Topical Finasteride versus Topical Spironolactone in the Treatment of Androgenetic Alopecia

Document Type : Original Article


The Department of Dermatology and Venereology, Faculty of Medicine, Zagazig University, Egypt* and Tripoli University, Libya**


Abstract Background: Androgenetic Alopecia (AGA) is a non-scarring alopecia that affects both males and females. It is characterized by a progressive miniaturization of hair follicles with a characteristic pattern distribution in genetically predis-posed men and women. Topical finasteride is being investigated as a new treatment for AGA with fewer side effects than oral finasteride. Topical Spironolactone is the most commonly used off-label anti-androgen for the treatment of AGA. In the treatment of AGA, it acts by decreasing the production and competitively blocking the androgen receptor in the target tissue. Aim of Study: The aim of this study was to evaluate the role and compare the effect of topical finasteride and topical spironolactone in the treatment of (AGA). Patients and Methods: After meeting inclusion and ex-clusion criteria and diagnosis of AGA was clinically established by the characteristic distribution of frontal and vertex hair in males and the Christmas tree pattern of diffuse hair loss at middle hairline in females. It was dermosopically established by the characteristic hair shaft thickness heterogeneity, peripilar brown depressions (peripilar signs) and focal atrichia and also folliscope established for hair density. Cases included in this study had Norwad-Hamilton Scale types I to VII for men and Ebling Scale types I to IV for women. Result: Our study shows that a topical spironolactone is better than topical finasteride in male and female group. Conclusion: In this study, topical finasteride and topical spironolactone are good options for management of androgenic alopecia but topical spironolactone is better than topical finasteride with few side effects when compared to oral administration.