Efficacy of Topical Combination of 0.25% Finasteride and 3% Minoxidil Versus 3% Minoxidil Solution in Female Pattern Hair Loss: A Randomized, Double-Blind, Controlled Study

Abstract

Background

The relationship between female pattern hair loss (FPHL) and androgenic hormones is not well established, but some evidence indicates oral finasteride may be efficacious in FPHL. Use of a topical formulation has been proposed to minimize unwanted effects.

Objectives

Our objective was to compare the efficacy and safety of topical 0.25% finasteride combined with 3% minoxidil solution and 3% minoxidil solution as monotherapy in the treatment of FPHL.

Methods

This was a prospective, randomized, double-blind study in 30 postmenopausal women with FPHL. Each participant was randomized to receive either topical 0.25% finasteride combined with topical 3% minoxidil or topical 3% minoxidil solution as monotherapy for 24 weeks. To determine efficacy, the hair density and diameter was measured and global photographic assessment was conducted at baseline and 8, 16, and 24 weeks. Side effects and serum dihydrotestosterone levels were also evaluated.

Results

By 24 weeks, hair density and diameter had increased in both groups, and finasteride/minoxidil was significantly superior to minoxidil solution in terms of hair diameter (p = 0.039). No systemic side effects were reported. However, serum dihydrotestosterone levels in the finasteride/minoxidil group significantly decreased from baseline (p = 0.016).

Conclusion

A topical combination of 0.25% finasteride and 3% minoxidil may be a promising option in the treatment of FPHL with an additional benefit of increasing hair diameter. Nevertheless, as it may be absorbed percutaneously, it should be reserved for postmenopausal women.

Trial Registration

clinicaltrials.in.th; identifier TCTR20160912002.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

References

  1. 1.

    Olsen EA. Female pattern hair loss. J Am Acad Dermatol. 2001;45(3 Suppl):S70–80.

    Article  CAS  PubMed  Google Scholar 

  2. 2.

    Birch MP, Messenger JF, Messenger AG. Hair density, hair diameter and the prevalence of female pattern hair loss. Br J Dermatol. 2001;144(2):297–304.

    Article  CAS  PubMed  Google Scholar 

  3. 3.

    Rojhirunsakool S, Suchonwanit P. Parietal scalp is another affected area in female pattern hair loss: an analysis of hair density and hair diameter. Clin Cosmet Investig Dermatol. 2017;11:7–12.

    Article  PubMed  PubMed Central  Google Scholar 

  4. 4.

    van Zuuren EJ, Fedorowicz Z. Interventions for female pattern hair loss. JAMA Dermatol. 2017;153(3):329–30.

    Article  PubMed  Google Scholar 

  5. 5.

    Rogers NE, Avram MR. Medical treatments for male and female pattern hair loss. J Am Acad Dermatol. 2008;59(4):547–66.

    Article  PubMed  Google Scholar 

  6. 6.

    Adil A, Godwin M. The effectiveness of treatments for androgenetic alopecia: a systematic review and meta-analysis. J Am Acad Dermatol. 2017;77(1):136–41.

    Article  PubMed  Google Scholar 

  7. 7.

    Yeon JH, Jung JY, Choi JW, Kim BJ, Youn SW, Park KC, Huh CH. 5 mg/day finasteride treatment for normoandrogenic Asian women with female pattern hair loss. J Eur Acad Dermatol Venereol. 2011;25(2):211–4.

    Article  CAS  PubMed  Google Scholar 

  8. 8.

    Iorizzo M, Vincenzi C, Voudouris S, et al. Finasteride treatment of female pattern hair loss. Arch Dermatol. 2006;142(3):298–302.

    Article  CAS  PubMed  Google Scholar 

  9. 9.

    Oliveira-Soares R, E Silva JM, Correia MP, André MC. Finasteride 5 mg/day treatment of patterned hair loss in normo-androgenetic postmenopausal women. Int J Trichol. 2013;5(1):22–5.

    Article  CAS  Google Scholar 

  10. 10.

    Boersma IH, Oranje AP, Grimalt R, et al. The effectiveness of finasteride and dutasteride used for 3 years in women with androgenetic alopecia. Indian J Dermatol Venereol Leprol. 2014;80(6):521–5.

    Article  PubMed  Google Scholar 

  11. 11.

    Price VH, Roberts JL, Hordinsky M, et al. Lack of efficacy of finasteride in postmenopausal women with androgenetic alopecia. J Am Acad Dermatol. 2000;43(5 Pt 1):768–76.

    Article  CAS  PubMed  Google Scholar 

  12. 12.

    Lee SW, Juhasz M, Mobasher P, et al. A systematic review of topical finasteride in the treatment of androgenetic alopecia in men and women. J Drugs Dermatol. 2018;17(4):457–63.

    PubMed  PubMed Central  Google Scholar 

  13. 13.

    Mazzarella F, Loconsole F, Cammisa A, et al. Topical finasteride in the treatment of androgenetic alopecia: preliminary evaluations after a 16-month therapy course. J Dermatol Treat. 1997;8(3):189–92.

    Article  Google Scholar 

  14. 14.

    Tanglertsampan C. Efficacy and safety of 3% minoxidil versus combined 3% minoxidil/0.1% finasteride in male pattern hair loss: a randomized, double-blind, comparative study. J Med Assoc Thai. 2012;95(10):1312–6.

    PubMed  Google Scholar 

  15. 15.

    Chandrashekar BS, Nandhini T, Vasanth V, et al. Topical minoxidil fortified with finasteride: an account of maintenance of hair density after replacing oral finasteride. Indian Dermatol Online J. 2015;6(1):17–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. 16.

    Sheikh S, Ahmad A, Ali SM, et al. A new topical formulation of minoxidil and finasteride improves hair growth in men with androgenetic alopecia. J Clin Exp Dermatol Res. 2015;6(1):253.

    Google Scholar 

  17. 17.

    Caserini M, Radicioni M, Leuratti C, et al. 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):842–9.

    Article  CAS  PubMed  Google Scholar 

  18. 18.

    Suchonwanit P, Srisuwanwattana P, Chalermroj N, Khunkhet S. A randomized, double-blind controlled study of the efficacy and safety of topical solution of 0.25% finasteride admixed with 3% minoxidil versus 3% minoxidil solution in the treatment of male androgenetic alopecia. J Eur Acad Dermatol Venereol. 2018. https://doi.org/10.1111/jdv.15171.

    Article  PubMed  Google Scholar 

  19. 19.

    Sinclair R, Patel M, Dawson TL Jr, et al. Hair loss in women: medical and cosmetic approaches to increase scalp hair fullness. Br J Dermatol. 2011;165(3 Suppl):12–8.

    Article  CAS  PubMed  Google Scholar 

  20. 20.

    Seale LR, Eglini AN, McMichael AJ. Side effects related to 5 alpha-reductase inhibitor treatment of hair loss in women: a review. J Drugs Dermatol. 2016;15(4):414–9.

    CAS  PubMed  Google Scholar 

  21. 21.

    Rushton DH, Norris MJ, Van Neste D. Hair regrowth in male and female pattern hair loss does not involve the conversion of vellus hair to terminal hair. Exp Dermatol. 2016;25(6):482–4.

    Article  Google Scholar 

  22. 22.

    Kelly Y, Blanco A, Tosti A. Androgenetic alopecia: an update of treatment options. Drugs. 2016;76(14):1349–64.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank the patients, investigators, and investigational site, whose participation made this study possible.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Poonkiat Suchonwanit.

Ethics declarations

Trial registration

clinicaltrials.in.th; identifier TCTR20160912002.

Funding

No sources of funding were used to conduct this study or prepare this manuscript.

Conflict of interest

PS, WI, and SR have no conflicts of interest that are directly relevant to the content of this study.

Ethical approval

This study was conducted in accordance with the principles of the Declaration of Helsinki and in compliance with the International Conference on Harmonization—Good Clinical Practice and local regulatory requirements. The study was reviewed and approved by the appropriate independent ethics committees, and written informed consent was obtained from all subjects prior to study initiation. This study was approved by the MU-IRB (Mahidol University Institutional Review Board) on 16 September 2015 (Protocol number 09-58-20).

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Suchonwanit, P., Iamsumang, W. & Rojhirunsakool, S. Efficacy of Topical Combination of 0.25% Finasteride and 3% Minoxidil Versus 3% Minoxidil Solution in Female Pattern Hair Loss: A Randomized, Double-Blind, Controlled Study. Am J Clin Dermatol 20, 147–153 (2019). https://doi.org/10.1007/s40257-018-0387-0

Download citation