.Finasteride and Its Potential for the Treatment of Female Pattern Hair Loss: Evidence to Date.
This clinical study is the original work or scientists and authors listed below, published at ...
.Finasteride and Its Potential for the Treatment of Female Pattern Hair Loss: Evidence to Date.
This clinical study is the original work or scientists and authors listed below, published at the National Library of Medicine, article no: PMC7060023 PMID: 32184564 Wimolsiri Iamsumang Kanchana Leerunyakul, Poonkiat Suchonwanit :
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Abstract
The currently approved treatment for female pattern hair loss (FPHL) includes topical minoxidil administration; however, this treatment fails to achieve hair regrowth in some patients. Finasteride, a selective 5α-reductase inhibitor (5-ARI), may be considered an alternative treatment.
However, due to its potential teratogenic effects, clinical studies and the use of finasteride for FPHL are limited. In this review, we aim to summarize the literature regarding the pharmacology, clinical efficacy, and adverse effects of oral finasteride for the treatment of FPHL and to provide novel therapeutic options, including topical finasteride and dutasteride, a new generation 5-ARI, for the treatment of FPHL.
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Female pattern hair loss (FPHL) is a common condition in women characterized by diffuse hair thinning over the crown and parietal scalp with retention of the frontal hairline. The prevalence of FPHL increases with advancing age, affecting 50% of women during their lifetime. FPHL presents with follicular miniaturization and shortening of the anagen phase, similar to androgenetic alopecia (AGA) in men; nevertheless, the pathogenesis of FPHL remains unclear. The present understanding of the relationship between androgenic hormones and FPHL is controversial, as evidence suggests normal hormone levels in most balding females, and there is uncertainty regarding its hereditary nature.
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Female pattern hair loss: hair thinning is mainly confined to the crown, with retention of the frontal hairline.
Various treatment options have been attempted to treat FPHL. The only agent approved by the US Food and Drug Administration (FDA) is topical minoxidil. Other available treatment options include low-level laser therapy, fractional laser therapy, platelet-rich plasma therapy, human follicle stem cell therapy, and hair transplantation. Nevertheless, the treatment outcome may not be satisfactory in some patients. Finasteride, an inhibitor of type II 5α-reductase enzyme, is currently indicated for AGA in men. It has been increasingly used as an off-label treatment for FPHL. Despite its potential teratogenic effects, several publications on finasteride in FPHL have shown positive results. Therefore, this review summarizes oral finasteride's pharmacology, therapeutic efficacy, and safety for treating FPHL. Furthermore, we provide novel therapeutic options, including the Sa-reductase inhibitor (5-ARI) topical finasteride and oral dutasteride.
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5% Minoxidil Clinical Studies for Women.A randomized, placebo-controlled trial of 5% and 2% topical minoxidil solutions in the treatment of female pattern hair loss
Original clinical studies were conducted by the authors listed below: Anne W Lucky, Daniel J Piacquadio, Cherie M Ditre, Frank Dunlap, Irwin Kantor, Amit G Pandya, Ronald C Savin, and Michael D Tharp. PMID: 15034503
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Abstract
Background: Topical minoxidil solution 2% stimulates new hair growth and helps stop the loss of hair in men with androgenetic alopecia and women with female pattern hair loss. Results can be variable, and historical experience suggests that higher concentrations of topical minoxidil may enhance efficacy.
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Objective: This 48-week, double-blind, placebo-controlled, randomized, multicenter trial compared the efficacy and safety of 5% topical minoxidil with 2% topical minoxidil and placebo in treating female pattern hair loss.
Methods: A total of 381 women (18-49 years old) with female pattern hair loss applied 5% topical minoxidil solution (n = 153), 2% topical minoxidil solution (n = 154), or placebo (vehicle for 5% solution; n = 74) twice daily. Primary efficacy variables were changed in nonvellus hair count at week 48, and patient and investigator assessments of change in hair growth/scalp coverage at week 48.
Results: After 48 weeks of therapy, 5% of the topical minoxidil was superior to placebo for each of the three primary efficacy
measures.
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The 2% topical minoxidil group demonstrated superiority over placebo for hair count and investigator assessment of hair growth/scalp coverage at 1 week 48; differences in patient assessment of hair growth at week 48 were not significantly different from placebo. The 5% topical minoxidil group demonstrated statistical superiority over the 2% topical minoxidil group in the patient assessment of treatment benefit at week 48. Both 5% and 2% topical minoxidil helped improve psychosocial perceptions of hair loss in women with female pattern hair loss. An increased occurrence of pruritus, local irritation, and hypertrichosis was observed with 5% topical minoxidil versus 2% topical minoxidil and placebo.
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Conclusion: In this 48-week study of 381 women with female pattern hair loss, 5% topical minoxidil was superior to placebo on each of the 3 primary efficacy end points: promoting hair growth as measured by change in nonvellus hair count and patient/investigator assessments of hair growth and scalp coverage. Application of 2% topical minoxidil was superior to placebo for assessments of nonvellus hair counts and investigator assessment of hair growth/scalp coverage at week 48; differences in patient assessment of hair growth at week 48 were not significantly different from placebo. At week 48, the 5% topical minoxidil group demonstrated statistical superiority over the 2% topical minoxidil group in the patient assessment of treatment benefit.
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Both concentrations of topical minoxidil were well tolerated by the women in this trial without evidence of systemic adverse effects. With the introduction of numerous herbal remedies for hair loss, most of which have not been tested in randomized, double-blind, placebo-controlled trials, it is essential to describe well-controlled trials that demonstrate the efficacy and safety of topical drugs.
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