Supplementary Material for: Drug-Induced Melasma in Patients on 5-Alpha Reductase Inhibitors: A Case Report

January 2026 in “ Figshare ”

figshare admin karger, Elhaj H., Orrell K., Beach R.A.

finasteride 5-alpha reductase inhibitors melasma frontal fibrosing alopecia benign prostatic hyperplasia cysteamine cream facial hyperpigmentation 5-ARIs

TLDR Finasteride can cause melasma, especially in people with darker skin.

This case report highlights two instances of finasteride-induced melasma, expanding the limited literature on pigmentary side effects associated with 5-alpha reductase inhibitors (5-ARIs). A 53-year-old woman and a 66-year-old man, both with darker skin types, developed melasma after prolonged use of finasteride for frontal fibrosing alopecia and benign prostatic hyperplasia, respectively. Discontinuation of finasteride and targeted melasma therapies, including cysteamine cream, led to partial improvement. The report emphasizes the importance of considering 5-ARI exposure in patients with new-onset or refractory facial hyperpigmentation, as early recognition and medication review may help mitigate persistent pigmentation.

View this study on karger.figshare.com →

Discuss this study in the Community →

Related Community Posts Join

6 / 1000+ results

community Does finasteride/dutasteride reverse aging?

in Chat 45 upvotes 1 year ago

Finasteride and dutasteride can improve skin texture and reduce acne by lowering DHT but do not reverse aging. They may enhance skin and hair health for some, but can also cause side effects like dry skin and sexual dysfunction.

community Why is Finasteride seen as “scary” for men, but hormonal birth control is totally normalized for women?

in Finasteride/Dutasteride 753 upvotes 9 months ago

Finasteride is seen as risky for men due to side effects like erectile dysfunction, while hormonal birth control for women is normalized despite its side effects. The discussion points out a double standard influenced by societal and gender norms.

community 34 Year old male - 20 month Finasteride 1.25 mg / day

in Progress Pictures 663 upvotes 8 months ago

A 34-year-old male experienced significant hair regrowth and increased density after 20 months of using 1.25 mg of finasteride daily, with no noticeable side effects. He did not use minoxidil due to adverse effects and plans to consider adding dutasteride weekly for further improvement.

community Research Backed Dutasteride Simulator (Serum/Scalp DHT included for all doses)

in Finasteride/Dutasteride 113 upvotes 1 year ago

A dutasteride simulator predicts that daily 0.5 mg dosing results in higher DHT suppression compared to less frequent dosing. Twice-weekly dutasteride may be as effective as finasteride 5 mg, providing a balance between efficacy and ease of use.

community 1600 grafts (~5500 hairs) | 10 month results

in Transplants 1669 upvotes 7 months ago

The user received 1600 hair grafts but is dissatisfied and plans a second transplant for better coverage. They use minoxidil and finasteride and are considering adding dutasteride.

community Research Backed Dutasteride Simulator (Serum/scalp DHT included for all doses)

in Research 489 upvotes 1 year ago

A Dutasteride Simulator predicts serum dutasteride, serum DHT, and scalp DHT levels using models from research papers. It simulates various dosing schedules to determine steady-state effects and visualizes outcomes, including hair growth-related scalp DHT suppression.

Similar Research

5 / 1000+ results

research Antiandrogens and Androgen Inhibitors in Dermatologic Treatments

November 2020 in “Elsevier eBooks”

Antiandrogens and androgen inhibitors like spironolactone, finasteride, and dutasteride can treat hair loss and skin conditions, but they have risks and side effects, including potential harm to pregnant women and risks of cancer and heart issues. Herbal remedies also have antiandrogenic effects but lack safety validation.

Hair Loss in Women: Comprehensive Overview and Treatment Options