Arch Dermatol. 2003 Sep;139(9):1219-21.

Minoxidil vs finasteride in the treatment of men with androgenetic alopecia (male pattern hair loss).

Saraswat A, Kumar B.

Cutis. 2001 Jul;68(1):35-40

Management of male pattern hair loss.

Sinclair RD.

The management of androgenetic alopecia (AGA) has been materially altered by the availability of the 5 alpha-reductase type 2 inhibitor, finasteride. Nevertheless, this agent is only one component of successful management, and an understanding of the role of camouflage agents, surgical options, and other medical treatments is important. Because no treatment completely reverses baldness, it is important to communicate the limitations of each modality to the patient so that he has appropriate expectations of the outcome of any intervention. Patient counseling and support are also often relevant.

Scand J Urol Nephrol Suppl. 1999;203:15-20.

Finasteride in the treatment of benign prostatic hypertrophy: an update. New indications for finasteride therapy.

Ekman P.

A phenomenon of the prostate gland, which is also shared by hair follicles, is that it is little influenced by testosterone (T) for androgenic stimulation, but instead by its metabolite 5alpha-dihydrotestosterone (DHT). By blocking the conversion of T to DHT, the circulating level of DHT is reduced by 80%, the size of the prostate gland is reduced by about 20% and the level of prostate-specific antigen (PSA) by about 50%. Treatment of patients with obstructive benign prostatic hypertrophy (BPH) with the drug Finasteride leads to a moderately improved urinary flow, symptomatic improvement and halts the natural progress of the disease. Since DHT potentiates the effect of testosterone on erectile function, the side-effects are impotence in 3% of patients, decreased ejaculatory volume, and gynaecomastia in 0.4% of patients. The drug could be regarded as a safe way to treat moderately symptomatic BPH. The efficacy of the drug is long-lasting (more than 7 years). It has also been tried in prostate cancer, but is less effective. It reduces PSA levels by 50% and, in combination therapy, therefore, PSA levels remain low for longer when Finasteride is added. An important finding is the efficacy of Finasteride treatment in haematuria from BPH. The drug interacts with vascular endothelium growth factor and efficiently prevents new bleeding. It could be regarded as a first-line therapy for this type of haematuria. Finasteride can also be used to stop male pattern baldness. It seems particularly effective in men aged 20-40 years; 85% of patients stopped losing hair when given Finasteride. When the treatment was stopped hair loss continued, thus therapy may have to be “lifelong".

Br J Dermatol. 1999 Sep;141(3):398-405.The psychosocial consequences of Pattern hair loss: a review of the research literature.

Cash TF.

edited

Androgenetic alopecia or pattern hair loss is a common dermatological condition, with potentially adverse psychosocial sequelae. The present review critically examines scientific evidence concerning the effects of androgenetic hair loss on social processes and psychological functioning, as well as the psychosocial outcomes of medical treatments. Research confirms a negative but modest effect of visible hair loss on social perceptions. More importantly, androgenetic alopecia is typically experienced as a moderately stressful condition that diminishes body image satisfaction. Deleterious effects on self-esteem and certain facets of psychological adjustment are more apparent among women than men and among treatment-seeking patients. Various ‘risk factors’ vis-à-vis the psychological adversity of androgenetic alopecia are identified. Medical treatments, i.e. minoxidil and finasteride, appear to have some psychological efficacy. A conceptual model is delineated to explain the psychological effects of hair loss and its treatment. Directions for needed research are discussed….

Australas J Dermatol. 2000 May;41(2):106-8.

Permanent alopecia following chemotherapy and bone marrow transplantation.

Tran D, Sinclair RD, Schwarer AP, Chow CW.
Department of Dermatology, Alfred Hospital, Prahran, Australia.

Alopecia can be a psychologically daunting prospect for people requiring cancer chemotherapy. Fortunately, most patients experience only temporary hair loss. We report the case of a 23-year-old woman with chronic myeloid leukaemia who developed permanent, near-total alopecia of her scalp, eyebrows, eyelashes, axillary and public hair following busulphan and cyclophosphamide chemotherapy which was used as conditioning prior to allogeneic bone marrow transplantation. The histology from a scalp biopsy revealed hair follicle destruction. Topical minoxidil failed to induce significant re-growth.

Acta Derm Venereol. 1985;65(2):172-5.

Topical minoxidil for extended areate alopecia.

Frentz G.

A double-blind cross over study on the effect of 3 months’ treatment with 1% topical minoxidil on 23 individuals with alopecia areata was performed. Thirteen of the patients showed some increase in terminal hair growth, the difference between the number of responders to placebo and minoxidil lotion being significant (p less than 0.005). However, in one case only, the result was cosmetically satisfying. In two male patients the blood pressure increased coinciding with the withdrawal of the minoxidil lotion.