Diciamo una cosa: nelle donne l'uso di finasteride è indicato da qualche dermatologo ( non mi è ancora ben chiaro se più per via di una supplica del paziente, e conseguente sfinimento del dermatologo piuttosto che per una reale efficacia), ma sembra sia un approccio terapeutico sostenuto maggiormente dal gruppo della Tosti & co. più che altro ( http://www.ncbi.nlm.nih.gov/pubmed/16549704).
Gli esiti del trattamento con finasteride nella donna sono controversi, così come sono anche poco codificati i dosaggi ( in letteratura si trovano dosaggi da 1.25 mg a 5 mg), gli studi sono in associazione con pillola anticoncezionale ( per ovvie ragioni), il che può produrre anche una confusione nell'attribuzione dei risultati, a meno che i criteri d'arruolamento non siano ben studiati per non dar adito a errate conclusioni.
Andare ad aggiungere Trigan a finasteride non ha quindi affatto senso, se il target su cui si vuole andare a mirare è esclusivamente la 5 alfa reduttasi.
Sarebbe interessante invece l'accoppiata Trigan ( per la presenza del ginseng rosso che avrebbe attività che vanno oltre la mera 5 alfa reduttasi) + minoxidil al 2 o 3%, ricalcando il seguente lavoro, che copio/incollo per intero visto che non è presente neppure l'abstract online:
The efficacy of 3% minoxidil vs. combined 3% minoxidil
and Korean red ginseng in treating female pattern
alopecia
Female pattern alopecia is a distressing condition that
involves diffuse hair loss of the crown and frontal scalp.
Thus far, no treatments specifically effective for female
pattern alopecia are available, except minoxidil. Currently,
the only FDA-approved treatment for female pattern
alopecia is 2% topical minoxidil. It has been known
for over 30 years that minoxidil stimulates hair growth,
yet its mechanism of action on the hair follicle is very
limited. Korean red ginseng (KRG) is a well-known herbal
medication in Korea that has many biologic activities.
The component of ginseng, known as ginsenoside, has
been shown to accelerate neovascularization in burn
wounds on the skin in mice.1 New vessel formation by
saponin may affect hair growth by delivering oxygen and
nutrients to the hair follicles. Kim et al.2 reported that
KRG had a potent effect on the recovery of hair follicles
through its combined effects on proliferation and apoptosis
of cells in hair follicles in mice. Our previous study3
showed that KRG may be helpful in the treatment of
androgenic alopecia in men. The present study was
designed to comparatively analyze the effects of oral
KRG in 41 patients with female pattern hair loss that
were split into two groups, one using only topical 3%
minoxidil (group 1, n = 21) and one using topical 3%
minoxidil and oral KRG (group 2, n = 20). These two
groups were evaluated before treatment, after 12 weeks,
and after 24 weeks by phototrichogram (FolliscopeTM
2.5; LeadM Corp, Seoul, South Korea) and clinical photos
(Fig. 1). KRG was taken as a capsule once a day that
contained major ginsenoside-Rb1, 0.71 mg/g; Rb2,
0.26 mg/g; Rc, 0.28 mg/g; Rd, 0.06 mg/g; Re,
0.22 mg/g; Rf, 0.09 mg/g; Rg1, 0.36 mg/g; Rg2,
0.04 mg/g; Rg3, 0.02 mg/g; and other minor ginsenosides.
The study protocol was approved by the institutional
review board of the Korea University Ansan Hospital (IRB no. AS 11075). Informed consent was
obtained from all study participants. Of the 35 patients
who finished the treatment (16 from group 1 and 19 from
group 2), hair density was improved significantly in group
2 (P < 0.05). For hair thickness, both groups showed significant
improvement after treatment. Group 2 showed an
improvement in hair density and thickness over group 1,
although statistically not significant (P > 0.05) (Table 1).
In the assessment of global photographs by an expert
panel of two dermatologists, the average score of group 2
was significantly higher than group 1. In the questionnaire
answered by patients about the size of the vertex
spot, hair loss on the top of scalp, bitemporal recession,
hair shedding, hair quality, and overall satisfaction, group
2 was more satisfied at 24 weeks. Based on the results of
our study, combination treatment with topical minoxidil
and oral KRG may be a more effective treatment than
topical minoxidil treatment alone. Therefore, KRG is
expected to be a helpful supplement in the treatment of
female pattern hair loss.
