Background:Female     pattern hair loss (FPI-Il,) is the most common type of hair loss, affecting

approximately  50%ofwomen   older than 40 years. Women with hair loss are more likely to have a lowered self-esteem  and lowered quality oflife  than men. Objective:Comparison    of the efficacy and safety of topical minoxidil  5%, topical minoxidil  2 % and  systemic finasteride  1   mg  in treatment of female  pattern hair loss.

Patients and  Methods:Study   included  80 patients with history of female pattern hair loss

(FPHL) of more than one year duration.  Patients were divided randomly  into 4 treatment groups and each patient received treatment  for 6 months,  group (A) topical minoxidil   5% (n=20),  group (B) topical minoxidil  2% (n=20) and group (C) systemic  finasteride 1 mg daily  (n=20) and lastly group (D) topical  placebo  (alcohol  10%) (n=20).  Efficacy was evaluated  by Ludwig's grade of frontal hair thinning,  patient self-assessment  and investigator's  assessment.

Results:Both   5% and 2% topical minoxidil  showed more statistically  significant  difference

than placebo  in promoting  hair growth in women with Fl'Hl..  Consistent  statistical  advantage of 5% topical minoxidil  over 2% topical minoxidil  was not demonstrated.  The highest prevalence  of   drug-related  adverse events of a dermatologic  nature (such as pruritus, dermatitis,  dryness,  scaling) were showed with placebo,  followed by minoxidil  5% then minoxidil  2%.  Finasteride  was no more effective than placebo except in slowing  down hair loss. Oral finasteride was well tolerated  by the women without  evidence  of systemic  adverse effects  except breast tenderness  and menstrual  irregularity.

Conclusion:Daily    applications  of minoxidil  5% or minoxidil  2% were found to be more

effective  than oral finasteride  lmg in treatment  of FPI-Il,.