In this article, you will learn what Propecia shedding is. You will find out the reason why it happens, when you can expect its onset, and for how long it could last.
The post will also cover ways for dealing with the shedding and look at alternatives to Propecia that do not involve any of its side effects.
What is Propecia Shedding?
Propecia shedding happens when you start taking Propecia for the first time on a regular basis. The active ingredient in Propecia pills is finasteride (1).
This drug works by inhibiting the enzyme 5-alpha-reductase, which converts testosterone into DHT. DHT in turn is the immediate cause of hair loss in susceptible men (2). Finasteride binds onto the 5-alpha-reductase molecules and effectively deactivates them, not allowing them to bind to testosterone as per their intended function.
DHT levels in the blood and scalp soon fall which will begin to reverse the miniaturization process.
When DHT attacks the follicles, its primary effect is an alteration of the hair growth cycle.
Every hair follicle on the scalp goes through an endless cycle of growth lasting a few years (anagen phase), followed by a very brief regression phase (catagen), and a slightly longer resting phase that is measured in weeks (telogen).
A completely new hair grows out with every cycle, and it only grows in length during the first part of the cycle, the growth phase (anagen).
DHT, however, alters the hair growth dynamics and decreases the duration of the growth phase (3). Eventually, the growth phase is so short that the growing hair does not even get a chance to appear out of the surface of the skin.
So when DHT levels drop (up to 70%) shortly after finasteride treatment begins, many of the hair follicles that were in a prolonged resting phase are suddenly propelled back into the growth phase (4). And due to the massive drop in DHT levels, this transition to the growth phase happens en masse, affecting thousands of hair follicles at once.
As the follicle kicks back into the growth phase, the resting hair that had stopped growing is pushed out from within by the new anagen hair that has started to grow.
The key to understanding the unusual loss of hair that takes place after finasteride treatment starts is this: under normal conditions, the hair cycles of the individual follicles are not synchronized across the 100,000 or so hair follicles on the scalp.
Even a minor degree of synchronization can lead to a few thousand hairs being shed in a very short period of time. And finasteride treatment brings about exactly such a synchronization.
When Will Shedding Start and How Long Will It Last?
You will not start shedding from one day to the next as soon as you start on Propecia. It will take a few weeks for the new hair that has started growing to push out the old anagen hairs.
There are no hard and fast rules, but most men should expect to see some shedding between one to three months (at the latest) after they begin treatment. The shedding should normally last around a few weeks. It will then resolve on its own.
Now as this is a transient phenomenon, the degree to which it will become noticeable from man to man will vary. A lot of it will boil down to mundane factors.
For example, most men will lose the majority of their hair in the shower as they massage the shampoo into their scalp and rub their hands through their hair. The friction causes old hairs that were on the verge of falling out to do so. Men who shampoo daily might not have the opportunity to notice much of a difference, compared to men who shampoo every few days or even weekly.
Even something as simple as the color of your pillows (white vs dark) can influence how obvious the hair loss becomes during this brief period in time.
Understanding this and accepting the Propecia shedding as a stage of treatment (rather than a side effect to be feared) is the single most important step you can take to prepare.
If anything, the shedding is a sign that the treatment is working: the levels of DHT in the body and follicles are decreasing. This, in turn, is bringing about a change in the steady but downward trajectory of hair growth, which in turn leads to this transient period of increased hair loss.
If, however, the shedding lasts for longer than a few weeks, it could be an indication of an underlying problem. In that case, it would be best to consult with your doctor.
How Can I Stop the Shedding?
There is nothing you can do to stop Propecia shedding directly, and you would not want to if you could. The hairs that are falling out are old telogen hairs, and as they fall they make way for newer and potentially stronger hairs.
These new hairs might remain in the growth phase for longer, becoming longer, thicker, and leading to an improvement in the appearance of your head (5).
This new, active hair should remain there for as long as you take Propecia. When you stop taking the drug, though, the follicles may return to their previous abnormal hair cycle, become miniaturized, and fall out again for good.
Having said that, there is plenty that you can do to help the new, strong hairs grow as quickly as possible. You can support them with everything they need to grow, like the nutrients, minerals, and enzymes that are required for hair production.
At the same time, you can cut down or eliminate hair-destroying chemicals, hormones, and other substances that are found in the blood.
What You Can Use Instead of Propecia
If you would prefer to avoid Propecia, there are other options to consider.
Firstly, stop drinking tap water. Most tap water contains fluoride and heavy metals which disrupt the endocrine system and hormonal balance. Fluoride in tap water has been correlated with hair loss.
Secondly, reduce the glycemic load of the foods you eat. Living on foods with a high glycemic load is an evolutionary novelty for our species, and has been linked to all sorts of “diseases of civilization,” including baldness (6).
This means no more white bread, pasta, or cereals. Eat foods that release their energy slowly into your blood. This prevents blood sugar spikes.
Thirdly, ensure that whole food makes up as much of your diet as possible.
A common cause of hair loss is vitamin and nutrient deficiencies. While there are medical conditions that can cause these deficiencies, a more likely cause is a poor diet.
You combat hair loss caused by lack of nutrients with a varied, whole foods diet. These include:
- Lean meats (in moderation)
- Nuts and seeds
- Leafy green vegetables
- Colorful fruits
- Whole grains
When these foods make up the majority of your diet, you will be less likely to suffer from nutrient deficiencies. You will also have less room in your diet for higher-calorie foods with little to no nutritional value.
Propecia shedding is a common (and normal) phenomenon that happens when you begin taking the hair loss drug Propecia (finasteride).
While it may be alarming, it should cease after a few weeks of continued use of the drug. The two major steps you can take are a) to be psychologically prepared and b) to support the growth of new hair via lifestyle and nutritional interventions.
There is only one way to avoid this shedding period and that is by avoiding Propecia altogether and opting instead for a multi-pronged, natural approach.