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

The study by da Silva et al. evaluated the effects of bicalutamide 25 mg/day combined with minoxidil 1 mg/day versus minoxidil alone for female pattern hair loss (FPHL) in a randomized double-blind trial with 32 participants per group. While no significant improvement in hair density was observed with the addition of bicalutamide, there was a reduction in hair shedding and facial hypertrichosis. The study's short follow-up period of 24 weeks may not be sufficient to detect changes in hair density, as antiandrogen treatments often require longer durations to show efficacy. Bicalutamide, a selective androgen receptor antagonist, may be a potential alternative for FPHL cases where other antiandrogens are poorly tolerated. The study suggests that longer-term trials are needed to better assess the efficacy of bicalutamide in improving hair density.