title: Topical minoxidil fortified with finasteride: An account of maintenance of hair density after replacing oral finasteride.
abstract: BACKGROUND
  Finasteride acts by reducing dihydrotestosterone levels, thereby inhibiting miniaturization of hair follicles in patients with androgenetic alopecia (AGA). Oral finasteride is associated with side effects such as decreased libido, sexual dysfunction, and gynecomastia.
  
  
  OBJECTIVE
  The aim of the following study is to assess the efficacy of maintaining hair growth with 5% topical minoxidil fortified with 0.1% finasteride in patients with AGA after initial treatment with 5% topical minoxidil and oral finasteride for two years.
  
  
  METHODS
  A retrospective assessment was done in 50 male patients aged 20-40 years with AGA. All the patients had been initially treated with topical minoxidil and oral finasteride for a period of two years, after which the oral finasteride was replaced with topical minoxidil fortified with finasteride. Five of 50 patients had discontinued the treatment for a period of 8-12 months and were then resumed with only topical minoxidil fortified with finasteride. The patients' case sheets and photographs were reviewed by independent observers and the efficacy of minoxidil-finasteride combination was assessed.
  
  
  RESULTS
  Of the 45 patients who underwent a continuous treatment for AGA, 84.44% maintained a good hair density with topical minoxidil-finasteride combinatio. Of the five patients who discontinued oral finasteride for 8-12 months, four demonstrated good improvement in hair density when treatment was resumed with topical minoxidil-finasteride combination.
  
  
  CONCLUSIONS
  Topical finasteride can be considered for hair density maintenance after initial improvement with oral finasteride, thereby obviating the indefinite use of oral finasteride.
authors: Department of Trichology, CUTIS Academy of Cutaneous Sciences, Bengaluru, Karnataka, India.
authors: B S
authors: BS
authors: Chandrashekar
authors: Department of Trichology, CUTIS Academy of Cutaneous Sciences, Bengaluru, Karnataka, India.
authors: T
authors: T
authors: Nandhini
authors: Department of Trichology, CUTIS Academy of Cutaneous Sciences, Bengaluru, Karnataka, India.
authors: Vani
authors: V
authors: Vasanth
authors: Department of Trichology, CUTIS Academy of Cutaneous Sciences, Bengaluru, Karnataka, India.
authors: Rashmi
authors: R
authors: Sriram
authors: Department of Trichology, CUTIS Academy of Cutaneous Sciences, Bengaluru, Karnataka, India.
authors: Shreya
authors: S
authors: Navale
keywords: Androgenetic alopecia; maintenance of hair density; oral finasteride; topical finasteride; topical minoxidil
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