Finasteride in the treatment of
men with androgenetic alopecia. Finasteride Male Pattern Hair Loss Study Group.
Am Acad Dermatol. 1998 Oct
Kaufman KD, Olsen EA, Whiting D, Savin R, DeVillez R, Bergfeld W, Price VH, Van
Neste D, Roberts JL, Hordinsky M, Shapiro J, Binkowitz B, Gormley GJ.
Department of Clinical Research, Merck Research Laboratories, Rahway, NJ 07065,
USA.
BACKGROUND: Androgenetic alopecia (male pattern hair loss) is caused by
androgen-dependent miniaturization of scalp hair follicles, with scalp
dihydrotestosterone (DHT) implicated as a contributing cause.
Finasteride, an
inhibitor of type II 5alpha-reductase, decreases serum and scalp DHT by
inhibiting conversion of testosterone to DHT.
OBJECTIVE: Our purpose was to
determine whether finasteride treatment leads to clinical improvement in men
with male pattern hair loss.
METHODS: In two 1-year trials, 1553 men (18 to 41
years of age) with male pattern hair loss received oral finasteride 1 mg/d or
placebo, and 1215 men continued in blinded extension studies for a second year.
Efficacy was evaluated by scalp hair counts, patient and investigator
assessments, and review of photographs by an expert panel.
RESULTS: Finasteride
treatment improved scalp hair by all evaluation techniques at 1 and 2 years (P <
.001 vs placebo, all comparisons).
Clinically significant increases in hair
count (baseline = 876 hairs), measured in a 1-inch diameter circular area (5.1
cm2) of balding vertex scalp, were observed with finasteride treatment (107 and
138 hairs vs placebo at 1 and 2 years, respectively; P < .001).
Treatment with
placebo resulted in progressive hair loss. Patients' self-assessment
demonstrated that finasteride treatment slowed hair loss, increased hair growth,
and improved appearance of hair.
These improvements were corroborated by
investigator assessments and assessments of photographs. Adverse effects were
minimal.
CONCLUSION: In men with male pattern hair loss, finasteride 1 mg/d
slowed the progression of hair loss and increased hair growth in clinical trials
over 2 years.
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