Efficacy of Topical Finasteride 0.5% vs 17α-Estradiol 0.05% in the Treatment of Postmenopausal Female Pattern Hair Loss: A Retrospective, Single-Blind Study of 119 Patients

Alfredo Rossi; Francesca Magri; Andrea D'Arino; Flavia Pigliacelli; Marta Muscianese; Pierpaolo Leoncini; Gemma Caro; Alessandro Federico; Maria Caterina Fortuna; Marta Carlesimo

doi:10.5826/dpc.1002a39

Efficacy of Topical Finasteride 0.5% vs 17α-Estradiol 0.05% in the Treatment of Postmenopausal Female Pattern Hair Loss: A Retrospective, Single-Blind Study of 119 Patients

Authors

Alfredo Rossi Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
Francesca Magri Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
Andrea D'Arino Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
Flavia Pigliacelli Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
Marta Muscianese Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
Pierpaolo Leoncini Department of Pediatric Hematology and Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Bambino Gesù Children's Hospital, Rome, Italy
Gemma Caro Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
Alessandro Federico Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
Maria Caterina Fortuna Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
Marta Carlesimo Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy

Keywords:

female pattern hair loss, topical finasteride, 17 α–estriadol, minoxidil

Abstract

Background and Objectives: Female pattern hair loss (FPHL) is a common form of scalp hair loss that occurs in 38% of females. Currently, minoxidil solution is the only therapy approved by the US Food and Drug Administration, but many other treatments are used, including cyproterone acetate, spironolactone, topical 17α-estradiol, and prostaglandin analogs. Systemic finasteride has been considered a treatment option in women even though its teratogenic effects tend to limit its prescription. Recently, topical finasteride has been evaluated to limit the side effect profile of the drug. The objective of the present study is to compare retrospectively the efficacy of topical 0.05% 17α-estradiol solution and a 0.5% finasteride lotion in the treatment of FPHL.

Patients and Methods: We enrolled 119 postmenopausal female patients. The first group comprised 69 women treated with finasteride 0.5% and minoxidil 2%. The second group included 50 women treated with 17α-estradiol 0.05% and minoxidil 2%. At baseline and at 6- and 12- to 18-month follow-up, global photographs were systematically taken. Three operators blind to the prescribed treatment evaluated photographs using a 7-point scale. One-way analysis of variance and unpaired Student t tests were performed to analyze 7-point scale scores.

Results: The improvement was statistically significant from 6 months to 12-18 months, both for finasteride (P < 0.005) and 17α-estradiol (P < 0.05). The efficacy of topical finasteride was significantly greater than that of 17α-estradiol solution, both at the 6-month (P < 0.05) and at the 12- to 18-month follow-up (P < 0.005). In general, the highest improvement was observed after 12-18 months of treatment with topical finasteride therapy.

Conclusions: Topical finasteride 0.5% in combination with minoxidil 2% could represent a valid therapeutic option for the treatment of postmenopausal FPHL, showing higher efficacy than topical 17α-estradiol with minoxidil 2% both at 6-month and 12- to 18-month follow-up.

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