Post Operative Finasteride Following Hair Transplant Compared with no Medication: A Prospective Comparative Study

Abstract

Background: Finasteride, a selective 5-α-reductase inhibitor, is frequently prescribed in androgenetic alopecia (AGA). Its benefit as an adjunct after hair transplantation remains a subject of debate. This prospective comparative study evaluated the effect of postoperative finasteride compared with no medication on graft survival and overall outcomes.

Materials and Methodology: Sixty male patients with AGA (Norwood grades III–V) undergoing follicular unit extraction were included. Group A (n = 30) received oral finasteride 1 mg daily for 12 months, while Group B (n = 30) received no adjunctive medication. Graft survival, hair density, standardized photographic assessment, and patient satisfaction were measured at baseline, 6 months, and 12 months. Safety data were also recorded.

Results: At 12 months, Group A demonstrated significantly higher graft survival (94% vs 90%, p<0.05), greater hair density gain (28.6 vs 24 hairs/cm²), and superior global photographic scores. Patient satisfaction was markedly higher in the finasteride group. Two patients (6.7%) reported transient reduced libido, which resolved spontaneously.

Conclusion: Postoperative finasteride use significantly improves graft survival, hair density, and cosmetic outcomes following hair transplantation, with minimal and self-limiting adverse events. It is recommended as a safe and effective adjunct in appropriately selected patients.