Response to Improvement of Female Pattern Hair Loss with Bicalutamide: A Time-Dependent Process

The document discusses the response to a study on the use of bicalutamide in combination with oral minoxidil for treating female pattern hair loss (FPHL). The authors acknowledge that the antiandrogenic effects of bicalutamide may take longer to manifest and that their trial, which was the first to assess this combination, did not show early improvement as seen in retrospective studies. The combination of two effective agents, such as bicalutamide and minoxidil, may mask the incremental benefits of bicalutamide, especially since minoxidil acts faster. The study suggests that bicalutamide at 25 mg/day may be less effective than previously thought, and higher doses might be needed. The authors call for larger and longer randomized trials to better understand the role of bicalutamide and antiandrogens in FPHL management.