Measuring Reversal of Hair Miniaturization in Androgenetic Alopecia by Follicular Counts in Horizontal Sections of Serial Scalp Biopsies: Results of Finasteride 1mg Treatment of Men
Dr. Whiting reported on the results of biopsies performed on men participating in Merck’s clinical studies for Propecia (Finasteride 1mg). These biopsies were taken in order to confirm the observed results and to evaluate the anatomical changes. Patients had 4mm punch biopsies before and after treatment (usually 12 months). A total of 26 patients were studied, 14 on finasteride and 12 on placebo. The observer (Dr. Whiting) was blind to whether the patient was on finasteride or the placebo and at the beginning or end of the treatment.
The following results were obtained when the biopsies were examined under a microscope for the actual number of hairs.
| Finasteride | Placebo | Difference | |
| Terminal Anagen Hairs | +4.9 | -0.2 | 5.1 |
| Terminal Telogen Hairs | +0.4 | +1.2 | 0.7 |
| Terminal Hair (Total) | +5.4 | +1.0 | 4.4 |
| Vellus Hair | -3.1 | -0.1 | 2.0 |
| Total Hair | +2.3 | -0.1 | 2.4 |
| # of Hairs – Baseline | # of Hairs – Final | % Change | |
| Propecia – Terminal Hairs | 15.5 | 20.9 | +34.8% |
| Placebo – Terminal Hairs | 17.3 | 18.3 | +5.8% |
| Propecia – Vellus Hairs | 26.7 | 23.6 | -11.6% |
| Placebo – Vellus Hairs | 21.3 | 20.3 | -4.7% |
The normal ratio of terminal hairs to vellus hairs on the male head is 6-8 terminal hairs to 1 vellus hair. In balding men, the ratio is anywhere from 0.1 to 3.9 terminal hairs to 1 vellus hair. Male patients on finasteride 1mg improved from a starting ratio of 1 terminal hair to 1.7 vellus hairs to 1 terminal hair to 1.1 vellus hairs, suggesting a reversal of the miniaturization process in finasteride patients.
Measuring Follicular Counts of Postmenopausal Women on Finasteride 1mg
Dr. Whiting presented information on Merck’s recent study of postmenopausal women using Propecia (Finasteride 1mg). In the study, 127 postmenopausal females were studied, 94 of whom had biopsies performed before and after 12 months of treatment. Of the 94 biopsied women, 44 were using finasteride and 50 were using placebo. The following results were obtained:
| Finasteride | Placebo | Difference | |
| Terminal Anagen Hairs | +0.7 | +1.6 | 0.9 |
| Terminal Telogen Hairs | -0.5 | +0.5 | 0.0 |
| Terminal Hair (Total) | +0.2 | +1.1 | 0.9 |
| Vellus Hair | -2.1 | -1.2 | 1.0 |
| Total Hair | -1.9 | -0.0 | 1.9 |
According to Dr. Whiting, the study of the biopsies clearly showed that women using Finasteride did not gain hair. This study did not study premenopausal women.
