Is Oral Finasteride Effective in Reversing Hair Loss in Men with Androgenetic Alopecia?

OBJECTIVE: The objective of this selective EBM review is to determine whether or not oral finasteride is effective in reversing hair loss in men with androgenetic alopecia. STUDY DESIGN: Review of two double blind, randomized controlled trials (RCTs), and one randomized open-label study published between 2009 and 2013, all in English language. The articles compared oral finasteride to a placebo, topical finasteride, and Serenoa repens, respectively. DATA SOURCES: The two double-blind, randomized controlled trials (RCTs), and one randomized open-label study were found using PubMed. All articles were published in peerreviewed journals and selected based on correlation to topic choice, date of publication, and evaluating POEMs. OUTCOMES MEASURED: Patient reported satisfaction with therapy, change in staging from baseline as measured by the Hamilton and the Hamilton-Norwood Classification Scale for androgenetic alopecia, and change in mean size of alopecia from baseline (cm). RESULTS: The three studies used in this review demonstrated inconsistent data on the effectiveness of oral finasteride for reversing hair loss in men with androgenetic alopecia. Rossi et al. demonstrated a statistically significant change in hair growth reversal in men taking oral finasteride when compared to Serenoa repens (P=0.013). Gubelin Harcha et al found statistically significant data that men treated with oral finasteride perceived they had increase in hair growth at the end of the trial when compared to the placebo. However, Gubelin Harcha et al found statistically insignificant data to support that men were overall satisfied with hair growth at the end of the trial (P=0.084). Hajheydari et al. demonstrated oral finasteride was statistically insignificant in reversing hair loss in men when compared to topical finasteride