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Value of hormonal levels in patients with male androgenetic alopecia treated with finasteride: better response in patients under 26 years old.

Camacho FM, García-Hernández MJ, Fernández-Crehuet JL

Department of Dermatology, Hospital Universitario Virgen Macarena, Avda. Dr Fedriani s/n. 41071 Sevilla, Spain.

Background Finasteride is a 5alpha-reductase inhibitor that has proved to be an effective treatment for men with androgenetic alopecia. Objectives To investigate the hormonal influence of finasteride 1 mg daily on hormonal levels and hair growth in men of different ages and with different degrees of alopecia according to the Hamilton-Norwood scale. Methods Two hundred and seventy men aged 14-58 years with male androgenetic alopecia III-VI Hamilton-Norwood score (II-III Ebling score) were treated with finasteride 1 mg daily. Steroid hormone (free testosterone, 5alpha-dihydrotestosterone, dehydroepiandrosterone-sulphate, delta4-androstenedione, 17-hydroxyprogesterone), prostate-specific antigen (PSA) and sebum levels, and trichogram changes were determined at baseline, and at 6 and 12 months of treatment. Results According to significant hormonal statistical analysis, the patients were divided by age (up to or over 26 years). In the group of patients </= 26 years, higher levels of 5alpha-dihydrotestosterone were found at the beginning of the treatment, but there was a 50% decrease between the onset of treatment and month 12, particularly noticeable at 6 months (P < 0.05) of treatment, running parallel to an improvement of the alopecia and an increase of anagen hairs in the trichogram. At 1 year, PSA levels decreased 20%, particularly in patients > 26 years. No variations in sebum levels were observed. Conclusions High levels of 5alpha-dihydrotestosterone in patients </= 26 years at the beginning of treatment are a predictive factor of good response to treatment with finasteride 1 mg daily.

Published 14 April 2008 in Br J Dermatol, 158(5): 1121-4.
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