Nonsurgical Follicle Treatment with Finasteride (Propecia®)
Finasteride (Propecia®) is the only FDA-approved prescription medication created specifically for male baldness. Many years of investigation and use by over one million patients show that finasteride has long-term effectiveness and safety in treating male baldness in men of a variety of national backgrounds. Finasteride as a 1mg daily dose for the treatment of male baldness is prescribed under the brand name Propecia®.
Testosterone is the most potent of the androgenic hormones. It is also one of the most important in its influence on sebaceous glands and follicles. Testosterone, however, does not act directly on the body. Within the cells, testosterone is converted into dihydrotestosterone (DHT) by the enzyme 5 alpha-reductase. It is testosterone in its DHT form that influences skin structures and follicles. The 5-alpha-reductase enzyme occurs in two forms, Type I and Type II:
- Type I predominates in sebaceous glands
- Type II occurs most abundantly in follicles
Finasteride (Propecia®) inhibits the activity of the Type II 5- alpha-reductase enzyme and thus lowers the blood level of DHT and allows for follicle growth.
In large randomized clinical trials comparing finasteride to placebo, finasteride was proven to produce long-lasting improvement in follicle growth and to slow baldness in a majority of men.
In general, men who took finasteride (Propecia®) maintained or increased the number of visible hairs and noticed improvement in their hair in the first year. Follicle counts in men who did not take finasteride continued to decrease. At 5 years, 90 percent of men taking Propecia® had improvement or no visible baldness(48 percent of patients improved; 42 percent of patients had no visible follicle loss).
Finasteride (Propecia®) is used for treatment of male baldness on the crown and the anterior mid-head area. It may take 3 months or longer for patients to notice a benefit from taking the medication. Finasteride (Propecia®) is a one milligram tablet that must be taken daily to maintain results. If the medication is discontinued, the follicles will gradually, over several months, revert to the stage of male pattern bladness that would have been present if the medication was never started. Finasteride (Propecia®) is considered by most experts to be more effective than the non-prescription treatment medication minoxidil (Rogaine®). There are studies, however, that suggest that the combination of finasteride and minoxidil is more effective than the use of either alone. Finasteride (Propecia®) is for use by men only. Women who are or may become pregnant should not handle Propecia®, as it may cause abnormalities of a male baby’s sex organs.
Propecia® can affect a blood test for PSA (Prostate Specific Antigen) for the screening of prostate cancer. The physician performing this blood test must be informed of the use of this medication so he may adjust the value to obtain an accurate result.
