Risk associated with the use of 5-alpha reductase inhibitors with minoxidil in treatment of male androgenetic alopecia – literature review

Introduction andObjective.Male androgenic alopecia (AGA), is an age-related, genetic, progressive condition affecting more than half of the male population over the age of fifty.5-alpha reductase inhibitors combined with minoxidil, commonly used in AGA therapy, are associated with potential risk of side-effects.The aim of the article was to ascertain the risk connected with the use of 5-alpha reductase inhibitors with minoxidil in AGA treatment.Review Methods.A comprehensive evaluation of the literature was conducted utilizing the electronic databases: PubMed and Google Scholar.Key terms included "androgenic alopecia", "finasteride", "dutasteride", "minoxidil", "5-reductase inhibitors", "side-effects", and variations of these terms.The literature review considered articles published between 2016 -2024.Brief description of the state of knowledge.The only two drugs registered in the treatment of male AGA are finasteride 1mg and topical minoxidil.Most common side-effects of finesteride 1 mg are erectile dysfunctions, decreased libido and ejaculatory dysfunctions.Dutasteride is used in AGA therapy off-label and associated with similar side-effects as finasteride.The side-effects of 5-alpha reductase inhibitors usually pass after cessation of the therapy.Side-effects with topical minoxidil are highly uncommon.However, some patients using minoxidil 5% may suffer from scalp irritation, hypertrichosis and pruritus.Summary.5-alpha reductase inhibitors with minoxidil in AGA therapy, administered in accordance with the Polish Dermatological Society's recommendations and the current state of medical knowledge, have a minimal risk of side effects.