Medication plus oral contraceptive may improve female pattern hair loss

Finasteride, a medication approved to treat hair loss in men, may also improve the condition in women when combined with oral contraceptives, according to an article in the March issue of Archives of Dermatology, one of the JAMA/Archives journals.

As many as half of all women experience female pattern hair loss during their lifetimes, according to background information in the article. Women who are affected often report feelings of embarrassment and social anxiety and the condition often worsens if left untreated. Current treatment generally involves minoxidil, a medication typically applied to the scalp to encourage hair regrowth, which is effective but not always well accepted by patients, the authors report.

Matilde Iorizzo, M.D., and colleagues at the University of Bologna, Italy, evaluated the effectiveness of 2.5 milligrams of finasteride taken by mouth daily and combined with an oral contraceptive in 37 women aged 19 to 50 years who consulted a physician about their hair loss. The contraceptive was necessary to prevent pregnancy in women in the study, because finasteride is known to cause birth defects. The researchers selected a type of contraceptive that reduces levels of male hormones, because that effect may also contribute to the treatment of hair loss. They took photographs of the patients' heads and assessed their hair density with a technique known as computerized light videodermoscopy at the beginning of the study and after they had taken the two medications for 12 months.

At the one-year mark, 23 (62 percent) patients were rated as improved using comparisons of the photographs. Thirteen patients did not improve, and one patient's condition worsened. Hair density scores increased in 12 patients. On a questionnaire, 29 patients reported that their condition improved after 12 months, eight said that it had stabilized and none reported that it had worsened. None of the participants had adverse reactions to the treatment.

"This treatment was well accepted by the patients, who judged the results to be even better than did the investigators," the authors write. "The clinical results using global photography, hair density scores and patient self-assessment provide a basis for future work. Further studies are needed to establish the optimal dosage and mode of administration of finasteride in premenopausal women and to definitively assess the efficacy of this drug compared with oral antiandrogens."

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(Arch Dermatol. 2006; 142:298-302. Available pre-embargo to the media at www.jamamedia.org.)


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