Androgenetic alopecia
First line
Finasteride 1 mg/day is first-line therapy for male androgenetic alopecia. Kaufman 1998 RCT (n=1879, 2 years) showed 86 hairs/cm² increase in vertex hair count, with sustained results during continued use. Effect plateaus by 12 months and persists only with continuous use – discontinuation leads to renewed hair loss. The drug is not approved in premenopausal women. Post-finasteride syndrome (PFS) – persistent sexual, cognitive, and emotional symptoms after discontinuation – has been reported in a small subgroup; incidence and causality remain debated. and BAD guidelines list finasteride as first-line for male androgenetic alopecia.