Video summary

How to tell if Finasteride is working

Main summary

Key takeaways

Educational

Main ideas / lessons

  • Early shedding on finasteride is often a normal, expected response and does not automatically mean the medication isn’t working.
  • Shedding can happen for two opposite reasons:
    • Finasteride may push resting hairs into the next growth cycle (a good sign).
    • Hair loss could be progressing despite treatment (a bad sign).
  • Shedding is normal for everyone and can vary seasonally; it may become more noticeable only after people start tracking hair fall.
  • Late shedding (months/years later) usually does not mean finasteride failed; the speaker argues it’s more often seasonal shedding than treatment failure.
  • Time matters: the video emphasizes waiting long enough before judging results.
  • You may not get dramatic regrowth, but finasteride can still be working by stabilizing hair loss and improving hair quality (thickness/weight), not just hair counts.
  • Self-assessment is unreliable. The speaker recommends objective monitoring, ideally by a dermatologist using photos and possibly hair counts / trichogram-style evaluation.
  • The speaker discourages relying on online forums (especially “tresless”), portraying them as fear-mongering and filled with misinformed claims.

Methodology / practical framework (how to tell if finasteride is working)

1) Interpret shedding correctly

  • Don’t panic if you shed after starting finasteride.
  • Shed fall may reflect:
    • Expected treatment effect (good):
      • Finasteride may shorten the telogen (resting) phase and shift hairs into the anagen (growth) phase earlier.
      • Shed hairs can be part of the normal transition where old hairs are replaced.
    • Possible treatment failure (bad):
      • If hair loss is truly progressing, shedding may reflect worsening miniaturization and androgenetic alopecia progression.
  • Normalize the baseline:
    • Everyone sheds daily (about 50–100 hairs/day).
    • Seasonal shedding can make shedding seem worse at certain times of year.
    • People often only notice shedding after starting treatment.

2) Use hair-cycle knowledge to understand why shedding happens

As described, the hair cycle includes:

  • Anagen (growth): ~3–5 years (or longer)
  • Transition phase: a few weeks
  • Telogen (resting): ~3–4 months
  • The speaker also references an “exigen/telogen renewal” concept between phases, describing follicles restarting the cycle.

In androgenetic alopecia (triggered by DHT in genetically susceptible people), the described effects include:

  • Anagen shortens (can reduce anagen:telogen ratio from normal ~12–14:1 down to ~5:1)
  • Miniaturization (thinner/smaller hairs; “vellus-like”)
  • Possible stalled follicles (referenced as a “kenogen” phase concept)

Ideal treatment (as framed) should:

  • Lengthen anagen
  • Restore the anagen:telogen balance
  • Reduce miniaturization
  • It may still cause shedding because follicles are being reset/renewed.

3) Decide how long to wait before judging response

  • Minimum: 6 months is presented as the bare minimum to start seeing meaningful effect.
  • Main recommendation: wait a full year before deciding finasteride isn’t working.
  • Rationale given:
    • Most people won’t be at peak improvement by 6 months.
    • Improvement can continue from 24 weeks (~6 months) to 48 weeks (~12 months) and beyond.
  • Practical guidance:
    • If undecided at 6 months, don’t switch yet.
    • Prefer 1 year, and sometimes up to 2 years, before major changes.
    • The speaker argues abrupt “multi-year failure after being fine” is not supported; late shedding is usually misinterpreted seasonal shedding.

4) Decide what counts as “working” if you don’t see regrowth

Finasteride can still be “working” through stabilization:

  • If after a year there is no deterioration, the speaker argues finasteride is working.

The video frames two outcome types:

  • Regrowth
  • Stabilization + improved hair quality

Evidence claims included in the speech:

  • Placebo group loses density over time; finasteride group shows benefits.
  • Hair weight/thickness may improve even if hair count doesn’t rise dramatically.

Statistics/claims presented from clinical-trial framing:

  • In a Phase 3 framing:
    • 83% no further hair loss after 2 years
    • 66% had regrowth
    • Remaining portion framed as stabilization-only vs continued loss, roughly ~17% stabilization-only and ~17% ongoing loss (as described)

5) When to consider switching (e.g., to dutasteride)

  • The speaker frames dutasteride as “stronger,” but claims many people don’t need it.
  • Key warning:
    • Dutasteride can induce a more powerful shed, which may cause panic and mistaken conclusions.
  • If someone wants regrowth but only stabilizes on finasteride:
    • The speaker suggests considering a switch only after waiting at least 1 year, preferably 2 years.

6) Monitoring and decision-making: rely on objective assessment

  • Do not self-assess progress; self-evaluation is described as unreliable.
  • Recommended monitoring:
    • Photos
    • Possibly hair counts or other objective measures (the speaker references trichograms generally)
  • Prefer a dermatologist:
    • Confirms diagnosis (androgenetic alopecia vs other causes)
    • Tracks response objectively
    • Adjusts treatment and may refer for procedures if needed

7) Avoid unverified online conclusions

  • The speaker advises against using Reddit/tresless-style communities to judge whether finasteride works.
  • Argument used:
    • Unmoderated forums are portrayed as dominated by fear-mongering, trolls, and bad-faith assumptions.

Main sources / speakers mentioned (and referenced studies)

Speaker / source

  • Kevin (“Hey Kevin”) — main narrator/speaker.

Studies / publications referenced

  • Topical minoxidil shedding study
    • Described as 49 subjects
    • Compared 2% vs 5% minoxidil
    • Shedding assessed every 4 weeks
    • Shows shedding increases early then decreases by 12 weeks
    • More shedding associated with better regrowth
  • Seasonal shedding study (1996)
    • Described peak telogen shedding around August–October
    • Sometimes with a second peak in spring
  • Finasteride randomized controlled trials
    • A study evaluating improvements in anagen:telogen ratio at 24 weeks continuing to 48 weeks
    • A larger trial comparing finasteride 1 mg/day vs placebo in 1,553 men, with improvements continuing up to 2 years
    • A long-term follow-up claim that some men who don’t improve by 1 year may improve later (example given: additional improvements after 10 years for those treated 5 years earlier)
  • Phase 3 finasteride trials
    • Statistics as presented in the speech

Community / forum sources mentioned (not endorsed)

  • Reddit “Tresless”
  • Terms used in the speaker’s commentary (not separate sources), such as:
    • “dutastasteride master race”
    • “finasteride peasant”

Original video