Table 1.
Clinical Studies of Finasteride in the Treatment of Female Pattern Hair Loss
| Author, Year | Study Design | N | Finasteride Regimen | Duration of Treatment | Population | Results | Side Effects |
|---|---|---|---|---|---|---|---|
| Oral finasteride | |||||||
| Price et al, 20003 | RCT | 137 | 1 mg/day vs placebo | 12 months | 41–60 years; normoandrogenic post-menopausal women, Ludwig scores III–IV | ● Decreased mean hair counts in both groups (−8.7 hairs in finasteride group vs −6.6 hairs in placebo group) ● No significant changes of hair loss by patients’ & physicians’ GPA, & histologic examination ● Decreased serum DHT & androstanediol glucuronide |
Folliculitis (n=1) |
| Carmina et al, 200336 | RCT | 48 | 5 mg/day vs CPA with EE vs flutamide 250 mg/day vs none | 12 months | 25±2 years; hyperandrogenic pre-menopausal women, Ludwig scores I–III | ● Flutamide significantly decreased Ludwig scores ● No significant changes in Ludwig scores and clinical evaluation in finasteride group |
● None in finasteride group ● Elevated liver enzyme in flutamide group (n=2) |
| Trueb et al, 200434 | Uncontrolled, prospective | 5 | 2.5 or 5 mg/day | 18 months | 55–69 years; normoandrogenic post-menopausal women, Ludwig score I, Hamilton-Norwood VII, Olsen type | ● Stabilization of hair loss (n=5) ● Noticeable hair growth (n=4) |
None |
| Iorrizo et al, 200630 | Uncontrolled, prospective | 37 | 2.5 mg/day + OCP | 12 months | 19–50 years; normoandrogenic pre-menopausal women, Ludwig scores I–II, Olsen type |
● 62% of patients improved GPA ● Increased mean hair density from 4.5 to 4.8 |
None |
| Kohler et al, 200735 | Retrospective survey | 12 | 5 mg/day | Unknown duration | 26–76 years; women with unspecified status | ● 93.3% of patients reported improvement | None |
| Yeon et al, 201037 | Uncontrolled, prospective | 87 | 5 mg/day | 12 months | 44.4±10.6 years; normoandrogenic pre- & post-menopausal women, Ludwig scores I–III | ● 18.9% increased hair density ● 9.4% increased hair diameter ● 81.4% of patients improved GPA |
Headache, irregular menstruation, dizziness, increased body hair (n=4) |
| Kim et al, 201232 | Uncontrolled, prospective | 18 | 1.25 mg/day | 7 months | 46.3±12.8 years; normoandrogenic pre- & post-menopausal women | ● 5.87% increment of hair density ● 11.8% increment of hair diameter ● 14.2% of patients improved according to patient’s and physician’s GPA |
NA |
| Oliveira-Soares et al, 201338 | Uncontrolled prospective | 40 | 5 mg/day | 18 months | <60 years; normoandrogenic post-menopausal women, Ludwig scores I–III | ● Approximately 50% of patients had major improvement from patient’s GPA at 6, 12 & 18 months ● Approximately 40% of patients had major improvement assessed by physicians at 6, 12 & 18 months |
Maintained loss of libido (n=4), elevated liver enzyme (n=1) |
| Boersma et al, 201433 | Retrospective | 120 | 1.25 mg/day or dutasteride 0.15 mg/day | 3 years | 16–84 years; pre- & post-menopausal women, Ludwig scores I–II | ● Improved hair thickness in 81.7% of patients in finasteride group, 83.3% patients in dutasteride group ● Improved hair density from GPA in 68.9% of patients in finasteride group vs 65.6% of patients in dutasteride group |
NA |
| Topical finasteride | |||||||
| Mazzarella et al, 199743 | Pilot RCT | 52 | 0.005% topical finasteride twice daily | 16 months | 18–38 years; men & pre-menopausal women, Hamilton-Norwood scales I–III in men, Ludwig scores I–II in women | ● Progressive decreased hair counts from wash test from 49.8 ± 5.9 to 45.2±7.5 at 6 months and 36.8±8.1 at 16 months ● Clinically improved hair density and increased hair regrowth |
None |
| Suchonwanit et al, 201944 | RCT | 30 | 0.25% topical finasteride + 3% MNX vs 3% MNX twice daily | 6 months | 56.8±6.6 years (finasteride+MNX) vs 59.8±7.7 years (MNX); post-menopausal women, Ludwig scores I–III | ● Mean increased hair diameter of 11.9 µm in finasteride+MNX group & 7 µm in MNX group at 6 months ● Mean increased hair density of 24.7 hairs/cm2 in finasteride+MNX group & 21.9 hairs/cm2 in MNX group at 6 months ● Approximately 93% of patients had improved GPA in both groups ● Decreased serum DHT level in finasteride+MNX group |
Folliculitis |
Abbreviations: CPA, cyproterone acetate; DHT, dihydrotestorone; EE, ethinyl estradiol; GPA, global photographic assessment; OCP, oral contraceptive; MNX, minoxidil; NA, not available; RCT, randomized controlled trial.