Bicalutamide: A Review

September 2024 in “ Journal of Cutaneous and Aesthetic Surgery ”

Shayna Aulakh, Venkataram Mysore

bicalutamide non-steroidal androgen receptor antagonist female pattern hair loss Sinclair grading pharmacological properties indications contraindications safety profile off-label use dermatological research

Studysummary This review focuses on the pharmacological properties, indications, contraindications, and safety profile of bicalutamide, a non-steroidal androgen receptor antagonist, in dermatological research, particularly its off-label use for improving female pattern hair loss as measured by Sinclair grading. Our plain-language summary of this paper — not a Tressless recommendation.

Bicalutamide, a non-steroidal androgen receptor antagonist, is primarily used for prostate cancer but has shown promise in treating conditions related to androgen excess, such as female pattern hair loss (FPHL), hirsutism, and acne. Studies indicate a 20.2% to 27.5% reduction in hair loss in FPHL patients over 6 months and a 61.6% reduction in hirsutism severity. Its favorable side effect profile and versatility make it a potential treatment for other conditions like frontal fibrosing alopecia and as part of gender-affirming therapy for transgender women. However, side effects such as mild gynecomastia, hepatotoxicity, and increased serum lipid levels necessitate regular monitoring, and it is contraindicated in pregnant women and those with hepatic dysfunction. Further studies are needed to establish its routine use in FPHL.

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Research cited in this study

16 / 16 results

research Mesotherapy With Bicalutamide: A New Treatment for Androgenetic Alopecia

January 2023 in “International Journal of Trichology”

This study found that bicalutamide mesotherapy resulted in subtle hair density improvements and was well tolerated by premenopausal women with androgenetic alopecia.

research Bicalutamide and the New Perspectives for Female Pattern Hair Loss Treatment: What Dermatologists Should Know

3 citations , January 2022 in “Journal of Cosmetic Dermatology”

This review highlights bicalutamide as a promising oral therapy for female pattern hair loss, noting its safety, tolerability, and effectiveness in women with hyperandrogenic symptoms like acne and hirsutism, though further trials are needed to confirm its ideal dose and efficacy.

research Hidradenitis Suppurativa and Comorbid Disorder Biomarkers, Druggable Genes, New Drugs and Drug Repurposing—A Molecular Meta-Analysis

15 citations , December 2021 in “Pharmaceutics”

This systematic review identified robust biomarkers associated with hidradenitis suppurativa and confirmed potential drugs for repurposing, highlighting key pathogenetic pathways and their links to comorbid disorders.

research Bicalutamide Improves Minoxidil-Induced Hypertrichosis in Female Pattern Hair Loss: A Retrospective Review of 35 Patients

4 citations , November 2021 in “Journal of The American Academy of Dermatology”

This article notes that low-dose systemic minoxidil combined with antiandrogen therapy is effective for treating female pattern hair loss, though hypertrichosis can occur in a significant percentage of patients.

Clinicopathological Characteristics and Treatment Outcomes of Fibrosing Alopecia in a Pattern Distribution: A Retrospective Cohort Study

research Clinicopathological Characteristics and Treatment Outcomes of Fibrosing Alopecia in a Pattern Distribution: A Retrospective Cohort Study

7 citations , August 2021 in “Journal of the European Academy of Dermatology and Venereology”

This study suggests that early initiation of treatment in fibrosing alopecia in a pattern distribution may lead to a more favorable outcome, as evident in some patients experiencing arrested disease progression and hair regrowth.

research Bicalutamide: A Potential New Oral Antiandrogenic Drug for Female Pattern Hair Loss

8 citations , April 2020 in “Journal of The American Academy of Dermatology”

This article discusses the potential of oral bicalutamide as a promising treatment for female pattern hair loss and reports no new clinical results.

research Safety of Oral Bicalutamide in Female Pattern Hair Loss: A Retrospective Review of 316 Patients

16 citations , March 2020 in “Journal of The American Academy of Dermatology”

This abstract discusses the efficacy of spironolactone, cyproterone acetate, and flutamide in treating female pattern hair loss, noting that flutamide use requires caution due to potential liver toxicity, especially at high doses.

research Impact of Estrogens in Males and Androgens in Females

120 citations , April 2019 in “The Journal of clinical investigation/The journal of clinical investigation”

This review discusses the roles estrogens play in males and androgens in females, challenging the traditional view of strictly "male" and "female" hormones, but it does not report new experimental findings.

research Female Pattern Hair Loss and Androgen Excess: A Report From the Multidisciplinary Androgen Excess and PCOS Committee

49 citations , February 2019 in “The Journal of Clinical Endocrinology and Metabolism”

This review offers evidence-based recommendations for diagnosing and treating female pattern hair loss, emphasizing clinical assessment and starting treatment with minoxidil, while noting that measurement of certain hormones and vitamins is optional.

research Androgens in Women: Role in Androgen-Mediated Cutaneous Disorders

56 citations , October 2018 in “Journal of The American Academy of Dermatology”

This review discusses the role of androgens in women's skin-related conditions like acne, hirsutism, and female pattern hair loss, noting the lack of dermatology guidelines for when to pursue endocrinologic evaluation.

research Gender-Affirming Hormone Therapy for Transgender Females

32 citations , September 2018 in “Clinical Obstetrics and Gynecology”

This article states that hormone therapy with estrogens and antiandrogens for transgender females is within an obstetrician-gynecologist's practice scope and involves careful dosing and monitoring to manage short-term thrombotic risks.

research Minoxidil Promotes Hair Growth Through Stimulation of Growth Factor Release from Adipose-Derived Stem Cells

42 citations , February 2018 in “International Journal of Molecular Sciences”

This study suggests that minoxidil may enhance hair growth by stimulating adipose-derived stem cell motility and growth factor secretion, promoting dermal papilla cell proliferation and accelerating anagen induction.

Combined Oral Contraception and Bicalutamide in Polycystic Ovary Syndrome and Severe Hirsutism: A Double-Blind Randomized Controlled Trial

research Combined Oral Contraception and Bicalutamide in Polycystic Ovary Syndrome and Severe Hirsutism: A Double-Blind Randomized Controlled Trial

25 citations , December 2017 in “The Journal of Clinical Endocrinology & Metabolism”

This study found that using an oral contraceptive with bicalutamide significantly reduced hirsutism in women with PCOS compared to an oral contraceptive alone, although it increased total cholesterol and LDL levels.

Androgens and Androgen Receptor Action in Skin and Hair Follicles