Bicalutamide: A Review

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.