Two Cases of Paradoxical Nonscarring Alopecia After Mesotherapy with Dutasteride

The document presents two cases of paradoxical nonscarring alopecia following mesotherapy with dutasteride, a treatment for hair fall that involves microinjection of the drug into the dermis. Dutasteride is a second-generation 5a-reductase enzyme inhibitor that decreases serum dihydrotestosterone levels by 90%. It inhibits both type 1 and 2 enzymes, while finasteride inhibits only type 2. While mesotherapy with dutasteride is becoming increasingly common and usually has only mild transitory side effects at the injection site, these two cases (one male and one female with androgenetic alopecia) developed patchy alopecia after treatment. One of them also developed skin atrophy on the affected areas without improvement at short term follow-up. These cases highlight the potential paradoxical side effects of mesotherapy as a therapeutic technique for hair loss.