The efficacy and use of finasteride in women: a systematic review

Int J Dermatol. 2019 Jul;58(7):759-776. doi: 10.1111/ijd.14370. Epub 2019 Jan 3.


Background: Physicians are beginning to use finasteride as treatment for hair loss, hirsutism, and various other dermatologic conditions in women. However, the reported efficacy and use of finasteride in the female population varies widely. The purpose of this study is therefore to better define the efficacy and use of finasteride in women and identify research gaps that require further investigation.

Methods: A systematic review of the current literature describing finasteride use in women.

Results: A total of 2,683 patients participated in 65 studies involving finasteride use in women published between January 1997 and July 2017. Most randomized controlled trials (RCTs) evaluated finasteride use in women with hirsutism (48.7%) or female pattern hair loss (34.7%). RCTs recommend finasteride treatment for women with hirsutism or polycystic ovarian syndrome. Meanwhile, other forms of hair loss were studied such as alopecia, lichen planopilaris, and frontal fibrosing alopecia, but no RCTs evaluating finasteride therapy were identified. Other prospective and retrospective studies report that finasteride may improve hair loss in women with female pattern hair loss or frontal fibrosing alopecia. Overall, doses of oral finasteride ranged from 0.5 to 5 mg/day, in females aged 6-88, over a duration of 6-12 months (57.6%), as monotherapy (88.9%), and for continuous use (96.4%).

Conclusion: The studies reviewed highlight the finasteride dosage, length of treatment, and candidate conditions that can benefit from finasteride therapy. Future long-term studies are necessary to fully assess the therapeutic mechanisms and potential consequences of finasteride use and to optimize treatment protocols.

Publication types

  • Systematic Review

MeSH terms

  • 5-alpha Reductase Inhibitors / administration & dosage*
  • 5-alpha Reductase Inhibitors / adverse effects
  • Alopecia / drug therapy
  • Dose-Response Relationship, Drug
  • Female
  • Finasteride / administration & dosage*
  • Finasteride / adverse effects
  • Hirsutism / drug therapy
  • Humans
  • Off-Label Use*
  • Polycystic Ovary Syndrome / drug therapy
  • Randomized Controlled Trials as Topic
  • Teratogenesis / drug effects
  • Time Factors
  • Treatment Outcome


  • 5-alpha Reductase Inhibitors
  • Finasteride