Actas Dermosifiliogr. 2026 Mar 20:104638. doi: 10.1016/j.ad.2026.104638. Online ahead of print.
ABSTRACT
BACKGROUND AND OBJECTIVE: Post-finasteride syndrome (PFS) refers to a set of persistent symptoms reported by patients after discontinuation of 5-alpha-reductase inhibitors (5-ARIs). This study aimed to explore the perception of PFS among dermatologists belonging to the Spanish Hair and Nail Disorders Group.
MATERIALS AND METHODS: We conducted a qualitative literature review to develop a survey. Fifty-four dermatologists participated in a questionnaire based on a Likert scale. Consensus was defined using specific statistical criteria, including a median within a predefined range and an interquartile range (IQR) ≤ 2.
RESULTS: A total of 83.3% of respondents had never encountered cases of PFS in their clinical practice. Most participants (98.1%) considered that PFS has a psychiatric origin, and 92.6% believed that any adverse effect of 5-ARIs is reversible after treatment discontinuation. The most widely reported symptoms, such as sexual dysfunction, were considered possibly related to the use of 5-ARIs. Symptoms such as cognitive impairment, anxiety, and depression were considered unrelated by the majority. Consensus was reached for 13 of the 15 items, with 90.7% agreeing that current scientific evidence on PFS is poor and 85.1% identifying a specific patient profile (young men with pre-existing anxiety or depression).
CONCLUSION: Dermatologists perceive PFS as an infrequent phenomenon with a predominantly psychiatric origin. Although awareness of the syndrome is widespread, high-quality longitudinal studies are needed to establish clear guidelines for its diagnosis and management.
PMID:41865985 | DOI:10.1016/j.ad.2026.104638
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