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Finasteride, an inhibitor of type 2 5α-reductase, inhibits conversion of testosterone to DHT, resulting in decrease in serum and scalp DHT levels believed to be pathogenic in AGA. 1 mg oral finasteride daily has been shown to be effective in prevention and treatment of hair loss in men, and has also shown some effect in aging males.

Traditionally, pattern hair loss in women has is treated with topical minoxidil, and with systemic antiandrogens, such as cyproterone acetate or spironolactone (Sinclair et al 2005), though the efficacy of the latter has also been challenged, at least in premenopausal women with normal androgen levels (Vexiau et al 2002). While oral finasteride has unanimously been shown to be effective in treatment of hair loss in men, its efficacy in women has remained controversial. Due to inconsistent data with respect to efficacy of finasteride in women, it has been suggested that not all types of female hair loss have the same pathophysiology, ie, a distinction should be made between alopecia with early or late (postmenopausal) onset, and with or without hyperandrogenemia. Due to teratogenicity for the male fetus, finasteride is contraindicated for use in premenopausal women.

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Dermscopy in alopecia

Dermatology. 2008 Sep 18;217(4):333-336. [Epub ahead of print]Significance of Dermoscopy in Acute Diffuse and Total Alopecia of the FemaleScalp: Review of Twenty Cases.Inui S, Nakajima T, Itami S.Department of Regenerative Dermatology, Graduate School of Medicine, OsakaUniversity, Suita, Japan.Background: Acute diffuse and total alopecia of the female scalp (ADTAFS) is anew subtype of alopecia areata that is characterized by rapid progression ofdiffuse alopecia of the female scalp, marked female predominance and a favorable prognosis. Differential diagnosis of other types of diffuse alopecia such asfemale pattern hair loss (FPHL) is necessary in some cases. Objective: Todescribe dermoscopic findings of ADTAFS and to investigate the possibility ofutilizing dermoscopy as a diagnostic tool for ADTAFS. Methods: Twenty cases ofADTAFS diagnosed by clinical and/or histological findings were examined bydermoscopy. Results: Cadaverized hairs (black dots), exclamation mark hairs(tapering hairs), broken hairs or yellow dots were seen in 18, 13, 19 and 17 out of 20 cases, respectively. One of these signs was seen in all cases (20/20). Onthe other hand, none of 12 cases with exclusively FPHL showed the dermoscopicfeatures such as cadaverized hairs, exclamation mark hairs or broken hairs. Only 1 FPHL patient showed a yellow dot in the hair loss area. Conclusion: Dermoscopy is a helpful diagnostic tool for ADTAFS, especially to distinguish it from FPHL. Copyright © 2008 S. Karger AG, Basel.PMID: 18799878 [PubMed - as supplied by publisher]Related Links Clinical significance of dermoscopy in alopecia areata: analysis of 300 cases.[Int J Dermatol. 2008] PMID:18613874 Dermoscopic findings in frontal fibrosing alopecia: report of four cases. [Int J Dermatol. 2008] PMID:18717858 The role of scalp dermoscopy in the diagnosis of alopecia areata incognita. [J AmAcad Dermatol. 2008] PMID:18440667 Acute diffuse and total alopecia of the female scalp. A new subtype of diffusealopecia areata that has a favorable prognosis. [Dermatology. 2002] PMID:12444333 Dry dermoscopy in clinical treatment of alopecia areata. [J Dermatol. 2007]PMID:17727366

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