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| CASE REPORT |
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| Year : 2023 | Volume
: 15
| Issue : 1 | Page : 39-40 |
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Mesotherapy with bicalutamide: A new treatment for androgenetic alopecia
Alba Gomez-Zubiaur1, Juan Jose Andres-Lencina1, Víctor Cabezas1, Cristina Corredera1, Fabio di Brisco2, Blanca Ferrer1, Ana Rodriguez-Villa1, Daniela Subiabre-Ferrer1, Cristian Valenzuela1, David Vega Diez1, Jose Maria Ricart1
1 Trichology Unit, Ricart Medical Institute, Madrid and Valencia, Spain
2 Pharmacy Unit, Ricart Medical Institute, Madrid and Valencia, Spain
| Date of Submission | 11-Jul-2021 |
| Date of Acceptance | 03-Mar-2022 |
| Date of Web Publication | 19-Apr-2023 |
Correspondence Address:
Alba Gomez-Zubiaur
Trichology Unit, Ricart Medical Institute, Paseo de la Habana 43, 28036 Madrid
Spain
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ijt.ijt_78_21
 Abstract | | |
Bicalutamide is a selective androgen receptor antagonist. To date, it has been used orally with good efficacy results, but not in mesotherapy. In our center, we assessed whether patients undergoing bicalutamide mesotherapy showed positive responses and tolerated the local administration of bicalutamide. Six premenopausal women, with a mean age of 35.7 years and clinical diagnosis of Olsen Grade II or III female androgenetic alopecia accompanied by significant seborrhea were treated with 1 ml bicalutamide 0.5% mesotherapy. Three monthly sessions were performed. A subtle improvement in hair density was described after the third session. The overall satisfaction of the patients with the treatment was 6.3, on a scale of 1–10. Premenopausal women require several therapeutic approaches to combat severe androgenetic alopecia. Our data showed that bicalutamide mesotherapy was well tolerated and welcomed by the patients; we, therefore, provide a new tool for the management of this pathology.
Keywords: Androgenetic alopecia, antiandrogen, bicalutamide, mesotherapy
How to cite this article:
Gomez-Zubiaur A, Andres-Lencina JJ, Cabezas V, Corredera C, di Brisco F, Ferrer B, Rodriguez-Villa A, Subiabre-Ferrer D, Valenzuela C, Diez DV, Ricart JM. Mesotherapy with bicalutamide: A new treatment for androgenetic alopecia. Int J Trichol 2023;15:39-40 |
How to cite this URL:
Gomez-Zubiaur A, Andres-Lencina JJ, Cabezas V, Corredera C, di Brisco F, Ferrer B, Rodriguez-Villa A, Subiabre-Ferrer D, Valenzuela C, Diez DV, Ricart JM. Mesotherapy with bicalutamide: A new treatment for androgenetic alopecia. Int J Trichol [serial online] 2023 [cited 2023 May 30];15:39-40. Available from: https://www.ijtrichology.com/text.asp?2023/15/1/39/374398 |
| Introduction | |  |
Bicalutamide is a selective androgen receptor antagonist. Thereby, it may be effective in the treatment of androgenetic alopecia in premenopausal women, as well as in seborrhea, acne, or hirsutism. Oral bicalutamide has shown a good efficacy and safety profile.[1],[2],[3] As with other antiandrogens, such as dutasteride,[4] it would be interesting to know the efficacy of bicalutamide after local use in mesotherapy.
| Case Report | | |
In our center, bicalutamide mesotherapy has been used in routine clinical practice in a series of six premenopausal women, with a mean age of 35.7 years and clinical diagnosis of Olsen Grade II or III female androgenetic alopecia accompanied by significant seborrhea (mean 5.3 washes per week). All patients signed the informed consent for the use of the drug off-label in mesotherapy. None of them had received any other oral, topical, or infiltrative treatment in the last 6 months. Two patients were diagnosed with polycystic ovary syndrome, five had menstrual irregularities, three had hirsutism, and four had abdominal obesity. In all cases, 1 ml bicalutamide 0.5% was mixed with 1 ml lidocaine 2%, making the total infiltrated volume per session to 2 ml, and infiltrated with a 1cc Luer lock syringe and 32G needle of 4-mm length. The injection points were distributed 4 cm on both sides of the interparietal midline, from its frontal beginning to the vertex, with a deposited volume of 0.01 ml per puncture. Three monthly sessions were performed, with protocolized images taken at baseline, after the third session, and 6 months after the first session using Fotofinder® technology. The images were evaluated by two independent dermatologists specializing in trichology. The degree of alopecia was not modified in any of the cases; however, in all cases, a subtle improvement in hair density was described after the third session [Figure 1]a and [Figure 1]b, which did not persist at the 6-month visit. The number of washes after three sessions decreased to 3.7 and was 5 at the end of 6 months. The visual analog scale was used to determine the pain associated with the procedure, with a mean evaluation of 3.3 and 6, respectively, for the puncture and entry of the product. The patients evaluated the degree of improvement in capillary density and seborrhea on a scale of 1–10, after 3 months, with a mean of 4.83 for the first and 5.2 for the second value. The overall satisfaction of the patients with the treatment was 6.3. | Figure 1: Androgenetic alopecia in premenopausal women. Baseline control (a) and after 3 months (b) of monthly treatment with 1 ml 0.5% bicalutamide mesotherapy
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| Discussion | | |
Premenopausal women require several therapeutic approaches to combat severe androgenetic alopecia. Based on the above data, bicalutamide mesotherapy is considered positive, well-tolerated, and welcomed by the patients, with a subtle efficacy in monotherapy regarding hair density and seborrhea, but with great potential as an adjuvant in the global management of androgenetic alopecia, combined with oral bicalutamide or other antiandrogens.[5] However, these findings are limited by the fact that the data were obtained retrospectively. Further well-designed studies are needed to evaluate the ideal concentration, infiltrate volume, and administration frequency of bicalutamide in mesotherapy.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Fernandez-Nieto D, Saceda-Corralo D, Jimenez-Cauhe J, Moreno-Arrones OM, Rodrigues-Barata R, Hermosa-Gelbard A, et al. Bicalutamide: A potential new oral antiandrogenic drug for female pattern hair loss. J Am Acad Dermatol 2020;83:e355-6.  |
| 2. | Fernandez-Nieto D, Saceda-Corralo D, Rodrigues-Barata R, Hermosa-Gelbard A, Moreno-Arrones O, Jimenez-Cauhe J, et al. Oral bicalutamide for female pattern hair loss: A pilot study. Dermatol Ther 2019;32:e13096. |
| 3. | Ismail FF, Meah N, Trindade de Carvalho L, Bhoyrul B, Wall D, Sinclair R. Safety of oral bicalutamide in female pattern hair loss: A retrospective review of 316 patients. J Am Acad Dermatol 2020;83:1478-9. |
| 4. | Saceda-Corralo D, Rodrigues-Barata AR, Vañó-Galván S, Jaén-Olasolo P. Mesotherapy with dutasteride in the treatment of androgenetic alopecia. Int J Trichology 2017;9:143-5. |
| 5. | Herz-Ruelas ME, Álvarez-Villalobos NA, Millán-Alanís JM, de León-Gutiérrez H, Ocampo-Garza SS, Gómez-Flores M, et al. Efficacy of intralesional and oral dutasteride in the treatment of androgenetic alopecia: A systematic review. Skin Appendage Disord 2020;6:338-45. |
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