Hair Health . Symptoms guide

Finasteride Not Working: What to Check Next

Finasteride works for most men but not all. When response is inadequate, the most useful next steps are confirming DHT suppression, ruling out nutritional and thyroid deficits, and considering whether the dose, formulation or adjunct treatment needs to change. A combined panel covers the bloodwork that would otherwise require several separate tests.

This patient information is being clinically reviewed by our team. The factual content draws on UK guidance (NHS, NICE, British Association of Dermatologists, British Society for Sexual Medicine where cited).

What this might be

  • Inadequate DHT suppression. Some patients need dutasteride or a higher dose. Testing DHT confirms whether the current regimen is suppressing it.
  • Coexisting telogen effluvium. Iron or thyroid deficits can drive ongoing shedding even when finasteride is working on miniaturisation.
  • Vitamin D deficiency. Affects response to all anti-androgen treatments.
  • Receptor sensitivity factors. Genetic variation in androgen receptor response. Bloodwork rules out the reversible causes first.

Common features that suggest this

  • Six or more months on finasteride
  • Hair loss continuing or worsening
  • No improvement in shed volume
  • Other potential drivers (stress, illness, restrictive diet)

Testing advice

Morning appointment recommended. Continue finasteride at your usual dose unless your prescriber has told you otherwise; testing on treatment is what we are interested in.

Common questions

Will testing DHT tell me if finasteride is working?

It tells you if finasteride is doing what it should biochemically (suppressing DHT). Whether that translates to hair preservation depends on follicular receptor sensitivity and other factors. The biochemistry is the foundation.

Should I switch to dutasteride?

That is a clinical decision based on response, bloodwork and individual risk. Our clinicians can review your panel and discuss options.