Persistent Gynecomastia due to Short-term Low-dose Finasteride for Androgenetic Alopecia.

Area of Science:

• Endocrinology
• Dermatology
• Pharmacology

Background:

• Finasteride, a 5-alpha-reductase inhibitor, is commonly prescribed for androgenetic alopecia.
• Gynecomastia is a known potential side effect of finasteride due to its mechanism of action.
• Limited reports exist for low-dose finasteride-induced gynecomastia, suggesting underreporting.

Purpose of the Study:

• To report a case of persistent gynecomastia in a young man using low-dose finasteride.
• To highlight the potential for underreported side effects of finasteride.
• To emphasize the importance of patient counseling and early intervention for finasteride-induced gynecomastia.

Main Methods:

• Case report of a 20-year-old male patient experiencing persistent gynecomastia.
• Discontinuation of finasteride and subsequent monitoring of gynecomastia.
• Treatment with raloxifene (a selective estrogen receptor modulator).
• Surgical intervention (bilateral mammoplasty) for persistent breast tissue.

Main Results:

• Persistent gynecomastia occurred in a healthy 20-year-old man after 1 month of low-dose finasteride.
• Gynecomastia remained unchanged 5 months after finasteride discontinuation.
• Partial regression of gynecomastia was observed after 6 months of raloxifene treatment.
• Surgical removal of remaining breast tissue was required 1 year later.

Conclusions:

• Low-dose finasteride may cause persistent and potentially irreversible gynecomastia.
• The incidence of finasteride-induced gynecomastia may be significantly underreported.
• Physicians should counsel patients on this risk and consider early interventions to prevent fibrotic changes.