Finasteride may be effective for the treatment of female pattern hair loss (FPHL), according to the results of a study reported in the March issue of Archives of Dermatology.

"If left untreated, FPHL may be rapidly progressive," write Matilde Iorizzo, MD, from the University of Bologna in Italy, and colleagues. "Treatment for FPHL consists mainly of topical minoxidil, which is effective but sometimes is not well accepted by the patient. The efficacy of oral antiandrogens is not well established."

Following outpatient consultation for hair disorders, 37 women with FPHL were treated with 2.5 mg/day of oral finasteride while taking an oral contraceptive containing drospirenone and ethinyl estradiol. Efficacy outcomes included appearance on global photography, hair density score on videodermoscopy, and a self-administered questionnaire in which patients evaluated the results of treatment.

At 12-month follow-up, global photography revealed that 23 (62%) of the 37 patients were improved, including 12 who were slightly improved, 8 who were moderately improved, and 3 who were greatly improved. Of the remaining 14 patients, 13 had no improvement, and 1 patient was worse. Twelve patients had a significant increase in hair density score (P = .002). No patients had adverse reactions to the drug.

"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," the authors write. "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 FPHL respond better to this treatment."

Study limitations include lack of randomization, blinding, placebo control, and scalp biopsies.

"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," the authors conclude.