Finasteride has proved to be relatively safe and effective in the therapeutic management of male androgenic alopecia. However, literature data report several endocrine imbalances inducing various adverse effects, which often persist after treatment cessation in the form of post-finasteride syndrome. Here we present the case of a 52-year-old man receiving finasteride (1 mg/day) who developed an uncommon adverse effect represented by generalized vitiligo 2 months after finasteride discontinuation. Associated adverse effects encountered were represented by mild sexual dysfunction (as determined by the International Index of Erectile Function, IIEF) and moderate depressive symptoms (according to DSM-V criteria), all of these manifestations aggregating within/as a possible post-finasteride syndrome. Further studies should develop and compare several therapeutic approaches, taking into account not only compounds that decrease the circulating dihydrotestosterone level but also those that could block the dihydrotestosterone receptors (if possible, compounds with selective tropism towards the skin). In addition, the possibility of predicting adverse effects of finasteride (according to hand preference and sexual orientation) should be taken into account.

1.
Ali AK, Heran BS, Etminan M: Persistent sexual dysfunction and suicidal ideation in young men treated with low-dose finasteride: a pharmacovigilance study. Pharmacotherapy 2015;35:687-695.
2.
Famenini S, Gharavi NM, Beynet DP: Finasteride associated melasma in a Caucasian male. J Drugs Dermatol 2014;13:484-486.
3.
Paunica S, Giurgiu M, Vasilache A, Paunica I, Motofei I, Dumitriu HT, Dumitriu AS: Finasteride adverse effects and post-finasteride syndrome; implications for dentists. J Mind Med Sci 2016;3:71-79.
4.
Motofei IG, Rowland DL, Georgescu SR, Tampa M, Baconi D, Stefanescu E, Baleanu BC, Balalau C, Constantin V, Paunica S: Finasteride adverse effects in subjects with androgenic alopecia: a possible therapeutic approach according to the lateralization process of the brain. J Dermatolog Treat 2016;4:1-3.
5.
Patrizi A, Bentivogli M, Raone B, Dondi A, Tabanelli M, Neri I: Association of halo nevus/i and vitiligo in childhood: a retrospective observational study. J Eur Acad Dermatol Venereol 2013;27:148-152.
6.
Gong Q, Li X, Gong Q, Zhu W, Song G, Lu Y: Hashimoto's thyroiditis could be secondary to vitiligo: the possibility of antigen crossover and oxidative stress between the two diseases. Arch Dermatol Res 2016;308:277-281.
7.
Irwig MS: Decreased alcohol consumption among former male users of finasteride with persistent sexual side effects: a preliminary report. Alcohol Clin Exp Res 2013;37:1823-1826.
8.
Al-Harbi M: Prevalence of depression in vitiligo patients. Skinmed 2013;11:327-330.
9.
Hodes GE, Kana V, Menard C, Merad M, Russo SJ: Neuroimmune mechanisms of depression. Nat Neurosci 2015;18:1386-1393.
10.
Caruso D, Abbiati F, Giatti S, Romano S, Fusco L, Cavaletti G, Melcangi RC: Patients treated for male pattern hair with finasteride show, after discontinuation of the drug, altered levels of neuroactive steroids in cerebrospinal fluid and plasma. J Steroid Biochem Mol Biol 2015;146:74-79.
11.
Cutolo M, Sulli A, Straub RH: Estrogen metabolism and autoimmunity. Autoimmun Rev 2012;11:460-464.
12.
Motofei IG, Rowland DL, Georgescu SR, Mircea T, Baleanu BC, Paunica S: Are hand preference and sexual orientation possible predicting factors for finasteride adverse effects in male androgenic alopecia? Exp Dermatol 2016;25:557-558.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.