Hair thinning/shedding. Am I having a reaction to Finasteride? (Photo)

Question

50 year old female on 1.25 oral minoxidil since March and 2.5 oral Finasteride since June. Was doing well but in September started shedding heavily. My concern is that should I stop Finasteride, am I having a reaction to it, making it worse? My dermatologist doesn't seem to think the shedding is from the Finasteride. I also do laser treatments, being treated for Thyroid, labs are normal. The only other thing is my ferritin is 27. I feel like my hair is getting thinner by the day.

Daniel J. Lee, MD, FACS, ABHRS · Answer

It appears that your hair loss started suddenly in September. One possibility is a condition called Telogen Effluvium. This is where a lot of hair in the "growing" phase is pushed into the "dormant" phase. At the end of this phase (about 1 - 2 months) the hair sheds. Normally a small number of hairs are in the dormant phase and we shed about 100 - 150 hairs per day. Telogen Effluvium can be caused by many factors including a stressful event such as pregnancy, a serious illness, emotional stress, etc. The good news is that the hair most often returns after 6 - 8 months after the stress is gone. Your ferritin is 27 which is at the low normal for a female so is likely not related to the loss. In addition it is unlikely that the loss is due to the finasteride. In my practice, however, I prescribe 1 mg of finasteride.

Anna Chacon, MD, FAAD · Answer

Experiencing increased hair shedding can be distressing, especially when taking medications like Finasteride and Minoxidil, which are intended to help with hair growth. Here are some considerations and potential steps you might take:

Medication Reaction:
While it's rare, some individuals may experience increased shedding when starting or changing doses of hair loss treatments. This can sometimes be a temporary phase known as "shedding," where older hairs are pushed out to make way for new growth.

Consultation with Your Dermatologist:
Since your dermatologist does not suspect Finasteride as the cause, consider seeking a second opinion if you continue to have concerns. Another professional might offer additional insights or alternative treatments.

Ferritin Levels:
A ferritin level of 27 is on the lower side, which may contribute to hair thinning. Iron deficiency can impact hair health, so discussing iron supplementation with your healthcare provider could be beneficial.

Thyroid Management:
Since you are being treated for thyroid issues and your labs are normal, it’s good to maintain regular monitoring, as thyroid imbalances can affect hair health.

Review of Hair Care Routine and Lifestyle:
Evaluate your hair care routine to ensure it's gentle and supportive of hair health. Also, consider factors like stress, diet, and overall health, as these can impact hair shedding.

Continuing Laser Treatments:
Laser treatments can be beneficial for some individuals in promoting hair growth. Ensure these are done consistently and as recommended by your healthcare provider.

Monitoring and Follow-Up:
Keep track of your hair shedding patterns and any other symptoms. Regular follow-ups with your healthcare providers can help in adjusting your treatment plan as needed.

Ultimately, it’s essential to work closely with your healthcare providers to determine the best course of action tailored to your specific situation.

Viktoryia Kazlouskaya, MD · Answer

Patients with androgenetic alopecia may experience periods of worsening. These can be linked to seasonal shedding, telogen effluvium (with low iron often playing a role), or natural fluctuations in androgenetic alopecia itself. Often, there’s no need to worry, especially if you already have a good treatment regimen. For selected patients, PRP (Platelet-Rich Plasma) injections can help reduce shedding quickly. Discuss iron supplementation with your physician. Standard photography and trichoscopy are very helpful to effectively monitor any improvement or worsening over time.

Hair thinning/shedding. Am I having a reaction to Finasteride? (Photo)

Answers (3)

Recommended reading

Everything you need to know about Hair Loss Treatment

Our mission is to create a world where every investment in modern beauty is Worth It.

Hair thinning/shedding. Am I having a reaction to Finasteride? (Photo)

Answers (3)

Browse related questions

Recommended reading

Everything you need to know about Hair Loss Treatment

Our mission is to create a world where every investment in modern beauty is Worth It.