Propecia is used for the treatment of male pattern hair loss (androgenetic alopecia) in men with established efficacy in ages between 18 to 41 years. But, hair re-growth is possible only in men with mild to moderate hair loss of the vertex and anterior mid-scalp area. However, the efficacy of Propecia has not been established in men with bitemporal recession.
Finasteride, the main ingredient in Propecia, blocks the conversion of testosterone into DHT, thereby stopping hair loss and aiding in hair re-growth. Finasteride comes in tablet form and is available in strength of 1mg only for hair loss treatment. In addition, numerous side effects have been reported with this drug, including impotence, decreased libido, and breast enlargement.
Brand-name finasteride (Proscar or Propecia) is manufactured by Merck & Co., Inc.
About Male Pattern Baldness
Male pattern baldness is a universal condition found in men who experience thinning of the hair on the scalp which starts with a gradual decline in men in their 20s. Oftentimes, this thinning of hair results in a receding hairline and/or balding on the top of the head.
It is generally believed by the doctors that male pattern baldness is by and large due to heredity and in addition, depends on hormonal effects also. This type of hair loss is generally referred to as androgenetic alopecia.
Hair is made up of hair follicles which are tiny pouch like bags found just under the surface of the skin. A single hair will stay in the follicle for about 3 years which is then shed and a new hair grows from the same follicle. This cycle of growth, shedding and new growth goes on throughout one’s life. The following pattern thought to occur in men as they gradually become bald which includes:
Affected hair follicles on the scalp gradually become smaller than normal
As the follicle shrinks, each new hair is thinner than the previous one
Before falling out, each new hair grows for much less time than the normal 3 years or so
Eventually, all that remains is a much smaller hair follicle and a thin stump of hair that does not grow out to the skin surface
Male hormones are responsible for these changes. Hair follicles convert testosterone, the male hormone, into another hormone called dihydrotestosterone. For reasons not yet unveiled, affected hair follicles become more sensitive to dihydrotestosterone, which causes the hair follicles to shrink. However, it is known that different hair follicles are affected at different times which make the balding process gradual.
Moreover, it is also not clear why only scalp hair is affected, and not the hair in the other areas like the beard or the armpits in men. But, male pattern baldness occurs gradually over time. Similarly, Propecia also has a gradual effect on hair re-growth.
Propecia for Men Hair Loss treatment
For most men, Propecia aids in increasing the number of scalp hair in the first year of treatment itself. Propecia helps to fill in the thin or balding areas of the scalp. In addition, hair loss slows down. Although, the results may vary, generally it is not possible to re-grow all of the lost hair. However, there is no proof as to Propecia working in the treatment of receding hairline in the temporal area on both sides of the head.
Propecia must be taken daily for three months or more before any benefit can be seen. Known to work over the long term, Propecia is an ongoing treatment for hair re-growth. However, if Propecia has not worked for you in twelve months, further treatment is not likely to bring any benefit. In addition, if Propecia intake is stopped, there will be a likely loss in the hair that was gained within 12 months of stopping treatment.
How does Propecia work?
Finasteride, the main ingredient in Propecia, is a competitive and specific inhibitor of Type II 5a-reductase, an intracellular enzyme that converts the androgen testosterone into DHT. Two distinct isozymes found in humans, Type I and II, are differentially expressed in tissues at different developmental stages. In humans, Type I 5a-reductase is predominant in the sebaceous glands including the scalp and liver and is responsible for approximately one-third of circulating DHT. Meanwhile, Type II 5a-reductase isozyme is primarily found in the prostate, seminal vesicles, epididymides, hair follicles and the liver and is responsible for two-thirds of the circulating DHT.
In humans, finateride's mechanism of action is primarily based on its preferential inhibition of the Type II isozyme. For both isozymes, finasteride inhibits and reduces the inhibitor to dihydrofinasteride. The turnover for the enzyme complex is slow and therefore the hair re-growth is slow.
Finasteride has no similarity with the androgen receptor and has no androgenic, antiandrogenic, estrogenic, antiestrogenic, or progestational effects. Propecia produces a rapid reduction in serum DHT concentration and has the ability to reach about 65% suppression within 24 hours of taking the 1mg oral dose.
In men with androgenetic alopecia, the balding scalp contains miniaturized hair follicles and increased amounts of DHT as compared to a hairy scalp. Use of Propecia successfully reduces scalp and serum DHT concentrations in these men. By this mechanism, finasteride interrupts a key factor in the progress of androgenetic alopecia in those patients who are genetically predisposed.
Who should buy Propecia?
Propecia has been introduced for the treatment of male pattern hair loss in men and should not be taken by women or children. Propecia can be taken by:
Men only above the age of 18 years
Anyone who is not allergic to any of the ingredients of Propecia
Women who are or may potentially be pregnant should not use Propecia or handle crushed or broken Propecia tablets. Because, if a pregnant woman with a male baby absorbs the active ingredient in Propecia, either by swallowing or through the skin, it may cause abnormalities to foetus' genital organs.
Propecia 1mg tablet is meant for oral administration and is the recommended daily dosage. These tablets are film-coated and contain 1mg of finasteride. it may be administered with or without meals.
In general, three months of regular use of Propecia is required before any benefit can be observed. Continuous use is recommended to sustain gained benefits. Withdrawal of treatment will lead to reversal of effect within 12 months.
Coated Propecia tablets help prevent contact with the active ingredient finasteride during normal handling, provided that the tablets are not broken or crushed.