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Hair Loss Study Abstract: A prospective randomized trial comparing finasteride to spironolactone in the treatment of hirsute women.
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Title
A prospective randomized trial comparing finasteride to spironolactone in the treatment
of hirsute women. Author
Wong IL; Morris RS; Chang L; Spahn MA; Stanczyk FZ; Lobo RA
Address
Department of Obstetrics and Gynecology, University of Southern California School of
Medicine, Los Angeles 90033. Source
J Clin Endocrinol Metab, 1995 Jan, 80:1, 233-8
Abstract
Enhanced 5 alpha-reductase activity has been found in the skin of the majority of women
with hirsutism. Finasteride is a specific competitive inhibitor of 5 alpha-reductase,
preferentially inhibiting the type 2 isoenzyme. Therefore, we randomly assigned 14 hirsute
women in a 2:1 ratio to 1 of 2 treatment arms: 1) finasteride (F) treatment (n = 9; 5 mg,
orally, daily), or 2) spironolactone (S) treatment (n = 5; 100 mg, orally, daily). Each
group was treated for 6 months. Patients were evaluated at baseline and after 3 and 6
months of treatment. The 2 groups were similar in age, weight, hip/waist ratio, baseline
Ferriman-Gallwey score (F, 19 +/- 2; S, 19 +/- 2), and baseline androgen levels.
Finasteride treatment resulted in a significant increase in testosterone (T; P 5 alpha-androstane-3 alpha,17 beta-diol glucuronide (3
alpha-diolG; P 05), the 3 alpha-diolG/T ratio (P alpha-diolG/androstenedione ratio (P 05). All changes were consistent with 5 alpha-reductase
inhibition. In contrast, spironolactone treatment did not result in significant changes in
serum hormone levels. Both treatments produced a significant decrease in anagen hair
diameters [F, -14.0 +/- 6.7% (P 05); S, -13.4 +/- 3.8% (P
05)] and Ferriman-Gallwey scores [F, -2.1 +/- 0.4 (P 05); S, -2.5 +/- 0.7 (P 05)].
In conclusion, despite significantly different effects on androgen levels, finasteride and
spironolactone treatment resulted in a similar clinical effect on hirsutism. Both caused
significant, but limited, improvement in hirsutism. Although promising, further studies
with finasteride are needed to verify its effectiveness as a treatment for hirsutism. Such
studies will also provide a better understanding of the relative contribution of 5
alpha-reductase isoenzymes to hirsutism.
Language of Publication LA=ENG
Unique Identifier 95130674
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