Finasteride for Androgenetic Alopecia

    January 1998 in “ NEJM Journal Watch ”
    Neil H. Shear
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    TLDR Finasteride increases hair count in men with hair loss, but the effect isn't permanent and hair loss returns if treatment stops.
    Finasteride, an inhibitor of type II 5α-reductase, has been found to be effective in reducing the conversion of testosterone to dihydrotestosterone (DHT) in hair follicles and the prostate. Two one-year, double-blind, randomized, controlled trials were conducted with 1,553 men with androgenetic alopecia. After one year of treatment with finasteride, scalp hair counts increased by about 80% from baseline, while those on placebo experienced a decrease of about 20%. Hair counts remained stable in men who continued finasteride for the second year, and those who switched from placebo to finasteride saw a 50% increase in hair counts. The treatment was well-tolerated, with only a small percentage of men experiencing decreased libido or erectile dysfunction. However, it is important to note that hair loss returns to baseline within six months of stopping finasteride, indicating that it is not a permanent solution.
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      in Research/Science  230 upvotes 5 months ago
      Finasteride can impact neurosteroids, potentially causing depression and other side effects in some users. Despite these concerns, many continue using it for hair loss, with some switching to topical applications to mitigate side effects.
      Diffuse hair loss and scalp biopsies

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      in Research  692 upvotes 4 months ago
      Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.
      FCE 28260: A Forgotten 5α-Reductase Inhibitor

      community FCE 28260: A Forgotten 5α-Reductase Inhibitor

      in Research  330 upvotes 3 months ago
      FCE 28260 (PNU 156765), an under-explored 5α-reductase inhibitor, showcases promising results in research by Giudici et al., outperforming well-known treatments like Finasteride in reducing the conversion of testosterone to DHT. Its superior efficacy, demonstrated through lower IC50 values in both natural and human recombinant enzyme studies, suggests it could offer more effective management of DHT-related conditions. Additionally, its lower molecular weight hints at better potential for topical application, potentially offering advantages in treating conditions such as androgenic alopecia. Despite its potential, it has not advanced in development, possibly due to financial limitations, leaving its therapeutic prospects and side effect profile largely unexplored.

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