Anti-androgen therapy for the treatment of female pattern hair loss: a clinical review of current and emerging therapies.

Androgenetic alopecia (AGA) is the most common hair loss type in women, but topical minoxidil is the only Food and Drug Administration-approved treatment option. The pathophysiology involves shortened anagen phases, lengthened telogen phases, and hair follicle miniaturization.

Androgens, particularly dihydrotestosterone, play a crucial role in male AGA pathogenesis, but their exact role in female pattern hair loss (FPHL) is unclear. Oral anti-androgens demonstrate some efficacy in women, albeit with considerations for side effects and contraindications.

Topical anti-androgens may be used in combination with topical minoxidil or as alternatives to oral medications, likely with fewer systemic adverse effects.

Patient-specific factors, including age, signs of hyperandrogenism, or need for contraception may help determine which anti-androgen therapy is most appropriate.

This review focuses on current anti-androgen treatments for FPHL available in the US and their limitations, as well as emerging treatments that are investigational, studied in other hair loss types, or available in other countries.