Treatment of Female Pattern Hair Loss with the Androgen Receptor Antagonist Flutamide

March 2011 in “ Australasian Journal of Dermatology ”

Anosha Yazdabadi, Rod Sinclair

female pattern hair loss androgen receptor antagonist flutamide spironolactone topical minoxidil androgens antiandrogens hyperandrogenic liver toxicity liver function monitoring FPHL androgen blocker Aldactone Rogaine

TLDR Flutamide improves female hair loss when other treatments fail, but may cause liver toxicity.

This article reports on a case of a woman with female pattern hair loss (FPHL) who did not respond to spironolactone and topical minoxidil, but showed improvement with flutamide, a potent androgen receptor antagonist. The role of androgens in FPHL is not clearly established, and the response to treatment with antiandrogens is variable. Flutamide works by inhibiting uptake and binding of androgens to receptors, and has been shown to be effective in the treatment of FPHL in hyperandrogenic women. While spironolactone is still recommended as a first-line therapy for FPHL, flutamide can be considered as a second-line treatment in non-responders. Patients should be warned about the potential of liver toxicity and serial liver function monitoring is required.

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