Review of selected endpoints in studies evaluating the effectiveness and efficacy of topical finasteride use for androgenetic alopecia

Abstract

Androgenetic alopecia (AGA) is a disorder that worsens over the time. A metabolite of testosterone called dihydrotestosterone is implicated in the pathogenesis of AGA by exerting its effect on genetically predisposed hair follicles. Oral finasteride (FNS) targets this enzymatic step and is one of the two approved medications for the condition, the other one being topical minoxidil. This paper aimed to dissect the current literature on the endpoints chosen to measure the efficacy and effectiveness of using topical FNS for managing AGA. PubMed database was searched from October to November 2021 with the following terms including (\"Finasteride\"[Title] OR \"Finasteride\"[MeSH Terms]) AND (\"Local\"[Title] OR \"Topical\"[Title]). All human studies that investigated the use of topical FNS for AGA were included. Following the initial abstract scanning, studies that only investigated animal objects were excluded. Additionally, studies that did not have at least one clinical endpoint were overlooked. This review highlighted the available tools of hair evaluation in the reviewed literature. Objective tools represent the majority. These assessment methods were inconsistently applied across the reviewed studies, which as discussed earlier led to results that are hard to combine statistically. Considering these observations, future investigators are encouraged to make use of validated and standardized methods. Despite their growing significant subjective measures of hair growth on the other hand were not included in all the investigations.