Topical finasteride microdosing as additional treatment?

deniak

Member
Reaction score
32
Hi guys!


Lately I digged into topic of topical finasteride. My stance about finasteride is straightforward – I dont want to wipe out one of most potent male hormones from my body; beside common sense, there is growing evidence than finasteride is not as safe as advertised. However Im not hypocrite and I know that finasteride and dutasteride are most effective things that we have today, and probably we wont see anything better in our lifteime (and almost certain in lifetime of our remaining hair follicles).
For people who use finasteride or dutasteride with success, this thread will be simply boring, so you can skip it. My english is poor, so I post only basics without to much speculations. Im also not scientist so I might be wrong, feel free to chime in and correct / add some insights:)


The question I asked myself is: can I use finasteride as powerful part of hairloss therapy without unwanted side effects?


Few facts:


1) Oral microdosing:


Thanks to Drake study we know few important things:


Dose as small as 0,01 mg is comparable to placebo both in DHT inhibition and hair count.


Dose as small as 0,05 mg blocks DHT in scalp almost like 1 mg dose, but reduce little less DHT in body (~50%).


Dose as smal as 0,2 mg have therapeutic effect, unfortunately after enough applications reduce systemic DHT just like 1 mg and 5 mg dose (60-70%).


finasteride.png



Conclusion – unfortunately I havent found information about hair count with dosages ranging from 0.02 mg-0.04 mg. But I assume that if you want to avoid side effects (loss of serum DHT) and same time save your hairs, oral microdosing is useless. With microdosing >0.05 mg soon or later serum DHT will be inhibited to "max" point (50-70% = possible sides)


2) Topical microdosing:


We got recent weak studies made by Polichem.


http://www.ncbi.nlm.nih.gov/pubmed/25074865


Dose as huge as 2,2 mg finasteride in 1 ml of P-3074 vehicle reduced DHT in body 20% after 1 day, while 7 days later reduction was identical to 1mg pill.


http://www.ncbi.nlm.nih.gov/pubmed/26636418


To avoid systemic effects, they tried microdosing with ED application for 7 days:


- 0,1 ml (0,22 mg finasteride) and 0,2 ml (0,45 mg) reduced skin DHT -47/-52% (almost same values as 0,2 mg oral which was proved as effective treatment), serum reduction was "only" -24/-26%
- 0,3 ml (0,62 mg) 0,4 ml (0,91 mg) reduced skin DHT -37/-54%, serum -44/-48%


0,1 ml and 0,2 ml looks quite good, but studies was short term and unfortunately... it matters a lot.


I encourage everybody to read log of user joestes from HLH. Years before Polichem he tried similiar treatment. Basically he tried to copy Mazzarella study (supposedly no systemic effects) by using 0,066 mg finasteride on scalp dailly (2 mg finasteride solved in 60ml of minoxidil, used 2 ml ED). After 21 days he checked his DHT levels and found that serum levels was reduced just like with pill. He was shocked and frustrated.


But if we look at chart from Gormley study its becoming obvious what happened:


gormley.jpg



White circle is dose of 0,04 mg administered orally. After one dosage DHT changed slightly, after 8 days of constant use we have 50% serum reduction and after 14 days we have DHT almost wiped out from body just like with "normal" oral dose.


I may be wrong, but this is my broscientist understanding: no matter if we swallow pill or put topical, we have point of saturation in different organs. For example: after few topical dosages finasteride is blocking reductase in scalp to some extent (about 60-70% inhibition, look at Drake graph or other studies). Less work with DHT in scalp means that applied finasteride is wandering through blood looking for other organs, like testicles or liver to act there. DHT rebuilds slowly (few days / weeks depending on dose and body type) so with enough small dosages we will achieve cumulated effect of one huge dose. Joestes used super small dose, but if we assume 10% of systemic absorption we have cumulation of 0,13 mg finasteride traveling through his body during 21 days of his experiment.


Conclusion – looks like topical microdosing WONT prevent systemic absorption IF we use finasteride continously for long enough time.


Knowing that, what we can do?


Last posts of Joestes thread are written by guy named defenderofcrown (love his name BTW:). He came with idea of microdosing but only once every few days. He wanted to achieve max DHT suppresion in scalp, while leaving internal organs untouched.


For example, lets look at 0,2mg dose applied topically once every 5 days. Assuming 10% absorption we have 0,02mg finasteride circulating in bloodstream.


fin_halflife.gif



Based on graph we see above, after single oral dose of 0,04 mg serum DHT was supressed about 10-20% and backs to "status quo" after 4 days.


I havent found any research on intermittent therapy like this, but I can assume that it wont work effectively as standalone treatment, bacuse a)DHT is slowly rebuilding in scalp and b) DHT from other organs attack follicle. BUT on paper it SHOULD have some efficiancy and it may be potent addition to any reputable androgen blocker. Most of guys here are using some blocker – from light weight like keto to heavywieght like RU. Moreover, topical route might be wortha a shot, heres link to old post of bryan (kudos to dench for link) where he writes about purpose of attacking DHT not inside body but directly at follicle zone.


One of unknown is dose and interval between dosages to get max saturation in scalp, while leaving serum levels in safe zone. It might be 0,2 mg every 5 days or 0,05mg every 3 days, or 0,01mg EOD etc... Its open topic. The higher frequency the bigger risk of serum inhibition. The higher dose, the bigger risk of unwanted absorption. Im currently searching for more info, there is lot of data, not only controlled research but also single cases.


Also, knowing cumulative effect of finasteride, its obvious why topical finasteride threads are mostly fail (sides etc):


- some guys use huge doses like in Polichem first trial, so after few dosages blood serum is reduced just like with single small oral dose
- there are guys using more or less "correct" microdoses, but EVERY day. DHT rebuilds long time, so with every subsequent dosage more and more finasteride is circulating in bloodstream reducing DHT in other organs (joestes case), up to full "saturation" point.


What you guys think?


PS. For those interested, heres additional link to old but gold thread: http://www.hairlosstalk.com/interac...benifits-of-propecia-without-the-side-effects
 

kiwipilu

Experienced Member
My Regimen
Reaction score
1,052
That thread might be interesting. Good researches .

About Finasteride gel 2,5% from H&W , the pharmacy selling for the product Europeans stated “Usually it should be applied 2-3 times per week »
 

Felipe302

Established Member
Reaction score
40
I am going to cycle anti androgens, using cb as a base, since it's supposed to be side effects free(even though a few guys reported sides when taking over extended periods of time)
I will use every other day cb and in the days between i will use ru or topical finasteride alternately.

I think I could avoid build up that way, I don't know, I'm also going to use low doses. Also, it's going to be more cost effective, since cb is expensive.

My goal is not really regrowth, but just to keep what I have without sides, so I can get a hair transplant.
 

MomoGee

Experienced Member
My Regimen
Reaction score
1,837
Thank you for the great work mate. I desperately need antiadrogens as Minoxidil isn't working very well with me (aggressive male pattern baldness since 16). Based on your research would you say that, if Polichem find the sweet spot for concentration, we could potentially have an effective treatment that is safe? Or at the frequency which is safe to use without side effects the DHT would build up quickly back on the scalp making the treatment ineffective?
 
  • Like
Reactions: Oro

shulk

Established Member
My Regimen
Reaction score
80
Good post, thank you.

Do you know why the Gormley graph tells us 0.04mg finasteride will eventually reach the same amount of Serum DHT inhibition as compared to 1mg? The drake study shows 0.05mg inhibits Serum DHT only for 49.5% after 42 days. This is a big difference in outcome.
 

Aleksandar

Established Member
Reaction score
63
Very interesting, thanks!

I wonder how a combination of once or twice a week low dosing finasteride with a weekly dose of hydrocortisone (to battle inflammation) would work.

At the moment I'm using hydrocortisone on a once a week basis and my scalp is very relaxed. Before it would get very inflamed and the shedding would pick up. Now that I'm using hydrocortisone the shedding has reduced greatly.
 

deniak

Member
Reaction score
32
MomoGee,
Or at the frequency which is safe to use without side effects the DHT would build up quickly back on the scalp making the treatment ineffective?
From my understanding this is the biggest obstacle to even think about it as a single treatment. We need receptor blockers also.
The problem is that guys who refuse to take finasteride, need to attack very hard with androgen blockers like RU or spironolactone. There is no sides free hairloss treatment, unfortunately not everyone is capable of using high concentartions of those compounds without noticing adverse effects. I think about dual therapy not only as hedging bets, but also as way to use smaller doses of both DHT inhibitor and receptor blocker. They should work, more or less, on different pathways.

Shulk,
Do you know why the Gormley graph tells us 0.04mg finasteride will eventually reach the same amount of Serum DHT inhibition as compared to 1mg? The drake study shows 0.05mg inhibits Serum DHT only for 49.5% after 42 days. This is a big difference in outcome.
I have no idea honestly. Fact is, the horse has already bolted and 50% is IMO very significant inhibition.

Yesterday I started topical alfatradiol, so our poor cousin of finasteride:) Will see if or how it will work.


Also, if someone is trying topical finasteride for first time I encourage you to check DHT blood levels before treatment and after month or so. It might be very helpful observation.
 

Rockinlove

Established Member
Reaction score
14
I wonder if there ever wil be a side-effect free hair loss treatment. Since the ones that we use now are something of a gamble and much akin to that of playing russian roulette.

Neverthless. there are presently no tenable treatments apart from minoxidil and 5ar blockers as well as nhibitors that have depicted efficacy towards resolving hair loss.

The problem I reckon is that hair loss is not completely understood We have conjectures that are somewhat tenable but there is a need for more in depth research to the puzzle that is hair loss. Since science is relegated to merely treating the symptoms (hair loss) without a true understanding of the cause.

In its blasest form, hair loss is a consequence of cellular atrophy. The reasons for its occurence still something of an enigma. All we know is that it has to do with androigens, AR receptors, l wnt signalling, inflammation and an increase in PGD2 among a few other important factors.

MomoGee,
From my understanding this is the biggest obstacle to even think about it as a single treatment. We need receptor blockers also.
The problem is that guys who refuse to take finasteride, need to attack very hard with androgen blockers like RU or spironolactone. There is no sides free hairloss treatment, unfortunately not everyone is capable of using high concentartions of those compounds without noticing adverse effects. I think about dual therapy not only as hedging bets, but also as way to use smaller doses of both DHT inhibitor and receptor blocker. They should work, more or less, on different pathways.

Shulk,

I have no idea honestly. Fact is, the horse has already bolted and 50% is IMO very significant inhibition.

Yesterday I started topical alfatradiol, so our poor cousin of finasteride:) Will see if or how it will work.


Also, if someone is trying topical finasteride for first time I encourage you to check DHT blood levels before treatment and after month or so. It might be very helpful observation.
 

Armando Jose

Senior Member
My Regimen
Reaction score
975
I wonder if there ever wil be a side-effect free hair loss treatment. Since the ones that we use now are something of a gamble and much akin to that of playing russian roulette.

Neverthless. there are presently no tenable treatments apart from minoxidil and 5ar blockers as well as nhibitors that have depicted efficacy towards resolving hair loss.

The problem I reckon is that hair loss is not completely understood We have conjectures that are somewhat tenable but there is a need for more in depth research to the puzzle that is hair loss. Since science is relegated to merely treating the symptoms (hair loss) without a true understanding of the cause.

In its blasest form, hair loss is a consequence of cellular atrophy. The reasons for its occurence still something of an enigma. All we know is that it has to do with androigens, AR receptors, l wnt signalling, inflammation and an increase in PGD2 among a few other important factors.

+1
 

caper0101

Member
Reaction score
0
From this data it looks to me like the answer is 0.5 mg every 3 days. Should give you a continuous 30% reduction in DHT. Am i missing something?
 

PrinceWilliamThe2nd

Member
My Regimen
Reaction score
54
It's pretty much unknown how DHT from the scalp contributes to the miniaturization of the follicle in comparison to DHT from serum. Would be great to see a study that evaluates the effectiveness on hair loss of mainly just inhibiting 5AR in the scalp by finding a sweet spot of topical finasteride/dutasteride that would change serum levels by just a few percent.
 

Afro_Vacancy

Senior Member
My Regimen
Reaction score
11,938
It's pretty much unknown how DHT from the scalp contributes to the miniaturization of the follicle in comparison to DHT from serum. Would be great to see a study that evaluates the effectiveness on hair loss of mainly just inhibiting 5AR in the scalp by finding a sweet spot of topical finasteride/dutasteride that would change serum levels by just a few percent.

That's what polichem is working on.
 

PrinceWilliamThe2nd

Member
My Regimen
Reaction score
54
That's what polichem is working on.

You are right! And the results look encouraging: https://www.researchgate.net/profil...c_alopecia/links/5694fea508ae3ad8e33d3e48.pdf

attachment.php
attachment.php


So, with 0.2275mg finasteride topical daily they inhibited ~50% of the scalp DHT, which is the same amount DHT inhibited with 1mg oral finasteride. Though, for the topical solution there was only a 24% decrease in serum DHT, while the tablet reduced serum DHT by 70%.

Maybe, this is the sweet spot for topical finasteride to inhibit just enough DHT in the scalp to stop the loss, and not to much to get sides...
 

Attachments

  • topical finasteride - high.png
    topical finasteride - high.png
    315 KB · Views: 2,157
  • topical finasteride - low.png
    topical finasteride - low.png
    393.1 KB · Views: 2,795
Last edited:

guybrush

Established Member
My Regimen
Reaction score
1
There's something really remarkable in these graphs. Once a day application yield better results (more scalp DHT inhibition) than twice a day. The same with the quantities they used: 100μl showed nearly the same DHT inhibition than 400μl with a much smaller systemic effect.


Apparently more doesn't mean better when it comes to topical finasteride.
 

PrinceWilliamThe2nd

Member
My Regimen
Reaction score
54
The study from Caserini et al. is actually very similar to the study from Mazzarella et al. from 1997, just with the addition that Caserini further characterized the DHT levels by comparing scalp and serum levels. Mozzarella et al. even used a lower amount of topical finasteride for their study, just 0.05mg daily and also observed positive results:

http://www.tandfonline.com/doi/abs/10.3109/09546639709160517
 

guybrush

Established Member
My Regimen
Reaction score
1
The study from Caserini et al. is actually very similar to the study from Mazzarella et al. from 1997, just with the addition that Caserini further characterized the DHT levels by comparing scalp and serum levels. Mozzarella et al. even used a lower amount of topical finasteride for their study, just 0.05mg daily and also observed positive results:

http://www.tandfonline.com/doi/abs/10.3109/09546639709160517

I think they used a 0.005% solution twice a day. That means 0.1mg of finasteride a day.

Interestingly, there's a another study from Rushton et al. where they used 0.05% b.i.d. and they found a 40% of sebum DHT reduction with no improvement on hair growth.
I came across the text and found out they applied 2ml each time, making it 2mg of finasteride a day.

Again, lower doses seem to perform better.
 

guybrush

Established Member
My Regimen
Reaction score
1
Hey guybrush,

can you post a link for that study please?

Thanks!

Actually I don't have the original paper and I don't think it's available online. Some guy posted parts of it years ago and I copy pasted into a word document.
I've been more than 5 years away from hair loss forums and I don't remember where I took this from but if you make a search on Google you'll find it's been discussed many times.

This is the name of the paper:
Topical 0.05% finasteride significantly reduced serum DHT concentration, but had no effect in preventing the expression of genetic hair loss in men.

- - - Updated - - -

Here it is, I've found it :)

http://www.hairlosstalk.com/interac...Here-s-one-of-the-topical-finasteride-studies!
 
Top