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Finasteride/ hormonal levels/ age / response

Br J Dermatol. 2008 May;158(5):1121-4

Value of hormonal levels in patients with male androgenetic alopecia treated with finasteride: better response in patients under 26 years old.

Finasteride is a 5alpha-reductase inhibitor that has proved to be an effective treatment for men with androgenetic alopecia.

To investigate the hormonal influence of finasteride 1 mg daily on hormonal levels and hair growth in men of different ages and with different degrees of alopecia according to the Hamilton-Norwood scale.

Two hundred and seventy men aged 14-58 years with male androgenetic alopecia III-VI Hamilton-Norwood score (II-III Ebling score) were treated with finasteride 1 mg daily. Steroid hormone (free testosterone, 5alpha-dihydrotestosterone, dehydroepiandrosterone-sulphate, delta4-androstenedione, 17-hydroxyprogesterone), prostate-specific antigen (PSA) and sebum levels, and trichogram changes were determined at baseline, and at 6 and 12 months of treatment.

According to significant hormonal statistical analysis, the patients were divided by age (up to or over 26 years). In the group of patients </= 26 years, higher levels of 5alpha-dihydrotestosterone were found at the beginning of the treatment, but there was a 50% decrease between the onset of treatment and month 12, particularly noticeable at 6 months (P < 0.05) of treatment, running parallel to an improvement of the alopecia and an increase of anagen hairs in the trichogram. At 1 year, PSA levels decreased 20%, particularly in patients > 26 years. No variations in sebum levels were observed.

High levels of 5alpha-dihydrotestosterone in patients </= 26 years at the beginning of treatment are a predictive factor of good response to treatment with finasteride 1 mg daily.

Only information in there:
No change in sebum secretion. So the putative link between the amount of DHT and the amount of sebum might be a tale. And itching as well…

» Only information in there:
» No change in sebum secretion. So the putative link between the
» amount of DHT and the amount of sebum might be a tale.

You’re making too big an assumption. The most likely explanation for the lack of effect of finasteride on sebum secretion isn’t that DHT doesn’t have anything to do with sebum, it’s that finasteride doesn’t have any effect on the 5a-reuctase type 1 enzyme within the sebaceous glands.


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