Italian study: Finasteride for Female Hair Loss

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Tricia
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Italian study: Finasteride for Female Hair Loss

Post by Tricia » Tue Mar 21, 2006 5:38 am

Female hair loss treatment hope
A drug used to treat male baldness could also help women with thinning hair, an Italian study suggests.
Up to half of women experience some hair thinning during their lifetime.

The researchers said the Archives of Dermatology findings showed finasteride could be used for those who could not use the standard lotion treatment.

But after the study involving 37 women, UK experts said more work was needed to prove the drug - which can be toxic in pregnancy - had benefits for women.

Lotion option

Women who experience loss or thinning of hair can feel embarrassed and be anxious that they do not have the "crowning glory" they would wish for - or that they feel they should have.


There isn't very good evidence that any form of medication has an impact on alopecia
Dr Nigel Hunt, Alopecia UK

It tends to be less obvious than male pattern baldness - resulting in thinning across the scalp rather than a male "monk's tonsure" pattern.

Hormonal changes, such as those which occur after pregnancy or stopping taking contraception, are a common cause of hair loss in women.

A common drug used to treat the condition is minoxidil, which is applied to the scalp to encourage hair regrowth.

However, some women are allergic to the lotion, or do not like having to apply it to their scalp twice a day.

The Italian researchers used finasteride, which is available in the UK to treat male baldness.

It works by blocking the conversion of the male hormone testosterone to dihydrotestosterone - high levels of which are linked to baldness.

The hair follicles are then not affected by this hormone, and can enlarge back to normal.

Patients photographed

In the study 37 women aged 19 to 50, who had experienced hair loss, were given gave 2.5 milligrams of finasteride and the contraceptive pill.

Women had to take the pill because finasteride is known to cause birth defects, so cannot be given if women are pregnant or if there is a chance they might conceive.

A contraceptive was given that reduced levels of male hormones which could also affect the rate of hair loss.

Researchers photographed patients' heads and assessed their hair density using a high-definition video technique called computerised light videodermoscopy.

They were examined at the beginning of the study and after they had taken the two medications for 12 months.

After a year, 23 patients (62% of those studied) were seen to have improved after the treatment.

No difference was seen in 13 patients, and one patient was found to have worsened.

The difference reflects that seen with other baldness treatments, where women with so-called "Christmas tree" baldness patterns - where there is hair loss down the middle of the top of the head - see more benefit from treatment than others.

The women themselves thought the treatment had been even more successful than the photos showed.

Twenty-nine patients felt their condition had improved while eight said theirs had stabilised.

None reported that it had worsened.

Pill 'preferred'

Professor Antonella Tosti, who led the research, said: "This drug would not be a first line treatment.

"But it could be used for women who aren't able to use the lotion or who are allergic to it."

She added that people often preferred taking a pill for something, rather than using a cream.

The researchers plan to carry out further research to see if the treatment might help post-menopausal women - who would also not need to take the pill.

But Dr Nigel Hunt, of the Alopecia UK, said more research was needed which compared women on finasteride with women who were not treated.

"There isn't very good evidence that any form of medication has an impact on alopecia.

"We would need to be certain it was going to be of benefit - particularly because of the potential damage to foetuses."

Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/1/hi/h ... 824348.stm

Published: 2006/03/21 00:54:52 GMT

BBC MMVI
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James

Post by James » Tue Mar 21, 2006 6:53 am

Wow, this is really interesting.

I do not understand the following quote though:
"There isn't very good evidence that any form of medication has an impact on alopecia."

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Post by Tricia » Tue Mar 21, 2006 7:08 am

That was just a disparaging comment on hair loss treatments in general. The quote looks weird in the text as it was copied and pasted. On the website where I pulled it, the quote was off to the side.

You have to agree with that statement though. No currently available drugs work like the bomb for alopecia. For most people, treatments help a little.
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Here's a better article covering the study.

Post by Tricia » Tue Mar 21, 2006 12:25 pm

Oral Drug for His Hair Loss May Also Help Her

By Judith Groch, MedPage Today Staff Writer
Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine.
March 20, 2006
Source News Article: BBC News

MedPage Today Action Points

Explain to patients that the modest results in this study are from a small uncontrolled study and that the efficacy of Propecia (2.5 mg) for female-pattern hair loss needs further study in well-designed trials.

Review
BOLOGNA, Italy, March 20 - An oral drug for male-pattern hair loss, used with an oral contraceptive, may help younger women with a female -pattern hair loss, researchers reported.
After a year of treatment, 23 of 37 (62%) premenopausal women with female-pattern hair loss were rated as improved, following treatment with oral Propecia (finasteride) at 2.5 mg a day. Of the other patients, 13 did not improve, and one patient's hair grew worse, according to a report in the March issue of the Archives of Dermatology.

Propecia was given along with the oral contraceptive Yasmin (drospirenone and ethinyl estradiol) because in women of childbearing age, Propecia is potentially teratogenic, said Antonella Tosti, M.D., of the University of Bologna here and colleagues.

Propecia is a 5α-reductase type II inhibitor that is FDA-approved to treat male androgenetic alopecia at a dose of 1 mg/d.

As many as half of all women have female-pattern hair loss at some stage, the researchers wrote. Topical treatment with Rogaine (minoxidil) applied to the scalp is effective, but is not always well accepted by patients. In their study, all the patients had refused treatment with Rogaine.

Improvement in hair density was rated by global photography and a hair-density score using computerized light videodermoscopy at the beginning and the end of the study. Patients also filled out a questionnaire assessing their own evaluation of treatment. The women were 19 to 50 years old and had consulted a physician about their hair loss, the researchers said.

Among the women rated as improved, 12 were slightly improved, eight were moderately improved, and three were greatly improved. There was a statistically significant increase in the hair density score for 12 patients (P=0.002). Propecia was well-tolerated, the researchers said, and none of the patients had adverse effects.

Not only was the treatment well accepted, but the patients judged the results to be even better than the investigators did. Twenty-nine patients reported that their condition had improved, and eight said it had stabilized. None said it had gotten worse.

That the patients' opinion was generally more optimistic was not surprising, the researchers said, because in double-blind trials using the drugs for men with androgenetic alopecia, even the patients given a placebo reported improvement.

The efficacy of Propecia in two-thirds of the patients might have been due to the higher dosage used (2.5 mg versus 1 mg), the researchers said. Also, the contraceptive Yasmin contains drospirenone, a progestin analog of Aldactone (spironolactone). It is possible that even at the very low dosage of 3 mg, the contraceptive pill might have had an additional effect in promoting hair growth, they suggested.

The efficacy of Propecia for female pattern hair loss is still controversial, Dr. Tosti said. An earlier multicenter, placebo-controlled, double-blind randomized study of postmenopausal women, conducted by other investigators, found negative results for Propecia at 1 mg/d. It is possible, she said, that the women's age may have been a factor. Hair thinning, she suggested, may not be androgen-dependent in senescent scalps, or it is possible that the dose was too low.

"Although our study was not randomized, blinded, and placebo controlled, and did not include scalp biopsies, the clinical results using global photography, hair density scores, and patient self-assessment provide a basis for future work," the authors wrote.

Further studies are needed to establish the optimal dosage and mode of administration of Propecia in premenopausal women and to understand which patterns of female hair loss respond better to this treatment, the investigators concluded.

Primary source: Archives of Dermatology 2006; 142: 298-302
Source reference:
Iorizzo, Matilde, et al, "Finasteride Treatment of Female Pattern Hair Loss"

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Post by HairLossFight.com » Thu Mar 23, 2006 12:21 am

Here's another abstract for the same study:
Finasteride Treatment of Female Pattern Hair Loss

Matilde Iorizzo, MD; Colombina Vincenzi, MD; Stylianos Voudouris, MD; Bianca Maria Piraccini, MD, PhD; Antonella Tosti, MD

Arch Dermatol. 2006;142:298-302.

Objective To evaluate the efficacy of oral finasteride therapy associated with an oral contraceptive containing drospirenone and ethinyl estradiol in premenopausal women with female pattern hair loss.

Setting Outpatient consultation for hair disorders at the Department of Dermatology, University of Bologna.

Patients and Intervention Thirty-seven women with female pattern hair loss were treated with oral finasteride, 2.5 mg/d, while taking an oral contraceptive containing drospirenone and ethinyl estradiol. Treatment efficacy was evaluated using global photography and the hair density score from videodermoscopy. A self-administered questionnaire was used to assess patient evaluation of treatment effectiveness.

Results At 12-month follow-up, 23 of the 37 patients were rated as improved using global photography (12 were slightly improved, 8 were moderately improved, and 3 were greatly improved). No improvement was recorded in 13 patients. One patient experienced worsening of the condition. There was a statistically significant (P = .002) increase in the hair density score in 12 patients. No adverse reactions to the drug were reported.

Conclusions Sixty-two percent of the patients demonstrated some improvement of their hair loss with the use of finasteride, 2.5 mg/d, while taking the oral contraceptive. It is unclear whether the success was due to a higher dosage of finasteride (2.5 mg instead of 1 mg) or to its association with the oral contraceptive containing drospirenone, which has an antiandrogenic effect. Further studies are necessary to understand which patterns of female pattern hair loss respond better to this treatment.


Author Affiliations: Department of Dermatology, University of Bologna, Bologna, Italy.

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Post by JessyS » Sat Apr 29, 2006 9:48 am

Wow this is interesting. (ignore my last post to in Tricia's post!)

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Post by HairLossFight.com » Sat Apr 29, 2006 10:00 am

JessyS,

Be very careful if you are considering Propecia. Make sure you are not planning to have any kids if that's what you want to do! Also, make sure to consult your doctor before starting a Propecia regimen.

Sam

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Re: Italian study: Finasteride for Female Hair Loss

Post by sherrybalesteros » Sat Jan 16, 2010 9:00 pm

Thanks for this Tricia..:)

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