S9   TREATMENT OF ANDROGENETIC ALOPECIA:  THE FINASTERIDE EXPERIENCE

Whiting, D.A., Baylor Hair Research and Treatment Center, Dallas, TX, U.S.A.

Studies have indicated that dihydrotestosterone (DHT) is important in the etiology of common baldness.  DHT is formed from testosterone by the enzyme type 2 5a-reductase.  Finasteride, a strong inhibitor of type 2 5a-reductase, has been evaluated in the treatment of androgenetic alopecia (AGA).

A pilot study in 200 males with AGA showed that finasteride 5 mg daily produced significant hair growth.  Subsequent dose-ranging studies proved that finasteride 1 mg daily was as effective.

Phase 3 studies of finasteride 1 mg daily vs placebo in 1553 males, with mild to moderate vertex hair loss, showed significant improvement in hair growth in 66% and cessation of hair loss in 83% of patients after 2 years.  A frontal study in 326 men confirmed that frontal hair growth could also be expected.  Side effects were minimal.  The increased growth of quality hair was confirmed by phototrichograms, hair-weight studies, and serial scalp biopsies.

A pilot study of finasteride 1 mg daily vs placebo in 136 post-menopausal females with mild to moderate AGA showed no improvement.