Androgenetic Alopecia: Treatments and Efficacy

January 2000 in “ Dermatologic Clinics ”

Marty E. Sawaya, Jerry Shapiro

androgenetic alopecia finasteride minoxidil spironolactone flutamide FDA-approved products over-the-counter products herbal agents Propecia Rogaine

From the encyclopedia

Finasteride →

Frontline, gold standard treatment for combatting androgenic alopecia

Minoxidil →

An essential vasodilator with some anti-androgenic effects

Spironolactone →

powerful topical and oral anti-androgen used mostly by women

Studysummary This article reviews the genetic and psychological aspects of androgenetic alopecia in men and women, reporting no new clinical findings while emphasizing the broad impact of this hair loss condition.

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

This document from 2000 discusses various treatments for androgenetic alopecia (AGA), including FDA-approved products like finasteride and minoxidil, as well as off-label treatments like spironolactone and flutamide. The document also discusses over-the-counter products and herbal agents that claim to treat AGA, but their effectiveness is uncertain. The document notes that only FDA-approved products have undergone rigorous clinical trials, and that it is important for physicians to guide patients and advise them on the efficacy of these treatments before they spend money and raise their hopes.

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Research cited in this study

17 / 17 results

research Androgen Receptor Polymorphisms (CAG Repeat Lengths) in Androgenetic Alopecia, Hirsutism, and Acne

186 citations , July 1998 in “Journal of Cutaneous Medicine and Surgery”

This study found that shorter CAG-repeat lengths in the androgen receptor may be associated with the development of androgen-mediated skin disorders like androgenetic alopecia, acne, and hirsutism in both men and women.

research Hair Regrowth

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This review discusses the advancements in understanding and treating androgenetic alopecia and alopecia areata but reports no clinical findings; the authors emphasize the need for further research on molecular control mechanisms.

research Comparison of Finasteride Versus Spironolactone in the Treatment of Idiopathic Hirsutism

76 citations , December 1997 in “Fertility and Sterility”

This study found that spironolactone was significantly more effective than finasteride in reducing hirsutism scores over 9 months, despite more side effects occurring in the spironolactone group.

Different Levels of 5α-Reductase Type I and II, Aromatase, and Androgen Receptor in Hair Follicles of Women and Men with Androgenetic Alopecia

research Different Levels of 5α-Reductase Type I and II, Aromatase, and Androgen Receptor in Hair Follicles of Women and Men with Androgenetic Alopecia

416 citations , September 1997 in “Journal of Investigative Dermatology”

People with hair loss have more androgen receptors and enzymes in certain follicles, with men and women showing different patterns.

research Alopecia: The Search for Novel Agents Continues

11 citations , August 1997 in “Expert Opinion on Therapeutic Patents”

This review discusses nearly 70 patent applications for the treatment of androgenetic alopecia and other hair conditions, highlighting the mechanisms of action explored but reports no clinical results.

research Clinical Updates in Hair

19 citations , January 1997 in “Dermatologic Clinics”

This chapter reviews various antiandrogens and androgen inhibitors, detailing their mechanisms, uses, and side effects, with a focus on spironolactone, finasteride, dutasteride, and oral contraceptives.

research Comparison of Flutamide and Spironolactone in the Treatment of Hirsutism: A Randomized Controlled Trial

165 citations , February 1994 in “Fertility and Sterility”

This study found that flutamide was more effective than spironolactone in reducing symptoms of hirsutism and related conditions in premenopausal women, with fewer discontinuations due to side effects.

research Comparison of Finasteride (Proscar) and Serenoa Repens (Permixon) in the Inhibition of 5-Alpha Reductase in Healthy Male Volunteers

73 citations , January 1994 in “European Urology”

This study found that finasteride significantly reduced serum dihydrotestosterone levels, confirming its efficacy as a 5a-reductase inhibitor, while Permixon showed no effect in healthy male volunteers.

A Comparative Study of a New Food Supplement, Viviscal, with Fish Extract for the Treatment of Hereditary Androgenic Alopecia in Young Males

research A Comparative Study of a New Food Supplement, Viviscal, with Fish Extract for the Treatment of Hereditary Androgenic Alopecia in Young Males

16 citations , November 1992 in “Journal of International Medical Research”

In this randomized study, ViviScal® significantly outperformed a fish extract in increasing non-vellus hair count and achieving clinical and histological improvement in young males with hereditary androgenic alopecia.

research Hair Loss With Minoxidil Withdrawal

15 citations , September 1992 in “The Lancet”

Stopping minoxidil caused significant hair loss, but regrowth occurred after resuming use.

research The Psychological Effects of Androgenetic Alopecia in Men

192 citations , June 1992 in “Journal of The American Academy of Dermatology”

Hair loss can cause low self-esteem, anxiety, and depression in men.

research The Biological Effects of a Pulsed Electrostatic Field with Specific Reference to Hair Electrotrichogenesis

27 citations , July 1990 in “International Journal of Dermatology”

In this controlled study, a pulsed electrical field treatment significantly increased hair regrowth compared to baseline and the control group over 36 weeks, without observed side effects.

research Delta 5-3 Beta-Hydroxysteroid Dehydrogenase Activity in Sebaceous Glands of Scalp in Male-Pattern Baldness

69 citations , August 1988 in “Journal of Investigative Dermatology”

research Side Effects of Spironolactone Therapy in the Hirsute Woman

80 citations , January 1988 in “The Journal of clinical endocrinology and metabolism/Journal of clinical endocrinology & metabolism”

This study observed that high-dose spironolactone frequently caused metrorrhagia in women with idiopathic hirsutism, leading the authors to suggest lower starting doses or additional hormonal therapy.

research Pharmacology of Antiandrogens

97 citations , November 1986 in “Journal of Steroid Biochemistry”

This review discusses the pharmacological properties and clinical applications of cyproterone acetate and similar antiandrogens, noting previous failures in local applications due to concentration limitations; it reports no new empirical results.

research The Effect of Spironolactone on Hirsutism and Female Androgen Metabolism

32 citations , August 1985 in “Clinical endocrinology”

This study concluded that spironolactone may be an effective therapy for a subgroup of hirsute patients, as it reduced plasma testosterone and improved certain hair growth measures.

research The Inheritance Of Common Baldness: To Be Or Not To Be?

203 citations , November 1984 in “Journal of the American Academy of Dermatology”

This study presents evidence suggesting that androgenetic alopecia is most likely inherited through a polygenic model, challenging the traditional view that it is caused by a simple Mendelian autosomal dominant gene.