Hair Loss Treatment with Anti-Androgens

Hair loss, in many cases, is believed to be androgen-dependent.Considered as the common baldness, the condition called androgenetic alopecia or pattern baldness is triggered by the build-up of the androgen dihydrotestosterone (DHT) in the hair follicles in the scalp.DHT is the chemical derivative of testosterone through the enzyme type II 5-alpha reductase (5-AR). Because of this androgenic nature, several anti-androgen therapies are devised to manage AGA in both men and women.Anti-androgens block the biological effects of androgens on responsive tissues. Anti-androgens work by (1) blocking the hormone receptors, (2) restricting androgen production, or (3) competing for binding sites on the cell’s surface. Anti-androgens vary, mostly depending on the gender.The following anti-androgen therapies are mostly helpful in the treatment of AGA:    * FinasterideOnly prescribed to men and postmenopausal women, finasteride is a popular anti-androgen therapy for hair loss which is FDA-approved. Finasteride is an orally-administered corrective hair loss treatment that works at a molecular level.Finasteride is a selective inhibitor of type II 5-alpha reductase, the enzyme responsible for the conversion of testosterone into DHT. Because it can cause birth defects to a male fetus, finasteride is contraindicated in women.The side effects of finasteride include loss of libido and erectile dysfunction. It is also reported that it increases the risk of men developing high-grade prostate cancer.    * DutasterideDutasteride is the other drug that works more or less like finasteride. The main difference between the two is that dutasteride is not a selective inhibitor. It blocks type I and type II of the 5-AR enzyme.It is also not approved by the FDA as a pattern hair loss treatment. Dutasteride produces the same side effects as finasteride does.    * SpironolactoneConsidered as the “king of anti-androgens,” spironolactone is a diuretic pill that has very strong anti-androgenic properties. It prevents DHT from binding with the androgen receptors on the hair follicles.It also obstructs the production of testosterone which is why it is rarely prescribed in men. Reducing testosterone levels reduces DHT levels simultaneously. When used in men, it can cause impotence and breast enlargement.    * Cyproterone AcetateCyproterone acetate also contains anti-androgenic properties that work best in women with hirsutism and hair loss. It blocks the androgen receptors in the follicles from binding with DHT. Administering estrogen therapy may be necessary in conjunction with cyproterone acetate.It may produce the same side effects as spironolactone does when used in men. Liver toxicity is one of the serious side effects of this hair loss treatment.