Note: Women who are pregnant or may become pregnant should not use finasteride or Dutasteride or handle the crushed or broken tablets. Finasteride can cause birth defects in male babies.
Minoxidil
Mechanism of action. Through an unclear mechanism, minoxidil enhances hair growth by enlarging miniaturized hair follicles, extending anagen, and shortening telogen.
Finasteride
Finasteride, a competitive inhibitor of type II 5-alpha reductase, decreases production of dihydroxytestosterone. Oral finasteride reduces scalp dihydroxytestosterone levels by approximately 60% to 70%, depending on the dosage.
Finasteride has been shown to increase the hair count, physician-assessed hair coverage, and hair mass compared with placebo.
Finasteride can result in lower prostate-specific antigen levels in men, which should be taken into consideration when interpreting laboratory results. Due to hepatic metabolism of finasteride, precautions should be taken with patients with liver disease. With chronic treatment, finasteride may cause mild to moderate elevations in serum liver enzymes, but this is usually self-limiting and rarely requires dose modification or drug discontinuation.
Dutasteride
Dutasteride, a potent type I and type II 5-alpha reductase inhibitor, is used to treat benign prostatic hyperplasia, but is also prescribed as an off-label treatment for pattern hair loss.
Latanoprost
Latanoprost is a prostaglandin F2 analogue that extends the anagen phase. A double-blind, placebo-controlled, randomized trial in 16 men demonstrated an increase in hair density when latanoprost 0.1% was applied to a small area of the scalp.
Ketoconazole, zinc shampoo
Ketoconazole, an antifungal medication that has anti-inflammatory and antiandrogenetic properties was found to reduce inflammation in pattern hair loss and to benefit women with hyperandrogenemia and female pattern hair loss.
Spironolactone
Spironolactone competitively inhibits the androgen receptor and also inhibits ovarian production of androgens. Of the antiandrogen drugs used off-label, it is the one most commonly used. It has been used to treat female pattern hair loss for over 2 decades and has a good safety profile.