Finasteride and sexual side effects

Mysore, Venkataram

doi:10.4103/2229-5178.93496

Cited by 55 publications

(43 citation statements)

References 16 publications

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“…As of today, more than twenty light‐based devices based on photobiomodulation have been safety‐cleared to market by the FDA for the management of hair regrowth . What is truly fascinating about light‐based therapy is that not only is its efficacy reported to be similar to that of existing FDA‐approved drugs for hair growth (i.e minoxidil and finasteride), but that it may even be superior being inherently free of potential side effects .…”

Section: Introductionmentioning

confidence: 99%

Photobiomodulation devices for hair regrowth and wound healing: a therapy full of promise but a literature full of confusion

Mignon

Botchkareva

Uzunbajakava

et al. 2016

Experimental Dermatology

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Photobiomodulation is reported to positively influence hair regrowth, wound healing, skin rejuvenation and psoriasis. Despite rapid translation of this science to commercial therapeutic solutions, significant gaps in our understanding of the underlying processes remain. The aim of this review was to seek greater clarity and rationality specifically for the selection of optical parameters for studies on hair regrowth and wound healing. Our investigation of 90 reports published between 1985 and 2015 revealed major inconsistencies in optical parameters selected for clinical applications. Moreover, poorly understood photoreceptors expressed in skin such as cytochrome c oxidase, cryptochromes, opsins etc. may trigger different molecular mechanisms. All this could explain the plethora of reported physiological effects of light. To derive parameters for optimal clinical efficacy of photobiomodulation, we recommend a more rational approach to underpin clinical studies, with research on molecular targets and pathways using well-defined biological model systems to enable translation of optical parameters from in vitro to in vivo. Furthermore, special attention needs to be paid when conducting studies for hair regrowth, aiming for double-blind, placebocontrolled randomized clinical trials as the gold standard for quantifying hair growth.

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Section: Introductionmentioning

confidence: 99%

Photobiomodulation devices for hair regrowth and wound healing: a therapy full of promise but a literature full of confusion

Mignon

Botchkareva

Uzunbajakava

et al. 2016

Experimental Dermatology

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“…Currently, reported literature proves the efficacy of a 2% solution in a novel carrier system . Similarly finasteride, another FDA approved drug, has been reported effective in 0.25% and 0.5% topical solution compared to an oral 1 mg/d dose . Other treatments such as low‐laser therapy, microneedling in scalp, hair mesotherapy, and hair transplantation are alternative treatments.…”

Section: Resultsmentioning

confidence: 99%

An overview of herbal alternatives in androgenetic alopecia

Dhariwala¹,

Ravikumar²

2019

J of Cosmetic Dermatology

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Summary The second most common alopecia—Androgenetic alopecia (AGA)—occurs due to hormonal imbalance. Dihydrotestosterone (DHT) an androgenic hormone is a sex steroid, produced in the gonads. The target sites of DHT are similar to that of testosterone, and it attaches easily remaining bound for 53 minutes as compared to 35 minutes of testosterone. Excess of DHT causes miniaturization of hair reducing the anagen phase and increasing the telogen phase leading to hair loss. Normally up to ten percent of testosterone in the body irreversibly gets converted into DHT by the action of enzyme 5‐alpha‐reductase. Inadequate blood flow to the scalp can also be another reason for hair loss encountered due to lower oxygen and nutrients reaching it. AGA affects both sexes; however in males, it leads to major hair loss. Conventional drugs such as minoxidil and finasteride are widely used for the treatment. However, several drawbacks such as allergic contact dermatitis, burning, ejaculation disorder, and decreased libido are reported. Available literature suggests the role of herbal drugs to have the action against 5‐alpha‐reductase enzyme inhibiting it and reducing the hair loss. This can be further potentiated since they exhibit lesser side effects. Recent advancements observed in the medicinal, cosmetic, and engineering fields can prove to be an asset. This article focuses on herbs which can be used in AGA. A review of Saw palmetto (Serenoa repens), Green tea (Camellia sinensis), Pumpkin seed (Curcurbita pepo), Rosemary (Rosmarinus officinalis), Grape seed (Vitis vinifera), and Licorice (Glycyrrhiza glabra) is attempted.

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“…[5] followed by subsequent upscaling of the dose may enhance patient compliance and abrogate the nocebo response. [35] This has been found to be effective for finasteride as well as isotretinoin. Finasteride doses as low as 0.2 mg/day adequately suppress both scalp skin and serum dihydrotestosterone levels, with clinical efficacy comparable to higher daily doses of 1 and 5 mg. [54] Similarly, low dose isotretinoin has been reported to be equi-efficacious to higher doses in multiple acne trials.…”

Section: Management Strategies To Alleviate Nocebo Effect In Clinicalmentioning

confidence: 96%

“…Any drug that interferes with the action of androgens is therefore assumed by the lay man to decrease libido and cause impotence. [35] Sexual adverse effects of finasteride are well publicised and are often already known to the patients when they visit the dermatologist. Incidence of sexual adverse effects has varied significantly in different studies.…”

Section: Nocebo Effect Informed Consent and Ethicsmentioning

confidence: 99%

“…Penile erection is mainly under the control of parasympathetic nervous system whereas ejaculation and detumescence depend on an intact sympathetic system. [35,37] Decreased ejaculatory volume because of predominant action of dihydrotestosterone on prostate has been reported to be the only sexual adverse effect with a causal relation to finasteride. [38] In many studies, incidence of sexual adverse effects with finasteride has been comparable to placebo.…”

Section: Nocebo Effect Informed Consent and Ethicsmentioning

confidence: 99%

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Nocebo effect in Dermatology

Sonthalia¹,

Sahaya²,

Arora³

et al. 2015

Indian J Dermatol Venereol Leprol

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Nocebo effect, originally denoting the negative counterpart of the placebo phenomenon, is now better defined as the occurrence of adverse effects to a therapeutic intervention because the patient expects them to develop. More commonly encountered in patients with a past negative experience, this effect stems from highly active processes in the central nervous system, mediated by specific neurotransmitters and modulated by psychological mechanisms such as expectation and conditioning. The magnitude of nocebo effect in clinical medicine is being increasingly appreciated and its relevance encompasses clinical trials as well as clinical practice. Although there is hardly any reference to the term nocebo in dermatology articles, the phenomenon is encountered routinely by dermatologists. Dermatology patients are more susceptible to nocebo responses owing to the psychological concern from visibility of skin lesions and the chronicity, unpredictable course, lack of 'permanent cure' and frequent relapses of skin disorders. While finasteride remains the prototypical drug that displays a prominent nocebo effect in dermatologic therapeutics, other drugs such as isotretinoin are also likely inducers. This peculiar phenomenon has recently been appreciated in the modulation of itch perception and in controlled drug provocation tests in patients with a history of adverse drug reactions. Considering the conflict between patients' right to information about treatment related adverse effects and the likelihood of nocebo effect stemming from information disclosure, the prospect of ethically minimizing nocebo effect remains daunting. In this article, we review the concept of nocebo effect, its postulated mechanism, relevance in clinical dermatology and techniques to prevent it from becoming a barrier to effective patient management.

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Finasteride and sexual side effects

Cited by 55 publications

References 16 publications

Photobiomodulation devices for hair regrowth and wound healing: a therapy full of promise but a literature full of confusion

Photobiomodulation devices for hair regrowth and wound healing: a therapy full of promise but a literature full of confusion

An overview of herbal alternatives in androgenetic alopecia

Nocebo effect in Dermatology

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