Ce comparateur présente l'état de la littérature scientifique. Ce n'est pas un avis médical : seul un médecin peut dire ce qui convient à votre situation.
Finastéride topique 0,25 %
2 études, 500 participants · Alopécie androgénétique · Hommes
En bref
Le finastéride topique 0,25 % fait mieux que le placebo chez l'homme atteint d'alopécie androgénétique, dans un essai de 458 hommes de fiabilité moyenne (Piraccini 2022) : +20,2 cheveux par cm² en 24 semaines et 42 % de patients jugés améliorés par leur médecin. Sur l'appréciation globale de la chevelure, les preuves restent faibles : +0,2 point contre +0,1 sous placebo, et un second petit essai de fiabilité limitée le trouve nettement plus efficace associé au minoxidil 5 % que seul (2 contre 0,6 point, Rossi 2024). Côté tolérance, 9,9 % des hommes ont un effet indésirable attribué au traitement et 2,8 % des troubles sexuels.
Votre profil
Efficacité
Ce que disent les études, une question à la fois. Les plus solides d'abord.
Sur une échelle d'appréciation, le finastéride en spray améliore-t-il la chevelure ?
Sur 24 semaines, un évaluateur en aveugle note une évolution de +0,2 point sous finastéride topique 0,25 %, contre +0,1 sous placebo et +0,3 sous finastéride oral (Piraccini 2022). Associé au minoxidil 5 %, il fait nettement mieux que seul : 2 contre 0,6 point à 26 semaines (Rossi 2024).
Pourquoi ce niveau de preuve
Point de départ élevé : deux essais randomisés, l'un à risque de biais élevé (12 à 19 hommes par bras). Dégradé de deux niveaux, pour risque de biais et imprécision. Le grand essai ne teste pas l'écart avec le placebo sur ce critère.
Niveau abaissé pour : risque de biais, imprécision.
La conclusion pourrait changer avec des essais de meilleure qualité.
À qui ça s’applique
Hommes adultes, européens dans l'essai Piraccini 2022. Suivi de six mois.
Les chiffres et leurs sources (5)
Évolution sur une échelle à 7 points (de -3 à +3)
+0,2 points Finastéride topique 0,25 % face à Placebo
Piraccini BM, Blume-Peytavi U, Scarci F et al.. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial.. J Eur Acad Dermatol Venereol 2022, DOI 10.1111/jdv.17738. Citation reproduite au titre du droit de courte citation (article L122-5 du Code de la propriété intellectuelle).
Évolution sur une échelle à 7 points (de -3 à +3)
+0,1 points Placebo face à Finastéride topique 0,25 %
Piraccini BM, Blume-Peytavi U, Scarci F et al.. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial.. J Eur Acad Dermatol Venereol 2022, DOI 10.1111/jdv.17738. Citation reproduite au titre du droit de courte citation (article L122-5 du Code de la propriété intellectuelle).
Évolution sur une échelle à 7 points (de -3 à +3)
+0,3 points Finastéride oral 1 mg face à Finastéride topique 0,25 %
Piraccini BM, Blume-Peytavi U, Scarci F et al.. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial.. J Eur Acad Dermatol Venereol 2022, DOI 10.1111/jdv.17738. Citation reproduite au titre du droit de courte citation (article L122-5 du Code de la propriété intellectuelle).
Évolution sur une échelle à 7 points (de -3 à +3)
+2 points Minoxidil 5 % le matin + finastéride topique 0,25 % le soir face à Finastéride topique 0,25 %
26 semaines · écart très probablement réel · Rossi 2024
Voir la citation
The global photographic assessment score (GPAS) was sig- use;
OA
nificantly higher in Group A compared to Group B (p < 0.001) and
articles
Group C (p 0.05), both at 3 and 6 months (2.0 0.7 vs. 0.6 0.8 and
< ± ±
are
1.3 ± 0.6; respectively at month 6) (Figure 5). A significantly greater
Citation complémentaire (inclusion)
Patients and Methods: Forty- two males, mean age 24 ± 3 years, with AGA (I– VII of
Norwood- Hamilton Grading Scale), treatment naive or free from any therapy for at
least 6 months, were enrolled and randomly assigned to three arm treatment groups
(2:1:1): group A (n = 19, the subjects applied 5% MNX in the morning and F spray in
the evening), group B (n = 12, the subjects applied F spray in the evening), and group
C (n = 11, the subjects applied 5% MNX twice daily). The efficacy of treatments was
Rossi A, Caro G. Efficacy of the association of topical minoxidil and topical finasteride compared to their use in monotherapy in men with androgenetic alopecia: a prospective, randomized, controlled, assessor blinded, 3-arm, pilot trial. Journal of Cosmetic Dermatology 2024, DOI 10.1111/jocd.15953. Citation sous licence CC-BY.
Évolution sur une échelle à 7 points (de -3 à +3)
+0,6 points Finastéride topique 0,25 % face à Minoxidil 5 % le matin + finastéride topique 0,25 % le soir
26 semaines · écart très probablement réel · Rossi 2024
Voir la citation
The global photographic assessment score (GPAS) was sig- use;
OA
nificantly higher in Group A compared to Group B (p < 0.001) and
articles
Group C (p 0.05), both at 3 and 6 months (2.0 0.7 vs. 0.6 0.8 and
< ± ±
are
1.3 ± 0.6; respectively at month 6) (Figure 5). A significantly greater
Citation complémentaire (inclusion)
Patients and Methods: Forty- two males, mean age 24 ± 3 years, with AGA (I– VII of
Norwood- Hamilton Grading Scale), treatment naive or free from any therapy for at
least 6 months, were enrolled and randomly assigned to three arm treatment groups
(2:1:1): group A (n = 19, the subjects applied 5% MNX in the morning and F spray in
the evening), group B (n = 12, the subjects applied F spray in the evening), and group
C (n = 11, the subjects applied 5% MNX twice daily). The efficacy of treatments was
Rossi A, Caro G. Efficacy of the association of topical minoxidil and topical finasteride compared to their use in monotherapy in men with androgenetic alopecia: a prospective, randomized, controlled, assessor blinded, 3-arm, pilot trial. Journal of Cosmetic Dermatology 2024, DOI 10.1111/jocd.15953. Citation sous licence CC-BY.
Autres résultats
Critères mesurés dans une seule étude : chaque ligne est un résultat isolé.
Efficacité
Amélioration marquée
8 % (1 sur 12)face à Minoxidil 5 % le matin + finastéride topique 0,25 % le soir
13 semaines · Rossi 2024
Voir la citation
percentage of subjects in Group A achieved a GPAS score of ≥2 in
comparison with Groups B and C after both 3 and 6 months (month by
the
3: 84% vs. 8% and 45%; month 6: 79% vs. 8% and 41%, respectively).
Citation complémentaire (inclusion)
Patients and Methods: Forty- two males, mean age 24 ± 3 years, with AGA (I– VII of
Norwood- Hamilton Grading Scale), treatment naive or free from any therapy for at
least 6 months, were enrolled and randomly assigned to three arm treatment groups
(2:1:1): group A (n = 19, the subjects applied 5% MNX in the morning and F spray in
the evening), group B (n = 12, the subjects applied F spray in the evening), and group
C (n = 11, the subjects applied 5% MNX twice daily). The efficacy of treatments was
Rossi A, Caro G. Efficacy of the association of topical minoxidil and topical finasteride compared to their use in monotherapy in men with androgenetic alopecia: a prospective, randomized, controlled, assessor blinded, 3-arm, pilot trial. Journal of Cosmetic Dermatology 2024, DOI 10.1111/jocd.15953. Citation sous licence CC-BY.
Amélioration marquée
8 % (1 sur 12)face à Minoxidil 5 % le matin + finastéride topique 0,25 % le soir
26 semaines · Rossi 2024
Voir la citation
percentage of subjects in Group A achieved a GPAS score of ≥2 in
comparison with Groups B and C after both 3 and 6 months (month by
the
3: 84% vs. 8% and 45%; month 6: 79% vs. 8% and 41%, respectively).
Citation complémentaire (inclusion)
Patients and Methods: Forty- two males, mean age 24 ± 3 years, with AGA (I– VII of
Norwood- Hamilton Grading Scale), treatment naive or free from any therapy for at
least 6 months, were enrolled and randomly assigned to three arm treatment groups
(2:1:1): group A (n = 19, the subjects applied 5% MNX in the morning and F spray in
the evening), group B (n = 12, the subjects applied F spray in the evening), and group
C (n = 11, the subjects applied 5% MNX twice daily). The efficacy of treatments was
Rossi A, Caro G. Efficacy of the association of topical minoxidil and topical finasteride compared to their use in monotherapy in men with androgenetic alopecia: a prospective, randomized, controlled, assessor blinded, 3-arm, pilot trial. Journal of Cosmetic Dermatology 2024, DOI 10.1111/jocd.15953. Citation sous licence CC-BY.
Densité capillaire totale
136,6 → 149,5 cheveux par cm²face à Minoxidil 5 % le matin + finastéride topique 0,25 % le soir
density over time (158.2 12.5 and 183.5 15.3 hair/cm2 at T3 and
± ±
T6 for Group A, 149.5 14.3 and 154.6 18.6 hair/cm2 at T3 and
± ±
T6 for Group B, and 212.3 18.4 and 223.7 19.8 hair/cm2 at T3
± ±
and T6 for Group C) although it was statistically significant only in
group A (Figure 2). The mean change in hair density from baseline
was statistically different between group A (MNX F) and group B
+
(F) (p < 0.01) but no statistical differences were observed between
group A (MNX F) and group C (MNX), both after 3 and 6 months.
Citation complémentaire (inclusion)
Patients and Methods: Forty- two males, mean age 24 ± 3 years, with AGA (I– VII of
Norwood- Hamilton Grading Scale), treatment naive or free from any therapy for at
least 6 months, were enrolled and randomly assigned to three arm treatment groups
(2:1:1): group A (n = 19, the subjects applied 5% MNX in the morning and F spray in
the evening), group B (n = 12, the subjects applied F spray in the evening), and group
C (n = 11, the subjects applied 5% MNX twice daily). The efficacy of treatments was
Citation complémentaire (valeur)
At baseline, mean ± SE hair density was 101.9 ± 13.4, 136.6 ± 13.9,
on
and 185.0 16.7 hair/cm2, for group A (MNX F), group B (F), and Wiley
± +
Rossi A, Caro G. Efficacy of the association of topical minoxidil and topical finasteride compared to their use in monotherapy in men with androgenetic alopecia: a prospective, randomized, controlled, assessor blinded, 3-arm, pilot trial. Journal of Cosmetic Dermatology 2024, DOI 10.1111/jocd.15953. Citation sous licence CC-BY.
Densité capillaire totale
136,6 → 154,6 cheveux par cm²face à Minoxidil 5 % le matin + finastéride topique 0,25 % le soir
density over time (158.2 12.5 and 183.5 15.3 hair/cm2 at T3 and
± ±
T6 for Group A, 149.5 14.3 and 154.6 18.6 hair/cm2 at T3 and
± ±
T6 for Group B, and 212.3 18.4 and 223.7 19.8 hair/cm2 at T3
± ±
and T6 for Group C) although it was statistically significant only in
group A (Figure 2). The mean change in hair density from baseline
was statistically different between group A (MNX F) and group B
+
(F) (p < 0.01) but no statistical differences were observed between
group A (MNX F) and group C (MNX), both after 3 and 6 months.
Citation complémentaire (inclusion)
Patients and Methods: Forty- two males, mean age 24 ± 3 years, with AGA (I– VII of
Norwood- Hamilton Grading Scale), treatment naive or free from any therapy for at
least 6 months, were enrolled and randomly assigned to three arm treatment groups
(2:1:1): group A (n = 19, the subjects applied 5% MNX in the morning and F spray in
the evening), group B (n = 12, the subjects applied F spray in the evening), and group
C (n = 11, the subjects applied 5% MNX twice daily). The efficacy of treatments was
Citation complémentaire (valeur)
At baseline, mean ± SE hair density was 101.9 ± 13.4, 136.6 ± 13.9,
on
and 185.0 16.7 hair/cm2, for group A (MNX F), group B (F), and Wiley
± +
Rossi A, Caro G. Efficacy of the association of topical minoxidil and topical finasteride compared to their use in monotherapy in men with androgenetic alopecia: a prospective, randomized, controlled, assessor blinded, 3-arm, pilot trial. Journal of Cosmetic Dermatology 2024, DOI 10.1111/jocd.15953. Citation sous licence CC-BY.
Gain de densité depuis le départ
+20,2 cheveux par cm²face à Placebo
24 semaines · écart très probablement réel · Piraccini 2022
Voir la citation
At week 24, the adjusted mean change from baseline in TAHC
was significantly greater with topical finasteride than with pla-
cebo(20.2vs.6.7hairs;P < 0.001),andwasnumericallysimilar
to that with oral finasteride (21.1 hairs;
Piraccini BM, Blume-Peytavi U, Scarci F et al.. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial.. J Eur Acad Dermatol Venereol 2022, DOI 10.1111/jdv.17738. Citation reproduite au titre du droit de courte citation (article L122-5 du Code de la propriété intellectuelle).
Piraccini BM, Blume-Peytavi U, Scarci F et al.. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial.. J Eur Acad Dermatol Venereol 2022, DOI 10.1111/jdv.17738. Citation reproduite au titre du droit de courte citation (article L122-5 du Code de la propriété intellectuelle).
Piraccini BM, Blume-Peytavi U, Scarci F et al.. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial.. J Eur Acad Dermatol Venereol 2022, DOI 10.1111/jdv.17738. Citation reproduite au titre du droit de courte citation (article L122-5 du Code de la propriété intellectuelle).
Piraccini BM, Blume-Peytavi U, Scarci F et al.. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial.. J Eur Acad Dermatol Venereol 2022, DOI 10.1111/jdv.17738. Citation reproduite au titre du droit de courte citation (article L122-5 du Code de la propriété intellectuelle).
Patients se jugeant nettement améliorés
26,5 %face à Placebo
24 semaines · écart qui peut être dû au hasard · Piraccini 2022
Piraccini BM, Blume-Peytavi U, Scarci F et al.. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial.. J Eur Acad Dermatol Venereol 2022, DOI 10.1111/jdv.17738. Citation reproduite au titre du droit de courte citation (article L122-5 du Code de la propriété intellectuelle).
Évaluation globale par l'investigateur
0,8 pointsface à Placebo
24 semaines · écart très probablement réel · Piraccini 2022
assessed adjusted mean change from baseline to week 24 in OA
patient hair growth/loss at the vertex was statistically signifi- articles
cantly greater with topical finasteride than placebo (0.8 vs. 0.3,
are
P < 0.001) and was numerically similar to that with oral finas- governed
teride(0.7). Blinded-assessor evaluation ofpatient hairgrowth/
Piraccini BM, Blume-Peytavi U, Scarci F et al.. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial.. J Eur Acad Dermatol Venereol 2022, DOI 10.1111/jdv.17738. Citation reproduite au titre du droit de courte citation (article L122-5 du Code de la propriété intellectuelle).
Tolérance
Incidence d'un effet indésirable lié au traitement
Piraccini BM, Blume-Peytavi U, Scarci F et al.. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial.. J Eur Acad Dermatol Venereol 2022, DOI 10.1111/jdv.17738. Citation reproduite au titre du droit de courte citation (article L122-5 du Code de la propriété intellectuelle).
Incidence d'un effet indésirable sexuel
2,8 %face à Placebo
24 semaines · Piraccini 2022
Voir la citation
Treatment-related sexual adverse events (sexual dysfunction, Online
erectile dysfunction, libido decreased, loss of libido) were
Library
reportedin2.8%vs.3.3%vs.4.8%ofpatientstreatedwithtopi-
Piraccini BM, Blume-Peytavi U, Scarci F et al.. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial.. J Eur Acad Dermatol Venereol 2022, DOI 10.1111/jdv.17738. Citation reproduite au titre du droit de courte citation (article L122-5 du Code de la propriété intellectuelle).
Incidence d'un effet indésirable, toutes natures confondues
Piraccini BM, Blume-Peytavi U, Scarci F et al.. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial.. J Eur Acad Dermatol Venereol 2022, DOI 10.1111/jdv.17738. Citation reproduite au titre du droit de courte citation (article L122-5 du Code de la propriété intellectuelle).
Incidence d'une baisse de libido
0,6 %face à Placebo
24 semaines · Piraccini 2022
Voir la citation
group.Treatment-relatedTEAEsreportedby≥3patientsinany
ofthetopicalfinasteride,placeboororalfinasteridegroupswere:
pruritus (2.2% vs. 0.6% vs. 1.2% of patients, respectively),
Piraccini BM, Blume-Peytavi U, Scarci F et al.. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial.. J Eur Acad Dermatol Venereol 2022, DOI 10.1111/jdv.17738. Citation reproduite au titre du droit de courte citation (article L122-5 du Code de la propriété intellectuelle).
Incidence d'une rougeur du cuir chevelu
2,2 %face à Placebo
24 semaines · Piraccini 2022
Voir la citation
group.Treatment-relatedTEAEsreportedby≥3patientsinany
ofthetopicalfinasteride,placeboororalfinasteridegroupswere:
pruritus (2.2% vs. 0.6% vs. 1.2% of patients, respectively),
Piraccini BM, Blume-Peytavi U, Scarci F et al.. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial.. J Eur Acad Dermatol Venereol 2022, DOI 10.1111/jdv.17738. Citation reproduite au titre du droit de courte citation (article L122-5 du Code de la propriété intellectuelle).
Prurit
2,2 %face à Placebo
24 semaines · Piraccini 2022
Voir la citation
Incidences of treatment-related TEAEs were 9.9%, 6.6% and
11.9% in the topical finasteride, placebo and oral finasteride
groups, respectively. Withdrawal rates due to treatment-related
TEAEs were 2.8% and 2.2% in the topical finasteride and pla-
cebo groups, respectively, and 7.1% in the topical finasteride
group.Treatment-relatedTEAEsreportedby≥3patientsinany
ofthetopicalfinasteride,placeboororalfinasteridegroupswere:
pruritus (2.2% vs. 0.6% vs. 1.2% of patients, respectively),
Piraccini BM, Blume-Peytavi U, Scarci F et al.. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial.. J Eur Acad Dermatol Venereol 2022, DOI 10.1111/jdv.17738. Citation reproduite au titre du droit de courte citation (article L122-5 du Code de la propriété intellectuelle).
MeanserumDHTconcentrationsatweek24were34.6%lower
than at baseline in the topical finasteride group (25.75 vs.
39.32 ng/dL, respectively), and were 55.6% lower than at base-
lineintheoralfinasteridegroup(15.75vs.35.50 ng/dL,respec-
tively). The adjusted mean difference in the change from
baseline in serum DHT concentrations was statistically signifi-
cant between topical finasteride and placebo (P < 0.05), and
<
between topical finasteride and oral finasteride (P 0.05), at
eachofweeks4,8,12and24(Fig. 5).
Piraccini BM, Blume-Peytavi U, Scarci F et al.. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial.. J Eur Acad Dermatol Venereol 2022, DOI 10.1111/jdv.17738. Citation reproduite au titre du droit de courte citation (article L122-5 du Code de la propriété intellectuelle).
Comparé directement à
Traitements testés contre celui-ci dans un même essai, sur les mêmes patients.
Piraccini 2022 · Essai randomisé, risque de biais modéré. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial. Financement : Almirall
Rossi 2024 · Essai randomisé, risque de biais élevé. Efficacy of the association of topical minoxidil and topical finasteride compared to their use in monotherapy in men with androgenetic alopecia: a prospective, randomized, controlled, assessor blinded, 3-arm, pilot trial