Alopecia androgenetic

Androgenetic alopecia (Propecia only) Treatment of male pattern hair loss (vertex and anterior mid-scalp) in patients between 18 and 41 years of age. 

Although early improvement may be seen, at least 6 to 12 months of therapy may be necessary to assess whether a beneficial response has been achieved. Androgenetic alopecia 1 mg once/day, with or without meals. Daily use for at least 3 months is necessary before benefit is observed. Continued use is recommended to sustain benefit. Withdrawal of treatment leads to reversal of effect within 12 months. 

SR018 Prager, N., K. Bickett, N. French, and G. Marcovici. A randomized, doubleblind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia. J Altem Complement Med 2002 8(2) 143-152. 

In an open comparative study of androgenetic alopecia in 90 men oral finasteride (1 mg/day for 12 months n = 65) was compared with 5% topical minoxidil solution twice daily (n = 25) (22). The cure rates were 80% for oral finasteride and 52% for topical minoxidil. The adverse effects were all mild, and did not lead to withdrawal of treatment. Of the 65 men given oral finasteride, six had loss of libido, and one had an increase in body hair at other sites irritation of the scalp was seen in one of those who used minoxidil. These adverse events disappeared as soon as the treatment was withdrawn. The laboratory data did not show any statistically or clinically significant changes from baseline values to the endpoint, except for the serum total testosterone concentration, which was increased, and free testosterone and serum prostate-specific antigen in the finasteride group which were reduced from baseline values. 

A 23-year-old man who was taking finasteride 1 mg/ day for 2 months for androgenetic alopecia developed painful enlargement of his right breast (71). Treatment was withdrawn and resolution occurred after 2 months. 

Area E, Acikgoz G, Tastan HB, Kose O, Kurumlu Z. An open, randomized, comparative study of oral finasteride and 5% topical minoxidil in male androgenetic alopecia. Dermatology 2004 209 117-25. 

Kaufman KD. Long-term (5-year) multinational experience with finasteride 1 mg in the treatment of men with androgenetic alopecia. Eur J Dermatol 2002 12 38-49. 

Meidan, V., and E. Touitou. 2001. Treatments for androgenetic alopecia and alopecia areata Current options and future prospects. Drugs 61 53. 

Clinical Aspects of Androgenetic Alopecia and Pharmacologic Approaches to Treatment... 

Fig. 7. Effects of finasteride in androgenetic alopecia. (A) 5a-Reductase-mediated conversion of testosterone (T) to dihydrotestosterone (DHT) leads to miniaturization of scalp hair follicles and eventual hair loss. (B) Finasteride inhibits continued miniaturization of scalp hair follicles and (C) converts miniaturized follicles back to terminal ana-gen hairs with time, leading to an increase of terminal scalp hair growth and slowing of further hair loss. (Panel A adapted from Randall et al., 1991 panels B and C from Kaufman and Dawber, 1999.)...

Effect on the Predictive Value of Serum Prostate-Specific Antigen in the Early Detection of Prostate Cancer in Men with Androgenetic Alopecia... 

V. Clinical Studies in Women with Androgenic Disorders A. Androgenetic Alopecia... 

Olsen EA, Dunlap FE, Funicella T, Koperski JA, Swinehart JM, Tschen EH, Trancik RJ. A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol 2002 47(3) 377-85. 

Sinclair RD, Mallari RS, Tate B. Sensitization to saw palmetto and minoxidil in separate topical extemporaneous treatments for androgenetic alopecia. Australas J Dermatol 2002 43(4) 311-12. 

Interestingly, saw palmetto has also been studied in a randomized, doubleblind, placebo-controlled trial for the treatment of androgenetic alopecia (25). Subjects received either active formulation or placebo for an average of 5 months. In the 10 subjects studied, six of the subjects (60%) were determined to have significant improvement in hair growth as assessed by both the investigators and the subject. 

Trade names Alopexy Apo-Gain Hairgaine Loniten (Par) Lonolox Lonoten Minoximen Regaine Rogaine (topical) (Pfizer) Indications Hypertension, androgenetic alopecia Category Vasodilator Half-life 4.2 hours... 

Minoxidil (1) Rogaine Upjohn Androgenetic alopecia (men and women)" 2%,5% solutions Topical application twice daily OTC... 

Finasteride (2) Propecia Merck Androgenetic alopecia (men only) 1 mg tablet 1 tabletlday Prescription... 

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