Treatment of hyperandrogenic alopecia in women.
OBJECTIVE
To determine the effectiveness of various antiandrogens for the treatment of premenopausal women with hyperandrogenic alopecia.


METHODS
Randomized, unmasked trial of three treatments in 36 hyperandrogenic women with alopecia and observation, without treatment, in 12 other similar patients.


METHODS
Endocrinologic outpatient practice in Italy.


METHODS
A total of 48 hyperandrogenic women with alopecia and 30 age- and weight-matched controls for the assessment of androgen levels.


METHODS
Randomization to cyproterone acetate (50 mg) with ethinyl estradiol (EE) in a reverse sequential regimen; flutamide (250 mg) or finasteride (5 mg) daily; all for 1 year. Twelve similar patients were observed without treatment for 1 year.


METHODS
Ludwig scores for hair thinning as well as patient and investigator assessments of treatment effectiveness.


RESULTS
Flutamide resulted in a reduction of 21% in Ludwig scores (2.3 +/- 0.2 to 1.8 +/- 0.1). The other treatment effects were not statistically significant. Patient and investigator assessments showed a similar trend.


CONCLUSIONS
Flutamide at a dose of 250 mg daily induced a modest improvement in alopecia after 1 year, whereas cyproterone acetate and finasteride were not effective. Treatment for more than 1 year may be required for better results.
Carmina
Enrico
E
Department of Obstetrics and Gynecology, University of Palermo, Palermo, Italy.
Lobo
Rogerio A
RA
D058891:5-alpha Reductase Inhibitors; D000328:Adult; D000505:Alopecia / Q000188:drug therapy* / Q000209:etiology; D000726:Androgen Antagonists / Q000627:therapeutic use*; D017373:Cyproterone Acetate / Q000009:adverse effects / Q000627:therapeutic use; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D004791:Enzyme Inhibitors / Q000494:pharmacology; D004997:Ethinyl Estradiol / Q000627:therapeutic use; D005260:Female; D018120:Finasteride / Q000009:adverse effects / Q000627:therapeutic use; D005485:Flutamide / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D017588:Hyperandrogenism / Q000150:complications*; D007558:Italy; D008099:Liver / Q000201:enzymology; D013739:Testosterone / Q000097:blood
D058891:5-alpha Reductase Inhibitors; D000726:Androgen Antagonists; D004791:Enzyme Inhibitors; D013739:Testosterone; D004997:Ethinyl Estradiol; D017373:Cyproterone Acetate; D019314:Dehydroepiandrosterone Sulfate; D018120:Finasteride; D005485:Flutamide