Treatment Of Idiopathic Hirsutism Research Articles

The effect of topical finasteride in treatment of idiopathic hirsutism

Hirsutism relatively is a common medical problem and an important influence on about 5-10% of women of reproductive age. Fifty five female shares in the study, seventeen of them did not continue the study, therefore we evaluated 38 females, aged 18-52 years old. In our study we compared pre-treatment and post-treatment for the color of the hairs and the hair removal frequency and the pain during hair removal for four groups which are good response group and moderate response group and mild response group and no response group, by subjective evaluation of all the patients noted a diminished rate of hair growth (fewer times needed for shaving) and a decrement in the density of hairs on the chin area and change in color of the hair but there was no significant difference between groups regarding hair color and there were highly significant difference in hair removal frequency before and after treatment (P<0.001) when we used finasteride cream 1% for 3 months. Six months of topically applied finasteride (0.5%) does not effect on number and thickness of facial hirsutism significantly. Despite lack of objective changes, on questioning, most patients in finastride group perceived a decrease in hair growth with time.

Evaluation of Topical Capislow Extract and Long Pulsed Nd-YAG Laser in the Treatment of Idiopathic Hirsutism.

Introduction: Hirsutism is a condition that affects 10% of women worldwide. In many cultures, hirsutism is regarded as loss of femininity and can be psychologically traumatizing to the suffering females. The aim of the present study was to evaluate how topical capislow would affect or enhance the efficacy of laser hair removal. Methods: A randomized, monoblinded, placebo controlled split face study of combined topical capislow and long pulsed Nd-YAG laser on one side of the face versus long pulsed Nd-YAG laser alone on the opposite side of the face. Laser sessions were done at 4 weeks interval for maximum seven sessions. Topical capislow and placebo were applied once daily from the day of the first laser session to the day of the last laser session. Patients were evaluated both subjectively and objectively in each laser session and for six months after the last laser session. Results: Both treatment modalities were well tolerated and accepted with significantly better results in combined capislow and laser group versus laser alone. Conclusion: Topical capislow can represent a safe and effective synergistic method for laser with faster results but this is a temporary effect retained only to the time of its application.

The effect of topical finasteride in treatment of idiopathic hirsutism

The effect of topical finasteride in treatment of idiopathic hirsutism

Preparation and clinical evaluation of Finastride gel in the treatment of idiopathic Hirsutism

Objective:Hirsutism is the presence of excess terminal hairs in females in a male-like pattern. The most accepted hypothesis for the development of hirsutism is increased 5α-reductase activity in hair follicles of hirsute women. Finasteride partially blocks the conversion of testosterone to dihydrotestosterone through inhibition of 5α-reductase in hair follicles. This study was designed to determine the efficacy of finasteride gel 0.25% in management of idiopathic hirsutism and treatment of hirsutism with topical finasteride to lessen the side-effects.Methods:Women after puberty that have idiopathic hirsutism criteria are divided randomly in two groups; treatment and control. The number of patients in each group is 15 and received finasteride and placebo gel once a day on their skins. The patients were visited every month by a dermatologist and the amount of response to the treatment and the patient satisfaction was recorded. Ferriman–Gallwey score of the treated area was determined.Results:After 6-months, mean thickness hairs in treating group were decreased from 102.00 ± 9.58 µm to 86.4 ± 11.4 µm (p < 0.05), this difference was statistically significant. Gel application did not indicate any type of side-effects.Limitations:Inclusion and exclusion criteria.Conclusion:Finasteride partially blocks 5α-reductase. Because of the good absorption through the skin and good solubility of this medicine, the prepared gel formulation applied on the hirsutism area showed a significant decrease in hair growth locally, so finasteride gel is an efficient and harmless therapy in patients with idiopathic hirsutism.

Complementary Therapies for Idiopathic Hirsutism: Topical Licorice as Promising Option.

Hirsutism is one of the most prevalent health problems in women. The aim of the study was to compare the effect of 755 nm alexandrite hair removal laser with that of alexandrite laser plus topical licorice on the improvement of idiopathic hirsutism. A double-blind, randomized placebo-controlled study was performed on 90 female subjects. The patients were divided into two groups: alexandrite laser plus 15% licorice gel (group A) and placebo (group B). Each subject received one of both products over one side of the face, twice daily for 24 weeks on the hirsute locations. Each group underwent five sessions of alexandrite laser at 6-week intervals. To minimize the effects of confounding variables, the test was performed on two separate zones of patients' skin. The mean ± SD numbers of terminal hairs in group A were 7.05 ± 4.55 for zone 1 and 6.06 ± 3.70 for zone 2. In group B, they were 3.18 ± 1.75 for zone 1 and 2.49 ± 1.63 for zone 2. The difference in the mean number of terminal hairs was statistically significant between the two groups (p < 0.001), and there were no serious adverse reactions. The treatment of idiopathic hirsutism with 755 nm alexandrite laser plus topical licorice is more effective than alexandrite laser only.

UPDATE ON IDIOPATHIC HIRSUTISM: DIAGNOSIS AND TREATMENT

Idiopathic hirsutism (IH) is defined as hirsutism in conjunction with normal ovulatory function and normal serum androgen levels. The pathogenesis of IH is still not clear. Increased peripheral 5α-reductase enzyme activity and abnormalities of androgen receptor gene polymorphisms have been postulated to explain the pathogenesis of this disorder. It is diagnosed in women who have hirsutism, normal ovulatory function, and normal levels of serum total or free testosterone. Combination treatment of IH, including androgen suppression, peripheral androgen blockade and cosmetic methods is most effective.

Clinical Efficacy of Low Dose Flutamide plus Diane-35 in the Treatment of Idiopathic Hirsutism and Polycystic Ovary Syndrome

Idiopathic hirsutism (IH) or polycystic ovary syndrome (PCOS) are the most common causes of hirsutism which affects 5-10% of all women. The aim of this study was to evaluate the efficacy of flutamide plus diane 35 in the treatment of idiopathic hirsutism and polycystic ovary syndrome. 26 polycystic ovary syndrome and 24 idiopathic hirsutism patients were evaluated. Fifty patients were divided into two groups according to their diagnosis: idiopathic hirsutism or polycystic ovary syndrome. All patients received 125 mg Flutamide once a day and Diane 35 tablets for 21 days of each month, for 12 months. We measured hirsutism scores and hormonal levels of all patients. Evaluations were done before treatment, in the 6th and 12th months of therapy. There were no significant differences in Ferriman-Gallwey scores at the beginning and at the end of the therapy between the IH and PCOS groups. The decreases in Ferriman-Gallwey scores were significant in both groups in the 6th and 12th month of therapy. Combined treatment significantly decreased total and free testosterone, DHEAS and significantly increased SHBG levels in both groups and additionally decreased levels of LH, androstenodione and LH/FSH ratio in the polycystic ovary syndrome group. Combined treatment was effective and safe in the treatment of hirsutism. Combined regimens have additional effects on the treatment of hirsutism.

Comparison of the clinical efficacy of flutamide and spironolactone plus Diane 35 in the treatment of idiopathic hirsutism: a randomized controlled study

To compare the effectiveness of flutamide and spironolactone plus Diane 35 in the treatment of idiopathic hirsutism (IH). Prospective randomized clinical study. Social Security Agency, Aegean Obstetrics and Gynecology Teaching Hospital, Department of Reproductive Endocrinology and Infertility, a tertiary referral center. Eighty women with IH who had been admitted to our center. Patients were randomly and equally assigned to receive flutamide (250 mg/d for the first 10 days of the cycle) and spironolactone plus Diane 35 (spironolactone 100 mg/d; Diane 35 is a combination tablet of 2 mg cyproterone acetate and 35 microg ethinylestradiol/d) for 9 months. Modified Ferriman-Gallwey (F-G) score and hormonal profile before treatment and at the end of treatment. In spite of the fact that there were no statistically significant differences in modified F-G scores in between the two groups, a significant decrease in modified F-G scores was observed in the flutamide (from 19.93 +/- 4.31 to 15.58 +/- 4.28) and spironolactone plus Diane 35 (from 18.77 +/- 3.76 to 14.54 +/- 3.29) groups. There were also no differences between the two groups with respect to hormonal profiles including serum FSH, LH, free T, 17-OH-progesterone, and DHEAS levels. No major side effect, including liver toxicity, was observed in either group. Our data suggest that both therapies have similar effectiveness in the treatment of IH.

Use of cyproterone acetate, finasteride, and spironolactone to treat idiopathic hirsutism

Objective To compare the effectiveness of cyproterone acetate, finasteride, and spironolactone in the treatment of idiopathic hirsutism. Design Prospective randomized clinical study. Setting University hospital. Patient(s) Forty-one women (median age, 21 years [range, 18–34 years]) with idiopathic hirsutism who had requested to use an oral contraceptive. Intervention(s) Patients were randomly assigned to receive cyproterone acetate (12.5 mg/d for the first 10 days of the cycle), finasteride (5 mg/d), or spironolactone (100 mg/d) for 12 months. Follow-up was done at the end of therapy. Main outcome measure(s) Ferriman–Gallwey score before treatment, at 6 and 12 months of treatment, and 1 year after the end of treatment, and androgenic profile before and after treatment. Result(s) At the end of therapy, the Ferriman–Gallwey score decreased by 38.9%, 38.6%, and 38.5% in patients who used cyproterone acetate, finasteride, and spironolactone, respectively. One year after therapy, the Ferriman–Gallwey score of patients who used spironolactone was significantly lower (6.74 ± 1.41) than that of patients who used either cyproterone acetate (7.92 ± 1.08), or finasteride (9.08 ± 0.99). The androgenic profile did not change significantly during treatment. Conclusion(s) In patients with idiopathic hirsutism, the short-term results of treatment with cyproterone acetate, finasteride, and spironolactone are similar, but spironolactone is effective for a longer time.

Comparison of finasteride and flutamide in the treatment of idiopathic hirsutism

Objective: To compare the effectiveness of finasteride and flutamide in the treatment of idiopathic hirsutism. Design: Randomized study. Setting: Department of Gynecological Endocrinology, University of Brescia, Italy. Patient(s): Forty-six women with idiopathic hirsutism were selected. Intervention(s): Patients were assigned randomly to receive 5 mg of finasteride once daily or 250 mg of flutamide twice daily for 12 consecutive months. Main Outcome Measure(s): Hirsutism was evaluated at 6 and 12 months of therapy by measuring the Ferriman-Gallwey score and the terminal-hair diameters (μm) taken from different body areas. Blood samples were taken and side effects were monitored during the treatment. Result(s): Both finasteride and flutamide induced a statistically significant decrease in hirsutism scores and hair diameters at the end of 12 months. Finasteride reduced the Ferriman-Gallwey score by 20.5% at 6 months and by 34.2% at 12 months, and hair diameter by 18.9%–23.6% at 6 months and by 29.6%–37.9% at 12 months. Flutamide reduced the Ferriman-Gallwey score by 26.6% at 6 months and by 50.9% at 12 months, and hair diameter by 22.3%–28.2% at 6 months and by 47.7%–56.5% at 12 months. Flutamide did not induce hormonal variations, whereas finasteride increased T levels by 60% and decreased 3α-androstanediol glucuronide by 69.5% at 12 months. Conclusion(s): Both drugs were effective in the treatment of idiopathic hirsutism, but flutamide was more effective than finasteride.

Effect of finasteride in idiopathic hirsutism.

Increased 5 alpha-reductase activity has been found in hair follicles of hirsute women, suggesting a pathogenetic role. The aim of the present study was to evaluate the effect of finasteride in the treatment of idiopathic hirsutism. Twenty-seven women with idiopathic hirsutism, aged 16-35 years, were treated for 6 months with finasteride, 5 mg once daily. Fourteen patients were on finasteride alone (group A), while the remaining received in addition an oral contraceptive (group B). Clinical, hormonal and biochemical evaluation were performed before, and after 3 and 6 months of treatment. Clinical evaluation was repeated 6 months after drug discontinuation in seven patients. Treatment was well tolerated by all patients; no side effects or adverse reactions were reported. A significant improvement of hirsutism was obtained by finasteride; clinical score observed at the 6th month of therapy was reduced from 11.71 +/- 2.23 to 7.92 +/- 1.81 (p < 0.05) and from 14.92 +/- 6.13 to 9.3 +/- 2.75 (p < 0.05) in group A and B, respectively. Clinical score in seven patients was still 8.61 +/- 2.28 (p < 0.05) 6 months after the end of therapy. Finasteride treatment alone (group A) induced a slight increase, though not significant, in serum androgens; DHT and SHBG did not change. In group B (finasteride plus oral contraceptive) total testosterone and free testosterone showed no significant decrease; after 6 months of therapy DHT was reduced significantly, while SHBG levels were increased. These data demonstrate that 5 alpha-reductase inhibition may be an effective treatment in women suffering from idiopathic hirsutism. This approach may be attractive due to the absence of adverse reactions, although the necessity of an adequate contraception should be kept in mind.

Comparison of finasteride versus spironolactone in the treatment of idiopathic hirsutism

Objective: To compare the efficacy of finasteride and spironolactone in the treatment of idiopathic hirsutism. Design: Prospective, randomized, single-blind study. Setting: A tertiary hirsutism clinic. Patient(s): Forty women with idiopathic hirsutism were selected. Intervention(s): Patients were assigned randomly to receive either 5 mg of finasteride or 100 mg of spironolactone for 9 months. Main Outcome Measure(s): Hirsutism scores were measured according to the Ferriman-Gallwey scoring system, and side effects were monitored for 9 months of treatment. Blood samples were taken at each visit for assessment of endocrine, biochemical, and hematologic parameters. Result(s): Hirsutism scores were decreased significantly in both groups at the end of 9 months. The mean percent change (±SD) in hirsutism scores in the finasteride and spironolactone groups was as follows: 5.91% ± 7.18% and 20.60% ± 12.59% at 3 months, 10.61% ± 12.18% and 32.57% ± 15.68% at 6 months, and 15.15% ± 15.38% and 42.36% ± 12.31% at 9 months, respectively. There was a significantly better response with spironolactone treatment at the end of 9 months. Eleven (55%) of 20 patients in the spironolactone group experienced side effects. However, none of them stopped treatment because of side effects. Conclusion(s): The present data suggest that both finasteride and spironolactone are effective in the treatment of idiopathic hirsutism. However, it appears that the spironolactone group responded significantly better.

FC055 Comparison of finasteride versus spironolactone in the treatment of idiopathic hirsutism

FC055 Comparison of finasteride versus spironolactone in the treatment of idiopathic hirsutism

Finasteride in the Treatment of Hirsutism

Objective To determine of the clinical and hormonal effects of finasteride (Proscar; Merck, Sharp, and Dohme, Rahway, NJ) in the treatment of idiopathic hirsutism and hirsutism in patients with polycystic ovary syndrome (PCOS). Design Controlled clinical study. Setting Istitute of Obstetrics and Gynecology, University of Naples Federico II. Patients Ten women affected by idiopathic hirsutism and 15 women with PCOS. Interventions Finasteride was administered orally at a daily dose of 5mg for a period of 6 months. Main Outcome Measures Rating of hirsutism with the Ferriman-Gallwey method; serum androgen assays. Results Finasteride produced a reduction in the average hirsutism scores (>50% in all patients), whereas no change was observed in serum T, androstenedione, and DHEAS levels. A significant reduction was measured in serum dihydrotestosterone and 3 α ,17 β -androstenediol glucuronide levels. Conclusions This study demonstrates that symptomatic hirsutism has to be considered as a skin disease associated with the increased activity of the 5 α -reductase. It also indicates that the selective 5 α -reductase inhibitor, finasteride, is very effective and well tolerated in the treatment of both idiopathic hirsutism and of hirsutism in patients with PCOS.

Finasteride in the treatment of hirsutism: new therapeutic perspectives

To determine of the clinical and hormonal effects of finasteride (Proscar; Merck, Sharp, and Dohme, Rahway, NJ) in the treatment of idiopathic hirsutism and hirsutism in patients with polycystic ovary syndrome (PCOS). Controlled clinical study. Istitute of Obstetrics and Gynecology, University of Naples "Federico II." Ten women affected by idiopathic hirsutism and 15 women with PCOS. Finasteride was administered orally at a daily dose of 5 mg for a period of 6 months. Rating of hirsutism with the Ferriman-Gallwey method; serum androgen assays. Finasteride produced a reduction in the average hirsutism scores ( > 50% in all patients), whereas no change was observed in serum T, androstenedione, and DHEAS levels. A significant reduction was measured in serum dihydrotestosterone and 3 alpha, 17 beta-androstenediol glucuronide levels. This study demonstrates that symptomatic hirsutism has to be considered as a skin disease associated with the increased activity of the 5 alpha-reductase. It also indicates that the selective 5 alpha-reductase inhibitor, finasteride, is very effective and well tolerated in the treatment of both idiopathic hirsutism and of hirsutism in patients with PCOS.

Predominant expression of 5 alpha-reductase type 1 in pubic skin from normal subjects and hirsute patients.

Dihydrotestosterone (DHT), the 5 alpha-reduced metabolite of testosterone, is the active molecule triggering androgen action, and 5 alpha-reductase (5 alpha-R), the enzyme converting testosterone to DHT, is a key step in this mechanism. Skin, like prostate, is a DHT- dependent tissue. Our laboratory demonstrated, many years ago, that 5 alpha-R in external genitalia was not regulated by androgens, whereas it was androgen dependent in public skin. As two genes, 5 alpha-R types 1 and 2, encoding for 5 alpha-R enzymes have been recently cloned, we undertook the present study to determine whether the two enzymes we had postulated on the basis of regulation studies were coincident with the cloned isoforms. The expression of the two isoforms was studied in genital and pubic skin fibroblasts from normal men, normal women, and hirsute patients. Messenger ribonucleic acid analysis, using Northern blot and RT-PCR techniques, indicated that both 5 alpha-R1 and -2 messenger ribonucleic acids are expressed in genital skin as well as in public skin fibroblasts. In contrast, studies using specific inhibitors of 5 alpha-R1 (LY306089) and 5 alpha-R2 (finasteride) showed that 5 alpha-R2 is predominant in pubic skin of normal men, normal women, and hirsute patients. These data raise the question of the possible use of specific 5 alpha-R1 inhibitors in the treatment of idiopathic hirsutism.

Clinical and Hormonal Effects of the 5 alpha-Reductase Inhibitor Finasteride in Idiopathic Hirsutism

Hyperactivity of 5 alpha-reductase in the skin is considered a major mechanism of excessive hair growth in hirsute women with normal levels of serum androgens (idiopathic hirsutism). Preventing the conversion of testosterone to dihydrotestosterone by inhibiting 5 alpha-reductase activity could thus be the most rational and effective treatment in this condition. The present study evaluated the effects of the oral administration of finasteride (5 mg once daily) for 6 months in 17 young women with idiopathic hirsutism, 5 of whom were also given an oral contraceptive. The degree of hirsutism (graded by a modified Ferriman-Gallwey score), serum sex hormone levels, and serum and urinary 5 alpha-metabolism steroid profiles were determined basally and periodically during the treatment period. The modified Ferriman-Gallwey score showed a remarkable reduction after 6 months of finasteride treatment (5.9 +/- 0.6 vs. 11.7 +/- 1.3; P < 0.01). Serum 5 alpha-dihydrotestosterone and 3 alpha-androstanediol glucuronide levels were decreased, and urinary C19 and C21 5 beta/5 alpha metabolite ratios were increased compared with pretreatment values. No significant adverse effect was reported. In women treated with finasteride and oral contraceptive, clinical efficacy was slightly more pronounced. In conclusion, the 5 alpha-reductase inhibitor finasteride is well tolerated and seems to be a useful tool in the treatment of idiopathic hirsutism.

Serum androgens and psychopathology in hirsute women.

Twenty consecutive women referred for evaluation and treatment of idiopathic hirsutism were evaluated with regard to levels of serum androgens, degree of hirsutism, nature and prevalence of psychological symptoms, and mood and affects. Androgens measured were total testosterone, free testosterone, biologically active testosterone, dehydroepiandrosterone, dehydroepiandrosterone sulfate and androstenedione. Psychological symptoms were quantified via the Derogatis Symptom Inventory, and mood and affects were measured by the Affects Balance Scale. Results revealed very significant correlations between unbound fractions of testosterone (i.e. free and biologically active testosterone) and both symptom and mood measures of depression (r = 0.60; p < 0.01). Significant inverse correlations were also observed between unbound fractions of testosterone and positive affects measures (e.g. 'contentment' r = -0.51; p < 0.05). Correlations between total testosterone and psychological variables were non-significant in all instances. Measures of degree of hirsutism correlated approximately zero (o) with psychological symptom and mood measures in this sample. When psychiatric 'caseness' criteria were applied to the cohort, seven of the 20 women (35%) were found to be positive. Results are interpreted to suggest that depression among hirsute women appears more likely to have its basis in a deranged neuroendocrine mechanism than in psychosocial causes.

Spironolactone in the treatment of idiopathic hirsutism and the polycystic ovary syndrome.

Forty-eight hirsute women were treated with spironolactone 100 mg twice daily for 3 to 12 months. Both facial and body hirsuties improved by 30-40%, and there was a threefold reduction in frequency of local treatments such as waxing or shaving. Plasma testosterone fell by 30%, though the improvement in hirsuties grading did not correlate with the fall in plasma testosterone. Six subjects discontinued treatment because of lack of effect, and 4 because of menstrual disturbance. Spironolactone was equally effective in the treatment of idiopathic hirsutism and of the polycystic ovary syndrome.

Treatment of idiopathic hirsutism with spironolactone.

The effect of spironolactone in a low dose (50 mg/day) on hirsutism in 21 women was investigated in an open study. A beneficial effect of treatment was obtained in 15 patients (71%).