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Finasteride (propecia) in Female Hair Loss

A recent Italian study looked at the effects of finasteride (the ingredient in Propecia) on women's hair loss when used in combination with a birth control pill.   Here is a link to the abstract which is quoted below:  Women's Hair Loss and Finasteride.   Interestingly, 62% of patients showed a positive response from the treatment. 

Finasteride treatment of female pattern hair loss.

Department of Dermatology, University of Bologna, Via Massarenti, I-40138 Bologna, Italy.

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.

PMID: 16549704 [PubMed - indexed for MEDLINE]

In the U.S. finasteride/propecia is NOT fda-approved for women--mainly because of the risk of a birth defect in a developing male fetus.  However, some physicians prescribe the treatment for their female patients 'off label'--especially if the woman is post-menopausal or has had a hysterectomy.      

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