What we need to know about topical finasteride

[HAL2016]

Since English is not my mother language, sorry in advance if I make mistakes, I will try to do my best…
There is a long discussion about topical finasteride, it is a topic we are talking about from year 2000 to now, but I think there are some questions about that, that have not been considered with the right approach and are not solved yet. And in some cases, it would be easy to solve some of them.
Considering some studies and the experience of the users in the forums in my humble opinion there is a general consensus, topical finasteride works, the unsolved discussion is about if it works only due to the systemic absorption or if it would be plausible to get good cosmetic results without systemic absorption (and side effects).
It is not corret to say “topical finasteride has systemic absorption”, because with high enough concentration, almost every drug would have systemic absorption. One of the main problems of the different studies and experiences is the % concentration used. Topical finasteride has been mostly used with an hidroalcoholic vehicle similar to minoxidil vehicle (finasteride is soluble in alcohol but not in water) in concentrations that go generally from 0,05% to 0,25%.
If I am not mistaken and we consider, for example, a 0,1% 2ml/day then we are using 2mg of finasteride per day. If we assume a reduced systemic absorption of 10%?*, then we are using a equivalent 0,2mg oral finasteride per day plus the topical effect…so…It is not a scientific conclusion but a common sense conclusion to think that 0,2mg/day side effects=0,1% 2ml/day side effects. If we are worried about systemic effect and we assume a 10% absortion it seems that 0,1% lotion probably does not solve our problem.
If we think about the oral finasteride studies, to avoid systemic effect we should use a lotion with systemic absortion under 0,05mg/day. Considering the 10% absortion we are using, the lotion should be a 0,025% lotion, much more less than the % generally used.
Maybe with that % we are not going to get good results but I think this is the approach that is needed to get the response we are looking for.
1st.- Determine the maximum %lotion that has not or minimum systemic effect.
2nd.- Determine if with the % obtained in the 1st point we have cosmetic effect or not.
To solve both points should be very easy and very cheap in comparison with other studies that have been done, and we would get a huge advance in our discussions about this eternal topic.
In 1998 there was an Italian study using a 0,005% concentration, and it claimed to have obtained good results without evidence of systemic effects (I have the study, is not a “myth”), the problem was that they did not show concrete numeric data of the values of the hormones, a reduced sample that included women, and cosmetic results based in subjective perception and in what they called “wash test”. Anyway, It was a promising study with statistically significative results but it was not further developed.

*(I am using the absortion % labelled of a known hidroalcoholic testosterone gel, that due to its structure I think can be appropriate, but it is only a reference, not a dogma %)

[inbrugge]

Looks like a good post. I haven't read all of it, but I wanted to let you know what you wrote wasn't in vain lol. This directly relates to what I'm looking into currently for my regimen.

[inbrugge]

is there a way to contact the people involved in the study, HAL? Maybe you can look up the people involved in the study and find their e-mails and shoot them a message?

[HAL2016]

is there a way to contact the people involved in the study, HAL? Maybe you can look up the people involved in the study and find their e-mails and shoot them a message?

The date of the italian study is 1998 (Mazzarella, University of , Bari), so it seems difficult to contact with them, but we could try...

[James7]

Since English is not my mother language, sorry in advance if I make mistakes, I will try to do my best…
There is a long discussion about topical finasteride, it is a topic we are talking about from year 2000 to now, but I think there are some questions about that, that have not been considered with the right approach and are not solved yet. And in some cases, it would be easy to solve some of them.

Your english is ok
I understand what you are saying, I think the way to solve it is different to what you are saying though.

One of the main problems of the different studies and experiences is the % concentration used. Topical finasteride has been mostly used with an hidroalcoholic vehicle similar to minoxidil vehicle (finasteride is soluble in alcohol but not in water) in concentrations that go generally from 0,05% to 0,25%.

I think with topicals, you lose a certain amount of the drug.

The skin is a barrier that protects the body from the outside world. Say for example you spill some juice on your hands and then wash it off with soap and water. All these things remain outside the body.
It's much more difficult to get something to be absorbed via the skin, than to simply swallow it as a pill.

imagine using minoxidil foam for example:
- a certain amount of the foam will get all over your hands and be absorbed there rather than your head
- a certain amount will get stuck in the hair that is still on your head
- some will also still not penetrate the barrier of the protective skin
- each user will have different amounts of hairloss, and probably attempt to cover the whole affected area. resulting in completely different amounts being used in different areas by every user.
- for those with high norwoods, a much greater chance of using more than the stated safe dose, in an attempt to cover the affected area.

So this is all to say, although people can use topicals, there are many factors that are ignored, and which are also hard to take into account and measure precisely.

So I'm not sure it's that easy to equate the percentage measurements of the different drug delivery systems. See?

Maybe with that % we are not going to get good results but I think this is the approach that is needed to get the response we are looking for.
1st.- Determine the maximum %lotion that has not or minimum systemic effect.
2nd.- Determine if with the % obtained in the 1st point we have cosmetic effect or not.
To solve both points should be very easy and very cheap in comparison with other studies that have been done, and we would get a huge advance in our discussions about this eternal topic.

I think there may have been some studies? Someone like Desmond, would probably know for sure.

The other problem though is, once the drug hits the bloodstream, it has gone 'systemic'.
And you can't really stop it from doing that, with this simple approach, which is what I think has been tried.

What you really need to make the thing work as a topical, is to have targeted drugs.
Something that causes the pill form of finasteride to only activate in the scalp, and then to deactivate everywhere else.
So you would need 2 new drugs really - a sort of finasteride pill, one that is encased in inactive chemicals, like a safe. The key to break those chemicals would be in the scalp (applied as a seperate topical drug).

Like the chemical equivalent of a safe with a lock and it's key. If you see what I mean

[35YrsAfter]

If we think about the oral finasteride studies, to avoid systemic effect we should use a lotion with systemic absortion under 0,05mg/day. Considering the 10% absortion we are using, the lotion should be a 0,025% lotion, much more less than the % generally used.
Maybe with that % we are not going to get good results but I think this is the approach that is needed to get the response we are looking for.

One study indicates decent effectiveness of topical finasteride... HERE Conclusion of this particular study: "The results of this study showed that the therapeutic effects of both finasteride gel and finasteride tablet were relatively similar to each other."

Another study HERE


35YrsAfter also posts as CITNews and works at Dr. Cole's office - Cole Hair Transplant, 1045 Powers Place, Alpharetta, Georgia 30009 - Phone 678-566-1011
The contents of my posts are my opinions and not medical advice

[Artista]

Hi Chuck!
Its been too long since the last time we had talked.
You do such a great job here on the forum..I certainly am curious as to the future of Topical Finasteride.
Cheers to you.

[Hairismylife]

Should I expect initial shed for topical fin?

[cichlidfort]

Everyone is different. Some shed, some don't. I would imagine for those that would shed if they took the pill form then they would also shed by taking the topical. Shedding means it's working too.

[Artista]

Cichlidfort is CORRECT !