With 6.5 million men in the UK experiencing hair loss, and the increasing affordability of hair transplants, it’s no surprise this treatment has grown more popular in recent years.
As any surgeon will tell you, the aftercare is just as important as the operation itself – if not more so. To maximise the results, most surgeons will recommend you take a medication called finasteride after a hair transplant.
This treatment can add expense to the procedure and may come with side effects. So many people ask: do you actually need to take finasteride after a hair transplant?
What is Finasteride?
Finasteride, also known as Propecia, is a medication primarily used to treat an enlarged prostate. However, it has also been found to benefit men experiencing hair loss.
Male pattern baldness is typically related to increased levels of a hormone called DHT. Finasteride works by preventing testosterone from being converted into DHT. Therefore, it can reduce hair loss.
Even without a hair transplant, finasteride can minimise hair loss in men.
The Benefits of Taking Finasteride After a Hair Transplant
Finasteride helps to promote hair growth and reduce hair loss. It can also be a useful addition after a hair transplant as it helps to minimise the initial shedding phase after the procedure.
Reduces ‘Shock Loss’
A hair transplant involves taking hair follicles from a donor area and implanting them in an area of baldness. This is a traumatic process for the scalp and can lead to some initial hair loss in the first two to four weeks following the procedure. This is known as telogen effluvium or ‘shock loss’.
During this time, the hair follicles may suddenly move into the shedding phase of the hair growth cycle. This means that they release the hair, but the follicle itself remains embedded in the scalp. Within a few days, the growing phase should restart and new hair will form in its place.
Promotes Hair Growth
Studies have found that finasteride increases the number of hair follicles and maximises the number of follicles in the growing phase of the hair growth cycle. This means that your hair should start to appear thicker and fuller than usual.
Prevents Future Hair Loss
As mentioned above, finasteride helps to stop the conversion of testosterone into a hormone called DHT. DHT typically shortens the growth phase of the hair follicle, increasing hair loss and thinning.
Therefore, reducing DHT levels can prolong the growth phase and increase the number of hairs in this phase at any one time, reducing hair loss.
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Hair Transplant Without Finasteride: Will It Still Work?
Most hair transplant surgeons will recommend that you take finasteride after your procedure. This will help to control your DHT levels, which should improve the results of your treatment.
However, a hair transplant can still be very effective without finasteride. The best option is to discuss finasteride with your surgeon before the operation to decide if it’s the right treatment for you. They will be able to discuss the benefits and risks of the treatment to help you make an informed decision.
There are many reasons why someone may be reluctant to take finasteride after a hair transplant.
Firstly, finasteride is not available for hair loss on the NHS. This means it can be a significant expense in addition to the cost of hair transplant surgery.
While finasteride is deemed to be a safe and effective treatment, it does, like all medications, carry a risk of side effects. The most common side effect of finasteride is sexual dysfunction. This could include erectile dysfunction, reduced sex drive or problems with ejaculation. Many men do not experience this side effect, but it is certainly something to be aware of, as some men will choose not to take finasteride if they experience those symptoms.
Other side effects are much less common, but include changes to the breast tissue in men, depression and skin reactions.
If you are concerned about side effects whilst taking finasteride, it is a good idea to discuss the pros and cons with your doctor or surgeon before stopping treatment. If you experience severe symptoms such as a significant allergic reaction, stop taking finasteride and seek urgent medical attention.
Alternatives to Finasteride for Hair Transplants
If you would prefer to avoid finasteride after your hair transplant, there are other options to consider.
Medicated Treatments
A similar drug called dutasteride is available. This works in the same way as finasteride and produces similar side effects, but some patients may prefer it.
Natural Alternatives
There are some more natural options that may produce similar effects to finasteride or dutasteride, but there is less evidence to support these treatments.
Caffeine shampoos, rosemary oil and pumpkin seed oil are all reported to reduce hair loss, so this may be something you want to consider.
However, it is important that you discuss any post-operative treatment plans with your surgeon beforehand to check that they are suitable for you.
Repeat Transplant
Lastly, in some cases, it may be possible to have repeat hair transplant procedures.
If there are enough viable follicles in the donor area, it may be possible to have a second or even a third hair transplant.
If there are not enough follicles available for transplant, this won’t be possible, so it is not recommended that you rely on this approach.
Summary
While most hair transplant surgeons will recommend you take finasteride after your procedure, a hair transplant can still be very effective without it. Make sure to discuss finasteride with your surgeon before the operation to decide if it’s the right treatment for you.
It is also important to remember that, after any procedure, it is always best to follow the surgeon’s aftercare advice. Generally, it is recommended that you do not wash your hair for several days following the procedure, and when you do wash your hair, you do so very gently.
Your surgeon should provide you with thorough guidance on the appropriate aftercare plan following your hair transplant.
References
Church End Medical Centre. (2023). Men’s Health. [online] Available at: https://www.cemc.nhs.uk/clinics-and-services/mens-health/.
Van Neste, D., Fuh, V., Sanchez-Pedreno, P., Lopez-Bran, E., Wolff, H., Whiting, D., Roberts, J., Kopera, D., Stene, J-J., Calvieri, S., Tosti, A., Prens, E., Guarrera, M., Kanojia, P., He, W. and Kaufman, K.D. (2000). Finasteride increases anagen hair in men with androgenetic alopecia. British Journal of Dermatology, 143(4), pp.804–810. doi:https://doi.org/10.1046/j.1365-2133.2000.03780.x.
