title: Guidelines on the use of finasteride in androgenetic alopecia.
abstract: BACKGROUND
  Finasteride is a widely used drug in dermatology for the treatment of androgenetic alopecia. There are many reports of associated sexual side effects. This article reviews the use of once-daily 1 mg finasteride in androgenetic alopecia and its associated sexual adverse effects.
  
  
  METHODS
  A literature search was performed to collect data on the use of finasteride in male pattern baldness. Relevant literature published till March 2014 was obtained from MEDLINE, EMBASE, CINAHL, Cochrane registers and LILACS. The keywords "finasteride", "male pattern baldness" and "androgenetic alopecia" were used for literature search. Similarly, a search was done for finasteride in female pattern hair loss with keywords "female pattern baldness", "finasteride" and "female pattern alopecia". All systematic reviews, meta-analyses, national guidelines, randomized controlled trials, prospective open label studies and retrospective case series in the English literature were reviewed.
  
  
  RESULTS
  Two hundred sixty two studies were evaluated, twelve of which fulfilled the inclusion criteria.
  
  
  CONCLUSIONS
  Current evidence on the safety of finasteride indicates that it is safe but there is growing concern about its sexual side effects. In view of this, proper information should be provided to patients prior to starting treatment (Level of recommendation 1+, Grade of recommendation B). The reported sexual side effects are few and reverse with stoppage of the drug (Grade of recommendation B) but further studies are required.
authors.affiliation: Department of Dermatology, Venkat Charmalaya, Institute for Advanced Dermatology and Postgraduate Training, Bengaluru, Karnataka, India.
authors.forename: Venkataram
authors.initials: V
authors.lastname: Mysore
authors.forename: B M
authors.initials: BM
authors.lastname: Shashikumar
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D000505:Alopecia / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D018120:Finasteride / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic / Q000592:standards*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D012189:Retrospective Studies; D012725:Sexual Behavior / Q000187:drug effects*; D014481:United States; D014486:United States Food and Drug Administration / Q000592:standards*
chemical_list: D058891:5-alpha Reductase Inhibitors; D018120:Finasteride