Online pharmacies have been urged to get proof of men’s receding hairlines before prescribing them a powerful anti-baldness drug amid a surge in demand.
Tens of thousands of men in their late teens, twenties and thirties are buying finasteride from online pharmacies, which have reported sales more than doubling in the past year.
However, finasteride has been linked to serious potential sexual and psychiatric side effects, and there are concerns men may not be being properly advised of the risks or undergoing checks.
Finasteride is a prescription-only daily tablet that is effective in preventing hair loss in men aged between 18 and 41. It is not available on the NHS, but brands including Boots, Superdrug and Lloyd’s offer it privately via online consultations, with one month’s supply costing about £30.
Organisations including the Royal Pharmaceutical Society (RPS) have now issued a warning that prescribers should inspect men’s hairlines, either in person or by requesting photos and videos.
Most online pharmacies selling finasteride do not require men to submit pictures of their hair, with some, such as Superdrug, instead asking men to select an image which best represents their hair loss. It also asks targeted hair-loss questions as part of an online consultation, and asks men to confirm they have understood side effects.
Superdrug Online Doctor said the number of new patients requesting finasteride is up 122 per cent in the first three months of 2025 compared with the same period in 2024.
Sales of the anti-balding drug have doubled in the past year
ALAMY
Alwyn Fortune, policy and engagement lead at the RPS, said that there has been a “significant” increase in demand for finasteride in recent years, adding: “What is absolutely essential is that any online consultations are just as thorough as a face-to-face consultation. That must include a full medical history, and checks to confirm the clinical need for the medicine.
“Obviously, with a face-to-face consultation, you see the patient in front of you so it is much easier to assess [whether they are balding].” He said online pharmacies should use photos and video checks to ensure the medication is clinically suitable.
The British Association of Hair Restoration Surgery (BAHRS) said that men should not be prescribed finasteride “on the basis of a completed online form” and should have a consultation, noting that “a presumptive diagnosis can often be made from photographs or appearance on video”.
Last year the Medicines and Healthcare Products Regulatory Agency issued an alert for men on finasteride to be vigilant for psychiatric and sexual side effects including depression, suicidal thoughts and erectile dysfunction. Research suggests one to two per cent of men suffer side effects, including low sex drive.
Dr Greg Williams, a hair transplant surgeon at the Farjo Hair Institute in London and vice-president of the BAHRS, said: “Finasteride is readily available. You can fill in an online form with no photos of pattern hair loss required, and get it sent to your house the next day.
“I disagree with how readily available it is online — it comes with side effects and it’s part of a range of treatment options that should be properly discussed with a healthcare professional. The benefits and risks should be weighed up by the patient. There is a balancing act of how distressed they are about their hair loss.”
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Williams says he has seen an increase in men expressing concerns about taking finasteride after reading “alarming things online and in the media”.
Dr Matee Rajput, a hair loss and hair transplant specialist, said there has been a “noticeable increase” in finasteride use, with social media influencers sharing hair-loss content online and men often starting “the medication much earlier in life now”.
He added: “Many industry experts, myself included, are concerned that tele-health online platforms may downplay side effects or don’t screen adequately for mental health or adverse history.”
Rajput said that in most cases, the benefits outweigh the risks, and doctors should encourage a balanced approach and appropriately monitor side effects. “For some men, fear of side effects or obsession over their hair loss can become overwhelming, so mental health support can be critical.”
Because finasteride is not prescribed for hair loss on the NHS, there are no exact figures available on how many men are taking it, but it is thought to run into the hundreds of thousands.
Finasteride works by reducing levels of a hormone called dihydrotestosterone (DHT), which can stop hair growing and make it fall out. Studies show it is effective in 80-90 per cent of men. It is also used, at a higher dose, to treat enlarged prostates in men.
‘I was cautious about taking finasteride — but it was a success’
When Alex, 38, a company director, started to experience hair loss in his late twenties and early thirties, he was keen to explore options. He was doing a lot of public speaking, making him feel conscious of his looks.
“I’d wake up and find hair on my pillow. It fell out into my hands in the shower, it was shocking.
“Hair loss can be devastating psychologically and emotionally. It impacts your self-confidence, particularly in social interactions.”
Alex has been taking finasteride for three years with none of the feared side effects, combined with a hair transplant. The treatment has been a success, and he has not suffered any hair loss since starting it.
“I exercised a healthy degree of caution when choosing finasteride, and sought advice from a renowned doctor.
“You wouldn’t take any medication without reading the list of possible side effects. You consider the risks when it comes to everything, whether it’s fast food or paracetamol. There’s a time and a place for all drugs.
“You shouldn’t be allowed finasteride just by filling in an online form — just as it shouldn’t be easy to buy controlled medications like opioids.”
‘Drug made me sink into crippling depression’
Adam Macciocchi-Lancia, 36, suffered side effects eight years on from taking finasteride
Not everyone who takes finasteride is so pleased with the results. Adam Macciocchi-Lancia, 36, an artist, took the drug for only three months aged 27 and is still experiencing side effects more than eight years later.
He sank into a “crippling depression” with brain fog, anhedonia and suicidal thoughts every day. He felt “bedridden” and like “just getting out of bed was like climbing a mountain”.
“I had a soulless look in my eyes. My mum would say to me over dinner, ‘you’re not there’.”
He considers himself lucky to be alive, describing taking finasteride as “playing Russian roulette with your life”.
In an attempt to help his erectile dysfunction, Adam tried steroid injections into the penis in order to stimulate growth of new blood vessels, which he describes as “traumatic”.
While the depression has now lifted, he feels that “the prime years of my life have been taken from [him]”. He got a hair transplant in Turkey, saying that “men feel [they] need [their] hair to get a woman, and to feel right or beautiful”.
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