Anti-androgen treatment must be continued for at least 12 months. Often two years is required before a subjective improvement is observed. Complete reversal of the hair loss can never be achieved unless treatment is instigated within two years of its onset. This is probably due to the atrophy of the miniaturized hair follicles with time. Some improvement in hair quality should be expected in all cases, although withdrawal of therapy results in further progression of the alopecia.
Nonhormonal aspects are critical to ensure an optimal therapeutic response is achieved.
And, the need to maintain vitamin and serum ferritin levels above values previously thought adequate has recently been demonstrated. The side effects of oral CPA therapy in combination with ethinyl-estradiol are well documented and are similar to those associated with other oral contraceptive regimens. To understand how these hormonal remedies work, you need to know a little science. DHT is one of several male hormones, called androgens, that compete for a berth on the hair follicle's receptor sites. In principle, if you could keep the receptor busy metabolizing other hormones, like progesterone, DHT would never have a chance to move in and start shrinking the follicle.