The effects of finasteride on scalp skin and serum androgen levels in men with androgenetic alopecia

BACKGROUND

Data suggest that androgenetic alopecia is a process dependent on dihydrotestosterone (DHT) and type 2 5alpha-reductase. Finasteride is a type 2 5alpha-reductase inhibitor that has been shown to slow further hair loss and improve hair growth in men with androgenetic alopecia.

OBJECTIVE

We attempted to determine the effect of finasteride on scalp skin and serum androgens.

METHODS

Men with androgenetic alopecia (N = 249) underwent scalp biopsies before and after receiving 0.01, 0.05, 0.2, 1, or 5 mg daily of finasteride or placebo for 42 days.

RESULTS

Scalp skin DHT levels declined significantly by 13.0% with placebo and by 14.9%, 61.6%, 56. 5%, 64.1%, and 69.4% with 0.01, 0.05, 0.2, 1, and 5 mg doses of finasteride, respectively. Serum DHT levels declined significantly (P <.001) by 49.5%, 68.6%, 71.4%, and 72.2% in the 0.05, 0.2, 1, and 5 mg finasteride treatment groups, respectively.

CONCLUSION

In this study, doses of finasteride as low as 0.2 mg per day maximally decreased both scalp skin and serum DHT levels. These data support the rationale used to conduct clinical trials in men with male pattern hair loss at doses of finasteride between 0.2 and 5 mg.

Acute urinary retention caused by vesical diverticula

Two children with acute urinary retention due to obstructing bladder diverticula are presented. This is an extremely rare but significant complication of congenital bladder diverticulum. The possible mechanisms of this complication are discussed. Voiding cystourethrography can provide the correct diagnosis.

The Rise of Global Mean Sea Level as an Indication of Climate Change

Rising mean sea level, it is proposed, is a significant indicator of global climate change. The principal factors that can have contributed to the observed increases of global mean sea level in recent decades are thermal expansion of the oceans and the discharge of polar ice sheets. Calculations indicate that thermal expansion cannot be the sole factor responsible for the observed rise in sea level over the last 40 years; significant discharges of polar ice must also be occurring. Global warming, due in some degree presumably to increasing atmospheric carbon dioxide, has been opposed by the extraction of heat necessary to melt the discharged ice. During the past 40 years more than 50,000 cubic kilometers of ice has been discharged and has melted, reducing the surface warming that might otherwise have occurred by as much as a factor of 2. The transfer of mass from the polar regions to a thin spherical shell covering all the oceans should have increased the earth's moment of inertia and correspondingly reduced the speed of rotation by about 1.5 parts in 10(8). This accounts for about three quarters of the observed fractional reduction in the earth's angular velocity since 1940. Monitoring of global mean sea level, ocean surface temperatures, and the earth's speed of rotation should be complemented by monitoring of the polar ice sheets, as is now possible by satellite altimetry. All parts of the puzzle need to be examined in order that a consistent picture emerge.