Hair loss can be stopped with medical treatment in the early stages. Especially in genetic type hair losses, early stage hair losses in young patients can be recovered with FDA-approved (American Food and Drug Administration) finasteride. Minoxidil active ingredient stimulates the hair growth, and is an important weapon in early stage hair losses when used together with finasteride.
Hairs that are only miniaturized with the medical treatment and slowly passing from anagen phase to telogen phase can be treated. After the hair is lost, it is impossible to get any results with medical treatment. This is why the most reasonable treatment method in total hair losses is the hair transplantation.
Hair transplantations cannot prevent the androgenic type hair losses but only allows the lost hairs to be replaced. This is why initiating the medical treatment in early stages both prevents the androgenic hair loss and allows hairs that are miniaturized and not growing come to life, and creates a hair mass again.
The enzyme that allows the testosterone to transform into dihydrotestosterone is 5 alfa reductase type 2 enzyme. The medicine that prevents hair loss by stopping the activity of this enzyme is “finasteride”. While the finasteride substance that is taken 1 milligram per day helps 90% of the male users above 18, the decrease in the amount of hair continued in only 10% of male patients. Especially in young patients whose hair lost and thinning have recently started, it achieves better results but attention should be paid while using on the ones below 18. Finasteride is less effective in the frontal hairline losses. It has been proved that the efficiency of finasteride was more in the back sides of the scalp and vertex area.
It should be used for at least 1 year for stopping the hair loss and strengthening the hair, and for the thickening effect in miniature hairs. It was reported that its effects usually remain even though users stop using after 5 years. When given up on using finasteride, 2-6 months later, a hair loss is again experienced in the increased hair volume and mass by the effect of the medicine, the effects of the medicine is lost and hair returns to its old state as if it was never treated.
The rate of side effects that may be seen due to the use of finasteride is 2%. Namely, no side effect is seen in 98 of 100 users. The most frequent and feared question that people ask to us is the sexual disfunction. This side effect that can be seen in the forms of erectile dysfunction, lack of appetite towards opposite sex and decrease in libido may occur right after the medicine use, and when the medication is stopped, the user recovers their normal sexual functions within one week; the side effects are not permanent.
As finasteride is a medicine that prevents the enlargement of prostate gland and shrinks it, it may decrease the intensity and amount of the ejaculation; and it may temporarily decrease the number of sperms. Apart from those, a slight enlargement and tenderness of the breast tissue is reported in 0.4% of patients. While side effects like breast tenderness and enlargement can be seen in males, there has not been seen any relationship between the development of breast cancer in males and finasteride use. Finasteride is a medicine that is used to prevent the enlargement of prostate, and the patient should inform his doctor that he used this medicine as approximately 50% decrease in prostate PSA values has been seen after using this medicine.
Finasteride use is forbidden in pregnant women because it may cause a congenital anomaly in the male fetus genital area. Having a sexual intercourse with a male who uses finasteride does not negatively affect the fetus and woman. In a study conducted on the use of 1 mg finasteride in women after menopause, it has been proved that this medicine had no effect and that it may be beneficial in androgenic female type alopecia when used in 5 mg.
Realities of finasteride
Myth: Finasteride grows hair again
In reality: No. Finasteride only affects the hairs that are thinning and help them thicken; it does not grow the hair in total hair loss cases.
Myth: Pregnant women cannot touch finasteride.
In reality: Yes, pregnant women should not even touch the crushed tablets. Orally administered drug powder may cause some deformities in the fetus.
Myth: One should continuously use it when used once.
In reality: No, one can quit anytime they desire. Within 2-6 months after quitting the medicine, the hair gets thinner again and changes back to its old state.
Myth: It is only effective in the vertex and back parts of the head.
In reality: No, it helps the hair in all areas get thicker but it is more efficient in the vertex.
Myth: It may lover the testosterone level.
In reality: No, on the contrary, the testosterone levels increase 10-15% by regular use.
Myth: Its sexual side effects are permanent.
In reality: No, a couple of weeks after quitting the medicine, sexual functions come back.
Minoxidil is the first FDA-approved medicine of which efficiency in preventing the hair loss is proven. It is a serum that needs to be rubbed in with massage by contacting the scalp. Its 2% forms are efficient in women and 5% forms are efficient in male type alopecia. It is aimed to control the high blood pressure at first use. As a result of minoxidil use, some patients may achieve very good curative effects and some may achieve moderate curative effects in terms of hair recovery; and some patients may achieve no benefits. In the ones who benefit from it, minoxidil stimulates the hair bulbs that start to miniaturize and provides hair generation and stops the hair loss. Its maximum effect is seen between 6 months and 2 years. After this period, its effect slightly increases. In continuous uses, the hair loss slows down and it is effective on the hair loss, in the vertex area in particular, in frontal areas and temples. The most common side effect among the users of the medicine is the rare hair growing in the body and face.
Although the mechanism of action of minoxidil is unknown, it is thought that it extends the anagen phase, in other words, the hair growth phase, and therefore increases the thickness and length of hairs. It should be applied on the scalp by rubbing in twice a day. It will only show its effect on the contact area, therefore the areas of application and dosage should be determined under supervision of a doctor. It should be applied not only on the vertex but also on front sides as well if there is thinning. Continuous use is advised; 3 months after quitting, its effect decreases and the hair changes back to its old state. When minoxidil is used together with finasteride, the hair loss is prevented in a stronger way with a synergistic effect. It is usually advised that these two FDA-approved medicines are used together.