Use of 5-Alpha Reductase Inhibitors in Dermatology: A Narrative Review

July 2023 in “ Dermatology and Therapy ”

Mariana Escamilla-Cruz, Mario Magaña, Sabrina Escandón-Pérez, Omar Yaxmehen Bello‐Chavolla

5-Alpha Reductase Inhibitors 5ARIs Androgenetic Alopecia AGA finasteride minocycline type I 5ARI hormone modulation therapies Frontal Fibrosing Alopecia FFA dutasteride hirsutism Propecia Accutane

TLDR 5-Alpha Reductase Inhibitors are effective for male hair loss and some skin conditions, but their effectiveness in women and safety concerns require careful use.

5-Alpha Reductase Inhibitors (5ARIs) have been found effective in treating Androgenetic Alopecia (AGA) in men, with studies showing that a daily dose of 1 mg of finasteride can promote hair growth and reduce hair loss. However, their effectiveness in women remains debatable. For Acne Vulgaris, significant improvement was observed in patients treated with minocycline alone and those receiving a combination of minocycline and a type I 5ARI. The review also suggests that women with Androgen-mediated skin disorders may benefit from hormone modulation therapies, including 5ARIs. In treating Frontal Fibrosing Alopecia (FFA), finasteride and dutasteride showed improvement or stabilization in a significant number of patients. For hirsutism, both 2.5 mg and 5 mg doses of finasteride were found to be safe and effective. However, the use of 5ARIs has been linked to serious adverse effects in men and women, leading to the creation of treatment guidelines to ensure their safe and appropriate use.

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28 / 28 results

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research Topical Finasteride for the Treatment of Male Androgenetic Alopecia and Female Pattern Hair Loss: A Review of the Current Literature

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Topical finasteride helps regrow hair and reduce hair loss in men and women.

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research Androgens in Women: Hormone-Modulating Therapies for Androgen-Mediated Cutaneous Disorders

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Hormone treatments can help with women's skin and hair disorders, but they need careful monitoring and more research.

research Efficacy of Topical Combination of 0.25% Finasteride and 3% Minoxidil Versus 3% Minoxidil Solution in Female Pattern Hair Loss: A Randomized, Double-Blind, Controlled Study

36 citations , February 2019 in “American Journal of Clinical Dermatology”

Combination of 0.25% finasteride and 3% minoxidil works better than just 3% minoxidil for increasing hair thickness in women.

research A Randomized, Double-Blind Controlled Study of the Efficacy and Safety of Topical Solution of 0.25% Finasteride Admixed with 3% Minoxidil vs. 3% Minoxidil Solution in the Treatment of Male Androgenetic Alopecia

43 citations , December 2018 in “Journal of The European Academy of Dermatology and Venereology”

Finasteride and minoxidil mix works better for hair growth than minoxidil alone, with similar safety.

research The Post-Finasteride Syndrome: Clinical Manifestation of Drug-Induced Epigenetics Due to Endocrine Disruption

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Finasteride can cause lasting sexual dysfunction, depression, and other side effects, needing more research for treatment.

research 5-Alpha-Reductase Inhibitor Treatment for Frontal Fibrosing Alopecia: An Evidence-Based Treatment Update

21 citations , March 2018 in “JEADV. Journal of the European Academy of Dermatology and Venereology/Journal of the European Academy of Dermatology and Venereology”

5-alpha-reductase inhibitors may help stabilize or slow down hair loss in some frontal fibrosing alopecia patients, but more research is needed to confirm their effectiveness and safety.

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research The Effectiveness of Finasteride and Dutasteride Used for 3 Years in Women with Androgenetic Alopecia

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research Frontal Fibrosing Alopecia: A Multicenter Review of 355 Patients

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Most patients with frontal fibrosing alopecia are postmenopausal women, and treatments like finasteride and dutasteride can improve or stabilize the condition.

research Finasteride 5 mg/Day Treatment of Patterned Hair Loss in Normo-Androgenetic Postmenopausal Women

44 citations , January 2013 in “International Journal of Trichology”

Finasteride 5 mg/day effectively treats hair loss in postmenopausal women without hyper-androgenism.

research Effect of Finasteride 5 mg (Proscar) on Acne and Alopecia in Female Patients with Normal Serum Levels of Free Testosterone

43 citations , January 2007 in “Gynecological Endocrinology”

Finasteride improves acne and hair loss in women with normal testosterone.

research The Importance of Dual 5α-Reductase Inhibition in the Treatment of Male Pattern Hair Loss: Results of a Randomized Placebo-Controlled Study of Dutasteride Versus Finasteride

215 citations , December 2006 in “Journal of The American Academy of Dermatology”

Dutasteride more effective for hair growth, but has more side effects than finasteride.

research Finasteride in the Treatment of Japanese Men with Male Pattern Hair Loss

12 citations , July 2004 in “PubMed”

Finasteride, especially in a 1mg dose, effectively slows hair loss and improves hair growth in Japanese men with male pattern hair loss.

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22 citations , April 2003 in “PubMed”

research Treatment of Hyperandrogenic Alopecia in Women

108 citations , January 2003 in “Fertility and Sterility”

Flutamide may slightly improve hair loss in women, but finasteride does not work.

research Hair Loss in Women with Hyperandrogenism: Four Cases Responding to Finasteride

92 citations , November 2002 in “Journal of The American Academy of Dermatology”

Finasteride improves hair loss in women with hyperandrogenism.

research Comparison of High-Dose Finasteride (5 mg/day) Versus Low-Dose Finasteride (2.5 mg/day) in the Treatment of Hirsutism

51 citations , October 2002 in “European journal of endocrinology”

Low-dose finasteride effectively treats hirsutism, is safe, and cost-effective.

research Molecular Mechanisms of Androgenetic Alopecia

229 citations , August 2002 in “Experimental Gerontology”

AGA causes hair loss by shrinking hair follicles due to DHT binding, and can be treated with finasteride and minoxidil.

research Long-Term Multinational Experience with Finasteride 1 mg in the Treatment of Men with Androgenetic Alopecia

20 citations , January 2002 in “PubMed”

Finasteride 1 mg/day for five years effectively improves hair growth and slows hair loss in men with male pattern baldness, and is safe for long-term use.

research Lack of Efficacy of Finasteride in Postmenopausal Women with Androgenetic Alopecia

239 citations , November 2000 in “Journal of The American Academy of Dermatology”

Finasteride doesn't effectively treat hair loss in postmenopausal women.

research Finasteride Increases Anagen Hair in Men with Androgenetic Alopecia

129 citations , October 2000 in “British Journal of Dermatology”

Finasteride helps increase hair growth in men with hair loss.

research The Effects of Finasteride on Scalp Skin and Serum Androgen Levels in Men with Androgenetic Alopecia

65 citations , October 1999 in “Journal of The American Academy of Dermatology”

Finasteride effectively reduces hair loss by decreasing androgen levels.

research Finasteride

187 citations , January 1994 in “The New England Journal of Medicine”

Finasteride treats enlarged prostate and may help with baldness, but effects on sexual function and male fetuses are unclear.

5 / 5 results

research Use of 5-Alpha Reductase Inhibitors in Dermatology: A Narrative Review

July 2023 in “Dermatology and Therapy”

5-Alpha Reductase Inhibitors are effective for male hair loss and some skin conditions, but their effectiveness in women and safety concerns require careful use.

research Luncheon Symposium: Update on the Efficacy and Safety of Dutasteride in the Management of Androgenetic Alopecia

January 2015 in “프로그램북(구 초록집)”

Dutasteride is effective and safe for treating common hair loss, and it's more potent than finasteride, leading to better hair growth and thickness.

research The Effect of 5α-Reductase Inhibition with Dutasteride and Finasteride on Semen Parameters and Serum Hormones in Healthy Men

195 citations , May 2007 in “The Journal of Clinical Endocrinology and Metabolism”

Dutasteride and finasteride may reduce sperm count and volume but don't affect movement or shape; effects are reversible after stopping.

research Marked Suppression of Dihydrotestosterone in Men with Benign Prostatic Hyperplasia by Dutasteride, a Dual 5α-Reductase Inhibitor

408 citations , May 2004 in “The Journal of clinical endocrinology and metabolism/Journal of clinical endocrinology & metabolism”

Dutasteride more effectively lowers DHT levels in men with enlarged prostates than finasteride.

research Finasteride

187 citations , January 1994 in “The New England Journal of Medicine”

Finasteride treats enlarged prostate and may help with baldness, but effects on sexual function and male fetuses are unclear.