Managing Male Pattern Baldness with Medications

by | Jan 10, 2020 | Hair Loss

The very first treatment that hair loss sufferers would usually try to stop hair loss is medication.
This is why brand names like Finasteride and Minoxidil are widely popular today. These medical hair loss treatments have been the first beacon of hope for many when it comes to restoring hair volume.


Finasteride is the generic name for Merck’s Proscar and Propecia. This drug was originally developed to treat patients who are suffering from benign prostatic hypertrophy (BPH) or enlarged prostate glands. But, it was later discovered during trials that it also stimulates hair growth as a side effect. This drove the manufacturers to market the drug to treat male pattern baldness.
Efforts were rewarded with an FDA approval in December of 1997. And since then, it has earned the reputation of being an effective treatment for male pattern baldness.

How it Works Again Hair Loss?

The success of Finasteride on the battle against hair loss comes from its inhibitory action against 5-alpha-reductase, which is the enzyme that is responsible for converting testosterone to its more potent form, DHT (dihydrotestosterone). Increased DHT levels causes the hair follicles to shrink or miniaturize, then fall off in excessive amounts, and eventually leads to balding.
According to WebMD, a one milligram dose of Propecia can lower DHT levels on the scalp by 60% when taken on a daily basis. This halted the progression of hair loss in about 86% of males who have taken the drug during clinical trials. There was a substantial amount of improvement in hair growth among 65% of the study participants.

Drawbacks of Finasteride

The success of Finasteride may be widespread; however, it also comes with a catch. There are reports that the drug causes increased rates in sexual dysfunction. This includes problems like erectile dysfunction and low libido. This is one of the major reasons why some men discontinue the drug despite its therapeutic effects regarding hair loss.

However, some still experience the side effects three months after they stop taking Finasteride. When this happens, it is already considered a “persistent” occurrence.
According to Dr. Michael S. Irwig from the Center for Andrology and Division of Endocrinology of George Washington University, “Prescribers of Finasteride and men contemplating its use should be made aware of the potential adverse medication effects.” This was his conclusion from the data he gathered after observing adult males who experienced Finasteride-associated sexual side effects. Today, Finasteride includes this warning on their labels.

Important Reminders When Taking Finasteride

It is important to note that Finasteride or Propecia should be used only by men. Women are advised against this treatment especially among those who may be or who are pregnant. This drug can pose abnormalities in the sex organs of a male baby. Simply coming in contact with a crushed Finasteride drug by hand can be a risk because of the active ingredient. If ever this happens, a pregnant woman should always consult her doctor immediately.

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How Minoxidil Works on Hair Loss?

The drug comes in liquid form, and it is to applied to your scalp twice a day. You have to follow instructions prescribed by your doctor carefully. Increasing dosage does not mean it can result to faster results, but instead, it only exposes you to increased side effects. This drug has to be used for at least 4 months before you can see results, in some cases it can take a year.
The 2% Minoxidil can be used to treat female hair loss. There are also 5% Minoxidil preparations which are marketed to be extra strength hair regrowth treatment. This is appropriate for men who are experiencing a generalized hair thinning on top of the scalp.
Minoxidil basically aids in extending the growth phase of the hair since each one goes through a growth cycle and male pattern baldness hastens the process.

Drawbacks of Minoxidil

The drug is not applicable for hair loss at the front of the scalp or for those men who have receding hairlines. It is also not advised among those who are 18 years old or younger, or if you are experiencing sudden patchy hair loss.
Related: Young and Bald: How to Deal With Hair Loss
Minoxidil works best for young men who are just starting to lose hair. Since everyone’s reaction to a drug varies, some may be able to overcome hair loss while others don’t experience any improvement at all.

What are the Most Common Side Effects with Minoxidil Topical Solution?

The treated areas will be reddened and you may experience some burning or stinging sensation. Should any serious side effects become apparent, it is important to report this immediately to the doctor.
Dizziness, fast and irregular heartbeat, difficulty in breathing and unwanted body hair growth are also some of the adverse reactions that you have to watch out for.

Can Finasteride and Minoxidil be Used Together?

There are men who use these two together to achieve a more effective outcome in treating hair loss. Propecia blocks DHT while Minoxidil improves blood flow to the scalp. This treatment is referred to as “fin and foam”, a short term for Finasteride and the foaming action of Minoxidil. Some men even triple treat the problem by adding Nizoral A-D into the mix. This is an antifungal medication that is aimed at treating accompanying dandruff.
There are also comparative studies that show the effects of oral Finasteride and 5% topical minoxidil in treating male pattern baldness. The results showed that both drugs are safe and effective as treatment for mild to severe androgenetic alopecia. But, the researchers noted that oral Finasteride was more effective without factoring in the side effects.

About Dr Tyng Tan

Dr. Tan Tyng Yuan, MBBS completed her graduate and medical education in the United Kingdom over a span of 10 years.

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