Battered and bruised, finasteride’s image has been tarnished by accusations ranging from inciting prostate cancer, depression, and permanent sexual adverse effects to stimulating male breast cancer.
he investigators evaluated the efficacy and safety of finasteride in Japanese men with AGA
They demonstrated that approximately 87% of men had experienced a positive effect on hair growth.
This study tells us that finasteride works fairly well across the board. Without going into great detail,
Classification Based on Pattern and Degree of Loss
The efficacy of this drug proved itself across all age groups. While the original studies on finasteride were conducted in men from 18 to 41 years of age, subsequent studies have confirmed a positive response
This drug works well in those with early (less than 5 years) as well as those with greater than 5 years of hair loss.
- The present study was conducted for 3.5 years in 3,177 men.
- Finasteride maintained a higher response rate of more than 80% even after a 2-year treatment period. The response rate may be due to the fact that Japanese men have hair of less density, larger diameter, and black colour of the hair shafts. This will show a marked contrast in hair colour compared to the thinner and lighter colour of the scalp and hair in Caucasians. Therefore, subtle changes in scalp hair growth in the Asian population can be easily identified by a global photographic assessment leading to a higher response rate in these men.
- The response rate improved with increasing duration of treatment.
- There was no increase in the incidence of adverse reactions due to longer treatment periods.
- Out of the 113 patients followed for 10 years, only 14% worsened.
- 86% of patients benefited from treatment. Side effects were observed in 5.9% of patients. This equated to 7 patients out of 113. A total of 4 patients elected to stop treatment due to reduced libido and 4 elected to stop treatment due to erectile problems.
There is so much good data and findings from the Rossi study that it is difficult to criticize the investigators. However, this Editor Emeritus did have considerable problems with the interpretation of their statistical analysis. Readers may have difficulty discerning the detailed transitional probabilities listed in the tables. Perhaps the more scholarly statistically minded individuals in our Society would care to publish an explanation and interpretation of the tables presented in this article.
Finally, another Japanese study deserves mention: “Oral finasteride improved the quality of life of androgenetic alopecia patients” (Yamazaki, M., et al. J Dermatol. 2011; 38(8):773-777). This study was conducted in order to ascertain whether treatment by oral finasteride can improve the quality of life of these patients. Oral finasteride improved the quality of life based on several questionnaires administered to patients. However, oral finasteride did not alleviate the patients’ anxiety, as shown by validated anxiety questionnaires.
Finasteride, much maligned by anecdotal reports in the press and on the Internet, has emerged with a silver lining. It not only works well in all age groups, but it keeps on working. It also improves the quality of life of our patients. Once again we are indebted to all the authors for their important contribution and look forward to hearing more from these groups.
Hair Transplant Forum International
Notes from the Editor Emeritus
Dow B. Stought, MD
Hot Springs, Arkansas, USA
This 19 year-old patient filled up our questionnaire and sent some photos by email in August, 2017. His pics suggest aggressive DUPA reason why we recommended finasteride and gave him an appointment one month after. In consultation, we assessed his scalp confirming the diagnosis of aggressive DUPA, made pictures and scheduled periodic controls in order to stabilize his hair-loss. After 6 months we observed a huge improvement in the quality of his hair. And, after a year, full recovery of the coverage, so we decided to continue with medical controls and discard the surgical option.
Although it is not the objective, we know that there are a small percentage of patients with a good response to medication, especially if the prevention is carried out at an early age. The improvement is usually partial, mainly at crown, but we already have seen several cases similar to the one presented. Therefore, that we never are in rush to send a patient to the operation room. We have to be patient and wait to see the effect of medication. If we mix both treatment and start medication at the same time than the procedure can mislead the final outcome and consider a medical result as a surgical treatment, mainly when you see improvement in non-treated areas.