Androgenetic Alopecia in Women and Men: Italian Guidelines Adapted from European Dermatology Forum/European Academy of Dermatology and Venereology Guidelines

December 2020 in “ Giornale italiano di dermatologia e venereologia ”

Aurora Alessandrini, Michela Starace, Roberto D'Ovidio, Lucia Villa, Alfredo De Rossi, Teodora R Stan, Piergiacomo Calzavara-Pinton, Bianca Maria Piraccini

androgenetic alopecia AGA dihydrotestosterone DHT trichoscopy topical minoxidil antiandrogen agents 5-alpha reductase inhibitors androgenic alopecia Rogaine Propecia

From the encyclopedia

Minoxidil →

An essential vasodilator with some anti-androgenic effects

Finasteride →

Frontline, gold standard treatment for combatting androgenic alopecia

Studysummary This guideline summarizes evidence-based and expert-based recommendations for treating androgenetic alopecia, adapted by an Italian expert group in alignment with Italian pharmacological policies.

Automatically generated from the study's abstract, not written by a person, and not a review of the full paper. Not medical advice or a treatment recommendation. Read the original study, and consult a qualified healthcare professional before changing treatment. Full disclaimer

View this study on minervamedica.it →

Discuss this study in the Community →

Research cited in this study

45 / 45 results

research Post-Finasteride Syndrome and Post-SSRI Sexual Dysfunction: Two Sides of the Same Coin?

40 citations , April 2018 in “Endocrine”

This review discusses post-SSRI sexual dysfunction and post-finasteride syndrome, highlighting unknowns about their true incidence and underlying causes, and reports no new clinical results.

research Drug Treatment for Androgenetic Alopecia: First Italian Questionnaire Survey on Dermatologists' Opinions about Finasteride

7 citations , March 2018 in “Dermatology and therapy”

This study found that Italian dermatologists commonly prescribe 1 mg/day finasteride for androgenetic alopecia despite reported sexual side effects, due to its perceived long-term efficacy.

research The Use of Minoxidil in the Treatment of Male and Female Androgenetic Alopecia: A Story of More Than 30 Years

5 citations , January 2018 in “Italian journal of dermatology and venereology”

This study discusses that while the precise mechanism of minoxidil is not fully understood, its efficacy in stimulating hair growth and treating androgenetic alopecia is well-supported, with evidence showing it increases hair count and hair follicle size in treated patients.

research Evidence-Based Guideline for the Treatment of Androgenetic Alopecia in Women and Men – Short Version

145 citations , November 2017 in “Journal of The European Academy of Dermatology and Venereology”

This guideline review by the European Dermatology Forum evaluates current treatments for androgenetic alopecia but reports no new research findings, aiming to assist dermatologists in selecting safe and effective therapies.

research Hair Transplantation Controversies

31 citations , October 2017 in “Dermatologic Surgery”

This review examines controversies in hair transplant surgery, including donor harvesting techniques and the roles of platelet-rich plasma and low-level light therapy, and reports no new clinical results.

research Dermatologic Manifestations of Endocrine Disorders

86 citations , October 2017 in “Translational pediatrics”

This review discusses how ophthalmic findings can reveal key endocrine disorders and reports no new clinical results, emphasizing the eye's role in diagnosing and managing systemic diseases like diabetes and Graves' ophthalmopathy.

Platelet-Rich Plasma in Combination With 5% Minoxidil Topical Solution and 1 mg Oral Finasteride for the Treatment of Androgenetic Alopecia: A Randomized Placebo-Controlled, Double-Blind, Half-Head Study

research Platelet-Rich Plasma in Combination With 5% Minoxidil Topical Solution and 1 mg Oral Finasteride for the Treatment of Androgenetic Alopecia: A Randomized Placebo-Controlled, Double-Blind, Half-Head Study

19 citations , May 2017 in “Dermatologic Surgery”

Combining platelet-rich plasma with 5% minoxidil solution improves hair regrowth in androgenetic alopecia patients.

research Association of Suicidality and Depression With 5α-Reductase Inhibitors

90 citations , March 2017 in “JAMA Internal Medicine”

In this study, older men using 5α-reductase inhibitors for prostatic enlargement did not show increased risk of suicide, but had elevated risks of self-harm and depression.

research Diet and Hair Loss: Effects of Nutrient Deficiency and Supplement Use

79 citations , January 2017 in “Dermatology practical & conceptual”

This article addresses the need to screen for nutrient deficiencies in patients with hair loss but reports no new findings, noting that supplementation without deficiency may not be beneficial and could pose risks.

research Sexual Side Effects of 5-Alpha-Reductase Inhibitors Finasteride and Dutasteride: A Comprehensive Review

21 citations , January 2017 in “Dermatology Online Journal”

This review discusses the sexual side effects of finasteride and dutasteride, two 5-α-reductase inhibitors, and reports no new clinical findings while calling for further research into dosage differences.

Effects of a Novel Finasteride 0.25% Topical Solution on Scalp and Serum Dihydrotestosterone in Healthy Men with Androgenetic Alopecia

research Effects of a Novel Finasteride 0.25% Topical Solution on Scalp and Serum Dihydrotestosterone in Healthy Men with Androgenetic Alopecia

42 citations , December 2015 in “International Journal of Clinical Pharmacology and Therapeutics”

This study found that applying a novel 0.25% finasteride solution to the scalp can effectively reduce scalp DHT levels in men with androgenetic alopecia, potentially reducing systemic side-effects.

research The Effect of Platelet-Rich Plasma in Hair Regrowth: A Randomized Placebo-Controlled Trial

214 citations , September 2015 in “Stem Cells Translational Medicine”

This study found that platelet-rich plasma injections significantly increased hair count and density in patients with male pattern hair loss without major side effects, suggesting it may be a safe and effective treatment option.

research Scalp Dermoscopy or Trichoscopy

69 citations , January 2015 in “Current problems in dermatology”

This review discusses trichoscopy as a noninvasive, effective technique for diagnosing various hair loss conditions and monitoring treatment, highlighting its potential to reduce scalp biopsy necessity.

research Topical Minoxidil Fortified with Finasteride: Maintenance of Hair Density After Replacing Oral Finasteride

32 citations , January 2015 in “Indian Dermatology Online Journal”

This study found that a combination of topical minoxidil and finasteride helped maintain hair density in patients with androgenetic alopecia after initial oral finasteride treatment.

research Platelet-Rich Plasma for Androgenetic Alopecia

107 citations , August 2014 in “Dermatologic Surgery”

This pilot study suggests injecting platelet-derived growth factors into the scalp may offer some clinical benefits for androgenetic alopecia, though further randomized trials are needed for confirmation.

A Novel Finasteride 0.25% Topical Solution for Androgenetic Alopecia: Pharmacokinetics and Effects on Plasma Androgen Levels in Healthy Male Volunteers

research A Novel Finasteride 0.25% Topical Solution for Androgenetic Alopecia: Pharmacokinetics and Effects on Plasma Androgen Levels in Healthy Male Volunteers

50 citations , July 2014 in “International Journal of Clinical Pharmacology and Therapeutics”

This study found that both topical and oral finasteride significantly reduced plasma DHT after one week, with lower finasteride plasma exposure for the topical formulation.

research Study of Platelet-Rich Plasma Injections in the Treatment of Androgenetic Alopecia Through a One-Year Period

164 citations , January 2014 in “Journal of Cutaneous and Aesthetic Surgery”

This study found that PRP injections may improve hair density and reduce hair loss in patients with androgenetic alopecia without significant side effects, but further research is needed to confirm efficacy.

research Scalp Dermatoscopic Findings in Androgenetic Alopecia and Their Relations with Disease Severity

30 citations , January 2014 in “Annals of Dermatology”

This study observed no significant relationship between trichoscopic findings and disease severity in male or female androgenetic alopecia, despite some specific patterns correlating with different severity levels in female patients.

research A Prostaglandin D-Synthase-Positive Mast Cell Gradient Characterizes Scalp Patterning

6 citations , December 2013 in “Journal of Cutaneous Pathology”

This study found that the distribution of mast cell prostaglandin d-synthase in the scalp spatially aligns with the pattern of androgenetic alopecia, suggesting a programmed vulnerability to hair loss.

research Low-Level Light Therapy for Androgenetic Alopecia: A 24-Week, Randomized, Double-Blind, Sham Device-Controlled Multicenter Trial

106 citations , April 2013 in “Dermatologic Surgery”

This study found that low-level light therapy significantly increased hair density and diameter in androgenetic alopecia patients compared to a sham device, suggesting it could be an effective treatment option.

research Serum Ferritin and Vitamin D in Female Hair Loss: Do They Play a Role?

62 citations , January 2013 in “Skin Pharmacology and Physiology”

This study found that low serum ferritin and vitamin D2 levels are associated with hair loss in females with chronic telogen effluvium and female pattern hair loss, suggesting potential benefits of screening and supplementation.

research Global Photographic Assessment of Men Aged 18 to 60 Years with Male Pattern Hair Loss Receiving Finasteride 1 mg or Placebo

35 citations , February 2012 in “Journal of The American Academy of Dermatology”

This study found that finasteride (1 mg) significantly increased hair growth in all scalp regions affected by male pattern hair loss over 24 months in men aged 18 to 60, with more pronounced effects in younger men.

A Randomized Double-Blind Placebo-Controlled Pilot Study to Assess the Efficacy of a 24-Week Topical Treatment by Latanoprost 0.1% on Hair Growth and Pigmentation in Healthy Volunteers with Androgenetic Alopecia

research A Randomized Double-Blind Placebo-Controlled Pilot Study to Assess the Efficacy of a 24-Week Topical Treatment by Latanoprost 0.1% on Hair Growth and Pigmentation in Healthy Volunteers with Androgenetic Alopecia

81 citations , August 2011 in “Journal of The American Academy of Dermatology”

In this study, latanoprost significantly increased hair density in young men with mild androgenetic alopecia after 24 weeks, suggesting it may stimulate hair follicle activity and treat hair loss.

research Prospective Cohort Study on the Effects and Tolerability of Flutamide in Patients with Female Pattern Hair Loss

42 citations , April 2011 in “Annals of Pharmacotherapy”

This study found that long-term flutamide treatment reduced hair loss in women with female pattern hair loss, but liver-related dropouts were minimized at a very low dose of 62.5 mg/day.

Efficacy, Safety, and Tolerability of Dutasteride 0.5 mg Once Daily in Male Patients with Male Pattern Hair Loss: A Randomized, Double-Blind, Placebo-Controlled, Phase III Study

research Efficacy, Safety, and Tolerability of Dutasteride 0.5 mg Once Daily in Male Patients with Male Pattern Hair Loss: A Randomized, Double-Blind, Placebo-Controlled, Phase III Study

92 citations , June 2010 in “Journal of The American Academy of Dermatology”

This study found that 0.5 mg of dutasteride significantly improved hair growth compared to placebo and was well tolerated over six months in men with male pattern hair loss.

research Innovative Use of Spironolactone as an Antiandrogen in the Treatment of Female Pattern Hair Loss

53 citations , May 2010 in “PubMed”

This paper discusses spironolactone as a potential off-label treatment for female pattern hair loss, noting its ability to halt hair loss progression and induce partial regrowth in a significant number of women but reports no new clinical results.

research Hormonal Therapy for Acne: Why Not as First Line Therapy? Facts and Controversies

76 citations , December 2009 in “Clinics in Dermatology”

This review discusses the indications, contraindications, and potential for using hormonal therapy as a first-line treatment for acne in females, but reports no new clinical results.

research Successful Treatment of Female-Pattern Hair Loss with Spironolactone in a 9-Year-Old Girl

26 citations , April 2009 in “Australasian Journal of Dermatology”

In this study, a 9-year-old girl with female pattern hair loss showed clinical improvement and hair regrowth after six months of daily oral spironolactone.

research Dermoscopy in Female Androgenic Alopecia: Method Standardization and Diagnostic Criteria

129 citations , January 2009 in “International Journal of Trichology”

This study found that trichoscopy criteria can distinguish female androgenic alopecia from chronic telogen effluvium, with specific features achieving 98% diagnostic specificity.

research Comparing the Therapeutic Effects of Finasteride Gel and Tablet in Treatment of Androgenetic Alopecia

57 citations , January 2009 in “Indian Journal of Dermatology, Venereology and Leprology”

This study found that both topical and oral finasteride had similar therapeutic effects in treating male androgenic alopecia, with no significant differences in hair thickness, counts, or bald area size.

The Ludwig Pattern of Androgenetic Alopecia Is Due to a Hierarchy of Androgen Sensitivity Within Follicular Units That Leads to Selective Miniaturization and a Reduction in the Number of Terminal Hairs Per Follicular Unit

research The Ludwig Pattern of Androgenetic Alopecia Is Due to a Hierarchy of Androgen Sensitivity Within Follicular Units That Leads to Selective Miniaturization and a Reduction in the Number of Terminal Hairs Per Follicular Unit

47 citations , September 2008 in “British Journal of Dermatology”

This study found that women with androgenetic alopecia experience diffuse hair loss due to a decrease in terminal hairs and an increase in vellus hairs per follicular unit.

research Promotive Effect of Minoxidil Combined with All-Trans Retinoic Acid (Tretinoin) on Human Hair Growth In Vitro

41 citations , January 2007 in “Journal of Korean Medical Science”

This study found that combining minoxidil with all-trans retinoic acid additively promoted hair growth in vitro by activating certain cell survival pathways and reducing apoptosis markers more effectively than minoxidil alone.

research Efficacy of 5% Minoxidil Versus Combined 5% Minoxidil and 0.01% Tretinoin for Male Pattern Hair Loss

43 citations , January 2007 in “American Journal of Clinical Dermatology”

This study concluded that a combined once-daily solution of 5% minoxidil and 0.01% tretinoin is as effective and safe as the conventional twice-daily 5% minoxidil application for treating androgenetic alopecia in men.

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

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 , November 2006 in “Journal of The American Academy of Dermatology”

This study found that dutasteride increased scalp hair growth in men with male pattern hair loss, particularly at a 2.5 mg dose, and was more effective than finasteride over 24 weeks.

research Distinguishing Androgenetic Alopecia From Chronic Telogen Effluvium When Associated in the Same Patient

63 citations , October 2005 in “Archives of Dermatology”

This study reports that a hair shedding threshold of 100 hairs or more may provide the best concordance with clinical diagnosis for distinguishing chronic telogen effluvium from androgenetic alopecia.

research Genetic Variation in the Human Androgen Receptor Gene Is the Major Determinant of Common Early-Onset Androgenetic Alopecia

195 citations , June 2005 in “American Journal of Human Genetics”

Genetic variation in the androgen receptor gene mainly causes early-onset hair loss, with maternal inheritance playing a key role.

research Treatment of Female Pattern Hair Loss With Oral Antiandrogens

179 citations , March 2005 in “British Journal of Dermatology”

This study found that 88% of women with female pattern hair loss who received oral antiandrogens saw no progression or improvement in their condition.

research Kenogen in Female Androgenetic Alopecia

40 citations , December 2004 in “Dermatology”

This study suggests that an increase in kenogen phases, along with rising vellus hair cycles and fewer normal hair cycles, is associated with the progression of female androgenetic alopecia.

research Histological Features of Peripilar Signs Associated with Androgenetic Alopecia

95 citations , January 2004 in “Archives of Dermatological Research”

This study found that peripilar signs on the scalp are linked to perifollicular lymphocytic infiltrates in early androgenetic alopecia, detectable even in areas with high hair density.

research Treatment of Hyperandrogenic Alopecia in Women

108 citations , January 2003 in “Fertility and Sterility”

This study found that flutamide at 250 mg daily modestly improved hair thinning in premenopausal women with hyperandrogenic alopecia over one year, while cyproterone acetate and finasteride were not effective.

research Effects of Minoxidil 2% vs. Cyproterone Acetate Treatment on Female Androgenetic Alopecia: A Controlled, 12-Month Randomized Trial

149 citations , June 2002 in “British Journal of Dermatology”

Minoxidil works better for female hair loss, but cyproterone reduces scalp oiliness and causes menstrual issues.

research Beneficial Effect of Spironolactone on Androgenic Alopecia

20 citations , December 1997 in “Clinical Endocrinology”

This article discusses the potential beneficial effect of spironolactone on androgenic alopecia but provides no new clinical findings.

research Topical Finasteride in the Treatment of Androgenic Alopecia: Preliminary Evaluations After a 16-Month Therapy Course

30 citations , January 1997 in “Journal of Dermatological Treatment”

This study reported that a 0.005% finasteride solution may encourage hair regrowth and reduce balding areas in patients with androgenic alopecia, without significant absorption or adverse effects.

research Topical Tretinoin for Hair Growth Promotion

73 citations , October 1986 in “Journal of the American Academy of Dermatology”

This study found that a combination of topical tretinoin and 0.5% minoxidil resulted in terminal hair regrowth in 66% of subjects with androgenetic alopecia over one year.

research Oral Spironolactone Therapy for Female Patients with Acne, Hirsutism, or Androgenic Alopecia

101 citations , January 1985 in “British Journal of Dermatology”

This article discusses oral spironolactone therapy for female patients with acne, hirsutism, or androgenic alopecia and reports no new clinical results.