Do You Have To Take Finasteride After Hair Transplant?

Hair transplant is one of the methods used to address hair loss or androgenetic alopecia in men and women. The other method being the use of medications like finasteride or supplements like Nutrafol. 

Hair transplant becomes a necessity when there is an extensive or prominent area of hair thinning and loss, leaving that area of the scalp bald. This is often embarrassing and can lower self-esteem, thereby making it necessary to replace the lost hair.  

In this article, the pharmacist will explain if you still have to take finasteride after hair transplant surgery. 

What to Know About Hair Transplant Surgery and Finasteride

Hair transplant surgery involves the removal of a healthy hair follicle from other parts of the scalp and planting them in the balded area. One common method used in the procedure is the follicular unit extraction (FUE). 

In this method, individual hair follicles are removed one by one from areas where the hair follicles are considered healthy and less prone to the balding effects of the male sex hormone – dihydrotestosterone. And then transplanted to the area where there is thinning or baldness. 

The hair follicles are often removed from the back or sides of the scalp. Surrounding hair follicles usually produce hair that will grow to cover up those sites of follicle extraction after the area has healed.

Finasteride is a prescription oral medication approved by the FDA for use, at a dose of 1 mg daily, in the treatment of hair loss. It is quite effective in the prevention of hair loss as well as the support of thick hair growth. 

However, it is riddled with side effects like low libido and erectile dysfunction, often leaving it less desirable to sexually active males. Even though the FDA only approved the oral formulation of finasteride for hair loss treatment. There has been unapproved prescription-only topical finasteride being marketed legally as compounded medications. 

Studies have shown that this topical formulation is just as effective as the oral, with the added advantage of having little to no sexual dysfunction side effects.

Do You Have To Take Finasteride After Hair Transplant?

It is often recommended to continue taking finasteride after a hair transplant surgery because it helps prevent thinning and hair loss in areas where transplantation didn’t take place, as well as prevent the loss of the transplanted hair in the future.

Hair transplantation surgery only grows hair in the area of the scalp that is bald or without hair. The procedure does not stop the loss of hair in other regions of the scalp. It also does not have any direct effect on the actual factor responsible for causing hair loss in the first place.

All it does is remove hair follicles that have good resistance to the balding effect of the hormone dihydrotestosterone, responsible for causing hair loss. And then planting them in the area where less resistant hair had fallen off, leaving it bald.

Finasteride on the other hand tackles the root cause of hair loss which is the hormone – dihydrotestosterone (DHT). It does this by blocking the enzyme 5-alpha reductase, which is responsible for converting testosterone into dihydrotestosterone (a more potent male sex hormone).

This action lowers the amount of DHT in the scalp and also in the blood. Thereby preventing the shrinking of hair follicles and the production of thin, weak hair strands that could easily fall off.

What Research Supports The Use Of Finasteride After Hair Transplant?

A study was conducted to examine whether taking 1 mg finasteride daily can help improve the appearance of scalp hair surrounding newly transplanted follicles in men undergoing hair transplantation surgery for androgenetic alopecia (male pattern baldness). 

The study involved 79 balding men aged 20-45. They were split into two groups. One group received 1 mg of finasteride daily while the other group received 1 placebo (inactive) pill once a day.

The treatment in these 79 subjects began 4 weeks before having follicular unit extraction (FUE) hair transplants and continued for 48 weeks after the surgery.

The results demonstrated that patients who took finasteride had substantial visible improvements in scalp hair density and growth in the areas bordering the transplants compared to those taking placebo. 

94% of the finasteride group achieved an observable increase of hair around the hairline and upper regions of the scalp close to the transplant sites. Compared to just 67% of those who received placebo; as assessed by expert dermatologist review of patient photographs. 

This outcome indicates that finasteride enhanced growth in non-transplanted native hair around the implanted follicles. It also suggests that supplementing hair restored through transplantation surgery with oral finasteride can improve hair growth in non-transplanted areas, while also supporting growth in transplanted areas.

How Soon Do You Have To Take Finasteride After Hair Transplant?

Ideally, you should begin taking finasteride as close to 1 month before your scheduled surgery as possible. Starting finasteride shortly before transplantation helps ensure adequate levels of the drug are already working to inhibit DHT and protect your hair follicles at the time of the procedure.

However, this can depend on your dermatologist’s recommendation. Your doctor may ask you to be off finasteride for some time before the surgery. This may be to help him assess the progressive extent of your hair loss. You should always follow your doctor’s advice for maximum benefits.

How Long Should I Take Finasteride After Hair Transplant?

It is often recommended to continue taking 1mg per day of finasteride for at least 1 full year after your hair transplant for maximum results. 

Consistently using finasteride for this duration after surgery, has been shown in studies to help stabilize areas where transplantation was not done. And to also optimize the growth of the newly implanted hairs.

Do I Have To Take Finasteride Forever After Hair Transplant?

Male pattern baldness is a progressive condition. Meaning that it will keep getting worse or severe with time because your body will always be producing dihydrotestosterone which causes it.

To stop the progression and prevent further hair loss, you have to take finasteride. So the answer to the question of whether you have to take finasteride forever solely depends on your needs.

If you do not want to keep losing your hair after a transplant, you have to take finasteride throughout your lifetime. But if you’re okay with shedding them once in a while and then growing them back, you can stop taking finasteride for as long as you want.

Remember, it all depends on your needs.

Will I Lose My Hair If I Stop Taking Finasteride After the Hair Transplant?

It’s possible to experience some renewed hair thinning or loss after discontinuing oral finasteride usage. This is more likely to predominantly affect the hairs in the non-transplanted areas that are still prone to male pattern baldness. 

The transplanted hairs themselves should remain intact for years without medication due to their DHT-resistant traits. This may change after some time and you may begin losing your transplanted hair.  

But protective effects on native non-transplanted hair end after quitting finasteride. Hence, increased shedding may occur in these areas over time.

Final Thoughts

It is not a bad idea to supplement your hair transplant with oral finasteride as supported by clinical research. Some dermatologist recommend this for their patients after a transplant surgery. However, you should ensure that finasteride is safe for you and that you’re taking it consistently.

References

• Leavitt M, Perez-Meza D, Rao NA, Barusco M, Kaufman KD, Ziering C. Effects of finasteride (1 mg) on hair transplant. Dermatol Surg. 2005 Oct;31(10):1268-76, discussion 1276. doi: 10.1111/j.1524-4725.2005.31202. PMID: 16188178.
• Zito PM, Raggio BS. Hair Transplantation. [Updated 2023 Feb 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. 
• Zito PM, Bistas KG, Syed K. Finasteride. [Updated 2022 Aug 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. 
• Ho CH, Sood T, Zito PM. Androgenetic Alopecia. [Updated 2022 Oct 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.