Yes, finasteride works for treating hair loss caused by androgenic alopecia for many men, and is most effective when started at the earliest signs of hair loss and used consistently afterwards.
What Is Finasteride and Who Is It For?
Finasteride is a medication available by prescription that reduces levels of dihydrotestosterone (DHT). Originally developed as a drug to treat benign prostate hypertrophy (BPH) , it was thereafter seen at a lower dose as a potential treatment solution for androgenic alopecia (AGA), through its action on the enzyme 5-alpha-reductase which produces the hormone DHT, the main culprit in AGA. Men who have AGA use finasteride as first line treatment and in many men, it has been very effective for stopping their hair loss and promoting thicker, healthier hair. Finasteride is best used when the follicles are still active, but less so.
Finasteride is not suitable for hair loss caused by other medications, stress, chemotherapy, or autoimmune deficiencies and because it can cause fetal abnormalities it is not suitable for use in women who have pattern hair loss, who are pregnant or planning to get pregnant.
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How Does Finasteride Work for Hair Loss?
Finasteride blocks the enzyme 5-alpha-reductase, which is responsible for converting testosterone into dihydrotestosterone (DHT). For men who are genetically predisposed to androgenetic alopecia, DHT is the main cause.
By lowering DHT levels in the scalp, finasteride:
- Slows, or in many cases stops, further hair loss
- Allows miniaturized follicles to recover from the effects of DHT
- Increases hair density in areas where follicles are still alive
- Works best in early- to mid-stage male pattern hair loss (AGA)
- Needs consistent, daily use to get the best results
Finasteride stops DHT from having its effect on the follicle, and by blocking DHT, results in shorter resting and longer hair growth (or anagen) phases. Earlier treatment produces better outcomes as finasteride won’t work on areas where follicles are already dead or non-functional, and hair loss too advanced.
Does Finasteride Lower Testosterone?
No, finasteride does not lower testosterone. In reported clinical studies, while there might be a small increase in testosterone transiently, patients using finasteride saw no effect on their testosterone levels over the longer term. Users may associate the two because when using finasteride, DHT levels decrease and DHT is a byproduct of testosterone, but the amount of testosterone itself remains unaffected due to the body’s adaptive mechanisms. Some patients did see a slight increase in testosterone in their bloodstream because less was being converted into DHT. (1) (2)
Our medical review, Does testosterone cause hair loss?, explains that testosterone itself is not the primary driver of male pattern baldness.
The issue is actually DHT and follicle sensitivity. When lowering DHT, not testosterone, finasteride interrupts the hormonal signal that causes hair follicles to miniaturize over time and hair to shed.
It’s worth mentioning that the sexual side effects associated with finasteride are not caused by testosterone levels. These side effects are related to changes in DHT and neurosteroid pathways, not a drop in T levels. DHT is a powerful male sex hormone in the body and is important for initiating and maintaining erectile function, libido and ejaculation.
Does Finasteride Actually Work? What the Evidence Shows
In a large clinical study on 1,553 men between ages 18 and 41, taking 1mg of finasteride for a year, significantly limited hair loss and increased hair growth when compared to placebo. (3)
Using a phototrichogram (a device used to diagnose and study hair loss) to examine the hair follicles, doctors saw that on 1mg per day for 48 weeks there was a 26% increase in anagen-hair counts. A 17/cm² increase in hair count, shows that finasteride has a meaningful effect on hair loss for many men, the question is just how well it works versus other treatments. (4)
In a 2022 study using 1mg of finasteride per day, hair growth of over 12.4 hairs/cm² at 24 weeks and 16.4 hairs/cm² at 48 weeks was observed. (5) When the 3 most common and effective hair loss solutions were compared, the results showed that a higher dosage of finasteride had even better results. This same meta-analysis indicated that combining finasteride or dutasteride with minoxidil is likely the most effective way to stop hair loss and promote hair growth for men with AGA. (6)
This doesn’t mean finasteride is a magic bullet for hair loss, but for many men it can be the best route to preserving existing hair and repairing hair follicles that have started to die off.
How Well Does Finasteride Work for Hair Loss at the Hairline vs the Crown Area?
In general, finasteride can work well on both areas, but some studies have shown that hair loss medications, including finasteride, tend to work better on the crown area at the top of your head. When it comes to your hairline, finasteride is best for stabilizing the hair follicles (especially if you catch it early). The bald spot on the crown or vertex (top) of your head is where you’ll tend to notice more significant regrowth and hair density with finasteride treatment. (7) (8) (9)
Does Finasteride Work for Everyone?
Unfortunately, finasteride does not work for everyone. The good news is that the majority of men with androgenetic alopecia do respond well to finasteride treatment. Every individual is different and things like genetics, degree or stage of hair loss, and how long you’ve been losing your hair will all affect how well you respond to the medicine.
How Long Does Finasteride Take to Work and Does It Work Forever?
It generally takes 3-4 months for finasteride to begin working, and at this stage you may actually see more hair loss. This is called the shedding phase and despite concerns you may have, it’s important to push through and continue treatment. By 4-6 months you’ll typically start to see the hair growing back and because the follicle is not being starved by DHT anymore you’ll start to see thicker, fuller hair. At the 1 year mark you should see a result getting closer to your final result and if you’re consistent, then by year 2 you will typically see a final result which in many men can be very significant improvement compared to baseline when treatment began. This is only the case for hair follicles that have not died off completely so starting sooner rather than later is essential for best results.
You generally need to use your finasteride treatment long-term. When you stop taking finasteride, your DHT levels will return to baseline before treatment and your hair loss will resume in 3 to 6 months and at 12 months of no treatment you’ll generally be at the same stage you started at before you began your treatment journey.
Oral vs Topical Finasteride: Which One Works Better?
Oral finasteride and topical finasteride are both effective options for treating hair loss with the key difference being the amount of systemic exposure and amount delivered to the hair follicle. Topical finasteride theoretically may pose lower risk of side effects because it is applied to the scalp and lower levels of medicine are intended to enter the blood stream. This is not always the case however and not all topicals achieve low blood levels. Because these are compounded options, meaning not FDA approved, pharmacies or online companies offering these topicals, may not have even studied the amount of medicine entering the bloodstream when delivered topically.
In our article Topical Finasteride vs. Oral Finasteride we go into detail of how each works so you can make the decision on which is best for you and your hair loss goals.
Both oral and topical finasteride can improve androgenetic alopecia, but they can differ in systemic exposure of the finasteride medication and because of this, they can differ in the degree (strength) of DHT suppression. Ideally, one wants a delivery that reduces DHT suppression at the hair follicle, but not in the systemic circulation (bloodstream) which can lead to more systemic-related symptoms such as ED or low libido. 9. Finasteride +
Minoxidil: Do They Work Better Together?
Yes, using finasteride and minoxidil together to treat androgenetic alopecia is generally more effective than using either one independently, although this may not always be the case. Clinical data has shown higher response rates and better hair growth by combining the two. In a 12-month randomized study of 428 men, 94.1% of men using oral finasteride + 5% topical minoxidil improved clinically, vs. 80.5% with finasteride alone and 59% with minoxidil alone. (10) Another more recent study found users of topical finasteride and topical minoxidil also showed significantly greater increases in hair density than either drug alone (11). Furthermore, a 2025 meta-analysis showed minoxidil-based combinations ranked finasteride + minoxidil as the most effective treatment, with the largest hair-density gains compared with minoxidil alone. (12) Whether or not combination treatment is the best solution for your hair loss is something you should discuss with your prescribing doctor.
When Is It Too Late to Take Finasteride?
Finasteride reduces DHT to prevent the hair follicles from miniaturization, so if the follicle has already reached a state where there is no viable hair, then it won’t be effective. If you notice that your hair is thinning, wispy, or it’s reached a state of looking like peach fuzz, then it is possible that finasteride can stop the hair follicle from dying and start it regrowing healthy, thicker strands of hair. When the skin is completely bald then it's too late to restart the hair growth, so finasteride will not be effective. The key to effective outcomes is starting as soon as you notice the hair thinning; starting treatment as early as possible will get the best results.
Hair Loss Types Finasteride Does Not Work For (Stress, Chemo, Fungal, etc.)
Finasteride will not work on all types of hair loss and is really mostly effective for androgenetic alopecia. Its mechanism of action is via blocking DHT, so if you are experiencing hair loss because of any other causes such as stress (telogen effluvium), chemotherapy, scalp infections such as tinea capitis, or immune mediated causes such as alopecia areata, you likely will see minimal change when taking finasteride.
Side Effects, ED and Hormone Concerns
The side effects of taking finasteride are a big topic for any man considering using it to treat his hair loss. The likelihood of experiencing side effects when using finasteride is is low (< 5% in published studies), but because these adverse effects are often sexual in nature, it’s still enough that many men would rather not take the risk. The most common side effects are lowered sex drive (Low libido) and erectile dysfunction, with some men experiencing changes in their ejaculation volume. Breast and testicle tenderness/pain have also been described as have mood or mental health changes such as depression or anxiety.
This is why many men decide on proceeding with compounded topical forms of finasteride which may lower the risk of these side effects by applying the medication to the scalp with less systemic absorption, rather than using the approved oral form of finasteride that is absorbed into the bloodstream. If you are using finasteride and it’s working on your hair, but you experience side effects, talk to your doctor about whether a compounded topical version might be worth considering.
Does HIMS Finasteride Work? Does Keeps Work? What Brand is Best?
There is no best brand for oral finasteride because they all use the same active ingredient. The differences arise when the medication is compounded for topical application, and in this case the delivery mechanism will make a difference on a user-by-user basis. HIMS and Keeps both offer topical versions as well as many other brands where they apply the medication as a foam, spray, or gel. HIMS has 0.3% finasteride, Keeps has 0.25% finasteride, and XYON uses 2.5%, a higher concentration, as the XYON SiloxysSystemTM gel technology concentrates more of the finasteride on the skin with low absorption of finasteride into the blood stream. The idea behind the SiloxysSystemTM gel technology is to increase the ratio of finasteride in the skin vs the bloodstream delivering more finasteride where it’s needed to work and less where finasteride can cause side effects.
How to Maximize Your Finasteride Results
The key to maximizing your hair regrowth while using finasteride is consistency, patience, and maintaining a healthy lifestyle. Using it along with minoxidil is another great way to get even more hair growth, especially in early stages of hair loss. Manage stress, stop smoking, adopt a cleaner more plant-based diet higher in monounsaturated and poly unsaturated fats, keep your scalp clean, and commit to using your medication as advised by your doctor for 12-24 months and you have a strong chance of stopping your hair loss and seeing a significant amount of new healthy hair growing again.
Real-World Results: Before-and-After Patterns and Patient Stories
Checking Reddit and other forums for real-world experience from actual users is a great way to get additional information. Hair loss treatments are widely discussed online with users helping other men make more informed decisions about how to treat their conditions. This kind of self-reported data, monitored by staff moderators, reiterates what the clinical trials have shown: success at stopping hair loss and regrowing thick, healthy hair.
After using topical finasteride for 1 year
Link: https://www.reddit.com/r/tressless/comments/1d175ae/topical_finasteride_1_year_results/
What they said:
“I now have minimal hair loss … seeing results in the quality of hair and the density on my hair line.”
No systemic side-effects.
After using topical finasteride and minoxidil for 1 year
Link: https://www.reddit.com/r/tressless/comments/1ji8rmt/one_year_progress_topical_finmin/
What they said:
“Diffuse thinning before. After a year, everything looks thicker.”
Uses topical finasteride + minoxidil and shows clear improvement in hairline and mid-scalp.
After using oral finasteride and topical minoxidil for 1.5 years
Link: https://www.reddit.com/r/tressless/comments/1klmm5c/18_months_of_treatment_my_honest_journey_before/
What they said:
“18 months in … finally seeing thickening and normal texture again.”
Started oral finasteride, later added topical fin/min, then stabilized.
After using topical finasteride and minoxidil for 4 months
Link: https://www.reddit.com/r/tressless/comments/1l98zc3/31m_4_month_progress_pictures_on_finmin_hybrid/
What they said
“Insane progress in 4 months.”
Clear hairline + temple density improvement in photos.
Early responder with very visible volume change.
After using oral finasteride for 1 year
Link: https://www.reddit.com/r/tressless/comments/1fw77ie/1_year_on_finasteride_1mg_before_and_after_photos/
What they said:
“Hairline thickened noticeably. Not miraculous but definitely better.”
Shows temple and mid-scalp thickening after one year.
Takeaway
Finasteride is the most effective medial treatment for androgenetic alopecia by targeting its root cause: the conversion of testosterone into follicle-shrinking DHT. It is highly effective but needs to be taken at the earliest sign of hair loss and it takes time to work, so men should expect to experience the full results and see stronger, healthier hair after using finasteride for 6 - 24 months. There are possible side effects to using finasteride and by applying it topically rather than taking a pill, users lower the possibility of those side effects. If men using finasteride want to maximize their results, studies have shown that combining it with minoxidil is even more effective for treating hair loss and regrowing hair.
FAQ
1. Does finasteride actually work for hair loss?
Yes. Clinical trials show that finasteride slows or stops hair loss in most men who use it consistently, and many experience measurable regrowth, especially at the crown. Real-world users commonly report reduced shedding, thicker hair, and stabilization over 6–12 months.
2. Is finasteride better for the crown or the hairline?
Finasteride is consistently more effective at the crown (vertex) than the frontal hairline. The hairline can still improve, especially if treatment starts early and is used consistently, but regrowth there tends to be more modest. Stabilization is by far the most common hairline outcome.
3. How long does finasteride take to show results?
Most users notice shedding in the first 3 months or so, then reduction in shedding around 3–4 months, with visible thickening or regrowth between 6–12 months. Maximum effect is usually seen after 12–24 months of consistent use.
4. Does finasteride work for everyone?
No. While most men respond, some are “non-or low-responders.” Finasteride won’t work if follicles are already dead (smooth, shiny scalp). Genetics, age, cause and duration of hair loss, and whether supportive treatments (e.g., minoxidil) are added, all influence results.
5. Can I stop finasteride once I see improvement?
No. Finasteride only works while DHT is suppressed. If you stop treatment, DHT returns to baseline within weeks, and hair loss typically resumes within 3–6 months, often returning to the pre-treatment baseline by 6–12 months. Continuous use is required to maintain gains.
References
Gupta AK, et al. Finasteride for hair loss: a review. Drugs Context. 2022. PMID: 34291720
https://pubmed.ncbi.nlm.nih.gov/34291720/
McClellan KJ, Markham A. Finasteride: a review of its use in male pattern hair loss. Drugs Aging. 1999. PMID: 9951956
https://pubmed.ncbi.nlm.nih.gov/9951956/
Kaufman KD, et al. Finasteride in the treatment of men with androgenetic alopecia. J Am Acad Dermatol. 1998. PMID: 9777765
https://pubmed.ncbi.nlm.nih.gov/9777765/
Van Neste D, et al. Finasteride increases anagen hair in men with androgenetic alopecia. Br J Dermatol. 2000. PMID: 11069460
https://pubmed.ncbi.nlm.nih.gov/11069460/
Leyden J, et al. Finasteride in the treatment of men with frontal male pattern hair loss. J Am Acad Dermatol. 1999. PMID: 10365924
https://pubmed.ncbi.nlm.nih.gov/10365924/
Hirshburg JM, et al. The role of 5-alpha-reductase inhibitors in androgenetic alopecia: a meta-analysis. J Am Acad Dermatol. 2016. PMID: 17348990
https://pubmed.ncbi.nlm.nih.gov/17348990/
Kaiser M, et al. Treatment of Androgenetic Alopecia: Current Guidance. Dermatol Ther (Heidelb). 2023. PMCID: PMC10239632
https://pmc.ncbi.nlm.nih.gov/articles/PMC10239632/
Adil A, et al. The effectiveness of treatments for androgenetic alopecia. J Am Acad Dermatol. 2017. PMID: 28396101
https://pubmed.ncbi.nlm.nih.gov/28396101/
McConnell JD, et al. Finasteride reduces DHT and increases testosterone. J Clin Endocrinol Metab. 1992. PMID: 1371291
https://pubmed.ncbi.nlm.nih.gov/1371291/
Roehrborn CG, et al. Testosterone changes during finasteride therapy (PLESS). J Urol. 2003. PMID: 14624915
https://pubmed.ncbi.nlm.nih.gov/14624915/
Traish AM, et al. Do 5α-reductase inhibitors raise circulating serum testosterone? Sex Med Rev. 2019. PMID: 30098986
https://pubmed.ncbi.nlm.nih.gov/30098986/
Zhao Y, et al. Relationship between DHT reduction and finasteride response. J Clin Endocrinol Metab. 2007. PMID: 17348990
https://pubmed.ncbi.nlm.nih.gov/17348990/
Jiang J, et al. Finasteride + topical minoxidil vs monotherapy. J Dermatolog Treat. 2015. PMID: 26031764
https://pubmed.ncbi.nlm.nih.gov/26031764/
Sharma AN, et al. Topical finasteride + topical minoxidil vs each alone. J Cutan Aesthet Surg. 2023. PMID: 37798906
https://pubmed.ncbi.nlm.nih.gov/37798906/
Gupta AK, et al. Network meta-analysis of minoxidil + finasteride combinations. JAMA Dermatol. 2025. PMID: 41041440
https://pubmed.ncbi.nlm.nih.gov/41041440/
Suchonwanit P, et al. Efficacy of topical minoxidil (systematic review). Dermatol Ther (Heidelb). 2024. PMID: 40730430
https://pubmed.ncbi.nlm.nih.gov/40730430/
Rietschel RL, et al. Long-term treatment with topical minoxidil. Arch Dermatol. 1987. PMID: 2180995
https://pubmed.ncbi.nlm.nih.gov/2180995/
Jiménez-Cauhé J, et al. Oral 5 mg vs topical 5% minoxidil RCT. JEADV. 2024. PMID: 38598226
https://pubmed.ncbi.nlm.nih.gov/38598226/
Shapiro J, et al. Oral minoxidil systematic review. JAAD. 2024. PMID: 40365252
https://pubmed.ncbi.nlm.nih.gov/40365252/
Starace MVR, et al. Topical minoxidil vs oral finasteride vs topical finasteride in postmenopausal women. Skin Appendage Disord. 2024. PMID: 39108554
https://pubmed.ncbi.nlm.nih.gov/39108554/
Does testosterone cause hair loss?
https://xyonhealth.com/blogs/library/does-testosterone-cause-hair-loss
Sexual Side Effects of Finasteride
https://xyonhealth.com/blogs/library/sexual-side-effects-of-finasteride
