• 04-07-2016 11:41 PM
    DepressedByHairLoss
    Desmond!!! Thank goodness you are back man. I really missed you posting on here! Anyway, I have a question. I had terrible side effects when I used finasteride. Do you think that this topical finasteride would give me the same side effects?
  • 04-08-2016 08:41 PM
    nobs
    Wouldn't something like this increase the absorption of topical finasteride into the bloodstream since finasteride is already lipophilic? Also, any indication that this would be available to consumers and not just pharmacists? This is the first time I'm hearing about this.
  • 04-09-2016 08:38 AM
    Desmond84
    Okay guys, let me blow your minds with the information we dug up and presented to the dermatologists in our area! Back in 1995 when Merck was testing Finasteride for AGA, they also ran a small trial of 52 patients using very low-dose topical finasteride! This trial used Finasteride in 0.005% concentration and ran for 16 months! Can you believe it! It was minuscule doses and guess what happened :)

    Quote:

    We present herein the results of a single-blind, placebo-controlled, 16- month trial carried out in 52 patients with AGA using a 0.005% finasteride solution. The clinical outcome, in terms of both hair regrowth and balding areas reduction, seems to be encouraging, in the absence of either any evidence of percutaneous absorption of finasteride, or local/systemic untoward effects.
    This study was later published in 1997 and is titled:

    Topical finasteride in the treatment of androgenic alopecia. Preliminary evaluations after a 16-month therapy course


    http://www.tandfonline.com/doi/abs/1...7#.VwkiYTB96Uk

    Quote:

    Results:
    Of the 52 patients enrolled, 36 (69.2%) completed the entire study period. Notably, all dropouts occurred in the placebo group after 1 to 10 months. Moreover, the overall tolerability of the treatment was excellent. No patient
    experienced any local or systemic untoward effect. In particular, in the finasteride group laboratory data revealed no relevant change in plasma levels of total testosterone, free testosterone or dihydrotestosterone. On the basis of these findings any significant percutaneous absorption of the drug could reasonably be excluded.
    The size of the balding reduced, terminal hair count increased while in the placebo group it all went to negatives. Surprise surprise. They even collected plasma DHT level data and it was barely changed but the hairloss improved.

    Now I don't why the topicals since then were being prepared in 1% concentrations which is higher than the oral dose you take but that is most probably why ppl experience sides even on topical fin.

    For those that don't know I am a compounding pharmacist and we have patients using topical fin in many different strengths ranging from 0.05% all the way to 0.1% and they all seem to be happy with it.

    So don't lose hope. Finasteride may still be a viable option for you. You just have to go down the topical route in very low doses.
  • 04-09-2016 09:01 AM
    Desmond84
    Quote:

    Originally Posted by Desmond84 View Post
    For those that don't know I am a compounding pharmacist and we have patients using topical fin in many different strengths ranging from 0.05% all the way to 0.1% and they all seem to be happy with it.

    Sorry I meant between 0.005% to 0.1% :) Missed a zero there LOL
  • 04-09-2016 09:03 AM
    Desmond84
    Now with regards to liposomal delivery. That is very interesting indeed. If you are able to get it then by all means go ahead and try it. Unfortunately as far as I'm aware liposomal drug delivery is a very complicated process and can not be made in a compounding pharmacy. If you can't access that then go right ahead and try this method instead.

    Cheers,

    Des.
  • 04-09-2016 09:12 AM
    Swooping
    How did you conclude that Merck ran that trial Desmond? I just glanced at the full study and it's from a university in Italy?

    The study is furthermore poorly designed;

    Quote:

    The trial was conducted over a 16-month period during which each patient applied 1.0 ml of the study medication using a graduated dropper twice daily to the balding area(s) of the scalp. All patients
    were examined at monthly intervals. At each visit, photographs were taken. During treatment the clinical response was followed by comparing sequential photographs. At the end of the study, the assessment of the results in terms of hair regrowth was made by the same staff member according to the six-point scale shown in Table 11. The results were also evaluated in terms of hair loss by performing a 'wash test' at 2-month intervals. The wash test was carried out according to the following standardized procedure: patients were asked not to wash their scalp for 1 week, during which they had to comb their hair twice a day (morning and evening). They were instructed to collect all hairs lost during shampooing at the end of this period (this was accomplished by placing a small-mesh net over the drain of the bathtub at home).
  • 04-09-2016 09:19 AM
    Desmond84
    This was pre-Propecia and 2 years after Proscar came to market so I thought who else would be testing it than Merck. They had the license for it. But you may be right.

    The 'wash test' was the Gold standard for trials back in the day LOL. I remember the Minoxidil trials back in the 80s employed wash test for efficacy as well. This is the best we've got with regards to a proper trial using topical finasteride and we know that even at 0.005% there was observable improvement. It's definitely worth a shot if you can't tolerate oral fin and want to use as little as possible and maintain till we have a better option.
  • 04-09-2016 09:32 AM
    Arashi
    But what's the catch here :) I mean, if it would work as good as the oral route but with less sides, then Merck would be quite stupid to sell it in a pill form, right ? I mean I'm sure a lot of people are not using Fin (like me) because they are afraid of the sides. It would be a big win for Merkc to sell it as a spray. So why dont they ? Doesn't make much sense to me ...
  • 04-09-2016 09:36 AM
    Desmond84
    Quote:

    Originally Posted by Arashi View Post
    But what's the catch here :) I mean, if it would work as good as the oral route but with less sides, then Merck would be quite stupid to sell it in a pill form, right ? I mean I'm sure a lot of people are not using Fin (like me) because they are afraid of the sides. It would be a big win for Merkc to sell it as a spray. So why dont they ? Doesn't make much sense to me ...

    LOL...well according to Merck there are no sides remember :P
    P.S. Patient compliance is much higher when it is in oral form than topical. They were short sighted and thought it'll be a blockbuster in oral form, little did they know the lawsuits they'll face 20 years later!
  • 04-09-2016 09:50 AM
    pilipili
    Thank you for all the informations. This can be easily compounded by our pharmacist indeed. What concentration should we start with? I mean 0.005% to 0.1% that's quite a range. How people chose at the end?
    Btw that's a huge difference with the 2,5% H&W topical finasteride being sold.
    ty.

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