Androgenetic alopecia or female pattern hair loss is a very common condition in women, generally…

Androgenetic alopecia or female pattern hair loss is a very common condition in women, generally presenting from the age of 40 years on. It affects 40% of the women over 70 years of age, and may already be noted in adolescent females. To most of the affected women, the baldness is perceived as a major cosmetic inconvenience and a significant psychological problem.

The effectiveness of finasteride in arresting hair loss due to androgenetic alopecia in women has been the subject of three prospective randomized controlled trials (RCTs), all of which concluded that the drug was ineffective. A recent Cochrane systematic review on the treatment of androgenetic alopecia in women concluded that these three RCTs were associated with a high risk of bias, and therefore could not be used to support recommendations in clinical guidelines on this subject. Moreover, the effect measure chosen, i.e. increase of hair density, and the short duration of the studies up to a maximum of 18 months further diminish their value for use in supporting clinical decision making. Clinical studies with designs other than a randomized controlled trial were not considered in this Cochrane review, yet these publications contain support for the effective and safe use of finasteride and dutasteride.