Finasteride: what it is and how it works
Finasteride lowers DHT to slow male pattern hair loss. Review who it is for, the side effects, pregnancy risks, and how to access it.
Key facts
- Finasteride + Minoxidil Scalp Solution is $53.50/month (billed $107 every 50 days), charged only after a clinician approves it.
- Answer a few health questions online. A licensed clinician reviews them. If approved, it ships to your door.
- Adults 18 or older. A licensed clinician reviews your health history and decides whether treatment is appropriate for you. Availability depends on the state you live in.
- A $20 clinician review, refunded if you don’t qualify.
Finasteride is a prescription medicine that reduces dihydrotestosterone (DHT), a hormone involved in male pattern hair loss. It is FDA-approved as an oral tablet for male pattern hair loss and benign prostatic hyperplasia (BPH), and it is sometimes used in other forms under clinician supervision. This page explains what finasteride does, who it may fit, key risks including sexual side effects and pregnancy exposure, and how access typically works.
- Finasteride lowers DHT to help slow male pattern hair loss.
- It is used long term, and benefits may fade after stopping.
- Sexual side effects can occur and may persist in some people.
- Finasteride can cause birth defects and must be avoided in pregnancy.
- Cost depends on formulation, pharmacy, and whether labs and follow-ups are needed.
What finasteride is
A prescription 5-alpha reductase inhibitor
Finasteride is a medication that blocks an enzyme called type II 5-alpha reductase. This enzyme converts testosterone into DHT. Lowering DHT is the main reason finasteride is used for androgenetic alopecia (male pattern hair loss) and for BPH.
FDA-approved oral uses
Finasteride tablets are FDA-approved to treat male pattern hair loss (at a lower-dose tablet) and to treat symptoms of BPH (at a higher-dose tablet). The hair loss indication is for men with mild to moderate hair loss on the top of the scalp, not for a receding hairline alone.
Topical combinations may be compounded
Some hair-loss treatments combine finasteride with minoxidil in a topical solution. When a product is compounded, it is prepared by a licensed pharmacy for an individual prescription and is not FDA-approved. Your clinician and pharmacy should explain the exact formulation and directions.
Not the same as minoxidil
Finasteride works by lowering DHT. Minoxidil works through a different pathway and is applied to the scalp or taken orally in some off-label regimens. Some people use one or the other, and some use both under clinician guidance.
- Drug class
- 5-alpha reductase inhibitor (type II selective)
- FDA-approved hair loss use
- Oral finasteride for male pattern hair loss in men
- Key pregnancy warning
- Contraindicated in pregnancy due to risk to a male fetus
- Main hormonal target
- Reduces DHT by inhibiting 5-alpha reductase
How finasteride works for hair loss
Reduces scalp and blood DHT
In androgenetic alopecia, hair follicles are sensitive to DHT, which can shorten the hair growth cycle and shrink follicles over time. By reducing DHT, finasteride can help slow further thinning and may increase hair counts in some men. The mechanism is described in the FDA labeling.
Works best for crown thinning
Clinical trials for oral finasteride in male pattern hair loss focused on men with thinning at the vertex (crown) and mid-scalp. Results are not guaranteed, and response varies. A clinician can help set expectations based on your pattern and duration of hair loss.
Does not create new follicles
Finasteride does not create new hair follicles. It may help existing follicles produce thicker hairs and slow miniaturization. If follicles have been inactive for a long time, regrowth may be limited.
Effect depends on continued use
Finasteride’s DHT-lowering effect is reversible. The FDA label notes that when treatment is stopped, benefits in hair count tend to reverse over time. If you are considering stopping due to side effects, discuss options with a clinician.
Who finasteride may be for
Men with male pattern hair loss
Oral finasteride is FDA-approved for male pattern hair loss in men. It is generally considered when you have ongoing thinning at the crown or mid-scalp and want a prescription option that targets DHT. A clinician can confirm whether your pattern fits androgenetic alopecia.
People using combination regimens
Some people use finasteride alongside other hair-loss strategies, such as topical minoxidil, low-level laser devices, or hair transplantation. Combining treatments can increase complexity and side effects, so it is best planned with a clinician.
People who can commit to monitoring
Because finasteride can affect sexual function and can change prostate-specific antigen (PSA) test results, it is important to share your full history and follow monitoring recommendations. If you have mood symptoms or sexual side effects, you should feel comfortable reporting them early.
People who understand pregnancy precautions
Finasteride is not for use in pregnancy, and exposure during pregnancy can harm a developing male fetus. If there is any possibility of pregnancy in your household, you should understand safe handling and storage guidance from the product labeling and your clinician.
Who should not take finasteride
Anyone who is pregnant
Finasteride is contraindicated in pregnancy. The FDA labeling warns that finasteride can cause abnormalities of the external genitalia of a male fetus. Pregnant people should not take finasteride and should avoid handling crushed or broken tablets.
People with hypersensitivity to finasteride
Do not use finasteride if you have had an allergic reaction to finasteride or any ingredient in the product. Signs can include rash, itching, hives, and swelling of the lips or face. Seek urgent care for trouble breathing or swelling of the tongue or throat.
Children
Finasteride is not indicated for use in children. Safety and effectiveness for pediatric use are not established in the hair-loss indication.
People needing careful prostate evaluation
Finasteride can lower PSA levels, which can affect prostate cancer screening interpretation. If you are being evaluated for prostate symptoms or cancer risk, tell your clinician you are taking finasteride so PSA results can be interpreted appropriately.
What to expect when using finasteride
A gradual change, not overnight
Hair growth cycles are slow, so changes in shedding or density usually take time. The FDA label for finasteride in male pattern hair loss describes assessment over months, and continued use is generally needed to maintain benefit. Your clinician can help you track progress with photos and consistent lighting.
Possible early shedding
Some people notice increased shedding early in treatment with hair-loss therapies, which can reflect hairs cycling into a new growth phase. Shedding can also be due to other causes like stress, illness, low iron, or thyroid disease. If shedding is sudden or patchy, ask a clinician to evaluate other causes.
Sexual and mood changes need attention
If you notice decreased libido, erectile difficulties, ejaculation changes, breast tenderness or enlargement, or mood changes, report them promptly. The FDA labeling includes sexual adverse reactions and notes that some sexual adverse reactions have been reported to persist after discontinuation. Do not ignore symptoms that affect your quality of life.
Lab work may be part of evaluation
Hair loss can have more than one contributor, including iron deficiency, thyroid disease, and hormonal factors. A clinician may recommend lab tests to look for treatable contributors and to guide a safe plan, especially if your pattern is not classic male pattern hair loss.
Finasteride side effects and warnings
Lower libido
Decreased sex drive is a reported adverse reaction with finasteride. If it occurs, discuss timing and severity with your clinician, since other factors and medications can contribute. Some reports describe persistence after stopping, so it is important to address it early.
Erectile dysfunction
Difficulty getting or keeping an erection has been reported with finasteride. Tell your clinician if this is new or worsening, especially if you have cardiovascular risk factors or take other medicines that affect sexual function. Persistent symptoms have been reported in postmarketing reports.
Ejaculation changes
Finasteride can cause decreased ejaculate volume or other ejaculation disorders. These effects may be distressing even when medically mild. A clinician can help you weigh benefits and risks and consider alternatives.
Breast changes
Breast tenderness or enlargement (gynecomastia) has been reported. Rarely, male breast cancer has been reported in people taking finasteride; report any breast lumps, pain, nipple discharge, or skin changes promptly for evaluation.
Mood changes and depression
Depression and, rarely, suicidal thoughts have been reported in association with finasteride use. If you notice new or worsening depression, anxiety, or thoughts of self-harm, seek urgent help and contact your clinician. Do not wait for a routine check-in.
Pregnancy exposure risk
Finasteride is contraindicated in pregnancy because it can cause abnormalities in the external genitalia of a male fetus. Pregnant people should not take finasteride and should avoid handling crushed or broken tablets. Ask your pharmacist about safe handling if this is a concern at home.
Cost and access: what affects what you pay
Formulation and pharmacy
Cost can differ between FDA-approved oral finasteride tablets and compounded topical combinations that include finasteride with other ingredients. Compounded medications are prepared for an individual prescription and are not FDA-approved, and pricing can vary by pharmacy and formulation.
Whether you use labs and follow-ups
Some people benefit from lab work to check for other contributors to hair loss, and follow-ups help monitor side effects and progress. A clinician may ask for recent lab results before prescribing. These steps can change overall out-of-pocket cost depending on what you and your clinician decide.
Insurance coverage varies
Coverage depends on your plan and the indication. Hair-loss treatment is sometimes treated differently from other medical uses, and compounded products are often not covered. If you use insurance, your pharmacy or clinician’s office can help you understand prior authorization or alternatives.
Current prices are shown on this page
If you are viewing this page through Vitals Vault, the current catalog price block for the listed treatment appears here. Prices can change over time and may differ based on the plan and any required clinical review.
How to get finasteride safely
- 1
Start with your hair-loss history
Note when thinning started, your pattern, family history, and any recent stressors, illness, or new medications.
- 2
Review risks and contraindications
A licensed clinician reviews your health history, pregnancy exposure risk, and potential side effects before recommending a plan.
- 3
Consider labs if the cause is unclear
A clinician may ask for recent lab results to check for contributors like thyroid or iron issues.
- 4
Follow up to monitor response
Plan periodic check-ins to discuss progress, side effects, and whether adjustments or alternatives make sense.
Frequently Asked Questions
What does finasteride do?
Finasteride blocks type II 5-alpha reductase, which lowers DHT. Lower DHT can slow male pattern hair loss and may increase hair counts in some men. It is also used at a different strength for BPH.
What is the finasteride brand name?
For male pattern hair loss, finasteride is marketed as Propecia, and for BPH it is marketed as Proscar. Many pharmacies also dispense FDA-approved generic finasteride. Your clinician can help match the product to the intended use.
How much does finasteride cost?
Finasteride cost depends on the formulation (FDA-approved tablets versus compounded topical combinations), the pharmacy, and whether follow-ups or labs are part of your plan. If you are viewing this page through Vitals Vault, current prices are shown in the on-page price block.
Is finasteride a generic?
Yes. Finasteride is the generic drug name, and FDA-approved generic finasteride tablets are available. Some topical finasteride combinations are compounded preparations, which are not FDA-approved and are not considered generics.
Is finasteride spray FDA-approved?
FDA approvals for finasteride are for oral tablets, not a finasteride spray. Some topical finasteride products are compounded by pharmacies for an individual prescription and are not FDA-approved. Ask your clinician which formulation you are being prescribed and why.