A prescription topical hair loss drug can cause lasting side effects that include erectile dysfunction, anxiety and brain fog, warned the Food and Drug Administration in an alert of April 22.
The finasteride, sold in oral form as a propecia and proscar, is a drug that treats loss By preventing the body from transforming testosterone into another hormone called dihydrotestosterone, or DHT.
Finasteride prescriptions have increased 200% for men aged 25 and over in the past seven years, according to a report by Epic Research in the name of NBC News. The increase is largely motivated by the expanded access through telehentated companies which offer the medication as a pill or a topical spray, concluded the report.
The use of finasteride is not intrinsically dangerous, but oral finasteride has been associated with sexual, mental and physical side effects that persist after someone stops taking the medication – a rare condition probably called post -fina -finasterid syndrome (PFS).
With the topical finasteride, the absorption “through the skin in the blood circulation is expected, and the reports describe adverse events which are consistent with those reported in association with approved oral products,” said FDA Alert.
According to the FDA, some people who declared side effects said they were not aware of the potential for them before taking topical finasterid. The agency called on health care providers to educate consumers on risks and patients to search for information.
“One of the problems is that these topics are available without seeing a dermatologist,” said Ronda Farah, MDAssociate Professor of Dermatology at the Faculty of Medicine at the University of Minnesota, specializing in hair loss.
While the FDA approved Propecia and Proscar in the 1990s, the agency did not lit up the drug. However, it is not uncommon to prescribe hot patients out of AMM, which is legal in the United States.
“We do things all the time out of AMM – use a product that is not specifically studied for, and it’s ok. But that means that the topical finasteride has not undergone rigorous tests,” Deirdre Hooper, MDA dermatologist certified on the board of directors at Audubon Dermatology, said Health.
The topical finasteride is manufactured by composition pharmacies which create alternative versions of drugs, such as those which do not contain certain ingredients or which have doses different from those of the standard.
The new alert has documented 32 cases of unwanted events reported to the FDA concerning the topical finasteride between 2019 and 2024.
Side effects included erectile dysfunctionAnxiety, suicidal ideas, brain fog, depression, fatigue, insomnia, decreased libidoAnd testicular pain, “following the use of topical products composed with finasteride alone or in combination with other active ingredients,” said the FDA.
Some people who submitted the reports said they wanted to have been informed of the possible side effects.
“I do not think that it is a medication that you should be able to obtain without speaking to a doctor,” said Hooper, adding that she does not prescribe the topical finasteride in his practice but is preparing for oral versions. “It’s a nuanced conversation.”
Farah said that the 32 reports probably underestimate how many people really live with the PFS. “Given the large number of people who probably get these topical treatments, this is probably a very low estimate,” she said Health.
While Hooper said that the alert was not sufficient for people to never use topical finasteride, she and Farah urged patients to speak to a doctor before starting the medication.
This advice even applies to people who are trying to obtain topical finasteride through a TV company, said Hooper, recognizing that these services can be attractive for the many people who do not have access to health care providers.
“I recommend intestine to use an outstanding product just by buying it online. As a patient, you should weigh the risks and benefits,” said Hooper. “I would do everything possible for at least one voice conversation with a doctor before using this medication. An appointment in person is the best choice, and a video meeting of Télésanté would be the second. ”
Health Contacted three TV companies that prescribe the topical finasteride – for, outfits and Hims and its own – clarifying if patients should be informed of potential side effects and, in the affirmative, how these companies do it.
A RO spokesperson said that the company did not comment on how they inform patients of the potential side effects associated with the finasteride.
At Keeps, patients are not required to have a video or a phone call with a doctor before receiving a finasterid prescription, a company spokesman said in an email.
But “all orders, including topical finasteride, are only published after a approved clinician reviews the medical history of a patient and determines whether the treatment is appropriate,” added the spokesperson. Providers check with patients during treatment and patients can send them at any time.
Keeps also provides “clear and consistent information on potential side effects with several points throughout the patient’s experience – on our website, during the prescription process and in product packaging,” said the spokesperson.
At Hims & Hers, a first video or telephone appointment is not necessary for a news prescription from the Finasteride, according to a company spokesperson.
Similar to Keeps, health care providers carry out an online assessment and prescribe treatment if necessary. Patients can provide message suppliers as often as necessary throughout the processing process, said the spokesperson in an email and receive information on side effects before the start of treatment and on a continuous basis.
Télésanty platforms have widely expanded access to finasteride in the United States, but Hooper said it was worrying that some people do not require that patients meet a doctor at least by phone before starting a medication.
“These products become so widely and easily available on the internet that it is in a way, for me, as a dermatologist certified by the board of directors, scary,” said Hooper. “Let people get these products that are not explained face to face by a doctor. People can simply click on a questionnaire and answer questions as they wish.”
According to Farah, it is not clear which could make some people more sensitive to the persistent side effects of finasteride. The absence of studies carried out on topical formulations, as well as the variation between composed products, makes it even more difficult to determine.
“We always learn how much to apply to cause a side effect like that,” said Farah. “When things are aggravated, it means that different pharmacies can make it a different way. In general, the more drugs you put on your skin, the more likely you are to have side effects.”
What is clear, however, is that people should not minimize the potential risks associated with topical drugs, said Hooper.
“You cannot forget that your skin is a solid absorber, and applying something to your skin is not without risk,” she said. “It is an organ of your body that has a function and structure.”