Propecia/Finasteride inhibits
DHT to Stop Hair Loss
How Finestaride or Propecia
Works
Finasteride is more popularly
known as Propecia. Propecia is the brand name for finasteride
at the 1 mg dose. It is one of the few medications that
work for many people. It is usully in table form taken
orally.
Male pattern baldness
(androgenetic alopecia) is caused by the effects of
male hormone dihydrotestesterone (DHT) on hair follicles
that are genetically vulnerable. They are usually located
in the front, top and crown of the scalp, leaving the
back and sides to remain relatively lush.
DHT affects hair loss
by shortening the growth phase of the cycle, leading
to a minitiarization of the hair follicles. The affected
hair grows more slowly or stops growing completely,
becoming shorter and finer until it dinally disappears.
The male sex hormones
involved in the hair thinning process are testosteerone
and DHT. The cells in the body metabolize testosterone
and turn it into DHT. This process is facilitated by
an anzyme called 5-alpha reductase (5AR). There are
two types of 5AR:
- Type 1, which is
mainly located in the sebaceous (sweat) glands, keratinocytes
and fibroblasts. This enzyme catgalizes the conversion
if testerone into another hormone called androstenedione
which is related to the production of sebum. Its role
in hair loss is not clear.
- Type 2, which is found
in the skin and the sheath of hair follicles has a
clearer role on hair loss. It appears to cause hair
loss for those who are genetically predisposed for
hair loss. Finesteride prevents hair loss by blocking
the effect of this hormone.
This drug works by making
5AR less potent, reducing its ability to produce DHT.
Taken at 1 milligram a day, clinically studies show
that ti can reduce the DHT levels by almost 70 percent.
Contrary to popular belief,
finasteride does not lower the testerone level. Instead
it increase it by 9 percent.
Efficacy of finasteride
or Propecia
Based on studies, almost
half the men treated with Propecia (brand name for finasteride
at the 1 mg dose) showed an increase in hair growth
and 90 percent of them maintained the increased hair
over the previously thinning areas. They were tested
over 5 years of treatment. 10 percent of the men tested
lost hair over this time period. As for those not given
Propecia, 75 percent of them lost hair over this time
period.
In a study published in 2010 involving the analysis of a dozen studies on the drug involving nearly 4,000 men, it has been found that most men who take finasteride experience a 30 percent improvement in hair growth in two years.[1]
Propecia appears to help
men under 50 and those who only started to lose hair
during the past 2 to 3 years to even regrow hair. Those
above 50 and have lost hair for many years can expect
to stop hair loss. For these subjects, a few may see
some hair regrowth but this is an exception rather than
the rule. We have seen better results with low
level laser therapy for hair growth.
Users of Propecia need
to know that within 2 to 6 months, they will revert
to their original condition for their hair if they discontinue
treatment. This generally apply to any treatment that
stops hair loss or re-grow hair as the causal reasons
for the hair loss will take over again. Where hair has
alrady been lost (as opposed to hair thinning, particularly
in the frontal area) Propecia is not expected to work
for these areas.
You need to be patient
when taking finasteride. Give one year to see results
and before your doctor can determine its effect. You
may still see some thinning within the first 6 months
as new hair replaces the sickly miniaturized hair.
Does Finasteride or
Propecia Work for Women?
Studies on the efficacy
of finasteride and Propecia on women have been inclonclusive.
One study evaluated the
effectiveness of the combination of a relatively high
dose of oral finasteride (2.5 mg as opposed to commercially
available 1 mg) with an oral contraceptive on perimenopausal
women with pattern hair loss. 62 percent of these women
showed a decrease in hair loss after one year.
Another study evaluated
the efficacy of 1 mg of finesteride on postmenopausal
momen found no significant hair growth after one year.
The two studies are conducted
under different conditions as stated above. The results
may suggest that finasteride may or may not work on
women depending on the conditions. The success in one
of the studies may suggest that finesteride could work
based on a high dosage of 2.5 mg and only for perimenopausal
women. On the other handit may not work with a regular
dosage on pstmenopausal women.
It should however be
noted that FDA has not approved finasteride for women.
Pregnant or women with the potential to be pregnant
should not handle broken finesteride/Propecia tablets
since the ingredients can be absorbed through the skin.
This poses a potential risk to a male fetus. There is
no risk with a man taking finesteride impregnates a
woman.
Based on facts available
women are not recommended to take finasteride.
Reference
1. Mella J M, Perret M C, Manzotti M, Catalano H N, Gordon Guyatt G. "Efficacy and Safety of Finasteride Therapy for Androgenetic Alopecia - A systematic Review". Arch Dermatol. 2010;146(10):1141-1150. doi:10.1001/archdermatol.2010.256.
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