Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/542
Title: Treatment of female pattern hair loss with oral antiandrogens.
Epworth Authors: Sinclair, Rodney
Other Authors: Wewerinke, M.
Jolley, D.
Keywords: Androgenetic Alopecia
Alopecia, Androgenetic
Androgenic Alopecia
Baldness
Female Pattern Baldness
Cyproterone Acetate
Spironolactone
Female
Dermatology
Female Pattern Hair Loss
FPHL
Oral Antiandrogen Therapy
Chair of Dermatology, Epworth HealthCare, Victoria, Australia
Head & Neck Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Mar-2005
Publisher: Wiley-Blackwell
Citation: British Journal of Dermatology. 2005 Mar;152(3):466-73.
Abstract: BACKGROUND: It has not been conclusively established that female pattern hair loss (FPHL) is either due to androgens or responsive to oral antiandrogen therapy. OBJECTIVES: To evaluate the efficacy of oral antiandrogen therapy in the management of women with FPHL using standardized photographic techniques (Canfield Scientific), and to identify clinical and histological parameters predictive of clinical response. METHODS: For this single-centre, before-after, open intervention study, 80 women aged between 12 and 79 years, with FPHL and biopsy-confirmed hair follicle miniaturization [terminal/vellus (T/V) hair ratio < or = 4 : 1] were photographed at baseline and again after receiving a minimum of 12 months of oral antiandrogen therapy. Forty women received spironolactone 200 mg daily and 40 women received cyproterone acetate, either 50 mg daily or 100 mg for 10 days per month if premenopausal. Women using topical minoxidil were excluded. Standardized photographs of the midfrontal and vertex scalp were taken with the head positioned in a stereotactic device. Images were evaluated by a panel of three clinicians experienced in the assessment of FPHL, blinded to patient details and treatment and using a three-point scale. RESULTS: As there was no significant difference in the results or the trend between spironolactone and cyproterone acetate the results were combined. Thirty-five (44%) women had hair regrowth, 35 (44%) had no clear change in hair density before and after treatment, and 10 (12%) experienced continuing hair loss during the treatment period. Ordinal logistic regression analysis to identify predictors of response revealed no influence of patient age, menopause status, serum ferritin, serum hormone levels, clinical stage (Ludwig) or histological parameters such as T/V ratio or fibrosis. The only significant predictor was midscalp clinical grade, with higher-scale values associated with a greater response (P = 0.013). CONCLUSION: Eighty-eight percent of women receiving oral antiandrogens could expect to see no progression of their FPHL or improvement. High midscalp clinical grade was the only predictor of response identified. A placebo-controlled study is required to compare this outcome to the natural history of FPHL.
URI: http://hdl.handle.net/11434/542
DOI: DOI: 10.1111/j.1365-2133.2005.06218.x
PubMed URL: http://www.ncbi.nlm.nih.gov/pubmed/15787815
ISSN: 0007-0963
1365-2133
Journal Title: British Journal of Dermatology
Type: Journal Article
Affiliated Organisations: University of Melbourne Department of Dermatology, St Vincent's Hospital, Fitzroy, Melbourne, Victoria, Australia.
Type of Clinical Study or Trial: Comparative Study
Appears in Collections:Head & Neck
Dermatology

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