Hair Are the Rankings—5-Alpha Reductase Inhibitors and Minoxidil in Male Androgenetic Alopecia

February 2022 in “ JAMA Dermatology ”

Kathie P. Huang, Maryanne M. Senna

5-α reductase inhibitors minoxidil androgenetic alopecia AGA topical minoxidil oral finasteride low-level light therapy oral minoxidil oral dutasteride Propecia Rogaine LLLT

From the encyclopedia

Minoxidil →

An essential vasodilator with some anti-androgenic effects

Finasteride →

Frontline, gold standard treatment for combatting androgenic alopecia

Low Level Laser Therapy →

laser therapy for anti-inflammatory and likely insignificant hair regrowth effects

Studysummary This abstract provides no research findings; it is just information about the JAMA Dermatology journal's website and access options.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

Androgenetic alopecia (AGA) is the most common type of hair loss in men in the US, affecting 50% of men by age 50 and up to 90% of men in their lifetime. It can moderately impair health-related quality of life and is associated with low self-esteem and depression. Currently, the only US Food and Drug Administration-approved therapies for AGA are topical minoxidil, oral finasteride 1 mg, and low-level light therapy. However, due to the high prevalence of AGA and its associated outcomes, there is an increasing trend in the literature reporting off-label use of oral minoxidil, oral dutasteride, and higher doses of oral finasteride and topical minoxidil to expand therapeutic options for patients.

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Research cited in this study

8 / 8 results

research Health-Related Quality of Life, Depression, and Self-Esteem in Patients With Androgenetic Alopecia

15 citations , July 2021 in “JAMA Dermatology”

This study found that androgenetic alopecia is significantly associated with moderate impairment of health-related quality of life and emotions, but not with depressive symptoms.

research Coming Full Circle (Almost): Low Dose Oral Minoxidil for Alopecia

5 citations , January 2021 in “Journal of The American Academy of Dermatology”

This article reflects on the history and significance of the FDA's approval of topical minoxidil for treating androgenetic alopecia in men and women, dating back to 1988 and 1991 respectively.

research Investigation of Suicidality and Psychological Adverse Events in Patients Treated With Finasteride

40 citations , November 2020 in “JAMA Dermatology”

This pharmacovigilance study found an increased association of suicidality and psychological adverse events with finasteride use, especially among younger patients using it for alopecia.

research Ongoing Concerns Regarding Finasteride for the Treatment of Male-Pattern Androgenetic Alopecia

5 citations , November 2020 in “JAMA Dermatology”

Finasteride may cause side effects; more research needed.

research Oral Minoxidil Treatment for Hair Loss: A Review of Efficacy and Safety

59 citations , July 2020 in “Journal of The American Academy of Dermatology”

This study concluded that oral minoxidil is an effective and well-tolerated alternative to topical minoxidil for healthy patients struggling with application-related compliance issues.

research 5-Alpha Reductase Inhibitors in Androgenetic Alopecia: Shifting Paradigms, Current Concepts, Comparative Efficacy, and Safety

19 citations , April 2020 in “Dermatologic Therapy”

This review found that dutasteride is more potent than finasteride as a dual receptor dihydrotestosterone blocker for treating androgenetic alopecia and shares a similar safety profile in terms of fertility, teratogenicity, neurotoxicity, and hepatotoxicity.

research A Review of the Treatment of Male Pattern Hair Loss

53 citations , February 2020 in “Expert Opinion on Pharmacotherapy”

This review discusses pharmacologic and non-pharmacologic treatments for androgenetic alopecia, noting that current medications like finasteride and minoxidil can slow hair loss but only partially restore hair growth, with early treatment offering better outcomes.

The Efficacy and Safety of 5α-Reductase Inhibitors in Androgenetic Alopecia: A Network Meta-Analysis and Benefit–Risk Assessment of Finasteride and Dutasteride

research The Efficacy and Safety of 5α-Reductase Inhibitors in Androgenetic Alopecia: A Network Meta-Analysis and Benefit–Risk Assessment of Finasteride and Dutasteride

66 citations , June 2013 in “Journal of Dermatological Treatment”

This study reported no significant difference in efficacy or sexual dysfunction risk between 5α-reductase inhibitors and placebo for androgenetic alopecia, suggesting that dutasteride 0.5 mg may be considered pending further research.