Topical finasteride microdosing as additional treatment?

[Dedicated12]

@Deniak
Based on that information, and the plethora of anecdotal evidence across this forum and others, I'm inclined to think that you cannot tackle male pattern baldness with propecia along whilst simultaneously avoiding side effects, whether immediate or long term. Now, considering the majority of propecia users do not get side effects within initial usage period i.e +- 5 years, you're mentioning of the cumulative effect = side effects are relatively unknown for long term users and those that get off, a sudden influx of DHT affecting the hypothalamic-pituitary axis thus causing PFS etc.
To avoid the systematic suppression of serum DHT whilst reducing scalp DHT, based on the aforementioned studies by Drake, and the oral efficiency tests of 0.05 all the way to 5mg, a twice per week micro dosing of 0.05mg of finasteride say on a Monday and Thursday coupled with low dose of RU dh blocker 20mg on say Sunday, Tuesday, Friday should sufficiently block DHT at the scalp whilst negating side effects attributed to lowered serum DHT. This anti-androgen regime in conjunction with say nizoral, Min and stemox would ideally create a healthy scalp environment for the hair? Furthermore, perhaps cycling your finasteride use say 0.05mg twice per week for 2 weeks, followed by 0.05mg once per week for 2 weeks all the while painting a potent scalp DHT blocker at a low dose as well would avoid systematic suppression of serum DHT? Im incline to think with this approach, you could more or less sufficiently reduce Scalp DHT consistently, reaping the full benefits from finasteride, and negating the negatives completely
I'm curious as to your thoughts?

 

[Afro_Vacancy]

Dedicated12,

Propecia's effects include inhibiting T->DHT in the skin, inhibiting T->DHT in the serum. We know that finasteride's effect on those two reactions are nearly flat above ~0.05 mg/day, and certainly above ~0.20 mg/day.

However, we have -- no idea -- if inhibiting 5-alpha reductase has a flat response curve with respect to 5α-dihydrocortisol, Alloprenanolone, etc. We also have no idea on the response curve of T->DHT and other hormones in the brain and spiral cord.

Therefore, it's possible that changing the dose can change effectiveness or side effects separately, as some of the side effects may be due to those other hormones.

 

[deniak]

Thanks for your input Dedicated12.

@Deniak
Based on that information, and the plethora of anecdotal evidence across this forum and others, I'm inclined to think that you cannot tackle male pattern baldness with propecia along whilst simultaneously avoiding side effects, whether immediate or long term. Now, considering the majority of propecia users do not get side effects within initial usage period i.e +- 5 years, you're mentioning of the cumulative effect = side effects are relatively unknown for long term users and those that get off, a sudden influx of DHT affecting the hypothalamic-pituitary axis thus causing PFS etc.

I would rather say that removing most of DHT from body is causing PFS in same males. We know that there is certain genotype (those Carrribean guys for example) living fairly healthy life with 5ar deficiency. As I believe that safety reports of finasteride are largely skewed (underreported), I also believe people who say that are perfectly fine even with 5mg/day dose. Do I have the balls to try if Im in that lucky group, saving both my dick and my hair? Not enough desperated at this very moment

To avoid the systematic suppression of serum DHT whilst reducing scalp DHT, based on the aforementioned studies by Drake, and the oral efficiency tests of 0.05 all the way to 5mg, a twice per week micro dosing of 0.05mg of finasteride say on a Monday and Thursday coupled with low dose of RU dh blocker 20mg on say Sunday, Tuesday, Friday should sufficiently block DHT at the scalp whilst negating side effects attributed to lowered serum DHT. This anti-androgen regime in conjunction with say nizoral, Min and stemox would ideally create a healthy scalp environment for the hair? Furthermore, perhaps cycling your finasteride use say 0.05mg twice per week for 2 weeks, followed by 0.05mg once per week for 2 weeks all the while painting a potent scalp DHT blocker at a low dose as well would avoid systematic suppression of serum DHT? Im incline to think with this approach, you could more or less sufficiently reduce Scalp DHT consistently, reaping the full benefits from finasteride, and negating the negatives completely
I'm curious as to your thoughts?

Well, my attitude is simple - if I ever swallow finasteride, it will be smallest effective dose so 0,2 mg dailly, I see no point in using less. My idea was to search for possibility to decrease DHT production MOSTLY in follicles, but honestly saying, with finasteride it may be dead end. There is also risk that topical microdosing as a "pulse" therapy aka cycles of removing/rebuilding DHT might be counterproductive. My mind is poverty compared to some guys on this forum and no one came with soundly idea about specific microdose substantiated by available research etc.


I slightly changed my strategy, ATM Im trying 17a-estradiol which is weak but proven 5-ar inhibitor (interestingly listed on wiki along with finasteride and dutasteride). Pantostin should be used dailly so it fits my criteria of working in scalp every day, unfortunately at the expense of potency (its only 0,25mg dose which is 40 times smaller than dose from study where alfatradiol 1% was compared with CB with great results). I have no delusions about its efficiancy, but soon I will team it up with low doses of RU (hopefuly in future cycled with CB or other blocker) to create synergistic effect. I already observed that previous irritating itch on temples is almost non existent now. It might be placebo, but honestly Im more bitter now about hair loss cures, no high expectations, so this is definitely small, but good news for me.

 

[Afro_Vacancy]

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%).


http://s23.postimg.org/iip5fa1pn/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:

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.

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

Excellent work.

 

[hilbert]

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.

read that thread months ago.
unfortunately, afaik normal blood tests are not good to measure dht, because of dynamicity and lack of accuracy.
e.g. off finasteride my dht was sometimes lowe than on finasteride.

you need to do multiple tests, average them etc. as Mazzarella did.
so, his study and microdose are still legit imho.

 

[whatevr]

Would oral + topical finasteride be more successful than oral alone?
Oral can only get around 50% scalp DHT AFAIK.
But it seems that also absorbing finasteride through the scalp would definitely make some more of it attach to the local 5 AR in the follicles maybe?
Or is that just too much of a layman's view...

 

[WangMQ]

The thoughts of topical microdosing have always been lingering in my head...

I've brought this up several times before: there were discussions on other forums about whether endocrine or paracrine/autocrine DHT plays the biggest role in male pattern baldness. An indirect evidence they had was that when treating androgen related problems (like gynos), you'd use a topical DHT cream instead of DHT injections. Injection simply doesn't work. That might indicate that serum DHT is not the real problem for us.

I also read an article saying serum DHT are not so easy to enter the cell memrane of hair follicles and less likely to activate androgen receptors (might be wrong, vague memory, sorry).

That combined with the evidences from OP and bryan lend a lot of credit to this topical angle.

When you consider the reports of Androgen Receptor up regulation and hyperandrogenecity, it also means that topical finasteride is safer not only because it MIGHT give you less sides, but also is less likely to change your body globally.

At last, I think even if we can't prevent all the sides with topical finasteride, at least it would be a more "cost effective" way. i.e. when applying the same dosage, you can't get more sides than with oral finasteride And to reach the same treatment effect, you'd need smaller dosage than oral. Perhaps the best way would be to combine oral and topical, both microdosing.

But the paper posted by guybrush suggesting topical finasteride having no effect hair wise is casting shadow on us here...

 

[WangMQ]

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.

I tried similar tricks before, i.e. rotating oral finasteride and RU EOD. Turns out it didn't quite work out. I think you can't assume your body will react to these drugs seperately. Even drugs from different angles have cumulative effects and when sides come they just make things even more complicated (too hard to analyze the source of sides)

 

[Mr White]

Would oral + topical finasteride be more successful than oral alone?
[...]

I was going to ask the same question.

Any thoughts on this?

 

[whatevr]

-screw this, it was wrong-

 

[hilbert]

I tried similar tricks before, i.e. rotating oral finasteride and RU EOD. Turns out it didn't quite work out. I think you can't assume your body will react to these drugs seperately. Even drugs from different angles have cumulative effects and when sides come they just make things even more complicated (too hard to analyze the source of sides)

eod? so you weren't rotating, but simply adding. rotating would be months on one, then months on the other, as @Swoop is doing afaik.

 

[deniak]

Would oral + topical finasteride be more successful than oral alone?
Oral can only get around 50% scalp DHT AFAIK.
But it seems that also absorbing finasteride through the scalp would definitely make some more of it attach to the local 5 AR in the follicles maybe?
Or is that just too much of a layman's view...

In theory its should be more succesful.

Two problems:
- with enough constant dosages more nad more finasteride is working in other parts of body, so serum gets lowered just as with oral doses
- risk of serious fetus impairement if any pregnant woman touch your head/hair.

 

[Afro_Vacancy]

So, any success stories with topical finasteride anywhere?

There's a guy with a thread who is going to try 0.03/0.04 mg/day, check on him in a few months.

 

[Kevand]

Assuming we get full efficacy with a oral dose of 0,05 mg, to hypothecate the efficacy of topical microdose application we would need understanding wether finasteride works mainly through local mechanism and how much of the drug is distrubuted to the scalp.

It seems logic what does matter is the constant level of scalp dht, if by somehow blood dht matters in this process, it should be by diffusing to the interstitial and thus countereffecting the local effect of finasteride.
That means that after topical administration we would get a reduction of scalp dht but at the same time the blood dht would compensate for this reduction and flow against the lower concentration and neglecting the effect.
However interestingly from the polichem study this might not be the case, since a dose of 0,22 mg (topical) reduce scalp dht with 50 % while only reducing serum dht 25 % this suggest that blood dht does not completely compensate for the reduction of dht in scalp.
It might be that finasteride inhibit 90 % of the local dht production and that the serum dht compensate for this loss with an equilibrium level of a 50 % reduction the dht in the scalp.
It might be that the serum concentration is much lower than the local production of dht in scalp, which would mean its diffusion through the scalp might be insignificant.

Now expecting 0,05 mg to give us efficacy through local mechanism the question remains how much of this reach the scalp.
"The distribution of a drug between tissues is dependent on , regional blood flow, cardiac output and perfusion rate of the tissue and the ability of the drug to bind tissue and plasma proteins and its lipid solubility" wiki

The scalp tissue should have high affinity for finasteride but 5ar type 2 is also expressed elsewhere.
The blodflow through the scalp at normal condition should be lower than 1-2%.
Making conclusion about the distribution is hard but im thinking at best that 1/10 is distrubuted which seems fairly high.
With a bioavailability of 80 % with oral administration and with 1/10-1/100 reaching the scalp. It seems that 0,004-0,0004 mg could be an effective topical dosage assuming everything is absorbed which its not.

 

[Kevand]

0,01 mg should to not have any systemic effect when taken orally according to Drake study what is dissapointing though is that johetes in HLH used 0,016 mg topically and he still got systemic reduction of dht. Of this 0,016 mg I would expect about 1/10 to reach the blood. But IF would assume half of IT would get absorbed even then IT should have not any effect.

Although this confusing results I think i am gonna try a solution with 0,0005-0,001 %.

I'm new to this forum but been following the threads for a long time. I'm amazed by the intellectual level, the scientific reasoning and the efforts in some of this threads. I'm gonna post an introduction of myself and My plan and hope I can contribute like everyone else.

 

[Desmond_84]

I'm currently using Finasteride 0.05% topical foam ONCE A WEEK (Wednesdays) and 0.25mg Finasteride tablets TWICE A WEEK (Mon & Sat).
I've been on finasteride 0.25mg for well over 4 years and have completely halted my loss. Decided to experiment with the topical last month and is now part of my regimen.

Personal experience: I used to feel a tingling itchy sensation on my temples on the third day when my tablet was due. Ever since I've added the topical foam, my scalp feels normal. No itchiness or tingling. Hair in the temples looks less flat. Never went through a shedding after adding the topical.

I'll keep updating here

Cheers.

Des.

 

[whatevr]

Topical dutasteride would be bomb. It would take out the 5AR1 present in the scalp. However due to the molecular weight > 500 dalton absorption is a bit tricky. Not sure what can be done about that to help it penetrate.

 

[inmyhead]

Desmond, what is your vechile for topical finasteride? i cant use ethanol + pg, scalp way too itchy

 

[WangMQ]

I'm currently using Finasteride 0.05% topical foam ONCE A WEEK (Wednesdays) and 0.25mg Finasteride tablets TWICE A WEEK (Mon & Sat).
I've been on finasteride 0.25mg for well over 4 years and have completely halted my loss. Decided to experiment with the topical last month and is now part of my regimen.

Personal experience: I used to feel a tingling itchy sensation on my temples on the third day when my tablet was due. Ever since I've added the topical foam, my scalp feels normal. No itchiness or tingling. Hair in the temples looks less flat. Never went through a shedding after adding the topical.

I'll keep updating here

Cheers.

Des.

Hi Desmond! Your success story is cheered by many!

I was wondering: have you ever tried the standard dosage of 1mg/d on finasteride? If so, did you experience any sides?

Knowing this would mean a lot to us microdosers (orally or topically)!

 

[hilbert]

I'm currently using Finasteride 0.05% topical foam ONCE A WEEK (Wednesdays) and 0.25mg Finasteride tablets TWICE A WEEK (Mon & Sat).
I've been on finasteride 0.25mg for well over 4 years and have completely halted my loss. Decided to experiment with the topical last month and is now part of my regimen.

Personal experience: I used to feel a tingling itchy sensation on my temples on the third day when my tablet was due. Ever since I've added the topical foam, my scalp feels normal. No itchiness or tingling. Hair in the temples looks less flat. Never went through a shedding after adding the topical.

I'll keep updating here

Cheers.

Des.

Hi Desmond,
thanks for reporting; I think this regimen makes a lot of sense.

To make it more complete, can you also provide some info on:
- occurrence of side effects (any, even the bearable ones, e.g. more liquid sperm)
- your hairloss degree and pattern

thanks again.