Finasteride Tablets are one of the most effective treatments for male pattern baldness. They can slow down or stop balding and even, in some cases, regrow hair. A common belief is that Finasteride works better at the crown than at the hairline. But is that actually true? We’ve looked into the research so you know what to expect from your treatment.
What You’ll Learn
Ø How finasteride works
Ø Whether finasteride can regrow hair
Ø How effective it is in different areas of the scalp
Ø Why early treatment is crucial
How does finasteride work?
Finasteride tablets are one of only two medications licensed as a treatment for male pattern baldness (MPB), the other being Minoxidil Spray.
It works by stopping testosterone turning into dihydrotestosterone (DHT), the hormone which is the main driver of male pattern baldness. In guys who are genetically susceptible, DHT binds to and gradually shrinks hair follicles, causing the anagen, aka growth phase, to get shorter and shorter with each cycle. Eventually, the follicle stops producing thick, ‘terminal’ hairs and only makes thin vellus hairs, which are barely visible. This shrinking process is called ‘miniaturisation’ and catching it as soon as possible and intervening with treatment is the best and most effective way to stop it.
Can finasteride regrow hair?
Finasteride prevents miniaturization by reducing DHT levels, protecting the hair follicles from damage and preventing further hair loss. In some cases, it can reverse miniaturization – but only if the hair follicle is still alive.
Studies have shown that finasteride is effective at not only ‘stabilizing’ hair loss, which means stopping any further thinning so you can keep the hair you had when you started the treatment. In some cases, studies found that men using 1mg of finasteride per day actually grew more hair than they started with – showing regrowth is possible for some.
Does finasteride work better at the crown?
There is a common belief that finasteride works best at regrowing hair at the crown.
In a clinical trial, men with vertex (crown) hair loss saw an 11% increase in hair growth compared to baseline (hair count at starting point) after 12 months of treatment with finasteride 1mg/day, compared to the placebo group who saw a 2.7% decrease in hair count. However, in the same trial, men with frontal hair loss also saw a statistically significant increase in hair count from month 3 of treatment, which was maintained or improved during the remainder of the 12-month trial. So, the positive effects of finasteride on hair growth were not restricted to just the crown area: it was beneficial in both the crown and hairline.
Another key trial looked at hair growth across 4 different parts of the scalp which are affected by MPB: vertex (scalp), frontal hairline, temporal hairline (around the temples) and the anterior/mid scalp. Findings showed that men treated with finasteride saw improvements in hair growth in all 4 of the regions during 24 months of treatment, compared with the placebo who continued to lose hair.
Interestingly, the greatest effect was seen in the crown and anterior/mid scalp regions. The researchers also found that the effect was greater in younger men, which they defined as men aged 18-41, compared with older men (41-60 years). In older men, finasteride was most effective in the crown and mid scalp region. So, according to the findings of this trial, the rumours that finasteride works best at the crown may be true. That said, that doesn’t mean finasteride doesn’t work in other areas: it is still shown to stop hair loss across all affected areas with the potential for regrowth.
Why is finasteride most effective at the crown?
While not fully understood, there are a few reasons why this may be.
Male pattern baldness tends to follow a predictable pattern, that has been classified into 7 stages by experts, called the ‘Norwood Scale’. The scale breaks down how hair loss typically progresses in most men. Usually, hair loss starts at the hairline, with the temples receding slightly. The next stage is usually thinning at the crown, and if left untreated, eventually the two might connect until the whole top of the scalp is bald, leaving hair only around the back and sides, where follicles tend to be resistant to the effects of DHT.
So, if men are starting to notice thinning at the crown, this typically means they are a bit further along the Norwood Scale and are likely to have experienced thinning at the hairline first. Overall, this tends to mean miniaturisation will be further along, and finasteride will have more work to do to revive these shrunken hair follicles.
Starting treatment earlier improves your chances of seeing results with Finasteride. It’s often easier to stabilise hair loss and keep the hair you have and stop losing any more, than to regrow hair that has been lost. Timing is key: the earlier you start, the more hair you’re likely to keep and the better your overall results will be.
If you’re interested in hair loss treatments, take our free consultation for personalised recommendations for your stage of hair loss.
All of our blog articles are reviewed by our Medical Director before publication.
