Anti-Androgen Treatments - Hair Loss & Hair Transplant Surgery Guide

As the market for male-pattern baldness treatments expands rapidly, it can be bewildering trying to evaluate different products and keep abreast of different procedures. New products seem to be constantly jostling for pharmacy shelf space. They’ve got pseudo-scientific names, testimonials from famous people, recommendations from the medical community. What do you choose?

One way of finding your way through this minefield is to understand a little bit more about how some of these products work. For example, while there are lots of different brands to choose from, many of them utilise the same types of pharmaceutical and take the same approach to treating male-pattern baldness.

In this article, we will take a closer look at a particular type of treatment for male-pattern baldness which uses drugs called anti-androgens. We’ll look at what they are, how they work and which brands incorporate them into their overall treatment.

What are Androgens?

Androgens are a group of hormones that help the development of male sex characteristics. One aspect of sexual development is the growth of hair and scientists have identified the Androgen group of hormones as the catalyst behind this hair growth. The presence of androgens at different levels and in different amounts therefore decides the rate of hair growth as men reach sexual maturity.

Armed with this knowledge, scientists were able to identify a link between androgens and the onset of male pattern baldness: in fact, it was the presence of androgens around the hair follicles that caused the hair follicles to weaken. The problem is that there are lots of different types of androgens and simply attempting to stop androgens from reaching hair follicles does not stop the onset of alopecia. The next step for scientists, therefore, was to try and isolate which androgen was responsible for causing male-pattern baldness.

Studies were made of men who had a genetic 5 Alpha-Reductase deficiency. 5 Alpha-Reductase is the enzyme that regulates the break-down of testosterone into the androgen DHT. Therefore, men with a 5 Alpha-Reductase deficiency produce much less DHT. It was these sorts of studies that finally indentified DHT as the chemical that caused male pattern baldness.

What are Anti-Androgens?

The obvious assumption to make is that stopping DHT will help to stop, or at least slow down, male-pattern balding. Therefore, pharmaceutical companies have developed a number of drugs that have the generic term anti-androgens. Anti-androgens are used to combat a number of conditions, of which male-pattern baldness is only one.

Anti-Androgens are usually classed as one of two types: they are either specific anti-androgens or generic anti-androgens.

As we mentioned above, generic anti-androgens, such as fluconazole, are not recommended for treating baldness as they do not target DHT effectively enough. Therefore, most anti-androgen based treatments will incorporate a specific anti-androgen such as one of the following:


Finasteride is the active component in the product Propecia. Available via prescription only, it is taken in tablet form and is effective at preventing further hair loss in around 99% of male patients. Finasteride is also used to treat benign prostatic hyperplasia and also prostate cancer.


Ketoconazole has the brand name Nizoral. Used as a shampoo, Nizoral can diminish the amount of testosterone and other androgens in the skin. You can either buy Nizoral over the counter with 1% Ketoconazole or you can get a stronger, 2% version on prescription. Ketoconazole is also used to treat conditions such as fungal scalp infections.


Tretinion can be applied to the scalp topically and is often used in tandem with Minoxidil in the treatment of alopecia. It appears to work in harmony with Minoxidil, strengthening the hairs and producing better re-growth.


Cycotol is not strictly an anti-androgen, but it works in a similar way to stop DHT from binding onto the hair follicles. Essentially, cycotol works competitively, getting to the hair follicle first so that the DHT cannot attach itself and begin to weaken the follicle. Cycotol was originally available in topical form in the 1980s but has since disappeared from use.

What other conditions can Anti-Androgens treat?

Because Anti-Androgens can be used to counteract some of the negative effects of male sex hormones, they are often used to treat a variety of conditions.

As we have already seen, Finasteride is also used to treat prostate cancer. Androgens encourage the growth of the cancer so Finasteride can be used in higher doses to block those androgens.

Blocking androgens can also help with serious cases of Acne – in fact, it was for this purpose that Cycotol was originally developed. Though there are lots of contributory factors to acne, androgens enable glands in the skin to produce Sebum, which makes the skin greasy. Anti-androgens can therefore help to reduce this greasiness.

These are just two examples of how anti-androgens can be applied to other conditions, as well as male-pattern baldness. The use of anti-androgens is a fast-emerging area of medicine and many scientists believe that there is much more we can learn about them.


We hope that this article has helped to clarify what anti-androgens are and how they can be used effectively to treat male pattern baldness. As new products emerge on to the market, it is more than likely that new anti-androgens will be developed while others, like Cycotol, may disappear from pharmacy shelves. However, no matter which company manufactures them, all anti-androgens aim for the same result: to diminish the amount of DHT that can attach itself to hair follicles. Some anti-androgens do this internally and work to stop DHT being manufactured; some simply work to block it before it reaches the hair follicle; others are applied externally and work only on the DHT already in the skin.

As anti-androgens become more widely available, we would recommend consulting your doctor before you embark on a course of treatment. Your doctor will be able to discuss possible side effects and assess whether you are likely to benefit from this type of treatment. Alternatively, you could arrange a consultation with a specialist trichologist, who will have an up-to-the-minute understanding and detailed knowledge of the latest treatments on the market.