Hur effektivt är finasteridbehandling mot ärftligt manligt håravfall?

Sammanfattning: The most common form of hair loss in young and old people is androgenic alopecia. Hereditary hair loss affects both men and women. Hereditary hair loss in some women begins at the age of 30, but as a rule hair loss begins in post-menopausal women. In women the hair thins out in an oval portion of the front part of the scalp. In men, hair loss can start as early as at the age of 20. The hairline then starts to slowly creep upward along the temples and gives characteristic flaps, and on the scalp a bald spot appears that over time becomes larger and larger. Hereditary androgenic alopecia is caused by androgenic effects on the hair follicles causing the anagen phase to shorten and the telogen phase to extend while the hair follicle size decreases. Polymorphism in the androgen receptor has been linked to androgenic alopecia. Finasteride is a fat-soluble synthetic steroid originally intended for the treatment of benign prostatic hyperplasia (BPH). In 1992 it was approved for BPH-treatment and in 1997 it was approved for male pattern baldness. Finasteride inhibits the function of type ІІ 5-α-reductase, and therefore inhibits the conversion of testosterone to dihydrotestosterone(DHT). The purpose of this study was to examine the effectiveness of finasteride treatment against hereditary male pattern baldness. Six studies on finasteride were selected from searching the database PubMed in february 2013. To get the most relevant results the search terms "finasteride alopecia" were used. Out of 42 hits, six articles were selected. Only articles with clinical testing on humans were selected. The articles included in this study demonstrate that finasteride treatment slows the development of hair loss and increases hair growth. Increased hair growth, however, requires long-term treatment. After one year of treatment, or longer, with finasteride 1 mg daily the increase in hair growth is of the order 7-10% more hairs than at the beginning of the treatment. A larger increase in hair weight suggests that the treatment also increases the thickness and/or the length of hairs. Men 18-19 have been treated with finasterid in the studies. The concentration of DHT was decreased by finasteride treatment in all studies. Adverse reactions include decreased libido, erectile difficulty, ejaculation problems and depression can occur in fewer than 1 in 100 people which was also mentioned in the studies.