Finasteride: The miracle cure for hair loss?

More than half of men over 50 years old experience hereditary hair loss. Those affected lose hair roots, for which a genetic disposition is responsible. A 5-alpha reductase inhibitor, whose efficacy has been proven in clinical trials, can help here. However, proven side effects of the active ingredient finasteride have repeatedly brought the anti-androgenetic alopecia drug into the headlines.

The most effective ingredient for hair loss

“He still has all of his hair,” claims Harold N. Bornstein, the family doctor of Acting US President, in an interview with The New York Times. Responsible is the active ingredient finasteride, the Donald Trump take regularly to prevent hair loss. In Germany, the “Association of German Hair Surgeons” referred to the active ingredient some years ago, which is now sold in generics and as an original preparation in large quantities.

Last year, according to figures from the market research company IMS Health, German consumers invested around 16 million euros in the funds. Pharmacritic expert Gerd Glaeske estimates that another five million euros was spent on selling finasteride products in online shops. Studies prove the effectiveness, which is why many men with hair loss to Propecia or a generic drug with the active ingredient finasteride.

Through extensive research, scientists found that the drug can stop hair loss in a majority of users . Often, the research suggests, finasteride even stimulates hair growth. However, the 5-alpha reductase inhibitor only works if the hair root has not completely receded. With a trained bald head Propecia or a generic does not help.

This is how Finasteride works against hair loss

The active ingredient finasteride inhibits the production of dihydrotestosterone (DHT), which researchers have identified as the cause of bald heads. When genetically predisposed releases DHT, which is formed from the male sex hormone testosterone, a regression of hair roots. Finasteride blocks the enzyme by stopping 5-alpha reductase.

By blocking the enzyme responsible for the formation of dihydrotestosterone, the agent inhibits production, which, if successful, reduces the effects of hereditary alopecia. Reactivation of hair follicles is possible while testosterone levels remain within the normal range.

Based on the proven effectiveness of studies and good tolerability, the original agent was launched in 1997 in the USA. Later, countries like Sweden followed. For some years, Propecia is also approved in Germany and can therefore be prescribed for the treatment of hereditary hair loss.

Finasteride does not help against more rare hair disorders. In men, only androgenetic alopecia can be treated with the drug. Efficacy against receding hairline has not been proven. There are risks for women, which is why finasteride is not approved for them.

Effectiveness of the drug

Success with finasteride confirms clinical trials . For example, 1,215 subjects received either a placebo or the remedy over a two-year period. On a predefined area, the number of hairs in many subjects who suffered from mild to moderate hair loss in the vortex and front areas increased.

In six out of seven people, the number of hairs remained constant or increased, with the head thinning in the placebo group. The study involved people between the ages of 18 and 41 years. Investigations proving an effect in older men are still pending.

Other results from another study, involving 1,879 men, show a “significant difference” in hair growth. While users of the drug enjoyed new growth, subjects from the placebo group continued to suffer.

Regular intake is crucial for the success of the treatment

The manufacturer of Propecia recommends the daily intake of a 1mg tablet. So far, it has not been proven that a higher dosage will have a greater effect. For daily use over a period of three to six months advises the manufacturer, which points out that upon discontinuation of the treatment, a return to the original state could occur.

The intake should only take place in consultation with a physician who accompanies the treatment permanently. Before giving Propecia or a generic medicine, a doctor needs to be aware of possible side effects. Following this, there is a possibility that the agent, which is given in tablet form, brings the hair loss to a standstill within three to six months.

Further treatment may stimulate growth while after settling the previous condition is achieved. The continuous continuation of finastaride therapy is the only way to benefit permanently from the action of the 5-alpha reductase inhibitor. Post-marketing reports were growing that complained of infertility or poorer semen quality.

Side effects: Full hair, but potency problems?

Initial studies on the drug revealed isolated side effects that did not occur in the further course. About 1.8 percent of Propecia-treated subjects complained of decreased libido and potency problems. Nevertheless, the drug proved to be compatible, so it was sold in high numbers in the following years.

Because of occasional depression, Propecia has been repeatedly criticized. In the US, about 1,400 people filed suit against the manufacturer, the Merck Group. In Germany, two people complained because they wanted to clarify whether the manufacturer was aware of possible side effects such as mental disorders. But because only a small number of users are affected, the manufacturer continues to produce its product.

In Germany and other European countries, the active ingredient is permanently available. Here, mainly generics manufacturers distribute the drug. Because the contained finasteride undoubtedly helps against the atrophy of hair roots in the crown and forehead, it remains one of the few remedies that produce visible effects.

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