Are There Any Long Term Side Effects of Propecia? Does Propecia Harm The Liver?

I have been using Propecia since it became available on the market, which is quite a few years. Have there been any adverse effects of using Propecia over a long period of time? Does this medication harm the liver in anyway?

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Dear Jason,

Finasteride was first approved by the FDA in 1992 as Proscar. As you’re probably aware, Proscar is a 5 mg dosage of Finsateride that is proscribed for the treatment of BPH or prostate enlargement. The 1 mg dose of finasteride, approved as Propecia in December of 1997, was the first truly effective treatment for male pattern hair loss.

To my knowledge, in the sixteen years that finsateride has been on the market there have been no reports of any adverse effects on the liver of those using the drug for an extended period of time. As always, I have to state clearly that I am not a physician and that my opinions and knowledge concerning hair loss and its treatments are based on extensive research and reporting on the subject as a consumer advocate and hair loss educator.

With this said, it’s important to note that Propecia cuts PSA levels in half after one year of use. PSA stands for prostate-specific antigen and is a protein produced by the cells of the prostate gland. The PSA blood test is commonly used to check for signs of prostate cancer and other related prostate problems. According to experts, men with prostate cancer often have elevated PSA levels because cancer cells make excessive amounts of this protein, Generally higher PSA levels are indicative of more cancer cells being present in your body. Now this isn’t always the case, it is possible to have prostate cancer without having elevated PSA levels, but the PSA test has been shown to significantly increase the ability for physicians to make an early diagnosis of the disease which is paramount for early intervention.

Since Propecia is prescribed to young men in their 20s, 30s and 40s it is important to tell your doctor that you are taking the medication so that PSA levels can be more accurately determined. The general rule of thumb is to double the levels of those using Propecia for more than a year. It’s also imortant to note the the PSA blood test is not the only way for doctors to determine the presence of prostate cancer.

Another long term concern that has been discussed in literature is the relationship between long term use of finasteride and male breast neoplasia or breast cancer.

During a 4 to 6 year placebo-controlled study testing finasteride 5 mg on 3,047 men, there were 4 cases of breast cancer in men treated with Proscar but no cases in men given placebo. In another 4 year placebo controlled study testing Proscar using 3,040 men, there were 2 cases of breast cancer in placebo treated men, but no cases were reported in men treated with Proscar. To my knowledge there have been no significant reports that can directly connect long term use of finasteride to male breast cancer.

As far as prostate cancer, the long term use of finasteride has recently been linked to a significant decrease in the risk of developing prostate cancer. Finasteride is also now being prescribed as a preventative treatment to some high risk patients, such as those with a strong family history of prostate cancer.

On a personal note, I have been using the drug for more than fourteen years and at this point have experienced no adverse side effects that I am aware of. There are countless men all over the world who are successfully treating their hair loss with Propecia. In my opinion, at this point there is no known reason to be concerned about long term adverse side effects.

Hope this helps,
Spencer Kobren
Host of The Bald Truth Radio Show
Founder, American Hair Loss Association
Founder and Director of Consumer/Patient Affairs, International Alliance of Hair Restoration Surgeons (IAHRS.ORG)


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  • Jason

    Though I have been using Propecia for many years, my hair on the top and crown area appear thinner as opposed to the thickness I had ten years ago when I first started the drug. I have been contemplating a hair transplant procedure but am unsure if I am a suitable candidate.
    Is it possible to receive a transplant just to thicken the hair you already have or do you have to have a total bald spot to have the procedure done. The reason I ask is because I heard that if you get a transplant done you end up harming the existing hair that is already in place. Is that accurate?

  • Spencer Kobren

    Hi Jason,

    Hair transplant surgery is a good option for many men experiencing male pattern hair loss, but there are several factors that make a good candidate.
    From what you are describing, it sounds like you still have a significant amount of hair. Attempting to simply “thicken” up your hair by undergoing a hair transplant procedure is not a good idea in my opinion. Shock loss from the trauma of surgery is a very real concern.

    Surgery will always be there. When the time is right check with The International Alliance of Hair Restoration Surgeons in order to find a reputable hair transplant surgeon. In the meantime you might want to try a cosmetic concealer to help camouflage the thinner appearance of you hair.

    Spencer Kobren

  • kathy

    Spencer, What do you recommend for woman for hair loss. So far after many test the only thing they have found is a extremely high dhea with no reason given except that my enzymes have changed and there is nothing I can do to lower my dhea which is 1200. So I am assuming that is what has been causing my hair to fall out constantly for 1.5 years now. Started after a big stress along with dermititis both at the same time. I have been thinking about spiro but am so afraid of the DREAD SHED. Do you know what percentage of people get this? Do you know of anything else that has been succesful for woman with hair loss due to hormones? Thank you. K

  • Just looking for your honest opinion based on your own results, and those of people you know.

    I’ll start off by saying I’m a guy in my early 20s, and have most likely been experiencing hairloss since i was 18 or so. It never really bothered me untill college, when i really started to notice that my hair was getting somewhat thinner on the top and the temples were receding. Still, I did nothing.

    Now I have noticeably thin hair, impossible to style so that it looks 100% normal. My temples have receded a pretty fair amount (probably 1.5 inches or so). However, I am by no stretch of the imagination totally bald, much less have any genuine bald spots. Its a diffuse thinning, with the classic receding temples. Honestly, I am 100% a-ok with my hairline…………..provided it stays this way (yeah right if I dont get treatment). I would really like to at least maintain what I have, and hopefully re-grow a bit of hair.

    I have made an appointment with my doctor (finally manned up, wish i would have done this 2 years ago) to talk about propecia. Hopefully, I am cleared and can get started on the drug.

    My question to you is this: What are the reasonable results I can expect if successful? I have plenty of hair on my head still, and I have TONS of fine, thin, almost colorless hairs. Is it unreasonable to hope those hairs eventually grow as normal (and even my colored hairs that are still thinning)? If so, I think i might be in business for a suprsingly normal head of hair (minus the temples, which could honestly be way worse).

    Also, do you have any opinion on the long-term success of this drug? Is it expected that at some point my hair just falls out again later down the road? Or is it reasonable to expect that if I respond well to the drug for 5+ years, that I can mostly hold on to what I have for “life”?

    Thanks a bunch if you managed to read all that, haha.

  • Gabe P

    I have been a propecia user for about 8 years now. I started taking it when I was 22 for the same reason like everyone else I was seeing my hair getting thin and since it was running in the family I got help in the early stages. Propecia helped me retain my hair I didnt see or notices any gains but I didnt seem to loose any either I think it helped me mantain what I had. I used it in conjunction with prescription strenghts NIZORAL shampoo which is 2% vs the one over the counter 1%. If you read the studies they have done it shows that subjects who used the shampoo were 20% more likely to benefit from propecia than those who are not using the shampoo. All in all I am a happy propecia user and I will stay on it till something better comes along.

  • I’m 40 and have been using 5% generic Minoxidil and Propecia for about 5 years, and it has helped a lot. I put about 3ml of Minoxidil across my entire scalp once per day.

    My doctor originally recommended cutting the Propecia 5mg tablet in half, because it was hard to cut any smaller. So I’ve been taking 2.5mg daily instead of the 1mg that is generally recommended. Last year, when I tried to cut the tablet into fourths, or about 1.2mg per day, my hair started falling out dramatically. After a few months of this consistent falling out, I went back to my 2.5mg daily dose and my hair has stabilized and isn’t falling out. Cutting back doesn’t appear to be an option for me.

    Am I at risk of side effects, or causing my body and liver harm by these larger doses of Propecia and Minoxidil? Thanks.

  • Hi,

    Erm my boyfriend who is only 22 is going bald. I think he still looks drop dead gorgeous but he hates the way he looks. I can’t do anything or say anything to make him feel any better. I have been completely honest with him but if it’s even the smallest of compliments he basically implies i’m lying. I don’t know what I can do to help him! I am so madly in love with him it’s unreal but even that doesn’t seem to help. He is so fixated with his hair he has no time for or interest in anything else, including me to be honest. I’m in agony because of my own depression (caused by the love I have for him) and because the man i’m in love with is suffering so much for something that shouldn’t be happening to him! I am praying with every bit of my heart that his new medicine will work and i’m also praying that once he starts to feel better he’ll be happy and will enjoy life, we can both be happy, enjoy our relationship and the he will fall in love with me too! I’m desperate for him to love me as I want to spend the rest of my life with him.

    Please please please God make my gorgeous boyfriend happy! Please help him, i’m begging you!

    If anyone on here who reads this and prays please could you spare a minute for my boyfriend Lee and pray that one day very soon he will happy again and really start to enjoy his life like he deserves too.

    Thank you lots for reading this.

    Good luck to anyone experience baldness or similar problems! I wish you every happiness

    Many Thanks

  • What pharmaceuticals, if any, are on the near or far term horizon to combat hair loss? I was thinking that perhaps those who manufacture Rogaine and all of its’ generic equivalents might be thinking about releasing a 10% version of minoxidil to consumers or patients. This would be similar to what happened several years ago when 5% minoxidil was marketed and released over the previous 2% version. What might be the hold up, if any? And what is the latest on dutasteride receiving FDA approval for hair loss?

  • Hi Jason,

    I have been using propecia for as long as you have, since the 1990s. I have had no side effects up until this last year.

    Recently, I have been experiencing some very strange effects on my health. Your comment about liver problems struck a cord, and has prompted me to post this message.

    I know very well that the common wisdom says that propecia has no long term side effects. Of course, if you think about this logically, how can this be known, since it has only been on the market for as long as we have been taking the drug? For example, doctors cannot say, “Oh, don’t worry about your supposed side effect, because people who have been taking the drug for 40 years are fine without any side effects.” There are no people alive who have been taking propecia for 40 years without any side effects, because the drug was released in the 1990s when we first began taking it.

    Or, in other words, we are the guinea pigs. 🙂

    In any case, my symptoms have mostly occurred with my eyes. My symptoms are that I wake up in the middle of the night with extremely red eyes. When I say “extremely red”, I mean there is /no/ white in my eyes. They are 100% red. This happens every night consistently at about 2-3 AM. When I wake up with red eyes, I also have to urinate and my urine has a strong chemical/acidic smell. Also, when I do wake up, I have a light-headed feeling and feel as though I will faint (but never have yet). The other side effect that presents itself all day (not just at night), is that I have developed many black eye floaters that are constantly in my field of vision. I seem to not be the only propecia user who has developed eye floaters ( Also, my eyes are chronically dry.

    I have mentioned this condition to several doctors because it has been on-going for the past year and a half. All of the doctors that I have spoken with say that there is nothing to worry about. However, I am still suspicious that my symptoms could be a barometer signaling towards bigger issues such as liver or kidney problems. I have suggested that I have blood work done to check for possible liver/kidney defects, but my doctor refuses to allow me to get this blood work, saying that there is no justification for it.

    In any case, I was just wondering if I am the only person experiencing these symptoms, or if others have acquired similar symptoms after ten plus years of use of propecia.


  • gsyadav

    please clarify is there any necesity of long term medication after hair transplant

  • Garth

    Hi BH,

    You said you have been on finasteride since the 90s and are now having side effects. What you are experiencing is most likely not from fin. You would have had the side effects YEARS ago if it was. Also I have never heard of fin causing the problems you are having. It is likely that this “side effects” are no side effects at all and are being caused by something unrelated. Liver problems would have your eyes turning yellow not red. However, you should consult a doctor and post anything you find out.

  • Jamie

    Hi, can anyone help me please? I’ve been taking Finasteride 1mg for 7 days now and have had a slight pain in my left breast area. I actually bought the medication online after researching and didn’t get it prescribed or talk to my doctor about it (I know very stupid of me)… Should I stop taking it? I’m 19 (nearly 20) and can’t deal with going bald!

  • Mirko

    Jamie I think you should stop taking the finasteride. And buy only original propecia if you take fin.
    I have been taking propecia for now six years and in meentime i tried everything i have found. the only solution for baldnes is, i am sory to say that, propecia. I have tried one year without but i have seen negative results quick after i stoped using it. But in meen time i have faced the true that i am going to be bald. I THINK THERE ARE TO MANY SIDEEFFECTS caused by propecia (i faced depresons, long term erection problems, irregular hart beat, uncotrolllables itchnes,…). I have monitored my self for six 14 monts every day and that are the results. So i will leave propecia forever…. And shave my head!!!
    Best sentece (my oppinion): Propecia turns men into woman!
    (sory for my bad english)

  • Mick Bell

    I have been taking Propecia for about 4 years. No signficant improvement or worsening of my thinning hair and receding hairline. However over the last 3 years I have suffered from extremly red eye rims and dry itchy eyes. I am also suffering from floaters although I can’t remember if they are pre or post starting with Propecia. So given the comments above in seems there is a consistent theme around eye-related side seffects.


  • Jan d Bosch

    I am using Propecia for 5 months. Ever since my scalp & hair became VERY oily. Please help !!

  • Dear BH,
    I too have had the same problems with red dry eyes. I was taking propecia from when I was 16 (no joke) to when I was 24. I am now 28 and have been off the drug since. When on the drug I would get constant red eyes and my eyes would be dry. I would carry Visene with me everywhere which would only help so much… they would usually still be a little red after dousing them. Still, that was the only side effect I think i incurred during those times. I quit the drug at 24 because my mom told me that they found out it had long term effects of birth defects in your children so upon hearing that, I quit cold turkey while doing limited research on if that was true. Upon reading here, it seems like no one else mentioned it so I might have made a mistake since my hair has thinned since. Anyways, good luck all and thanks for the read!

  • navedo

    my ex boyfriend is also taking propecia not sure for how long maybe more then two years .he mentioned alot of dry eyes and headaches.he is turning 30 years old. i think he is in denial of the side effects. he has experience slight deppression how ever blames it on other stuff. he cries more than i do and am a women so you figure that one out. we talk about having a child however the fear of birth defects help me to make a wise choice to say no.



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