Deciding to start hair loss treatment is a big step, and you probably have a few questions about what to expect.
Before you order your first course of finasteride or minoxidil, it helps to know what the first few months look like. That includes how long finasteride takes to work, and why you might lose more hair before it starts to fill in again. Here are five things worth knowing before you start hair loss treatment.
1. It starts with the right diagnosis
Not all hair loss is male pattern baldness. And treatments like finasteride and minoxidil are only licensed for androgenetic alopecia, the medical name for it.
Hair loss caused by stress, illness, weight loss or low iron is usually temporary and often sorts itself out. So it's worth getting checked by your doctor before committing to a long-term treatment.1
Sudden, patchy hair loss, or hair loss with a sore or scarred scalp? See a GP before starting any treatment.
The NHS recommends seeing a GP if you're worried about hair loss, especially if it's sudden, patchy or comes with other symptoms, so the right cause can be found before you start.1
That's also why prescription-only hair loss treatments involve a consultation before anything is dispensed. A pharmacist or prescriber needs to confirm your pattern of hair loss matches androgenetic alopecia, and check the treatment is suitable for you.
2. Results take months, not days
Finasteride doesn't work overnight. The product information says you'll generally need three to six months of daily use before your hair loss visibly stabilises. Fuller results are usually judged at around 12 months.2
That's one of the most common reasons people give up too early. They expect a visible difference within a few weeks, see nothing, and assume it isn't working.
Take a photo of your hairline and crown in the same light before you start. It's the easiest way to spot progress later.
In reality, the medicine is working from your first dose. New hair just takes time to grow long enough to see.
It's also worth knowing that finasteride only works for as long as you keep taking it. If you stop, its effects start to reverse within six months, and are usually back to where you started by nine to twelve months.2
3. You might shed before you see an improvement
It sounds counterintuitive, but noticing more hair coming out in the first few weeks doesn't mean your treatment is failing. Minoxidil in particular can trigger a temporary increase in shedding. Resting (telogen) hairs get pushed out early to make way for new growth.3
This shedding phase is usually mild and settles within a few weeks, though it can sometimes carry on for a couple of months.3 Think of it as your hair follicles resetting their growth cycle, not a sign your hair loss is getting worse.
Heavy shedding carrying on for longer than that, or not sure what you're seeing is normal? Flag it to a pharmacist, rather than stopping treatment suddenly.
4. Daily consistency matters more than the brand
Taking finasteride at the same time every day matters more than which brand or version you use. There's no evidence that a higher dose works better, so stick to the prescribed 1mg a day. Don't double up after a missed dose.2
Notice low mood or thoughts of self-harm on finasteride? Stop taking it and speak to your GP or prescriber straight away.
The odd missed dose won't undo months of progress, but frequent gaps can slow things down. Many people find it easier to tie the tablet to an existing daily habit, like brushing their teeth. Or set up a repeat prescription so your next delivery arrives before your current pack runs out.
The same goes if you're using Regaine alongside finasteride. Minoxidil needs to be applied consistently, usually twice a day, to keep working.
5. Combining treatments can work better than either alone
Finasteride and minoxidil work in different ways. That's why many men see better results using both together, rather than choosing one or the other.
Finasteride lowers DHT, the hormone that shrinks hair follicles. Minoxidil improves blood flow to your scalp and extends the hair growth phase.4
A recent review of randomised trials found that combining topical minoxidil with finasteride gave bigger improvements in hair density and thickness than minoxidil alone.4
It's not the right approach for everyone, though. A pharmacist can help you decide whether starting with one treatment or both makes sense for your hair loss and any other medicines you take.
Still deciding where to start? Our comparison of minoxidil and finasteride breaks down how each one works.
Frequently asked questions
How long does finasteride take to work?
Generally, three to six months of daily use are needed before any
stabilisation of hair loss becomes noticeable, with fuller results usually
judged at around 12 months. Finasteride works from the first dose, but
new hair needs time to grow to a visible length.
Is it normal to shed more hair after starting finasteride or minoxidil?
Yes. Both treatments can trigger a temporary increase in shedding in the
first few weeks, as resting hairs are pushed out early to make way for new
growth. This shedding phase is usually mild and settles within a few
weeks, though it can occasionally continue for a couple of months.
Can you take finasteride and minoxidil together?
Yes. Finasteride and minoxidil work through different mechanisms, and
evidence from randomised trials shows the combination can produce greater
improvements in hair density than minoxidil alone. A pharmacist can
advise whether combining them suits your pattern of hair loss.
Do you need a prescription for finasteride in the UK?
Yes. Finasteride is a prescription-only medicine in the UK and is not
routinely available on the NHS for hair loss, so it is usually accessed
through a private prescription following an online or in-person
consultation.
When should you start finasteride?
Finasteride is licensed for the early stages of male pattern hair loss; its
effectiveness in advanced baldness or in hair loss limited to the temples
has not been established. For that reason, it is generally started as
soon as thinning is noticed and confirmed as androgenetic alopecia, rather
than left until later.
How will you know if finasteride is working?
The earliest sign is usually less hair falling out day to day, rather than
visible regrowth, which tends to appear later. Comparing photos taken in
the same lighting every few months is a more reliable way to track change
than judging it day to day.
References
- NHS. Hair loss. nhs.uk
- Finasteride 1mg film-coated tablets. Summary of Product Characteristics (SmPC). medicines.org.uk
- Ho CH, Zito PM. Androgenetic Alopecia. In: StatPearls / Endotext. National Center for Biotechnology Information. ncbi.nlm.nih.gov
- Systematic review and meta-analysis of randomised controlled trials comparing topical minoxidil-finasteride combination with minoxidil monotherapy for male androgenetic alopecia. ncbi.nlm.nih.gov
This article is intended for informational purposes only and does not replace professional medical advice. Always read the patient information leaflet supplied with your medication and speak to a healthcare professional if you have specific concerns.