Treating Female Androgenetic Alopecia with Proscar and Avodart?

Hello Dr. Rassman,

Thank you for your ongoing commitment to hair loss! You are a Godsend, my friend.

I have female androgenetic alopecia (first uncoverd after using Accutane) diagnosed at age 27 by scalp biopsy. I began using regular Rogaine, only available at that time. I am now 41 and use an advance regimen of Xandrox 5% BID topically, Proscar 5 mg QD, Spironolactone 100 mg BID, Avodart 2.5 mg (just started two weeks ago) as well as Saw Palmetto, Stinging Nettle, Pygeum, Soy Isoflavones, as well as a few other things like Viviscal and use the Laser Comb every other day. I try to keep up with the latest advanced and spend a lot of time and resources keeping my hair on my head.

My question is there is conflicting information in the literature about the best birth control pill to take to help with adrogenetic alopecia. I currently take Desogen but have tried Ortho Cyclen, Ortho Tri-Cyclen and Yasmin. I use the American Hair Loss Associations guidelines now. Can you weigh in?

Also, any idea when there will be a topical growth modultor that keeps the follicles in anagen? I’ve seen Dr. Kevin J. McElwee of the University of Vancouver’s work with mice and it is facinating.

Your thoughts on these issues as well as any other advice is much appreciated. Take care and thanks in advance for your kind reply.

You are scaring me!

Finasteride currently does not have a FDA approval for use in women. Even if it did, Proscar (5mg finasteride) is a very high dose for androgenic alopecia and in the studies on men, it was shown that the 1mg dose was just as effective as the 5mg dose. That is why the recommended dose is 1mg for androgenic alopecia.

Avodart (dutasteride) is not FDA approved for the treatment of androgenic alopecia. There are many patients who still use Avodart for hair loss, but they typically do not use it in combination with Propecia or Proscar and I do not understand the logic for this therapy. Avodart has a very long half life (the time it take half of the drug to be cleared from the blood stream) measured in weeks or months (compared to a few hours for Propecia) and this makes its dosing a controversial issue because nobody really knows what the best dosage to use is. The most important factor for women taking these medication is its potential implication of cervical, uterine, ovarian, and breast cancer because of its hormonal interactions and its potential for birth defects (well proven in pregnancy).

General disclaimer that needs repeating — BaldingBlog is not meant to diagnose medical condition or give medical treatment plans or advise. It is meant to educate the general public on hair loss issues. Before taking or stopping any medication, please see your doctor and discuss any issues, but I can state categorically that you are on a plan that has little benefit in sight and great harm as a possible clinical outcome.