Hair loss drug finasteride 'biggest mistake of my life'

A BBC investigation has found that some online websites are prescribing men with potentially risky hair loss drugs without adequate safety checks. The drug, called finasteride, has side effects including suicidal thoughts and impotence, yet some major brands are mailing the medication without any face-to-face or online consultation with the customer.

Kyle, a 26-year-old from Wakefield, deeply regrets purchasing the drug online after filling out a "tick-box" form. He stated that one rash decision completely turned his life upside down. The 1mg tablet is commonly used to treat male pattern baldness.

Kyle started taking finasteride last spring, after it was recommended by a friend. Although he did some research beforehand, the online purchasing process was very simple. "I just googled it, and loads of online pharmacies came up," Kyle said. "It was everywhere, and it was so easy to get." Less than a week after ordering, the prescription medication was delivered to his doorstep. "I didn't have a consultation with a doctor, I didn't have any video calls. I didn't even need to send them any pictures to make sure I actually had male pattern baldness."

Kyle states that since taking the drug, he has experienced problems with his sexual, mental, and physical health, which have persisted even after he stopped taking it. "Life feels grey, it’s like it's castrated my emotions," Kyle said. "It's taken everything from me, my personality and everything. I don't go out with my friends anymore, I don't play football anymore, and I've started having all sorts of issues."

Finasteride is one of the most common medications used to treat hair loss, with tens of thousands of men in the UK taking it. It is only available via private prescription. It works by stopping testosterone from being converted into another hormone called dihydrotestosterone (DHT), which prevents hair growth. Kyle took it for about six weeks but stopped after experiencing problems including suicidal thoughts. He stated that after a month and a half, his hair was falling out more, along with other side effects including a loss of muscle tone.

In late April 2024, just weeks after Kyle obtained his prescription, UK regulators took emergency action on finasteride, requiring packaging to include special safety warning cards alerting to the risk of serious side effects, including suicidal thoughts and sexual dysfunction. After being contacted by other men like Kyle through “Your Voice, Your BBC News”, we asked a male colleague to purchase finasteride from three leading online providers to see what the checks were like now.

The online prescription service "Hims" mentioned side effects. Superdrug also offered the option to chat with a doctor, but this required an extra fee. Only Boots pharmacy asked for a photo of hair loss. When some of the packages arrived, none included the new patient warning cards that drug manufacturers are required to add. Some online pharmacies ask customers to state what type of hair loss they have. The Medicines and Healthcare products Regulatory Agency says manufacturers have a year to comply, but it could take longer.

Boots, Hims, and Superdrug say that customers buying finasteride online need to confirm that they have read and understood the possible risks. They say that users can read the patient information leaflet that comes with the medication to learn about side effects, before the warning cards are "rolled out" and put into the packaging. The Royal Pharmaceutical Society says online prescriptions are useful for many patients, particularly those who are embarrassed to see a doctor. But checks must be rigorous.

James Davies, the Royal Pharmaceutical Society’s director for England, told BBC News: “It’s really important that thorough checks are done, whether that’s online or face-to-face. That means taking a full medical history, having the opportunity to understand the medications that might be prescribed, the side effects, risks, and benefits.” He said it could be helpful to share photos of hair loss with the prescribing doctor and to discuss any issues via video call.

The British Association of Hair Restoration Surgery (BAHRS) believes patients should not be able to obtain the drug simply by filling out an online form. Greg Williams, the vice president of BAHRS and a hair transplant surgeon, said that while finasteride is an effective treatment for many, the small risk of serious side effects must be explained and closely monitored. "Some patients may have risk factors that make finasteride a high-risk prescription. I'm not saying that it shouldn't be prescribed, but patients need to be properly counselled."

European drug regulators are conducting a safety review of finasteride, which could include a ban. Almost a year on since first ordering the drug, Kyle says he deeply regrets taking finasteride. “It’s just a little pill. You take it and you don’t really think about what it’s going to do to you,” he said. “Every day I beat myself up and say ‘you had a perfect life, you shouldn’t have risked it for your hair’.”

“It was my vanity…but when you feel insecure you do stupid things. If I’d have known what it was going to do, I’d never have taken it,” Kyle concluded.