Systematic Review of Finasteride for Women's Hair Loss

When it comes to treating genetic hair loss, the medication finasteride has only been prescribed to medically-suitable men aged 18 and over.

It is one of only two clinically-proven, MHRA-licensed and FDA-approved treatments for Male Pattern Baldness when prescribed in 1mg per day oral doses.

Its purpose is to inhibit the formation of the testosterone by-product dihydrostestosterone (DHT). In cases of androgenetic alopecia, this protein binds to the hair follicles located along the top of the scalp, from crown to hairline and temples, causing thinning hair and hair loss.

Recently, however, its applications in relation to women's hair loss have become an area of great interest. Numerous studies have been, and continue to investigate whether oral or topical finasteride may benefit women with hair disorders, particularly those with Female Pattern Hair Loss.

The International Journal of Dermatology published a report on 3rd January 2019 detailing the findings of researchers from the University of California's Department of Dermatology who carried out a systematic review of the efficacy and use of finasteride in women.

Efficacy and use 'varies widely' for women

Study authors Allison Hu, Lance Chapman MD and Natasha Mesinkova MD, noted the reason for this review of current uses of finasteride for women, as follows:

"Physicians are beginning to use finasteride as treatment for hair loss, hirsutism, and various other dermatologic conditions in women. However, the reported efficacy and use of finasteride in the female population varies widely. The purpose of this study is therefore to better define the efficacy and use of finasteride in women and identify research gaps that require further investigation."

The systematic review took in literature from January 1997 to July 2017 inclusive, which comprised 65 studies into finasteride for women, involving a total of 2,683 participants.

The Irvine-based team found that almost half of all randomised controlled trials (48.7 per cent) involved exploring finasteride as a treatment for excessive hair growth (hirsutism) in women. At 34.7 per cent, the next most common RCTs used finasteride to treat Female Pattern Hair Loss.

Additional research was shown to have considered the potential of finasteride as a treatment for various other hair loss conditions. These included Frontal Fibrosing Alopecia, the autoimmune disorder Alopecia Areata, and Lichen Planopilaris; these studies were not supported by actual clinical trials.

In terms of administration, dosing and the duration of treatment, it was noted that these varied considerably across the board: "Overall, doses of oral finasteride ranged from 0.5 to 5 mg/day, in females aged 688, over a duration of 612 months (57.6%), as monotherapy (88.9%), and for continuous use (96.4%)."

Whilst the Californian team found that finasteride may have a positive effect when used to treat Female Pattern Hair Loss and Frontal Fibrosing Alopecia, due to the varying doses, durations and array of conditions being studied, they made clear that far more investigation was still necessary to find the safest, most effective way to administer finasteride therapy, and to whom.

Current women's hair loss treatment options

Finasteride is not currently available for prescription to women in topical nor oral forms in the UK. The only women's hair loss treatment that is currently authorised by both the UK and USA's medical regulatory bodies - the MHRA and FDA - is the topical product high strength minoxidil.

This vasodilator comes in a range of formulations, all of which are applied directly to the scalp where needed, either once or twice daily as directed, in order to encourage hair growth in cases of Female Pattern Hair Loss.

It can be used alone or in conjunction with appropriate hair growth supporting products. These include low-level laser therapy (LLLT) delivered by FDA-cleared devices such as the HairMax LaserComb or LaserBand, which is an ergonomic aid that stimulates the follicles. Highly-targeted food supplements, such as Hair Vitalics for Women which contains an exclusive blend of nutrients, including biotin, zinc and selenium for the maintenance of normal healthy hair growth, may also be used alongside pharmaceutical treatment.

Anyone who has noticed hair thinning or a drop in the volume of their hair - often noticeable as an increasingly wide parting and/or ponytails feeling thinner than normal - who is worried about losing their hair now should consult a specialist.

A consultation with an expert from a dedicated hair loss clinic - whether in-person or online - can be a simple way to gain a diagnosis, professional advice and personalised treatment recommendations for consideration.

At present [February 2019], Belgravia does not offer finasteride to women due to its current experimental uses and lack of official MHRA and FDA authorisations. However, we are keeping abreast of all relevant trials and research and will publish updates here on our hair loss blog as and when these become available.