Propecia (technical name finasteride) is an oral medication that was approved by the FDA in 1998 to treat men with male pattern baldness. It works by inhibiting the 5 alpha-reductase enzyme, the enzyme that converts testosterone into DHT, the hormone that causes male pattern baldness. The FDA’s Dermatologic and Ophthalmic Drugs Advisory Committee agreed in discussions that Propecia is efficacious in treating male pattern baldness. Three studies involved 1,879 men, ages 18 to 41, who had mild to moderate but not complete hair loss. These studies, which lasted 24 months, demonstrated that treatment with Propecia prevented further hair thinning, and significantly increased hair growth in the majority of men (86%). However, 46% of the men using the placebo also saw improvement.
But don’t get too excited—there are negatives to taking this drug. Propecia can cause birth defects for pregnant women and may decrease men’s libido. However, as several doctors pointed out to me, the research showed the libido decrease was minor and that it was not significantly different from that of the placebo group. What the study warnings didn’t point out was that in some people finasteride raised the levels of testosterone and increased the libido! For some that’s a great side effect, and you may get some of your hairline back at the same time. (Sources: European Journal of Dermatology, January-February 2002, pages 38-49; Archives of Dermatology, August 1999, page 990; and Journal of the American Academy of Dermatology, June 1999, pages 930-937.)
There is also research showing that a combination of applying minoxidil topically while taking the oral medication Propecia has the most impressive and long-lasting results (Sources: Dermatologic Surgery, November 2003, pages 1130-1134; and Journal of Dermatology, August 2002, pages 489-498).
I should point out that one study, published in Dermatologic Surgery (May 2004, pages 761-763) and conducted at the University of California Los Angeles, showed significantly fewer desirable results than every other study published about finasteride (Propecia). A total of 1,261 patients were monitored every three months with telephone calls after finasteride was initially prescribed. After 12 months, a detailed questionnaire was sent to all patients. The study noted that 32% (414 men) continued to take finasteride daily for one to three years, that 24% (297 men) discontinued the drug between 3 and 15 months because of poor results, and that the remaining 44% (549 men) dropped out of the study for unknown reasons. Of the 414 men who continued to take the medication, less than half returned their detailed questionnaires; a small percentage of this group felt that they grew hair and the others noted poor results.