Finasteride is not working, can I stop taking?

Question

I’m 45 and I’ve been taking Finasteride for 20 months now and I can’t see any improvement, if anything my hair looks worse. I also have Seborrheic Dermatitis that I can’t completely get rid of. I’ve had a few mild side effects and would like to know if I can just stop taking it....Regards

Fas Arshad, MBChB, MRCS, FRCS · Answer

Irrespective of how long you have been taking finasteride I am not aware of any reason why you cannot just simply stop taking it. Unlike some other medications (e.g. steroids which cause adrenal suppression if used for a significant period and therefore should be gradually reduced) finasteride does not require you to stop by reducing the dose gradually. In relation to your Seborrheic Dermatitis I would suggest seeing a local dermatologist so they can examine you scalp and advise you appropriately. All the best.

Serkan Aygin, MD · Answer

If you discontinue the treatment of Finasteride you should expect testosterone to be converted back to DHT. This will encourage hair thinning since the effects of Finasteride only last as long as it is active in your body. Side effects of Finasteride will likely also stop once you continue the treatment. However, in very rare cases they can potentially continue over a long period of time. If you’re considering taking or stopping a long-term medication, it is always best to check with your GP first.

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. I suggest that you consult with your board certified facial plastic surgeon to decide if you should stop finasteride and turn to another potential solution, the best of which is NeoGraft Hair Restoration. This incisionless procedure creates natural regrowth after a short recovery period.
Best wishes,

Donovan Rosas, MD · Answer

Finasteride cessation should be done with the understanding that any gains made while using the medication will be lost.With regards to your specific question, after 20 months you should have seen an improvement. Cessation at this point may be warranted. The issue of greater concern is the untreated/inadequately treated seborrheic dermatitis. This inflammatory pathologic process can worsen losses due to androgenic alopecia.As always, discuss your concerns with a board certified plastic surgeon (ABPS).Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic
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Jeff Rapaport, MD · Answer

I agree that if you stop the Finasteride you will lose the hairs  that have been repressed from fallout. I do believe you need to treat the seborrheic dermatitis aggressively. This is an inflammation of the scalp that can enhance hair loss. 
Jeff Rapaport MD FAAD
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Robert Nettles, MD · Answer

You should stop taking Finasteride if you do not like how it is working for you. Finasteride affects everyone differently, and lucky for us in 2019 there are newer, better options available for hair loss.Propecia (also known as Finasteride) 
affects everyone differently because is not customized to the 
individual. Like millions of Big Pharma medications out there, the exact
 same dose of Propecia/Finasteride is given to people who have different
 heights, weights and biochemistry. This means that men who want to stop
 hair loss for good can take the recommended dose of Propecia every day,
 and experience nasty side effects for no good reason! While for other's
 their dose may be insufficient to even reduceDHT by the 60% it is rated at.
Also, even if you do not receive any side effects:
Finasteride only works for a short
period of time.  It works for just a few hours a day (its half-life is 6 hours).Finasteride
 does a poor job of
actually blocking DHT production. Propecia only blocks 1 out of 3 types 
of DHT receptors. That means hair loss is
STILL taking place while you are using the medication.  This combined 
with the short half life means that Propecia is about 60% effective at 
stopping DHT from thinning your hair.Any
 medicine that actually can make changes inside your body, are required 
under the FDA to be available by prescription only. This therefore means
 that it is not possible for anything that does not require a 
prescription to cure or prevent hair loss or regrow thinning hair. Thus,
 a personalized medicine will be the best choice because instead of a 
"one size fits all" approach, you will be taking something which is truly catered to your body's needs.
The treatment is out there. Good luck on your search.

Matt Tahsini, MD · Answer

Hello, great question. This is really a personal choice but you might benefit by having a consultation with a doctor that knows your specifics. Finasteride slows hair loss and you might not see growth. Whatever your choice I wish you luck.

Ramtin A. Cohanim, MD · Answer

Stopping Finasteride is obviously a personal choice but its beneficial to make this decision having more info. Although you might not be seeing a lot of regrowth, finestride might be slowing your loss. Stopping the medication will reverse that.  The side effect you have experienced might be alleviated by changing your dosage or frequency.

Artur Kierach, MD · Answer

See any improvement is obviously subjective to what you expect or want. Slowing down can be considered an improvement for some, for others an improved thickness in the hair. The only way to know, unfortunately is to actually stop the treatment. The net benefits you receive will slowly cease as the finasteride is flushed from your system. You may wish to reduce the dosage over a period of months and see if there is any change. Or, simply just stop.

Jeff Donovan, MD, PhD · Answer

I tell my patients if they want to stop finasteride then stop finasteride. The choice is theirs provided they understand all the issues. Be sure to speak to a physician. First finasteride may be slowing hair loss down a bit. Even though it’s not growing hair it may be slowing it down. I say to patients that instead of moving forward a 10 % loss per year maybe it’s only 2 % right now. Second, make sure you got the right diagnosis. If your seborrheic dermatitis is really not seborrheic dermatitis but rather lichen planopilaris- the plan is different yet. All in all, if you want to stop - stop. Just be aware that you may lose hair. See a doctor to review.

Finasteride is not working, can I stop taking?

Answers (14)

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