What Is Propecia: Uses, Side Effects & How It Works

6 min
There are numerous medical preparations and medications specialized in treating hair loss. However, the most renowned among them is Propecia (the brand name for finasteride), which is primarily prescribed to address hair loss on the top of the head and the mid-frontal area of the scalp in males. Propecia has garnered immense popularity due to its high effectiveness. It is an oral prescription drug that takes a targeted approach to inhibiting the enzyme responsible for converting testosterone to dihydrotestosterone (DHT), distinguishing it from other hair loss treatments. By reducing DHT levels in the scalp, Propecia helps tackle the root cause of hair loss in men, potentially leading to improvements in hair growth and density over time. It is important to note that Propecia is intended for adult men only and is strictly prohibited for use by women or children. Despite its widespread acclaim, Propecia may not be suitable for everyone, hence comprehensive evaluation by a healthcare professional is essential to ensure safe and optimal treatment outcomes.
Propecia How it works

How Propecia Works for Hair Growth

Propecia (finasteride) works by blocking an enzyme called 5-alpha reductase, which plays a crucial role in the formation of dihydrotestosterone (DHT) in a man’s body. Let’s break down how it operates:

DHT and Hair Loss:

DHT is a potent androgen hormone that contributes to male pattern hair loss (androgenetic alopecia).

It binds to hair follicles, causing them to shrink over time.

As a result, hair becomes thinner and shorter, eventually leading to hair loss.

How it works:

  • Finasteride inhibits the activity of 5-alpha reductase.
  • By doing so, it reduces the conversion of testosterone to DHT.
  • This decrease in DHT levels helps preserve existing hair follicles and prevents further hair loss.


  • Slows Hair Loss: Propecia doesn’t magically regrow lost hair, but it effectively slows down the progression of hair loss.
  • Visible Results: Users typically notice a benefit after 3 months of consistent daily use.
  • Rejuvenation: Some dormant hair follicles may become active again, leading to thicker hair on the scalp.

Uses of Propecia in Hair Loss Treatment

Propecia is specifically approved by the FDA for treating male pattern hair loss in men. Here are the key points about its uses:

Male Pattern Hair Loss:

  • Propecia is specifically FDA-approved for treating male pattern hair loss in men.
  • This condition, also known as androgenetic alopecia, leads to thinning of hair on the scalp.
  • Men often experience a receding hairline and balding on the top of the head due to male pattern hair loss.

Mechanism of Action:

  • DHT (dihydrotestosterone) plays a significant role in hair loss.
  • Propecia works by inhibiting the conversion of testosterone to DHT in the body.
  • By reducing DHT levels, it preserves existing hair follicles and helps prevent further hair loss.


  • When taken daily, Propecia can lower DHT levels in the scalp by up to 60%.
  • While it doesn’t regrow lost hair, it effectively slows down the progression of hair loss.
  • Some users may even notice rejuvenation of dormant hair follicles, leading to thicker hair.

Potential Side Effects of Propecia

Before identifying the side effects, remember that individual experiences may vary, and it’s essential to consult a healthcare professional if you have any concerns. Now here is the most prominent of these side effects:

Serious Side Effects:

  • Chills, cold sweats, and confusion may occur.
  • Dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position.
  • Breast enlargement and tenderness.
  • Hives, itching, or skin rash.
  • Rapid weight gain or swelling of the face, arms, hands, lower legs, or feet.
  • Tingling of the hands or feet.
  • Unusual weight gain or loss.
  • Clear or bloody discharge from the nipple, dimpling of the breast skin, or inverted nipple.
  • Lump in the breast or under the arm.
  • Persistent crusting or scaling of the nipple.
  • Redness or swelling of the breast.
  • Sore on the skin of the breast that does not heal.

Other Side Effects:

  • Some side effects of finasteride may not need immediate medical attention:
  • Decreased interest in sexual intercourse.
  • Inability to have or keep an erection.
  • Loss in sexual ability, desire, drive, or performance.
  • Runny or stuffy nose, sleepiness, or unusual drowsiness.
  • Back pain, decreased amount of semen, diarrhea, dizziness, and headache.

Genitourinary Effects:

  • Reports of gynecomastia (breast enlargement) in men taking finasteride.
  • Some patients experienced partial or complete remission after discontinuing finasteride.
  • Erectile dysfunction may continue beyond treatment discontinuation.
  • Normalization or improvement of seminal quality has been reported after withdrawing finasteride treatment.

Safety Considerations and Precautions

For Men Only:

  • Propecia is intended for use by men only.
  • Women and children should not take Propecia.
  • Pregnant women should avoid handling broken Propecia tablets, as finasteride can cause birth defects if absorbed through the skin.
  • If a woman accidentally comes into contact with a broken or crushed tablet, she should wash the area with soap and water immediately.

Prostate Cancer Risk:

  • Using Propecia may increase the risk of developing prostate cancer.
  • Consult your doctor about this risk.

Liver Function:

  • Inform your doctor if you have a history of liver disease or abnormal liver function tests.
  • Regular monitoring is essential.

Allergic Reactions:

  • Before taking Propecia, tell your doctor if you’ve ever had an allergic reaction to finasteride or a similar medicine called dutasteride (Avodart).


  • Take Propecia exactly as prescribed by your doctor.
  • Follow all directions on your prescription label.
  • Your doctor will perform tests to ensure it’s the right treatment for you.

Alternatives to Propecia for Hair Growth

While these options may not directly replace Propecia, they can be helpful in promoting hair health and growth:

Hair Transplants:

  • When hair loss has progressed significantly, hair transplants become a viable option.
  • In this surgical procedure, hair grafts are extracted from a donor area (where hair still grows) and implanted into balding areas.
  • Hair transplants use DHT-resistant donor hair to rebuild the hairline.

Topical Minoxidil:

  • Minoxidil is an underrated hair growth treatment.
  • It promotes hair growth and follicle health without directly addressing DHT effects.
  • Available as topical foams or solutions, it’s applied directly to the scalp.

Low-Level Laser Therapy (LLLT):

  • LLLT devices, such as laser caps or helmets, use low-level laser light to stimulate hair follicles.
  • Convenient and effective, they can be used at home.

Stem Cell Injections:

  • Stem cell therapy involves injecting stem cells into the scalp to promote hair growth.
  • Research is ongoing, but it shows promise as an alternative.

Platelet-Rich Plasma (PRP) Injections:

  • PRP injections use your own blood plasma, rich in growth factors, to stimulate hair follicles.
  • It’s a minimally invasive procedure.

Natural Remedies:

  • Saw Palmetto: Derived from the berries of the saw palmetto plant, it inhibits DHT production and supports hair health.
  • Pumpkin Seed Oil: Rich in antioxidants, it may block DHT and promote hair growth.

Frequently Asked Questions

  1. What are the pros and cons of using Propecia?


  • Efficient: Slows down hair loss and thickens thinning hair.
  • Rejuvenation: Some dormant follicles become active, leading to more hair on the scalp.
  • Effective for Male Pattern Baldness: Well-studied for this type of hair loss.
  • Visible Benefit: Results are noticeable after 3 months of consistent use.


  • Sexual Side Effects: Diminished sex drive, erectile dysfunction, and decreased semen volume.
  • Consistent Use Required: Must take it daily for results.
  • Mood Side Effects: Some users report depression.
  1. Can Propecia affect fertility or unborn children?

  • Propecia is not intended for use in women or children.
  • Pregnant women should avoid handling broken Propecia tablets, as finasteride can cause birth defects if absorbed through the skin.
  1. Does Propecia lower testosterone?

Propecia, also known as finasteride, works by inhibiting the enzyme 5-alpha-reductase, which converts testosterone into dihydrotestosterone (DHT). While Propecia decreases levels of DHT, it typically does not have a significant effect on overall testosterone levels in the body. However, some individuals may experience minor decreases in testosterone levels while taking Propecia, but these changes are usually not clinically significant and do not typically cause symptoms of low testosterone. It’s essential to discuss any concerns about hormone levels with a healthcare professional when considering Propecia treatment.

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