Post-finasteride syndrome: survey of dermatologists from the Spanish Hair and Nail Disorders Group

fx1 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.