Therapeutic hotline. Treatment of androgenic alopecia with finasteride may result in a high grade prostate cancer in patients: fact or fiction?

Finasteride at a dose of 1 mg (Propecia®) has been used for the treatment of androgenic alopecia in men. Though finasteride has been successfully used, there is ongoing controversy surrounding its use since the publication of the Prostate Cancer Prevention Trial (PCPT) which includes claims of increased risk for higher grade prostate cancers. This has produced confusion on consulting and treatment of patients interested in starting finasteride for androgenic alopecia. We felt there was a need to clarify further the results of PCPT for our readers and help understanding the real risk of prostate cancer development of patients on finasteride. In conclusion, we suggest the guidelines for treatment monitoring for patients on finasteride which based on comprehensive review of the trial presents safe treatment for androgenetic alopecia without the concern for the induction of high-grade prostate cancer.