Evaluation of long‐term efficacy of finasteride in Korean men with androgenetic alopecia using the basic and specific classification system

Abstract

Finasteride 1 mg is considered to be the standard treatment method for male androgenetic alopecia ( AGA ). However, there have only been a few studies investigating its long‐term efficacy. Moreover, its effect on various types of AGA remains unknown. In this study, the authors investigated the 5‐year efficacy of finasteride 1 mg in Korean men with AGA and analyzed the changes in hair growth according to the distribution of hair loss. The medical records of male AGA patients who were treated with oral finasteride for a period of at least 5 years at two university hospitals were retrospectively reviewed. Patients' photographs were evaluated using the basic and specific ( BASP ) classification and investigator's global assessment. Of the total 126 patients, 108 (85.7%) showed improvement after 5 years of treatment. According to the BASP classification, hair loss of the anterior hair line (basic type), vertex (V type), and frontal area (F type) was improved in 44.4%, 89.7% and 61.2% of patients, respectively. The V type showed a more rapid and steady improvement compared with the other types. Progression of alopecia after peak improvement was seen in 10.3% of cases of the V type, 16.2% of the F type and 0% of the basic type. In conclusion, finasteride 1 mg showed a sustainable effect for at least 5 years in Korean male AGA patients. The exact time points showing signs of first clinical improvement and sustainability were different depending on the type of alopecia.

Efficacy and Safety of Oral Minoxidil 5 mg Once Daily in the Treatment of Male Patients with Androgenetic Alopecia: An Open-Label and Global Photographic Assessment

“…An improvement scale score of + 2 (moderate increase, + 41–70% improvement) and 3 (large increase, > + 70–100% improvement) were reported in 93.3% of patients in the vertex and 73.3% of patients in the frontal area. The frontal area also showed a significant response, but less than that of the vertex, which is consistent with many previous reports [ 17 , 18 ]. In previous studies, the vertex type of AGA showed a more rapid and obvious improvement with oral 1 mg finasteride compared with the other areas [ 18 , 19 ].…”

Three-Dimensional Proteome-Wide Scale Screening for the 5-Alpha Reductase Inhibitor Finasteride: Identification of a Novel Off-Target

“…5α-R type II (5α-R2) is present in the outer root sheaths of hair follicles, the epididymis, vas deferens, seminal vesicles, and prostate. 4 − 6 Thus, in men, FIN reduces prostatic and serum DHT levels by more than 90 and 70%, respectively. 7 Accordingly, most common complaints reported during FIN use are linked to sexual functions in both observational and clinical studies.…”

The Role of Finasteride in the Management of Androgenetic Alopecia in Male: A Narrative Review

“…Both Shin JW et al and Yoshitake et al concluded that more than 85% of the patients was presented with observable improvement and almost 100% of them was present with no disease progression. 23,41 In short, administration of oral finasteride 1 mg once daily was associated with significant improvement in terms of quantitative outcomes among AGA males in any age groups. The first improvements in hair growth could be observed as soon as 3 months whereas in long term studies it could be observed that patients were presented with stable improvement and without further disease progression along the years (Table 1).…”

“…In addition, two 5 years follow-up studies were conducted among the Asian populations. Shin JW et al 23 stated that 44.4% of basic type AGA was presented with clinical improvement whereas 89.7% showed improvement in vertex type and 61.2% in frontal type. Both Shin JW et al and Yoshitake et al concluded that more than 85% of the patients was presented with observable improvement and almost 100% of them was present with no disease progression.…”

“…Type II 5α-reductase isomer is normally found in the outer root sheaths of hair follicles, the epididymis, vas deferens, seminal vesicles and prostate whereas Type III is normally found in peripheral tissues at higher level. [22][23][24][25] 26,27 Finasteride mainly acts as Type II 5α-reductase, resulting in effective inhibition of the conversion of testosterone to Dihydrotestosterone (DHT) and reduce both scalp and serum DHT levels. 28,29…”