Finasteride Associated Melasma in a Caucasian Male

April 2014 | Volume 13 | Issue 4 | Case Reports | 484 | Copyright © April 2014

Shannon Famenini BS,a Nima M. Gharavi MD PhD,b and David P. Beynet MDb

aDepartment of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA
bDivision of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, CA

in BPH patients on finasteride therapy.8-10 Therefore, we hypothesize that the development of melasma observed in our patients on finasteride therapy may be due to the potential increased activity of P450 aromatase and increased levels of estradiol induced by finasteride, locally in the skin. Additional research in this area will be needed to confirm this hypethesis.
In conclusion, we propose two mechanisms underlying the association between melasma and finasteride: 1) finasteride’s inhibition of 5α-reductase leads to increased levels of progesterone available to drive the pigmenatry changes observed, and 2) finasteride induces decreased DHT levels and increased testosterone levels available for aromatization to estradiol, which subsequently induces enhanced pigmentation.Furthermore, physicians and patients should be aware of this uncommon, though unwanted, potential side effect of finasteride for androgenetic alopecia.


The authors do not have any financial interests to disclose.


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David P. Beynet