Male-pattern baldness affects most men at one point in their lives.
(CNN)A receding hairline. A bald spot spreading on the top of head. Painfully thin hair that is especially noticeable where the hair parts. Some 90% of men will suffer some form of hair loss during their lifetime, often leading to symptoms of low self-esteem, anxiety and depression.
Studies on which nonsurgical treatments work best for male-pattern baldness have been limited, leaving men at a loss as to the most effective solution.
Now a new meta-analysis of 23 studies sheds light on that issue. The study, published Wednesday in the journal JAMA Dermatology, analyzed research on the impact on thinning male hair of using various dosages of the three oral and topical medications -- minoxidil, dutasteride and finasteride -- for two to four months.
"This meta-analysis is important. We don't have randomized clinical trials that compare these medications for male pattern baldness against one another, which would be ideal," said dermatologist Dr. Anthony Rossi of Memorial Sloan Kettering Cancer Center in New York City, who was not involved in the study.
Top performer: The analysis found taking 0.5 milligrams a day of oral dutasteride had the highest probability of reducing male hair loss.
Dutasteride is a prescription drug approved by the US Food and Drug Administration for the treatment of enlargde prostate glands in men. It's also used to treat male-pattern baldness, but that use is considered "off-label" since dutasteride does not have FDA approval as a hair loss treatment.
Off-label use is quite common in medicine, Rossi said. "Many medications are used off label, but there's usually enough evidence out there to explain why we believe those drugs will work," he added.
Dutasteride does have more severe side effects than several of the treatments, however, including a loss of sexual drive and the ability to get and keep an erection.
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