Finding the Most Effective Treatment for Hair Loss in Men
By Joseph E. Scherger, MD, MPH
Core Faculty, Eisenhower Health Family Medicine Residency Program, Eisenhower Health Center, La Quinta, CA; Clinical Professor, Keck School of Medicine, University of Southern California, Los Angeles
SYNOPSIS: Among three common treatments for male androgenic alopecia, the authors of a meta-analysis found 0.5 mg/day of dutasteride to be the most effective.
SOURCE: Gupta AK, Venkataraman M, Talukder M, Bamimore MA. Relative efficacy of minoxidil and the 5-alpha reductase inhibitors in androgenetic alopecia treatment of male patients: A network meta-analysis. JAMA Dermatol 2022; Feb 2:e215743. doi: 10.1001/jamadermatol.2021.5743. [Online ahead of print].
Gupta et al sought to determine the efficacy of three drugs used to treat androgenetic alopecia: minoxidil, dutasteride, and finasteride. The authors conducted a literature review to find studies of any dose and administration route of these three solutions. This network meta-analysis uncovered 848 articles; after additional screening, 23 studies were left for quantitative analyses. The endpoints were changes in terminal and total hair count after 24 weeks and 48 weeks. The mean age ranged from 22.8 years to 41.8 years. The most efficacious treatment was 0.5 mg/day of dutasteride, followed by 5 mg/day of oral finasteride, 5 mg/day of oral minoxidil, 2% topical minoxidil, and 0.25 mg/day of oral minoxidil.
COMMENTARY
There are multiple options for treating hair loss in men, all of which are efficacious to varying degrees. The potent antihypertensive drug minoxidil was found to cause hair growth, so clinicians largely abandoned prescribing the drug for hypertension and started recommending it to treat hair loss. Later, the 5-alpha reductase inhibitors (dutasteride and finasteride) used for prostatic hypertrophy were found to promote hair growth. Options in this class include finasteride and dutasteride. This work by Gupta et al can help clinicians guide patients concerned about hair loss toward the treatment that is most appropriate and effective.
Among three common treatments for male androgenic alopecia, the authors of a meta-analysis found 0.5 mg/day of dutasteride to be the most effective.
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