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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. A doctor can confirm male pattern hair loss from photos and a video call, explain the side effects and prescribe finasteride when it suits you.
- How it works: it blocks the enzyme that turns testosterone into DHT, the hormone that shrinks hair follicles, lowering DHT in the scalp by up to 60%.
- Results: it stops hair loss or regrows hair in about 9 in 10 men who take it long term. Improvement shows after 3 to 6 months.
- Side effects: problems with sex drive, erections or ejaculation affect 1 or 2 in 100 men. Low mood and suicidal thoughts are rare, and mean stopping and getting advice.
- Emergency: call 112 for thoughts of ending your life that you might act on, or swelling of the face, lips or throat after taking finasteride.
Do not book a video appointment if you have thoughts of ending your life and feel you might act on them, or swelling of the lips, mouth, throat or tongue, or difficulty breathing after taking finasteride. Call 112 or go to an emergency department.
Can an online doctor prescribe finasteride?
Yes. Male pattern hair loss is usually recognised from photos and a video call, and finasteride is a prescription-only medicine that a doctor can prescribe once it is clear it suits you. The doctor talks through the benefits, the sexual side effects and the rare effects on mood before any prescription, and reviews your progress on comparison photos. Women who could become pregnant do not take finasteride, and hair loss that is patchy, sore or scarred needs an examination in person.
How an online consultation helps with finasteride
- Male pattern hair loss confirmed: Finasteride helps hair loss driven by DHT, not patches, shedding after an illness or scarring.
- Side effects discussed first: Sexual side effects, changes in mood and breast changes: what to watch for and what to do.
- The right combination: Finasteride alone, with minoxidil, or minoxidil alone, depending on your hair loss and your preferences.
- Honest reviews: Comparison photos at 6 and 12 months, and a clear decision about whether to carry on.
What the doctor checks in an online finasteride consultation
The doctor asks about the warning signs first, then about your hair loss and your health. The doctor asks about:
- Warning signs: low mood or thoughts of harming yourself, a lump, pain or discharge in the chest area, and any allergic reaction to a medicine.
- The pattern: a receding hairline and thinning crown fit male pattern hair loss; patches, shedding all over or a sore scalp point elsewhere.
- The timeline and family history: when it started, how fast it is changing, and hair loss in either side of the family.
- Your mental health: depression or anxiety now or in the past, so that the effects on mood can be watched for properly.
- Fertility: whether you and your partner are trying for a baby.
- Your prostate: urinary symptoms and any PSA blood tests, because finasteride changes the result.
- Your medicines: including minoxidil and any other treatment for hair loss.
Before the call, take photos of your hairline, temples and crown in bright daylight, with dry hair and no styling products. Use the same angles every time, so later photos can be compared fairly.
What is finasteride, and how does it work?
Finasteride is a prescription-only tablet used for two things: male pattern hair loss, and an enlarged prostate. The tablets for hair loss are a lower strength than those for the prostate. Finasteride is the name of the medicine itself, and it is sold under several brand names.
It blocks an enzyme called 5-alpha reductase, which turns testosterone into dihydrotestosterone (DHT). In men with male pattern hair loss, hair follicles on the temples and crown are sensitive to DHT, which makes them shrink and produce thinner, shorter hairs. Finasteride lowers DHT by up to 70% in the blood and up to 60% in the scalp, which slows the shrinking and lets some follicles recover.
Does finasteride lower testosterone?
Finasteride does not work by lowering testosterone. It stops testosterone being converted into DHT, so it is DHT that falls, by up to 70% in the blood.
Does finasteride work, and how long does it take?
Yes, for most men with mild to moderate male pattern hair loss. In trials, 86 in 100 men taking finasteride kept or increased their hair count, and after 12 months 14 in 100 had more hair loss, compared with 58 in 100 taking a dummy tablet. Long-term studies report that it stops hair loss or regrows hair in about 9 in 10 men. Improvement shows after 3 to 6 months, and if there is none after 12 months, carrying on is unlikely to help.
Swipe sideways to compare →
| When | What usually happens | What to do |
|---|---|---|
| Months 1 to 3 | Little visible change | Take it every day, and keep your baseline photos |
| Months 3 to 6 | The first improvement: less hair loss, then thicker hair | Compare photos taken from the same angles |
| Months 6 to 12 | The main improvement, or a halt in thinning | Review with the doctor at 6 and 12 months |
| After 12 months | No improvement means carrying on is unlikely to help | Talk to the doctor about adding or switching treatment |
| Long term | The benefit continues while you take it | Keep taking it if you want to keep the result |
| After stopping | Hair regrown in the first year is usually lost within 12 months | Talk to the doctor before stopping |
Does finasteride regrow hair?
It can. Thinning hairs thicken and some regrow, but finasteride is better at keeping the hair you have than at bringing back hair that has gone. The trials included men with mild to moderate hair loss aged up to 41, not men with complete baldness, so the evidence is strongest for men with mild to moderate hair loss.
How long can you take finasteride?
As long as you want the benefit. For hair loss it is a long-term treatment, often for years, and the NHS describes it as generally safe for long-term use. If you stop, hair loss usually comes back, so talk to the doctor before stopping.
What are the side effects of finasteride?
Most men have none. The most common are sexual: lower sex drive, problems getting an erection and less semen, each affecting 1 or 2 in 100 men, against about 1 in 100 taking a dummy tablet. Rare side effects include breast changes, low mood and suicidal thoughts.
Swipe sideways to compare →
| Side effect | How common | What to do |
|---|---|---|
| Lower sex drive | 1.8 in 100 men (1.3 in 100 on a dummy tablet) | Talk to the doctor if it bothers you |
| Problems getting an erection | 1.3 in 100 (0.7 in 100 on a dummy tablet) | Talk to the doctor if it bothers you |
| Less semen, or problems ejaculating | 0.8 in 100 (0.4 in 100 on a dummy tablet) | Tell the doctor if there is very little or none |
| Testicle pain | Reported | Tell the doctor |
| Breast swelling, a lump, pain or nipple discharge | Rare: fewer than 1 in 1,000 | See a doctor promptly: very rarely it is breast cancer |
| Low mood, depression or suicidal thoughts | Rare; how often is not known | Stop finasteride and get medical advice as soon as possible; 112 for immediate danger |
| Rash, hives, or swelling of the lips, face or throat | Rare | Call 112 for swelling of the throat or difficulty breathing |
Do the sexual side effects go away?
Usually. They often improve over time, and most settle after stopping. In some men they continue after stopping: in one analysis, erection problems lasting more than 3 months after stopping were reported in about 1 in 100 men who had taken finasteride, but at a similar rate in men who had taken a dummy tablet, so whether finasteride causes them is uncertain. Some men describe a set of lasting symptoms called post-finasteride syndrome; how often it happens is still debated.
Finasteride, mood and suicidal thoughts
A European review completed in 2025 confirmed suicidal thoughts as a side effect of finasteride tablets. It is rare, and how often it happens is not known; most reports came from men taking it for hair loss. The review concluded that the benefits still outweigh the risks, and packs of the hair loss tablets now include a patient card explaining what to do. Stop finasteride and contact a doctor as soon as possible if your mood changes. Tell family or friends that you take it, so they can help you notice changes. If you have thoughts of ending your life, the suicidal thoughts page explains where to get help, and immediate danger means 112.
Is finasteride safe?
For most men, yes. Most have no side effects, the NHS describes it as generally safe for long-term use, and the European review concluded that its benefits outweigh its risks. The doctor checks your mental health history before prescribing, and you should know the warning signs: changes in mood, breast changes, and sexual side effects that bother you.
Can women take finasteride, and is it safe if your partner is pregnant?
Women who are or could become pregnant must not take finasteride, because it can affect the development of a male baby’s genitals. They should not handle crushed or broken tablets either; if that happens, wash the skin with soap and water and tell a doctor. After the menopause, specialists occasionally use finasteride off-label for female pattern hair loss, with less dramatic results than in men. For most women, minoxidil is the treatment with the most evidence.
For men taking it, only very small amounts reach the semen, and a pregnant partner is very unlikely to be harmed. Manufacturers still recommend condoms with a pregnant partner, but most experts consider them unnecessary. Some men have lower sperm quality on finasteride, which usually returns to normal after stopping, so tell the doctor if you are trying for a baby.
Finasteride, minoxidil or both?
Both work for male pattern hair loss, in different ways, and specialists often combine them. Finasteride acts on the hormone behind the hair loss; minoxidil acts directly on the follicle and can be used by women too.
Swipe sideways to compare →
| Question | Finasteride | Minoxidil |
|---|---|---|
| How it works | Blocks the conversion of testosterone into DHT | Keeps follicles in their growing phase for longer |
| How you get it | Prescription-only tablets | Solution or foam from a pharmacy; tablets on prescription |
| Who can use it | Men; not women who could become pregnant | Men and women; not in pregnancy or breastfeeding |
| First results | 3 to 6 months | At least 4 months |
| Main side effects | Sexual side effects in 1 or 2 in 100; rare mood changes | Scalp irritation; extra facial or body hair, especially with tablets |
| If you stop | Hair regrown in the first year is usually lost within 12 months | Hair goes back to how it was over about 3 to 4 months |
Topical finasteride and dutasteride
A finasteride spray for the scalp is also available. It is often combined with minoxidil and appeals to men worried about sexual side effects, and the European review found no evidence linking it to suicidal thoughts. Dutasteride works in a similar way and is used for an enlarged prostate; the same review could not establish a link with suicidal thoughts, but mood warnings were added as a precaution.
Does saw palmetto work like finasteride?
There is not enough evidence. A few small studies of saw palmetto for male pattern hair loss, taken by mouth or put on the scalp, are too limited to show whether it works. It does not appear to affect PSA results, and it may be unsafe in pregnancy or while breastfeeding.
Which treatment might the doctor recommend?
The choice depends on the type of hair loss, your preferences about side effects, and your health. This is the framework the doctors use:
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| A receding hairline or thinning crown, never treated | Finasteride, minoxidil or both, after a talk about side effects | Yes | Not usually needed |
| No improvement after 12 months on finasteride | A review: adding minoxidil, or changing the plan | Yes | Not usually needed |
| Sexual side effects that bother you | A review: stopping, or switching to minoxidil | Yes | Not usually needed |
| Changes in mood while taking it | Stopping finasteride, and support | Yes, to assess | If you feel unsafe: call 112 |
| A lump, pain or discharge in the chest area | An examination | Partly | Promptly, for the examination |
| A woman with thinning hair | Minoxidil, and checks for other causes; finasteride is not used if you could become pregnant | Yes | Not usually needed |
| Patches, or a red, scaly, sore or scarred scalp | Finding the cause first | Partly | For an examination, often by a dermatologist |
| Thoughts of ending your life that you might act on | Emergency help | No | Call 112 now |
Wondering whether finasteride is right for you? A doctor can tell you in one consultation.
See available times →Treatment options for male pattern hair loss
What you can do yourself
- Take photos every 3 months from the same angles, so you and the doctor can judge the result.
- Start minoxidil solution or foam from a pharmacy if you would rather not take a tablet.
- Swallow finasteride tablets whole, and keep them where a pregnant woman will not handle broken ones.
- Tell family or friends that you take finasteride, so they can help you notice any change in mood.
- Tell the doctor or the laboratory before a PSA blood test.
Prescription treatment
A prescription is never issued without a consultation. If male pattern hair loss is confirmed and finasteride suits you, the doctor may prescribe finasteride tablets, taken every day for as long as you want the benefit, after talking through the sexual side effects and the rare effects on mood. The doctor may suggest minoxidil alongside it, or minoxidil tablets for men who prefer not to take finasteride. Repeat prescriptions follow a review of your progress and any side effects. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Saw palmetto and other supplements, which do not have enough evidence behind them. Stopping and restarting, which loses the hair you have gained. Crushing or breaking the tablets. Carrying on after 12 months without any improvement, instead of reviewing the plan.
Special situations
Depression or anxiety, now or in the past
Tell the doctor. A history of depression or thoughts of harming yourself needs discussing before you start, and changes in mood while taking finasteride mean stopping it and getting advice. Depression and anxiety can be treated online too.
Prostate tests and men over 50
Finasteride lowers the PSA blood test result by about half, so the result is doubled to estimate the risk of prostate cancer. Tell whoever tests your PSA that you take it. Studies have not shown that finasteride raises the risk of prostate cancer, although US medicine information mentions a possible increase in high-grade prostate cancer.
Giving blood
You cannot give blood while taking finasteride, or for a time after stopping. Check with the blood service before you donate.
Finasteride while travelling in Europe
Take enough for the whole trip, in the original packaging with the patient card, and keep a copy of your prescription. Stopping for good loses the benefit. Keep the tablets away from anyone who is pregnant.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When finasteride is prescribed online, and when you need in-person care
Treated online: confirming male pattern hair loss, the side effect discussion, starting finasteride, combining it with minoxidil, reviews on comparison photos, repeat prescriptions, and advice about side effects.
In-person care: a lump, pain or discharge in the chest area, hair loss that is patchy, sore or scarred, tests that need a laboratory, such as PSA, and any emergency sign.
When to get in-person care
Call 112 or go to an emergency department now for:
- thoughts of ending your life that you feel you might act on
- swelling of the lips, mouth, throat or tongue
- difficulty breathing or swallowing, or wheezing
- a swollen, blistered or peeling rash with feeling very unwell
Get medical advice the same day for:
- low mood, depression or a change in behaviour while taking finasteride: stop the tablets
- a lump, pain or swelling in the chest area, or discharge from a nipple
- an itchy rash or hives after starting finasteride
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about your hair loss: show your hairline, temples and crown on camera, say when it started and what you have tried, and mention any history of low mood and your medicines.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Finasteride treats male pattern hair loss only. Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Minoxidil can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about finasteride
What is finasteride used for?
Finasteride is used for male pattern hair loss, and, at a higher strength, for an enlarged prostate. It is a prescription-only tablet. It is not used by women who could become pregnant.
What does finasteride actually do?
Finasteride blocks the enzyme that turns testosterone into DHT, the hormone that makes hair follicles on the temples and crown shrink. DHT falls by up to 60% in the scalp, which slows hair loss and lets some follicles recover.
Does finasteride work?
Yes, finasteride works for most men with mild to moderate male pattern hair loss. In trials, 86 in 100 men kept or increased their hair count, and long-term studies report that it stops hair loss or regrows hair in about 9 in 10 men who keep taking it.
How long does finasteride take to work?
Improvement with finasteride usually shows after 3 to 6 months, with the main effect within the first year. If there is no improvement after 12 months, carrying on is unlikely to help.
How do I get the best results from finasteride?
Take finasteride every day, because missed days let DHT rise again, and give it a full 12 months before judging it, with photos of the crown and hairline from the same angles at the start, 6 months and 12 months. Using minoxidil as well adds to the effect for many men, and starting early, while the follicles still make fine hairs, matters more than anything else. Tell the doctor about any change in mood or sexual function rather than stopping on your own.
What is the biggest side effect of finasteride?
The most common side effects of finasteride are sexual: lower sex drive, problems getting an erection and less semen, each in 1 or 2 in 100 men. The most serious are rare: low mood and suicidal thoughts, which mean stopping the tablets and getting advice.
Is finasteride safe?
For most men, finasteride is safe. Most have no side effects, and the NHS describes it as generally safe for long-term use. A doctor checks your mental health history first, and changes in mood, breast changes or sexual side effects that bother you need a review.
Does finasteride lower testosterone?
No, finasteride does not work by lowering testosterone. It stops testosterone being converted into DHT, so DHT falls, by up to 70% in the blood. Testosterone itself is not removed.
Can finasteride cause depression?
Rarely, yes. A European review in 2025 confirmed suicidal thoughts as a rare side effect of finasteride tablets. Stop finasteride and contact a doctor if your mood changes, and call 112 if you feel you might act on thoughts of ending your life.
What happens if I stop taking finasteride?
The benefit of finasteride fades: hair regrown in the first year is usually lost within 12 months of stopping, and hair loss continues as it would have without treatment. Most sexual side effects settle after stopping.
Can women take finasteride?
Women who are or could become pregnant must not take finasteride or handle broken tablets, because it can affect a male baby’s development. After the menopause, specialists occasionally use it off-label. For most women, minoxidil is the treatment with the most evidence.
Does topical finasteride work?
A finasteride spray for the scalp is available and is often combined with minoxidil. It is popular with men worried about sexual side effects, and the European review found no evidence linking it to suicidal thoughts.
Can an online doctor prescribe finasteride?
Yes. A doctor can confirm male pattern hair loss from photos and a video call, talk through the side effects and prescribe finasteride when it suits you. It is not available on the NHS for hair loss, so it needs a private prescription.
- Finasteride: about finasteride, NHS, National Health Service (UK), reviewed 2 August 2023.
- Side effects of finasteride, NHS, National Health Service (UK), reviewed 2 August 2023.
- Common questions about finasteride, NHS, National Health Service (UK), reviewed 2 August 2023.
- Finasteride: fertility and pregnancy, NHS, National Health Service (UK), reviewed 2 August 2023.
- Who can and cannot take finasteride, NHS, National Health Service (UK), reviewed 2 August 2023.
- Finasteride- and dutasteride-containing medicinal products: referral, EMA, European Medicines Agency, European Commission decision 22 August 2025.
- Finasteride, DermNet, New Zealand, updated April 2026.
- Finasteride, MedlinePlus, US National Library of Medicine, revised June 2026.
- Finasteride, International Society of Hair Restoration Surgery (ISHRS), updated March 2025.
- Hair loss, NHS, National Health Service (UK), reviewed 24 January 2024.
- Minoxidil solution, DermNet, New Zealand, updated November 2025.
- Summation and recommendations for the safe and effective use of topical and oral minoxidil, Olsen EA, Sinclair R, Hordinsky M, et al. Journal of the American Academy of Dermatology, 2025.
- Saw palmetto, NCCIH, US National Center for Complementary and Integrative Health, updated April 2025.
- Medications and giving blood, Scottish National Blood Transfusion Service, 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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