From the Research
Finasteride is not recommended as a first-line treatment for lichen planopilaris (LPP) due to limited evidence supporting its efficacy in this condition. The most recent and highest quality study on LPP treatment, published in 2024 1, does not mention finasteride as a treatment option, instead highlighting the effectiveness of hydroxychloroquine and cyclosporine in reducing clinical symptoms. Other studies, such as those published in 2019 2 and 2020 3, suggest that finasteride may be considered as an adjunctive treatment for LPP, particularly in cases with androgenetic alopecia overlap or when standard treatments have failed. However, these studies do not provide strong evidence to support the use of finasteride as a primary treatment for LPP.
Some key points to consider when evaluating the use of finasteride for LPP include:
- The mechanism of action of finasteride, which involves inhibiting 5α-reductase and potentially reducing inflammation in hair follicles
- The potential side effects of finasteride, including sexual dysfunction, gynecomastia, and depression
- The need for regular follow-up appointments to monitor treatment response and side effects
- The importance of considering alternative treatment options, such as hydroxychloroquine and cyclosporine, which have shown efficacy in reducing clinical symptoms of LPP
In terms of specific treatment guidelines, the study published in 2019 2 suggests that 5-alpha reductase inhibitors, such as finasteride, may be effective in treating frontal fibrosing alopecia (FFA), a variant of LPP. However, this study does not provide strong evidence to support the use of finasteride as a primary treatment for LPP. Overall, the use of finasteride for LPP should be approached with caution and considered on a case-by-case basis, taking into account the individual patient's medical history and treatment goals.