Download PDF
CC BY-NC-ND 4.0 · Indian J Plast Surg 2021; 54(04): 422-434
DOI: 10.1055/s-0041-1739254
Review Article

Pharmacological Management of Pattern Hair Loss

Sandeep Suresh Sattur
1   HAIRREVIVE- Centre for Hair Restoration & Skin Rejuvenation, Santacruz West, Mumbai, Maharashtra, India
,
Indu Sandeep Sattur
1   HAIRREVIVE- Centre for Hair Restoration & Skin Rejuvenation, Santacruz West, Mumbai, Maharashtra, India
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Pattern hair loss (PHL) is a condition that worsens with time and the only way it can be slowed down is with pharmacological intervention. Pharmacological treatments for PHL, from an evidenced-based perspective with respect to safety and efficacy, are limited to only two drugs, minoxidil and finasteride. However, there are a host of drugs being used, off-label with limited evidence. This article attempts to review the literature on this topic, and the authors add to this, with their experience of over two decades on incorporating pharmacologic treatments along with hair transplantation in their management of PHL.

Keywords

Pattern Hair Loss - Minoxidil - Finasteride - Post finasteride syndrome - Dutasteride - Topical finasteride


Publication History

Article published online:
13 December 2021

© 2021. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Tamashunas NL, Bergfeld WF. Male and female pattern hair loss: treatable and worth treating. Cleve Clin J Med 2021; 88 (03) 173-182
    CrossrefPubMedGoogle Scholar
  • 2 Cotsarelis G, Millar SE. Towards a molecular understanding of hair loss and its treatment. Trends Mol Med 2001; 7 (07) 293-301
    CrossrefPubMedGoogle Scholar
  • 3 Higgins CA, Christiano AM. Regenerative medicine and hair loss: how hair follicle culture has advanced our understanding of treatment options for androgenetic alopecia. Regen Med 2014; 9 (01) 101-111
    CrossrefPubMedGoogle Scholar
  • 4 Varothai S, Bergfeld WF. Androgenetic alopecia: an evidence-based treatment update. Am J Clin Dermatol 2014; 15 (03) 217-230
    CrossrefPubMedGoogle Scholar
  • 5 Campo D, D'Acunzo V. Doctors and baldness: a five thousand year old challenge. G Ital Dermatol Venereol 2016; 151 (01) 93-101
    PubMedGoogle Scholar
  • 6 Kandil H, El-Mohamdy M. Role of the hair in ancient Egypt. International Journal of Tourism and Hospitality Management 2018; 1 (01) 77-95
    CrossrefGoogle Scholar
  • 7 Rongen GA, Marquet P, van Gerven JMA. et al. The scientific basis of rational prescribing. A guide to precision clinical pharmacology based on the WHO 6-step method. Eur J Clin Pharmacol 2020
    PubMedGoogle Scholar
  • 8 Yesudian P. Serendipity in trichology. Int J Trichology 2011; 3 (01) 1-2
    CrossrefPubMedGoogle Scholar
  • 9 Avram MR, Cole JP, Gandelman M. et al; Roundtable Consensus Meeting of The 9th Annual Meeting of The International Society of Hair Restoration Surgery. The potential role of minoxidil in the hair transplantation setting. Dermatol Surg 2002; 28 (10) 894-900 , discussion 900
    PubMedGoogle Scholar
  • 10 Leavitt M, Perez-Meza D, Rao NA, Barusco M, Kaufman KD, Ziering C. Effects of finasteride (1 mg) on hair transplant. Dermatol Surg 2005; 31 (10) 1268-1276 , discussion 1276
    CrossrefPubMedGoogle Scholar
  • 11 Pantelireis N, Higgins CA. A bald statement - Current approaches to manipulate miniaturisation focus only on promoting hair growth. Exp Dermatol 2018; 27 (09) 959-965
    CrossrefPubMedGoogle Scholar
  • 12 Trüeb RM, Henry JP, Davis MG, Schwartz JR. Scalp condition impacts hair growth and retention via oxidative stress. Int J Trichology 2018; 10 (06) 262-270
    CrossrefPubMedGoogle Scholar
  • 13 Peyravian N, Deo S, Daunert S, Jimenez JJ. The inflammatory aspect of male and female pattern hair loss. J Inflamm Res 2020; 13: 879-881
    CrossrefPubMedGoogle Scholar
  • 14 Blume-Peytavi U, Blumeyer A, Tosti A. et al; European Consensus Group. S1 guideline for diagnostic evaluation in androgenetic alopecia in men, women and adolescents. Br J Dermatol 2011; 164 (01) 5-15
    CrossrefPubMedGoogle Scholar
  • 15 Avital YS, Morvay M, Gaaland M, Kemény L. Study of the international epidemiology of androgenetic alopecia in young Caucasian men using photographs from the Internet. Indian J Dermatol 2015; 60 (04) 419
    CrossrefPubMedGoogle Scholar
  • 16 Krupa Shankar D, Chakravarthi M, Shilpakar R. Male androgenetic alopecia: population-based study in 1,005 subjects. Int J Trichology 2009; 1 (02) 131-133
    CrossrefPubMedGoogle Scholar
  • 17 Gupta AK, Ivanova IA. Analysis of YouTube hair loss treatment information: What makes for engaging content?. Dermatol Ther (Heidelb) 2020; 33 (06) e14244
    PubMedGoogle Scholar
  • 18 Gupta AK, Ivanova IA. Hair loss treatment information on Facebook: content analysis and comparison with other online sources. J Cosmet Dermatol 2021; 20 (02) 577-583
    CrossrefPubMedGoogle Scholar
  • 19 Kanti V, Messenger A, Dobos G. et al. Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men - short version. J Eur Acad Dermatol Venereol 2018; 32 (01) 11-22
    CrossrefPubMedGoogle Scholar
  • 20 Manabe M, Tsuboi R, Itami S. et al; Drafting Committee for the Guidelines for the Diagnosis and Treatment of Male- and Female-Pattern Hair Loss. Guidelines for the diagnosis and treatment of male-pattern and female-pattern hair loss, 2017 version. J Dermatol 2018; 45 (09) 1031-1043
    CrossrefPubMedGoogle Scholar
  • 21 Stafford N, Kahn G. BMJ 2014; 349: g7798
    Crossref
  • 22 Rossi A, Cantisani C, Melis L, Iorio A, Scali E, Calvieri S. Minoxidil use in dermatology, side effects and recent patents. Recent Pat Inflamm Allergy Drug Discov 2012; 6 (02) 130-136
    CrossrefPubMedGoogle Scholar
  • 23 Davies GC, Thornton MJ, Jenner TJ. et al. Novel and established potassium channel openers stimulate hair growth in vitro: implications for their modes of action in hair follicles. J Invest Dermatol 2005; 124 (04) 686-694
    CrossrefPubMedGoogle Scholar
  • 24 National Center for Biotechnology Information. PubChem Compound Summary for CID 4201, Minoxidil. Accessed August 29, 2021 at: https://pubchem.ncbi.nlm.nih.gov/compound/Minoxidil
    Google Scholar
  • 25 Gupta AK, Foley KA. 5% Minoxidil: treatment for female pattern hair loss. Skin Therapy Lett 2014; 19 (06) 5-7
    PubMedGoogle Scholar
  • 26 Suchonwanit P, Thammarucha S, Leerunyakul K. Minoxidil and its use in hair disorders: a review. Drug Des Devel Ther 2019; 13: 2777-2786
    CrossrefPubMedGoogle Scholar
  • 27 Choi N, Shin S, Song SU, Sung JH. minoxidil promotes hair growth through stimulation of growth factor release from adipose-derived stem cells. Int J Mol Sci 2018; 19 (03) 691
    CrossrefPubMedGoogle Scholar
  • 28 Trüeb RM. Pharmacologic interventions in aging hair. Clin Interv Aging 2006; 1 (02) 121-129
    CrossrefPubMedGoogle Scholar
  • 29 Kwack MH, Kang BM, Kim MK, Kim JC, Sung YK. Minoxidil activates β-catenin pathway in human dermal papilla cells: a possible explanation for its anagen prolongation effect. J Dermatol Sci 2011; 62 (03) 154-159
    CrossrefPubMedGoogle Scholar
  • 30 Ng KW. Penetration enhancement of topical formulations. Pharmaceutics 2018; 10 (02) 51
    CrossrefPubMedGoogle Scholar
  • 31 Novak E, Franz TJ, Headington JT, Wester RC. Topically applied minoxidil in baldness. Int J Dermatol 1985; 24 (02) 82-87
    CrossrefPubMedGoogle Scholar
  • 32 Chitalia J, Dhurat R, Goren A. et al. Characterization of follicular minoxidil sulfotransferase activity in a cohort of pattern hair loss patients from the Indian Subcontinent. Dermatol Ther (Heidelb) 2018; 31 (06) e12688
    CrossrefPubMedGoogle Scholar
  • 33 Sharma A, Goren A, Dhurat R. et al. Tretinoin enhances minoxidil response in androgenetic alopecia patients by upregulating follicular sulfotransferase enzymes. Dermatol Ther (Heidelb) 2019; 32 (03) e12915
    PubMedGoogle Scholar
  • 34 Monselise A, Cohen DE, Wanser R, Shapiro J. What ages hair?. Int J Womens Dermatol 2017; 3 (1, Suppl): S52-S57
    CrossrefPubMedGoogle Scholar
  • 35 Leenen FH, Smith DL, Unger WP. Topical minoxidil: cardiac effects in bald man. Br J Clin Pharmacol 1988; 26 (04) 481-485
    CrossrefPubMedGoogle Scholar
  • 36 Ferry JJ, Shepard JH, Szpunar GJ. Relationship between contact time of applied dose and percutaneous absorption of minoxidil from a topical solution. J Pharm Sci 1990; 79 (06) 483-486
    CrossrefPubMedGoogle Scholar
  • 37 Saxena K, Savant SS. Body to scalp: evolving trends in body hair transplantation. Indian Dermatol Online J 2017; 8 (03) 167-175
    CrossrefPubMedGoogle Scholar
  • 38 Gupta AK, Charrette A. Topical minoxidil: systematic review and meta-analysis of its efficacy in androgenetic alopecia. Skinmed 2015; 13 (03) 185-189
    PubMedGoogle Scholar
  • 39 Ghonemy S, Alarawi A, Bessar H. Efficacy and safety of a new 10% topical minoxidil versus 5% topical minoxidil and placebo in the treatment of male androgenetic alopecia: a trichoscopic evaluation. J Dermatolog Treat 2021; 32 (02) 236-241
    CrossrefPubMedGoogle Scholar
  • 40 Santos AC, Pereira-Silva M, Guerra C. et al. Topical minoxidil-loaded nanotechnology strategies for alopecia. Cosmetics 2020; 7 (02) 21
    CrossrefGoogle Scholar
  • 41 Randolph M, Tosti A. Oral minoxidil treatment for hair loss: a review of efficacy and safety. J Am Acad Dermatol 2021; 84 (03) 737-746
    CrossrefPubMedGoogle Scholar
  • 42 Villani A, Fabbrocini G, Ocampo-Candiani J, Ruggiero A, Ocampo-Garza SS. Review of oral minoxidil as treatment of hair disorders: in search of the perfect dose. J Eur Acad Dermatol Venereol 2021; 35 (07) 1485-1492
    CrossrefPubMedGoogle Scholar
  • 43 Ramos PM, Sinclair RD, Kasprzak M, Miot HA. Minoxidil 1 mg oral versus minoxidil 5% topical solution for the treatment of female-pattern hair loss: a randomized clinical trial. J Am Acad Dermatol 2020; 82 (01) 252-253
    CrossrefPubMedGoogle Scholar
  • 44 do Nascimento IJB, Harries M, Rocha VB. et al. Effect of oral minoxidil for alopecia: systematic review. Int J Trichology 2020; 12 (04) 147-155
    CrossrefPubMedGoogle Scholar
  • 45 Vañó-Galván S, Pirmez R, Hermosa-Gelbard A. et al. Safety of low-dose oral minoxidil for hair loss: A multicenter study of 1404 patients. J Am Acad Dermatol 2021; 84 (06) 1644-1651
    CrossrefPubMedGoogle Scholar
  • 46 Almohanna HM, Perper M, Tosti A. Safety concerns when using novel medications to treat alopecia. Expert Opin Drug Saf 2018; 17 (11) 1115-1128
    CrossrefPubMedGoogle Scholar
  • 47 Davey RA, Grossmann M. Androgen receptor structure, function and biology: from bench to bedside. Clin Biochem Rev 2016; 37 (01) 3-15
    PubMedGoogle Scholar
  • 48 Hibberts NA, Howell AE, Randall VA. Balding hair follicle dermal papilla cells contain higher levels of androgen receptors than those from non-balding scalp. J Endocrinol 1998; 156 (01) 59-65
    CrossrefPubMedGoogle Scholar
  • 49 Azzouni F, Godoy A, Li Y, Mohler J. The 5 alpha-reductase isozyme family: a review of basic biology and their role in human diseases. Adv Urol 2012; 2012: 530121
    CrossrefPubMedGoogle Scholar
  • 50 Kische H, Arnold A, Gross S. et al. Sex hormones and hair loss in men from the general population of northeastern Germany. JAMA Dermatol 2017; 153 (09) 935-937
    CrossrefPubMedGoogle Scholar
  • 51 Sawaya ME, Price VH. Different levels of 5alpha-reductase type I and II, aromatase, and androgen receptor in hair follicles of women and men with androgenetic alopecia. J Invest Dermatol 1997; 109 (03) 296-300
    CrossrefPubMedGoogle Scholar
  • 52 Ustuner ET. Cause of androgenic alopecia: crux of the matter. Plast Reconstr Surg Glob Open 2013; 1 (07) e64
    CrossrefPubMedGoogle Scholar
  • 53 Carmina E, Azziz R, Bergfeld W. et al. Female pattern hair loss and androgen excess: a report from the multidisciplinary androgen excess and PCOS Committee. J Clin Endocrinol Metab 2019; 104 (07) 2875-2891
    CrossrefPubMedGoogle Scholar
  • 54 Alves R. Androgenetic alopecia: a review and emerging treatments. Clin Res Dermatol Open Access 2017; 4 (04) 1-13
    Google Scholar
  • 55 McClellan KJ, Markham A. Finasteride: a review of its use in male pattern hair loss. Drugs 1999; 57 (01) 111-126
    CrossrefPubMedGoogle Scholar
  • 56 Accessed August 29, 2021 at: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/020788Orig1s017.pdf
  • 57 Tumkur A, Ern C, Shuang C. et al. The role of finasteride in the management of androgenetic alopecia in male: a narrative review. Indian Journal of Pharmacy Practice. 2019; 13: 3-13 DOI: 10.5530/ijopp.13.1.2.
    CrossrefGoogle Scholar
  • 58 Zito PM, Bistas KG, Syed K. Finasteride. Treasure Island (FL): StatPearls Publishing; 2021
    Google Scholar
  • 59 Sonthalia S. Hair restoration in androgenetic alopecia: looking beyond minoxidil, finasteride and hair transplantation. Journal of Cosmetology & Trichology 2016;02(01):
    Google Scholar
  • 60 Van Neste D, Fuh V, Sanchez-Pedreno P. et al. Finasteride increases anagen hair in men with androgenetic alopecia. Br J Dermatol 2000; 143 (04) 804-810
    CrossrefPubMedGoogle Scholar
  • 61 Kassimir JJ. Use of topical minoxidil as a possible adjunct to hair transplant surgery. A pilot study. J Am Acad Dermatol 1987; 16 (3 Pt 2): 685-687
    CrossrefPubMedGoogle Scholar
  • 62 Hirshburg JM, Kelsey PA, Therrien CA, Gavino AC, Reichenberg JS. Adverse effects and safety of 5-alpha reductase inhibitors (finasteride, dutasteride): a systematic review. J Clin Aesthet Dermatol 2016; 9 (07) 56-62
    PubMedGoogle Scholar
  • 63 Lee S, Lee YB, Choe SJ, Lee WS. Adverse sexual effects of treatment with finasteride or dutasteride for male androgenetic alopecia: a systematic review and meta-analysis. Acta Derm Venereol 2019; 99 (01) 12-17
    Google Scholar
  • 64 Irwig MS. Persistent sexual and nonsexual adverse effects of finasteride in younger men. Sex Med Rev 2014; 2 (01) 24-35
    CrossrefPubMedGoogle Scholar
  • 65 Fertig RM, Gamret AC, Darwin E, Gaudi S. Sexual side effects of 5-α-reductase inhibitors finasteride and dutasteride: A comprehensive review. Dermatol Online J 2017; 23 (11) 13030/qt24k8q743
    CrossrefGoogle Scholar
  • 66 Traish AM, Hassani J, Guay AT, Zitzmann M, Hansen ML. Adverse side effects of 5α-reductase inhibitors therapy: persistent diminished libido and erectile dysfunction and depression in a subset of patients. J Sex Med 2011; 8 (03) 872-884
    CrossrefPubMedGoogle Scholar
  • 67 Arias-Santiago S, Camacho-Martínez FM. Adverse effects of 5-alpha reductase inhibitor therapy in men with androgenetic alopecia: is there cause for concern?. Actas Dermosifiliogr 2016; 107 (09) 709-711
    CrossrefPubMedGoogle Scholar
  • 68 Canguven O, Burnett AL. The effect of 5 alpha-reductase inhibitors on erectile function. J Androl 2008; 29 (05) 514-523
    CrossrefPubMedGoogle Scholar
  • 69 Liu L, Zhao S, Li F. et al. Effect of 5α-reductase inhibitors on sexual function: a meta-analysis and systematic review of randomized controlled trials. J Sex Med 2016; 13 (09) 1297-1310
    CrossrefPubMedGoogle Scholar
  • 70 Shin YS, Karna KK, Choi BR, Park JK. Finasteride and erectile dysfunction in patients with benign prostatic hyperplasia or male androgenetic alopecia. World J Mens Health 2019; 37 (02) 157-165
    CrossrefPubMedGoogle Scholar
  • 71 Gupta AK, Charrette A. The efficacy and safety of 5α-reductase inhibitors in androgenetic alopecia: a network meta-analysis and benefit-risk assessment of finasteride and dutasteride. J Dermatolog Treat 2014; 25 (02) 156-161
    CrossrefPubMedGoogle Scholar
  • 72 Haber RS, Gupta AK, Epstein E, Carviel JL, Foley KA. Finasteride for androgenetic alopecia is not associated with sexual dysfunction: a survey-based, single-centre, controlled study. J Eur Acad Dermatol Venereol 2019; 33 (07) 1393-1397
    CrossrefPubMedGoogle Scholar
  • 73 Mondaini N, Gontero P, Giubilei G. et al. Finasteride 5 mg and sexual side effects: how many of these are related to a nocebo phenomenon?. J Sex Med 2007; 4 (06) 1708-1712
    CrossrefPubMedGoogle Scholar
  • 74 Anitha B, Inamadar AC, Ragunatha S. Finasteride-its impact on sexual function and prostate cancer. J Cutan Aesthet Surg 2009; 2 (01) 12-16
    CrossrefPubMedGoogle Scholar
  • 75 Traish AM, Goldstein I, Kim NN. Testosterone and erectile function: from basic research to a new clinical paradigm for managing men with androgen insufficiency and erectile dysfunction. Eur Urol 2007; 52 (01) 54-70
    CrossrefPubMedGoogle Scholar
  • 76 Tosti A, Piraccini BM, Soli M. Evaluation of sexual function in subjects taking finasteride for the treatment of androgenetic alopecia. J Eur Acad Dermatol Venereol 2001; 15 (05) 418-421
    CrossrefPubMedGoogle Scholar
  • 77 Tosti A, Pazzaglia M, Soli M. et al. Evaluation of sexual function with an international index of erectile function in subjects taking finasteride for androgenetic alopecia. Arch Dermatol 2004; 140 (07) 857-858
    CrossrefPubMedGoogle Scholar
  • 78 Chamsi-Pasha M, Albar MA, Chamsi-Pasha H. Minimizing nocebo effect: Pragmatic approach. Avicenna J Med 2017; 7 (04) 139-143
    Article in Thieme ConnectPubMedGoogle Scholar
  • 79 Finn DA, Beadles-Bohling AS, Beckley EH. et al. A new look at the 5alpha-reductase inhibitor finasteride. CNS Drug Rev 2006; 12 (01) 53-76
    CrossrefPubMedGoogle Scholar
  • 80 Dyson TE, Cantrell MA, Lund BC. Lack of association between 5α-Reductase Inhibitors and Depression. J Urol 2020; 204 (04) 793-798
    CrossrefPubMedGoogle Scholar
  • 81 Kim JH, Shim SR, Khandwala Y, Del Giudice F, Sorensen S, Chung BI. Risk of depression after 5 alpha reductase inhibitor medication: meta-analysis. World J Mens Health 2020; 38 (04) 535-544
    CrossrefPubMedGoogle Scholar
  • 82 Schmitz-Dräger BJ, Fischer C, Bismarck E, Dörsam HJ, Lümmen G. [The Prostate Cancer Prevention Trial (PCPT). Relevance for clinical practice]. Urologe A 2007; 46 (10) 1364 , 1366–1368, 1370
    CrossrefPubMedGoogle Scholar
  • 83 Wallerstedt A, Strom P, Gronberg H, Nordstrom T, Eklund M. Risk of prostate cancer in men treated with 5α-reductase inhibitors-A large population-based prospective study. J Natl Cancer Inst 2018; 110 (11) 1216-1221
    CrossrefPubMedGoogle Scholar
  • 84 Unger JM, Hershman DL, Till C. et al. Using Medicare claims to examine long-term prostate cancer risk of finasteride in the prostate cancer prevention trial. J Natl Cancer Inst 2018; 110 (11) 1208-1215
    PubMedGoogle Scholar
  • 85 Reed AB, Parekh DJ. The utility of 5-alpha reductase inhibitors in the prevention and diagnosis of prostate cancer. Curr Opin Urol 2009; 19 (03) 238-242
    CrossrefPubMedGoogle Scholar
  • 86 Carlson RH. PSA test sensitized by finasteride. Oncology Times 2006; 28 (19) 12-13
    CrossrefGoogle Scholar
  • 87 Etzioni RD, Howlader N, Shaw PA. et al. Long-term effects of finasteride on prostate specific antigen levels: results from the prostate cancer prevention trial. J Urol 2005; 174 (03) 877-881
    CrossrefPubMedGoogle Scholar
  • 88 D'Amico AV, Roehrborn CG. Effect of 1 mg/day finasteride on concentrations of serum prostate-specific antigen in men with androgenic alopecia: a randomised controlled trial. Lancet Oncol 2007; 8 (01) 21-25
    CrossrefPubMedGoogle Scholar
  • 89 Accessed August 29, 2021 at: https://www.cdc.gov/cliac/docs/addenda/cliac0311/Addendum_D_JAROW.pdf
  • 90 Accessed August 29, 2021 at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/852392/Finasteride_risk_of_male_breast_cancer.pdf
  • 91 Meijer M, Thygesen LC, Green A. et al. Finasteride treatment and male breast cancer: a register-based cohort study in four Nordic countries. Cancer Med 2018; 7 (01) 254-260
    CrossrefPubMedGoogle Scholar
  • 92 Kjærulff TM, Ersbøll AK, Green A. et al. Finasteride Use and risk of male breast cancer: a case-control study using individual-level registry data from Denmark, Finland, and Sweden. Cancer Epidemiol Biomarkers Prev 2019; 28 (05) 980-986
    CrossrefPubMedGoogle Scholar
  • 93 Overstreet JW, Fuh VL, Gould J. et al. Chronic treatment with finasteride daily does not affect spermatogenesis or semen production in young men. J Urol 1999; 162 (04) 1295-1300
    CrossrefPubMedGoogle Scholar
  • 94 Laborde E, Brannigan RE. Effect of 1-mg dose of finasteride on spermatogenesis and pregnancy. J Androl 2010; 31 (02) e1-e2
    CrossrefPubMedGoogle Scholar
  • 95 Samplaski MK, Lo K, Grober E, Jarvi K. Finasteride use in the male infertility population: effects on semen and hormone parameters. Fertil Steril 2013; 100 (06) 1542-1546
    CrossrefPubMedGoogle Scholar
  • 96 Glina S, Neves PA, Saade R, Netto Jr NR, Soares JB, Galuppo AG. Finasteride-associated male infertility. Rev Hosp Clin Fac Med Sao Paulo 2004; 59 (04) 203-205
    CrossrefPubMedGoogle Scholar
  • 97 Traish AM. Post-finasteride syndrome: a surmountable challenge for clinicians. Fertil Steril 2020; 113 (01) 21-50
    CrossrefPubMedGoogle Scholar
  • 98 Pereira AFJR, Coelho TOA. Post-finasteride syndrome. An Bras Dermatol 2020; 95 (03) 271-277
    CrossrefPubMedGoogle Scholar
  • 99 Diviccaro S, Melcangi RC, Giatti S. Post-finasteride syndrome: an emerging clinical problem. Neurobiol Stress 2019; 12: 100209
    CrossrefPubMedGoogle Scholar
  • 100 Rezende HD, Dias MFRG, Trüeb RM. A comment on the post-finasteride syndrome. Int J Trichology 2018; 10 (06) 255-261
    CrossrefPubMedGoogle Scholar
  • 101 Trüeb RM, Régnier A, Dutra Rezende H, Gavazzoni Dias MFR. Post-finasteride syndrome: an induced delusional disorder with the potential of a mass psychogenic illness?. Skin Appendage Disord 2019; 5 (05) 320-326
    CrossrefPubMedGoogle Scholar
  • 102 Chandrashekar BS, Nandhini T, Vasanth V, Sriram R, Navale S. Topical minoxidil fortified with finasteride: an account of maintenance of hair density after replacing oral finasteride. Indian Dermatol Online J 2015; 6 (01) 17-20
    CrossrefPubMedGoogle Scholar
  • 103 Sheikh S, Ahmad A, Shoukath AM. et al. A new topical formulation of minoxidil and finasteride improves hair growth in men with androgenetic alopecia. Clin Exp Dermatol Res 2015; 6: 1
    Google Scholar
  • 104 Caserini M, Radicioni M, Leuratti C, Annoni O, Palmieri R. A novel finasteride 0.25% topical solution for androgenetic alopecia: pharmacokinetics and effects on plasma androgen levels in healthy male volunteers. Int J Clin Pharmacol Ther 2014; 52 (10) 842-849
    CrossrefPubMedGoogle Scholar
  • 105 Rai PB. et al. Comparing the therapeutic efficacy of topical minoxidil and finasteride with topical minoxidil and oral finasteride in androgenetic alopecia: a randomized trial. Int J Res Dermatol. 2018; 4 (03) 386-390
    CrossrefGoogle Scholar
  • 106 Marihart S, Harik M, Djavan B. Dutasteride: a review of current data on a novel dual inhibitor of 5alpha reductase. Rev Urol 2005; 7 (04) 203-210
    PubMedGoogle Scholar
  • 107 Choi GS, Kim JH, Oh SY. et al. Safety and tolerability of the dual 5-alpha reductase inhibitor dutasteride in the treatment of androgenetic alopecia. Ann Dermatol 2016; 28 (04) 444-450
    CrossrefPubMedGoogle Scholar
  • 108 Zhou Z, Song S, Gao Z, Wu J, Ma J, Cui Y. The efficacy and safety of dutasteride compared with finasteride in treating men with androgenetic alopecia: a systematic review and meta-analysis. Clin Interv Aging 2019; 14: 399-406
    CrossrefPubMedGoogle Scholar
  • 109 Murugusundram S. Serenoa repens: does it have any role in the management of androgenetic alopecia?. J Cutan Aesthet Surg 2009; 2 (01) 31-32
    CrossrefPubMedGoogle Scholar
  • 110 Evron E, Juhasz M, Babadjouni A, Mesinkovska NA. Natural hair supplement: friend or foe? Saw Palmetto, a systematic review in alopecia. Skin Appendage Disord 2020; 6 (06) 329-337
    CrossrefPubMedGoogle Scholar
  • 111 Guo EL, Katta R. Diet and hair loss: effects of nutrient deficiency and supplement use. Dermatol Pract Concept 2017; 7 (01) 1-10
    CrossrefPubMedGoogle Scholar
  • 112 Finner AM. Nutrition and hair: deficiencies and supplements. Dermatol Clin 2013; 31 (01) 167-172
    CrossrefPubMedGoogle Scholar
  • 113 Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. The role of vitamins and minerals in hair loss: a review. Dermatol Ther (Heidelb) 2019; 9 (01) 51-70
    CrossrefPubMedGoogle Scholar