Comparing the therapeutic efficacy of topical minoxidil and finasteride with topical minoxidil and oral finasteride in androgenetic alopecia: a randomized trial

Background: There is an increased interest in the development and use of topical finasteride for treating androgenic alopecia (AGA) due to growing evidence of side effects from oral finasteride. In this study we aimed to compare the treatment outcomes of topical 5% minoxidil with 0.1% finasteride and topical 5% minoxidil with oral 1 mg finasteride. Methods: 50 patients of stage III and IV of Hamilton-Norwood scale were randomly assigned to either Group A receiving topical 5% minoxidil and oral finasteride 1 mg and Group B receiving topical 5% minoxidil and topical 0.1% finasteride. After taking uninterrupted treatment for 12 months, patients were assessed for hair regrowth and maintenance using global photography and trichoscopy and compared with baseline parameters. Patients in both the groups were assessed for any adverse effects as well. Results: At baseline, patients in both the treatment groups were similar with respect to their age at the time of presentation, family history of hair loss and Hamilton Norwood scale. In group A, three discontinued treatment and of the rest 65% maintained a good hair density and reduced hairfall. In group B, five discontinued treatment, of the rest 83% patients demonstrated good improvement in hair density (p<0.05). Conclusions: The results of this study strongly support the use of topical finasteride in combination with topical 5% minoxidil for AGA and this may obviate the need of taking long term oral finasteride.