5 mg/day finasteride treatment for normoandrogenic Asian women with female pattern hair loss

Background Various treatments have been attempted for female pattern hair loss (FPHL), including topical minoxidil, oral antiandrogen and finasteride. But, there is no consensus on the standard treatment options. Clinical efficacy of finasteride in treating FPHL is still in controversy, but there is a tendency to high dose finasteride, which is more effective than lower dose.

Objectives The purpose of this study was to evaluate the clinical efficacy of high dose (5 mg/day) oral finasteride in normoandrogenic Asian women with FPHL.

Methods Total of 87 normoandrogenic, pre and post-menopausal women with FPHL were enrolled in this study. They were treated with oral finasteride (Proscar^®), 5 mg daily for 12 months.

Efficacy was evaluated with hair density and thickness changes assessed by phototrichogram and global photographs using 7-point scale.

Results Eighty-six patients completed 12 months of finasteride treatment schedule. One patient (1.1%) withdrew due to headache. At initial visits, mean hair density was 90 ± 22/cm² and mean hair thickness was 64 ± 11 μm. After 12 months of finasteride treatment, hair density was significantly increased to 107 ± 23/cm² (P < 0.001), and hair thickness was also significantly increased to 70 ± 9 μm (P = 0.02). In global photographs, 70 (81.4%) of the 86 patients were improved (57 were slightly, 10 were moderately and four were greatly improved). Patients without any changes were 13 (15.1%) and 3 (3.5%) patients reported slightly aggravated. Four patients (4.6%) reported adverse events (headache, menstrual irregularity, dizziness and increased body hair growth). However, these adverse events were mild and disappeared soon.

Conclusions Oral finasteride, 5 mg/day, may be an effective and safe treatment for normoandrogenic women with FPHL.