, so the more blood that passes through the scalp, the more the follicles are nourished by these substances. When the hair follicles are healthy and nourished, they are able to produce thick, healthy hair – and so massaging your scalp every day will help to improve the appearance of the new hair that grows as a result of taking Finasteride. 

2. Use Minoxidil Alongside Finasteride

Like Finasteride, Minoxidil is a hair loss medicine. It works by widening the blood vessels in the scalp, which allows more blood to pass by the hair follicles. This means that the follicles are fed with more oxygen and nutrients than they otherwise would be, which will boost hair growth. 

Minoxidil is sold under the brand name Rogaine. When it takes the form of a topical liquid or foam, it can be purchased over the counter at a pharmacy. Alternatively, patients can take the medicine orally in the form of a tablet if they get a prescription from their doctor. 

Patients should consult their doctor about using Minoxidil alongside Finasteride to confirm that they are a suitable candidate for this treatment. 

3. Take Vitamins and Supplements

There are lots of vitamins available which can boost hair growth or improve the strength and thickness of your hair. Supplements with biotin, collagen, hyaluronic acid, keratin, omega-3, omega-6, zinc, or vitamins A, C, D, and E, all help to reduce hair loss whilst also improving the strength, thickness, and overall health of your hair.

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FAQs

When does Finasteride shedding start?

Different patients experience Finasteride shedding at different times. Whilst it is most common to notice hair being shed after 2 to 3 months have passed since you first started taking the medicine, some patients notice shedding after only 2 weeks. 

How long does Finasteride shedding last?

Finasteride causes the hair to shed for roughly 2 weeks. If the shedding persists for significantly longer than this, you should speak to your doctor. 

Can you control Finasteride shedding?

Unfortunately, Finasteride hair shedding is an unavoidable side effect of taking the medication, and there is no way to prevent it. The best thing to do is to remember that the shedding only lasts for 2 weeks, and it will eventually lead to the growth of new, healthy hair. 

Finasteride can only produce new growth if it is taken consistently, in keeping with the instructions laid out by your doctor. If you stop taking the medication, Finasteride will not produce the results that you want, and you will continue to lose hair. Therefore, Finasteride shedding cannot be avoided by ceasing to take the medicine, and patients must resist the temptation to do so. 

Ultimately – though Finasteride shedding is inevitable – the best way to control it is to eat a healthy, balanced diet, exercise regularly, and reduce stress. This will help your new hair to grow stronger and faster, which, in turn, will help you to overcome the shedding phase of the medication as quickly as possible. 

How much Finasteride shedding is normal?

When Finasteride shedding begins (which, again, is approximately 2 to 3 months after you begin taking the medicine, though it can be sooner or later than this), it is normal to lose roughly 50 to 100 hairs a day. However, the amount of hair shedding caused by Finasteride will vary from patient to patient, so don’t worry if you are experiencing a little more or less hair loss than this.

How bad is Finasteride shedding?

When Finasteride shedding begins, you will notice your hair falling out at a faster rate than usual. It is normal to discover hairs on your pillow when you wake up in the morning, or to have hairs fall out into your fingers as you shampoo your scalp in the shower.

The best way to deal with Finasteride shedding is to view the hair loss as part of the process of achieving new hair, rather than an unpleasant side effect. Remind yourself that the shedding is a sign that the medicine is working correctly, and that it will only last for two weeks. 

How can you tell if Finasteride is working for you?

It takes time for new hair to grow, and so it takes time before there are any visible signs that the medicine is working for you. In fact, the onset of Finasteride hair shedding after 2 to 3 months of use is the first indication that DHT levels are decreasing and the medicine is working effectively.

After 6 to 8 months of daily use, most men will notice new hairs emerging from the scalp. 

How long does it take to see sustained hair growth from Finasteride?

Although the timeline varies from person to person, most men notice a substantial amount of new hair beginning to grow after they have been taking Finasteride consistently for 6 to 8 months. The final result of the medicine is typically visible after 12 to 18 months.

Sources:

Ricki Rusting, ‘Hair: Why it Grows, Why it Stops’, Scientific American, 284 (2001), 70-79. 

Walter Armin Brown, ‘Testosterone and Human Behaviour’, International Journal of Mental Health, 9 (1980/81), 46-66. 

Tim Jewell, ‘What You Need to Know about DHT and Hair Loss’, Healthline, 2019. 

‘Finasteride’, NHS, <https://www.nhs.uk/medicines/finasteride/>

Rose Kivi, ‘Male Pattern Baldness’, Healthline, 2019. 

‘Hair Loss’, NHS, <https://www.nhs.uk/conditions/hair-loss/>

About the Author

Dr Anny Choudhry

Dr Choudhry, also commonly known as Dr Anny, is trained in a variety of medical and surgical specialities including Dermatology and Plastic Surgery in London and East of England Deanery.

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