More DHT in balding scalp? Study

[michael barry]

The effect of finasteride, a 5 alpha-reductase inhibitor, on scalp skin testosterone and dihydrotestosterone concentrations in patients with male pattern baldness.

Dallob AL, Sadick NS, Unger W, Lipert S, Geissler LA, Gregoire SL, Nguyen HH, Moore EC, Tanaka WK.
Merck Research Laboratories, Rahway, New Jersey 07065.

The effects of the 5 alpha-reductase inhibitor, finasteride, on scalp skin testosterone (T) and dihydrotestosterone (DHT) levels were studied in patients with male pattern baldness. In a double blind study, male patients undergoing hair transplantation were treated with oral finasteride (5 mg/day) or placebo for 28 days. Scalp skin biopsies were obtained before and after treatment for measurement of T and DHT by high pressure liquid chromatography-RIA. In 10 male subjects studied at baseline, mean (+/- SEM) DHT levels were significantly higher in bald (7.37 +/- 1.24 pmol/g) compared to hair-containing (4.20 +/- 0.65 pmol/g) scalp, whereas there was no difference in mean T levels at baseline. In bald scalp from 8 patients treated with finasteride, the mean DHT concentration decreased from 6.40 +/- 1.07 pmol/g at baseline to 3.62 +/- 0.38 pmol/g on day 28. Scalp T levels increased in 6 of 8 subjects treated with finasteride. Finasteride decreased the mean serum DHT concentration from 1.36 +/- 0.18 nmol/L (n = 8) at baseline to 0.46 +/- 0.10 nmol/L on day 28 and had no effect on serum T. There were no significant changes in scalp or serum T or DHT in placebo-treated patients. In this study, male subjects treated with 5 mg/day finasteride for 4 weeks had significantly decreased concentrations of DHT in bald scalp, resulting in a mean level similar to the baseline levels found in hair-containing scalp.

Publication Types:

* Clinical Trial
* Randomized Controlled Trial


PMID: 8077349 [PubMed - indexed for MEDLINE]




I think this is particularily interesting:

"................5 mg/day finasteride for 4 weeks had significantly decreased concentrations of DHT in bald scalp, resulting in a mean level similar to the baseline levels found in hair-containing scalp. "

 

[bubka]

dude, it drops the dht level in less than 3 days

 

[Wash n' Gone]

That is interesting. Suggestive that mean levels of scalp DHT could be the prime mechanism in male pattern baldness, rather than simple androgen sensitivity in the hair follicle?

 

[Bryan]

That is interesting. Suggestive that mean levels of scalp DHT could be the prime mechanism in male pattern baldness, rather than simple androgen sensitivity in the hair follicle?

I don't think that's a legitimate conclusion to draw. You have to keep in mind that when you take finasteride, the 5a-reductase enzyme is inhibited to a greater degree than just what those numbers in the abstract suggest. In other words, it's completely unnatural for that enzyme to be inhibited to as great a degree as it is when you take Proscar or Propecia. The sensitivity to androgens within hair follicles must also be an important factor, in my opinion.

 

[docj077]

I found this interesting...like I always do...even though we all know this fact...

"Scalp T levels increased in 6 of 8 subjects treated with finasteride."



So, I found this:




The modulation of aromatase and estrogen receptor alpha in cultured human dermal papilla cells by dexamethasone: a novel mechanism for selective action of estrogen via estrogen receptor beta?

J Invest Dermatol. 2006; 126(9):2010-8 (ISSN: 0022-202X)
Thornton MJ; Nelson LD; Taylor AH; Birch MP; Laing I; Messenger AG
Department of Biomedical Sciences, University of Bradford, West Yorkshire, UK. m.j.thornton@bradford.ac.uk

Steroid hormones have important modulatory effects on the hair follicle, but the mechanisms by which they regulate human hair growth are still poorly understood. It is now clear that there are two distinct estrogen receptors (estrogen receptor alpha (ERalpha) and estrogen receptor beta (ERbeta)) that bind 17beta-estradiol. Since the follicular dermal papilla is known to control hair growth, and steroid hormones regulate receptor and aromatase expression in other tissues, we tested the hypothesis that steroid hormones would similarly modulate estrogen receptor and/or aromatase expression in cultured dermal papilla cells derived from human hair follicles. Primary cultures of non-balding occipital and frontal scalp and beard dermal papilla cells (n = 10) were established. Immunocytochemical studies showed the expression of ERalpha in both the cytoplasm and nucleus, whereas ERbeta was confined to the nuclei. The cells derived from occipital scalp were also incubated for 24 hours with 10 nM of either 17beta-estradiol, estrone, testosterone, 5alpha-dihydrotestosterone, 5alpha-androstane-3alpha, 17beta-diol, 5alpha-androstane-3beta, 17beta-diol, or 100 nM tamoxifen or dexamethasone in phenol red-free, serum-free medium to measure the steady-state levels of ERalpha, ERbeta, and aromatase mRNA by semiquantitative reverse transcriptase-PCR. Although androgens and estrogens did not alter ERalpha mRNA levels, treatment with dexamethasone significantly reduced ERalpha levels to 38% of the untreated control. By contrast, ERbeta mRNA levels were unaffected by any steroid treatment. Furthermore, dexamethasone significantly stimulated the expression of aromatase mRNA approximately 9-fold. Aromatase activity, assayed by the tritiated water method, was stimulated in both frontal scalp and beard dermal papilla cell cultures by dexamethasone. These observations provide evidence for a glucocorticoid-dependent mechanism whereby the selective action of estradiol via ERbeta may be promoted. Additionally, upregulation of aromatase combined with downregulation of ERalpha provides a basis for selective action of estradiol produced locally by autocrine or paracrine mechanisms.


This is something that I'm sure we were all aware of, but I thought that is was interesting. I don't know how long aromatase activity is increased for with one dexamethasone application, but it could eliminate the likely problem of increased scalp testosterone for some guys. I also know that applying steroids long term to the skin is a bad idea, but it might be a fruitful endeavor for those that are getting no results.

 

[blaze]

Hey Doctor,

Where can you get a dexamethasone topical from anyway?

Also wouldnt an anti-androgen topical like spironolactone solve the extra Testosterone issue by blocking the receptor?