Comparitive Effectiveness and Finasteride Vs Serenoa Repens in Male Androgenetic Alopecia: A Two-Year Study

Abstract

The objective of this open label study is to determine the effectiveness of Serenoa repens in treating male androgenetic alopecia (AGA), by comparing its results with finasteride. For this purpose, we enrolled 100 male patients with clinically diagnosed mild to moderate AGA. One group received Serenoa repens 320 mg every day for 24 months, while the other received finasteride 1 mg every day for the same period. In order to assess the efficacy of the treatments, a score index based on the comparison of the global photos taken at the beginning (TO) and at the end (T24) of the treatment, was used. The results showed that only 38% of patients treated with Serenoa repens had an increase in hair growth, while 68% of those treated with finasteride noted an improvement. Moreover finasteride was more effective for more than half of the patients (33 of 50, i.e, 66%), with level II and III alopecia. We can summarize our results by observing that Serenoa repens could lead to an improvement of androgenetic alopecia, while finasteride confirmed its efficacy. We also clinically observed, that finasteride acts in both the front area and the vertex, while Serenoa repens prevalently in the vertex. Obviously other studies will be necessary to clarify the mechanisms that cause the different responses of these two treatments.Androgenetic alopecia (AGA) is a common form of scalp hair loss that affects up to 80% of elderly males (mostly over 60 years old). The onset ofAGA is extremely variable and the physical aspect is characterized by progressive miniaturization of scalp hair follicles (1, 2). Even though this condition is not considered a serious pathology, it is well known that loss of hair leads to stressful events for patients, often with considerable psychosocial consequences. Genetic factors and androgens playa major role in the pathogenesis of the disease. Polymorphism of the androgen receptor genes was first identified in association with androgenetic alopecia. These facts lead to different kinds of AGA patterns that often occur in members of the same families.Anamnesis and clinical examination can lead to the correct diagnosis of AGA, as well as a dermoscopy that can evidence the beginning of the miniaturization of the scalp hair follicles. The presence of more than 20% vellus-like hair in the androgen dependent areas can also lead to diagnosis of initial AGA (3-6).Minoxidil and finasteride are commonly used in treating AGA, both of which have FDA approval; dutasteride, a type I and II 5-alpha-reductase inhibitor, should also be considered and is currently in Phase

Efficacy of a Nutritional Supplement, Standardized in Fatty Acids and Phytosterols, on Hair Loss and Hair Health in both Women and Men

“…Cell cultures treated with Serenoa repens (Saw Palmetto, Serenoa repens, fruit fat-soluble extract (oil), ≥ 85.0% total fatty acids from NvH, Italy) 40 µg/ml, corresponding to 200 mg/day human dose, which is the most common dosage, used for hair reinforce food supplements [28].…”

Alternative Medicine for Hair Loss

“…After this period, only 38% of patients had an increase in hair growth. But, this improvement was lower than the group treated with finasteride (68% of patients) [62]. Satisfactory results were also observed after application of topical products containing S. repens extract for 24 weeks in male patients with AGA [65].…”

“…It is one of the herbal medicines that have inhibitory effect on both types 1 and 2 of 5α-reductase enzyme. In addition to inhibitory effect on 5α-reductase, S. repens may also decrease DHT uptake by hair follicle and decrease the binding of DHT to androgenetic receptors [62,63]. Anti-inflammatory effect has been demonstrated with a composition containing saw palmetto, carnitine, and thioctic acid in hair follicle keratinocytes [64].…”

Addressing Androgenetic Alopecia-A Complex Disorder-with a Multilateral Treatment Strategy

“…Supplementation with saw palmetto, via oral route, has shown beneficial effects in male subjects suffering from AGA. 39 Also, in a comparative study saw palmetto extract induced positive hair growth in 38% subjects in comparison to the control finasteride treated group, where improvements in hair growth were observed in 68% subjects. 40 Interestingly, the hair growth promoting effects of saw palmetto were limited to only vertex, whereas, both frontal and vertex areas showed improvements after finasteride treatment.…”

“…19 Constituents of saw palmetto extract have been reported to possess anti-androgenic activities by competitively blocking both type I and II 5α-reductase in indiscriminately manner. 39,40 This results in reduction in DHT influence on hair follicles. In addition, via estrogen receptor-mediated actions saw palmetto assists in maintenance and prolongation and of anagen phase.…”