Male pattern baldness, primarily influenced by the androgen hormone testosterone, leads to gradual hair thinning and loss through its conversion to dihydrotestosterone (DHT). The primary treatments are finasteride and dutasteride, which inhibit the conversion of testosterone to DHT, thereby promoting hair growth. Recent trends show a decrease in the age of patients seeking early treatment, heightening the need for understanding the long-term use of these medications due to the potential for hair loss progression after discontinuation. The accumulation of long-term clinical data on finasteride showcases its efficacy and safety; studies in South Korea have shown that 98.4% of patients maintaining a regimen of 1mg finasteride experienced no further hair loss progression over five years, with significant symptom improvement in 85.7% of cases. A similar ten-year study from Japan indicated that 91.5% of patients reported symptom improvement, and 99.1% experienced inhibited hair loss progression, underscoring the importance of early intervention in treatment outcomes. Despite concerns regarding adverse sexual effects associated with long-term finasteride use, evidence indicates these occurrences are significantly low, often reversible and temporary. A comparative study of 1,553 male patients taking finasteride revealed side effect rates below 2% after one year, decreasing further after five years of treatment. Thus, experts encourage continued use of these medications alongside informed patient discussions and monitoring to alleviate concerns regarding side effects while effectively addressing hair loss.