| Bicalutamide: A Game changer in Female Pattern Hair Loss Introduction: Female pattern hair loss (FPHL) is common and distressing condition. While topical or oral minoxidil and antiandrogens are standard options, responses are unsatisfactory, variable and tolerability can limit use. Bicalutamide, a non-steroidal selective androgen receptor antagonist, can be used for FPHL. Aim: To evaluate efficacy of bicalutamide in Female pattern Hair Loss Methodology: 3 patients included with grade 2-4 FPHL on Ludwig scale, after baseline LFTs, received bicalutamide 25mg alternate day then updosed to 50 mg alternate days at 8 weeks and then 50 mg daily with concomitant topical therapy. Results & Discussion: Patients demonstrated decrease in hair shedding (subjective) and increased density (objective) with new hair growth at end of 6 months- 1yr. Patients receiving concomitant topical minoxidil showed better results.The addition of bicalutamide can be considered when patients have reached maximum recommended doses of spironolactone or finasteride/dutasteride with suboptimal results. LFT monitoring is required monthly while updosing and then 3-6 monthly. It can be used in patients with hyperandrogenic conditions hormonal acne and hirsutism. |
