Hair loss treatment: finasteride and minoxidil after a doctor's review

Pattern hair loss and other kinds

Male pattern hair loss usually starts with a receding hairline or thinning at the crown, often runs in families and can begin at a young age. In women the same tendency shows as thinning over the crown. It develops gradually, and it is the type of hair loss that finasteride and minoxidil are meant for.

Other types behave differently. Alopecia areata causes patches of hair loss, and the hair usually grows back. Telogen effluvium is general shedding after an illness, stress, weight loss, childbirth or iron deficiency, and it usually settles within a few months once the cause has passed. Frontal fibrosing alopecia thins the hairline and the eyebrows and needs a specialist. Hair loss is rarely a sign of illness, but the type decides the treatment.

How the assessment works

The questionnaire asks how long you have been losing hair and where, whether it runs in your family, how your general health is and which medicines you take, followed by a few safety questions. The doctor may ask for clear photographs of your hairline and crown, or for more detail, and may decline if the picture does not fit pattern hair loss. Everything happens in writing, without a video call or a phone appointment.

If treatment is appropriate, the prescription comes to you as a PDF by email, and you take it with photo identification to a pharmacy of your choice.

The safety questions and why they are asked

You will be asked whether you are a woman of childbearing age, because finasteride is not used in that situation, and whether the hair is falling out suddenly, in patches, or with an itchy or red scalp, which points away from pattern hair loss. Further questions cover prostate cancer or a raised PSA, depression or thoughts of suicide now or in the past, liver disease, and whether you have used finasteride or minoxidil before.

Each answer has a reason. Finasteride affects the result of the PSA blood test, so any doctor checking your prostate needs to know you take it. A history of low mood matters because of the side effects described below, and liver disease changes how the medicine is handled by the body.

What finasteride and minoxidil can do

Finasteride 1 mg is a tablet taken once a day by men. It reduces the conversion of testosterone into dihydrotestosterone, the hormone that makes hair follicles shrink in pattern hair loss, so it can slow the loss and in some men improve the density of what remains. Improvement, if it comes, usually shows after three to six months, and the benefit wears off after stopping.

Minoxidil is a solution or foam applied to the scalp, and in Ireland it is sold without a prescription. It also needs months of regular use, and the effect is lost when it is stopped. Irritation or itching of the scalp is the commonest complaint, and liquid running onto the face can cause unwanted hair growth there. Minoxidil tablets are a different medicine, used for high blood pressure.

As the HSE points out, no hair loss treatment is fully effective, so it helps to know what a realistic result looks like before you start.

Side effects to know before starting finasteride

Finasteride can affect sexual function: lower desire, difficulty getting an erection and problems with ejaculation. In 2025 the European Medicines Agency confirmed suicidal thoughts as a side effect of finasteride tablets, with most reports coming from people using the 1 mg tablet for hair loss. Its advice is that anyone taking finasteride for hair loss who notices a change in mood should stop the tablets and contact a doctor as soon as possible, and that sexual side effects also deserve medical advice because they can contribute to low mood. A patient card about these risks is being added to packs of 1 mg tablets.

Tell a doctor about any change in your breast tissue, such as a lump, pain, swelling or nipple discharge. Women who are or could be pregnant should not handle crushed or broken tablets, because the medicine can affect the development of a male baby.

When a GP or dermatologist should see you

Speak to a GP rather than starting treatment online if hair is coming out in clumps or suddenly, if bald areas are itchy or sore, if the hairline and eyebrows are thinning together, or if hair loss comes with other symptoms such as tiredness or weight change. These patterns need someone to look at the scalp, sometimes with a blood test or a dermatologist's opinion, because treatment for pattern hair loss may not help. Hair loss in a child should always be seen by a GP.

Your prescription for a long-term treatment

Finasteride is taken for as long as you want the effect, so it helps to know how the document works. The PDF carries the fields set out in the Annex to Commission Implementing Directive 2012/52/EU, with the active substance, strength, quantity and dosage written out, and it is issued by lek. Damian Wojno, a doctor registered with the Polish Medical Chamber (licence no. 3211301) who is not on the Irish Medical Council register.

Bring a printed copy and photo identification to the chemist. The pharmacist checks the document and decides whether to dispense; the PSI guidance for pharmacists on prescriptions from other EEA countries does not oblige anyone. The tablets are paid for at the pharmacy, and continuing treatment later needs a new assessment.