Lack of effect of topical finasteride suggests an endocrine role for dihydrotestosterone

Price, Thomas M.; Allen, Susan J.; Pegram, G. Vernon

doi:10.1016/s0015-0282(00)00600-2

Cited by 10 publications

(12 citation statements)

References 4 publications

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“…Topical finasteride gel (0.25–0.5%) demonstrated inconsistent efficacy in IH management . An RCT compared topical finasteride at various concentrations for 6 months and showed no difference between hair density, hair diameter, serum testosterone levels, and serum DHT levels in all groups .…”

Section: Resultsmentioning

confidence: 99%

“…67,68 Topical finasteride gel (0.25-0.5%) demonstrated inconsistent efficacy in IH management. 45,46,69,70 An RCT compared topical finasteride at various concentrations for 6 months and showed no difference between hair density, hair diameter, serum testosterone levels, and serum DHT levels in all groups. 69 However, more recent studies proved topical finasteride alone or prior to diode laser (810 nm) treatment to be efficacious in reducing mean hair counts (MHC) and/or mean hair thickness (MHT) after 6-12 months.…”

Section: Acnementioning

confidence: 99%

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The efficacy and use of finasteride in women: a systematic review

Chapman

Mesinkovska

2019

Int J Dermatology

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Background Physicians are beginning to use finasteride as treatment for hair loss, hirsutism, and various other dermatologic conditions in women. However, the reported efficacy and use of finasteride in the female population varies widely. The purpose of this study is therefore to better define the efficacy and use of finasteride in women and identify research gaps that require further investigation. Methods A systematic review of the current literature describing finasteride use in women. Results A total of 2,683 patients participated in 65 studies involving finasteride use in women published between January 1997 and July 2017. Most randomized controlled trials (RCTs) evaluated finasteride use in women with hirsutism (48.7%) or female pattern hair loss (34.7%). RCTs recommend finasteride treatment for women with hirsutism or polycystic ovarian syndrome. Meanwhile, other forms of hair loss were studied such as alopecia, lichen planopilaris, and frontal fibrosing alopecia, but no RCTs evaluating finasteride therapy were identified. Other prospective and retrospective studies report that finasteride may improve hair loss in women with female pattern hair loss or frontal fibrosing alopecia. Overall, doses of oral finasteride ranged from 0.5 to 5 mg/day, in females aged 6–88, over a duration of 6–12 months (57.6%), as monotherapy (88.9%), and for continuous use (96.4%). Conclusion The studies reviewed highlight the finasteride dosage, length of treatment, and candidate conditions that can benefit from finasteride therapy. Future long‐term studies are necessary to fully assess the therapeutic mechanisms and potential consequences of finasteride use and to optimize treatment protocols.

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Section: Resultsmentioning

confidence: 99%

Section: Acnementioning

confidence: 99%

The efficacy and use of finasteride in women: a systematic review

Chapman

Mesinkovska

2019

Int J Dermatology

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“…Finasteride is a 5 α -R inhibitor which can be used systemically or locally. Finasteride decreases hair growth by causing less exposure of hair follicles to androgen stimulation 21 , 22 . Although the efficacy of systemic finasteride has been reported in different studies, there are a few articles in which the efficacy and tolerability of topical gel of finasteride has been evaluated.…”

Section: Introductionmentioning

confidence: 99%

Preparation and clinical evaluation of Finastride gel in the treatment of idiopathic Hirsutism

Tahvilian

Ebrahimi

Beiki

et al. 2015

Journal of Drug Assessment

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ObjectiveHirsutism is the presence of excess terminal hairs in females in a male-like pattern. The most accepted hypothesis for the development of hirsutism is increased 5α-reductase activity in hair follicles of hirsute women. Finasteride partially blocks the conversion of testosterone to dihydrotestosterone through inhibition of 5α-reductase in hair follicles. This study was designed to determine the efficacy of finasteride gel 0.25% in management of idiopathic hirsutism and treatment of hirsutism with topical finasteride to lessen the side-effects.MethodsWomen after puberty that have idiopathic hirsutism criteria are divided randomly in two groups; treatment and control. The number of patients in each group is 15 and received finasteride and placebo gel once a day on their skins. The patients were visited every month by a dermatologist and the amount of response to the treatment and the patient satisfaction was recorded. Ferriman–Gallwey score of the treated area was determined.ResultsAfter 6-months, mean thickness hairs in treating group were decreased from 102.00 ± 9.58 µm to 86.4 ± 11.4 µm (p < 0.05), this difference was statistically significant. Gel application did not indicate any type of side-effects.LimitationsInclusion and exclusion criteria.ConclusionFinasteride partially blocks 5α-reductase. Because of the good absorption through the skin and good solubility of this medicine, the prepared gel formulation applied on the hirsutism area showed a significant decrease in hair growth locally, so finasteride gel is an efficient and harmless therapy in patients with idiopathic hirsutism.

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“…Administered orally at 1 mg/d, it is effective in retarding hair loss in approximately 30% to 50% of treated males [Kaufman et al, 1998;Price, 1999]; up to 4% of users experience impotence, decreased libido, and ejaculation disorders, which are reversible upon treatment cessation [Frankel, 1999;McElroy, 2001;Price et al, 2000]. Finasteride applied topically has shown limited efficacy [Mazzarella et al, 1997;Rushton et al, 1996], attributed to systemic absorption rather than a direct effect on the hair follicle [Price et al, 2000]. Dutasteride, a recently approved inhibitor of both type I and II 5a-reductase for treatment of benign prostate hyperplasia, is reportedly being evaluated for treatment of AGA, although no efficacy data are presently available (http://www.dutasteride.…”

Section: Introductionmentioning

confidence: 99%

“…Propecia (finasteride), an approved systemic therapy for male AGA, reduces serum DHT levels by inhibiting type II 5a-reductase, an enzyme responsible for catalyzing the reduction of testosterone to DHT. Administered orally at 1 mg/d, it is effective in retarding hair loss in approximately 30% to 50% of treated males [Kaufman et al, 1998;Price, 1999]; up to 4% of users experience impotence, decreased libido, and ejaculation disorders, which are reversible upon treatment cessation [Frankel, 1999;McElroy, 2001;Price et al, 2000]. Finasteride applied topically has shown limited efficacy [Mazzarella et al, 1997;Rushton et al, 1996], attributed to systemic absorption rather than a direct effect on the hair follicle [Price et al, 2000].…”

Section: Introductionmentioning

confidence: 99%

Development of fluridil, a topical suppressor of the androgen receptor in androgenetic alopecia

Seligson

Campion

Brown

et al. 2003

Drug Development Research

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Nonsteroidal antiandrogens (AA) cannot be topically used for androgenetic alopecia (AGA) because of systemic resorption. A new class of androgen receptor (AR) suppressors designed for safe topical treatment of AGA was synthesized from (3-amino-2-hydroxy-2-methyl-N-(4-nitro-3-trifluoromethyl)phenyl) propanamide (BP-34), to contain perfluoroalkyl moieties. The trifluoromethyl derivative (fluridil) at 10 mM decreased expression of the AR in LNCaP human cells by 95%, its serum half-life was 6 h; it decomposes hydrolytically to BP-34 and trifluoroacetic acid. Acute intraperitoneal maximum tolerated dose (MTD) of fluridil in mice is 270-300 mg/kg/d and the subacute MTD is 450 mg/kg/d. The oral LD 50 in mice was 2,872 mg/kg in males, 2,232 mg/kg in females, and 42,500 mg/kg in rats. Fluridil solution in isopropanol was not cutaneously absorbed in rabbits, did not sensitize or show any phototoxic or photoallergic effects on guinea pig skin, and demonstrated no skin irritation potential in rabbits and humans. Fluridil solid induced only slight and reversible eye irritancy in rabbits and displayed no cytotoxicity to rabbit corneal fibroblasts in vitro. Fluridil demonstrated no significant mutagenicity potential by Ames method. In a double-blind study, 43 males with AGA, Norwood grade II to Va, used topical 2% fluridil in isopropanol or the vehicle daily for 12 months. Anagens (growing hairs) increased in the fluridil group from 76% to 89%. All hematological and biochemistry values remained within normal range, including testosterone, which varied but seasonally. No fluridil or its decomposition product (BP-34) was detected in serum. No adverse side effects were reported. Drug Dev.

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Lack of effect of topical finasteride suggests an endocrine role for dihydrotestosterone

Cited by 10 publications

References 4 publications

The efficacy and use of finasteride in women: a systematic review

The efficacy and use of finasteride in women: a systematic review

Preparation and clinical evaluation of Finastride gel in the treatment of idiopathic Hirsutism

Development of fluridil, a topical suppressor of the androgen receptor in androgenetic alopecia

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