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Propecia is a synthetic medication that treats male pattern baldness as well as benign prostatic hyperplasia, which is a condition in which the prostate becomes enlarged. It has a few off label uses including hormone replacement therapy and alcohol withdrawal. It is known technically as finasteride as well as the alternate brand name Proscar when it is marketed for benign prostatic hyperplasia. It is for use only by men and should not be taken by women or children, nor handled by women or children because it can be absorbed through the skin and can result in severe birth defects. It is what is known as a a type II 5α-reductase inhibitor.

The most common use of Propecia today is to combat male pattern baldness, mainly on the vertex and the anterior mid-scalp area along with thinning hair in the front along the hairline. It works by preventing the conversion of testosterone to dihydrotestosterone (DHT). DHT is an extremely powerful androgen, more powerful than testosterone. This medication reduces this androgen activity in both the scalp and the prostate, which reduces prostate size as well as reversing the effects of thinning hair and slows subsequent hair loss. Male pattern baldness is cause by hair follicles being shrunk by androgens and is an inherited trait.

In the 1970s, Julianne Imperato-McGinley of Cornell Medical College made a number of observations regarding birth-defects in the Caribbean that ultimately lead to the synthesis of Propecia. The children she studied had a noticeable DHT deficiency that was associated with smaller prostates and a lack of inheritance of male pattern baldness. The children were born with intersex characteristics, but later developed more male characteristics at puberty. A few years later Merck's basic-research chief, P. Roy Vagelos, came across Imperato-McGinley's research. He created a drug that essentially mimicked the effects of the disorder and he intended it to be used by adult males. It was approved by the FDA in 1992 to treat enlarged prostates and then in 1997 to treat male pattern baldness.

Propecia is associated with a number of side effects, but they are not common. They include some sexual side effects like premature ejaculation, decreased ejaculation and decreased libido, swelling of extremities or breasts, dizziness, headache and runny nose. The sexual side effects sometimes continue even after you have stopped taking the medication, but will eventually stop. In some cases, use of this drug has dramatically decreased the size of prostate tumors. This is positive, but it sometimes results in the late detection of prostate cancer in users when earlier detection would have been beneficial.

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