Oral Fin necessary if on Topical Fin

[Illusion]

Show me one study which topical finasteride was superior to oral finasteride and with a higher serum dht. Finasteride works after it is metabolized by the liver, which is why topical works to the extent it is absorbed in the bloodstream. Same goes for dutasteride. This isnt minoxidil we are dealing with. Lets be honest, do you think after 25 years merck never once thought to try it as a topical?

It's not about it being superior to oral fin, it's about not having (as much) sides as with oral fin.

Though I thought that wether you take it orally or apply it topically doesn't make a big difference, I though that for fin to work it has to go systematically?

[Justinian]

Show me one study which topical finasteride was superior to oral finasteride and with a higher serum dht. Finasteride works after it is metabolized by the liver, which is why topical works to the extent it is absorbed in the bloodstream. Same goes for dutasteride. This isnt minoxidil we are dealing with. Lets be honest, do you think after 25 years merck never once thought to try it as a topical?

If you google you will find that 5ar (what Finasteride inhibits) is in the scalp. The biggest issue is that it is primarily type 1 (which DUT also inhibits), whereas Finasteride targets type 2.

http://www.ncbi.nlm.nih.gov/pubmed/10583052

There is definitely some Type 2 5ar in the scalp, but there simply hasn't been enough studies of topical finasteride to prove that it works or doesn't and whether it is local or not. There are 2-3 studies and some show positive results, some don't.

Also, Merck supposedly applied for a topical finasteride patent years ago. There just probably isn't a very big market for it since most people who get don't get side effects would prefer the pill.

[cthulhu2]

If you google you will find that 5ar (what Finasteride inhibits) is in the scalp. The biggest issue is that it is primarily type 1 (which DUT also inhibits), whereas Finasteride targets type 2.

http://www.ncbi.nlm.nih.gov/pubmed/10583052

There is definitely some Type 2 5ar in the scalp, but there simply hasn't been enough studies of topical finasteride to prove that it works or doesn't and whether it is local or not. There are 2-3 studies and some show positive results, some don't.

Also, Merck supposedly applied for a topical finasteride patent years ago. There just probably isn't a very big market for it since most people who get don't get side effects would prefer the pill.

This is one of many studies:
Int J Clin Pharmacol Ther. 2014 Oct;52(10):842-9. doi: 10.5414/CP202119.
A novel finasteride 0.25% topical solution for androgenetic alopecia: pharmacokinetics and effects on plasma androgen levels in healthy male volunteers.
Caserini M, Radicioni M, Leuratti C, Annoni O, Palmieri R.
Abstract
OBJECTIVE:
Finasteride, a selective inhibitor of type 2 5-alpha reductase isoenzyme, inhibits the conversion of testosterone to dihydrotestosterone (DHT) and is indicated in the treatment of male androgenetic alopecia. The study objective was to evaluate a newly developed finasteride 0.25% topical solution in comparison to the marketed finasteride 1 mg tablet, with respect to finasteride pharmacokinetics and suppressive effects on plasma DHT.

METHODS:
24 healthy men with androgenetic alopecia were randomized in a single center, open-label, parallel-group, exploratory study, and received either multiple scalp applications of the topical solution b.i.d. or oral doses of the reference tablet o.d. for 7 days. Plasma finasteride, testosterone and DHT concentrations were determined.

RESULTS:
After multiple doses, mean (± SD) finasteride Cmax and AUC0-t corresponded to 0.46 ± 0.28 ng/mL and 6.64 ± 7.50 ng/mL x h for the topical solution and to 6.86 ± 1.78 ng/mL and 57.93 ± 29.38 ng/mL x h for the tablet. Plasma DHT was reduced by ~ 68 - 75% with the topical solution and by ~ 62 - 72% with the tablet. No relevant changes occurred for plasma testosterone with either treatment. No clinically significant adverse events occurred.

CONCLUSIONS:
A strong and similar inhibition of plasma DHT was found after 1 week of treatment with the topical and tablet finasteride formulations, albeit finasteride plasma exposure was significantly lower with the topical than with the oral product (p < 0.0001).

I am still waiting for someone to prove me wrong with one study that topical finasteride has the same efficacy as oral with less sides.

[Justinian]

This is one of many studies:
Int J Clin Pharmacol Ther. 2014 Oct;52(10):842-9. doi: 10.5414/CP202119.
A novel finasteride 0.25% topical solution for androgenetic alopecia: pharmacokinetics and effects on plasma androgen levels in healthy male volunteers.
Caserini M, Radicioni M, Leuratti C, Annoni O, Palmieri R.
Abstract
OBJECTIVE:
Finasteride, a selective inhibitor of type 2 5-alpha reductase isoenzyme, inhibits the conversion of testosterone to dihydrotestosterone (DHT) and is indicated in the treatment of male androgenetic alopecia. The study objective was to evaluate a newly developed finasteride 0.25% topical solution in comparison to the marketed finasteride 1 mg tablet, with respect to finasteride pharmacokinetics and suppressive effects on plasma DHT.

METHODS:
24 healthy men with androgenetic alopecia were randomized in a single center, open-label, parallel-group, exploratory study, and received either multiple scalp applications of the topical solution b.i.d. or oral doses of the reference tablet o.d. for 7 days. Plasma finasteride, testosterone and DHT concentrations were determined.

RESULTS:
After multiple doses, mean (± SD) finasteride Cmax and AUC0-t corresponded to 0.46 ± 0.28 ng/mL and 6.64 ± 7.50 ng/mL x h for the topical solution and to 6.86 ± 1.78 ng/mL and 57.93 ± 29.38 ng/mL x h for the tablet. Plasma DHT was reduced by ~ 68 - 75% with the topical solution and by ~ 62 - 72% with the tablet. No relevant changes occurred for plasma testosterone with either treatment. No clinically significant adverse events occurred.

CONCLUSIONS:
A strong and similar inhibition of plasma DHT was found after 1 week of treatment with the topical and tablet finasteride formulations, albeit finasteride plasma exposure was significantly lower with the topical than with the oral product (p < 0.0001).

I am still waiting for someone to prove me wrong with one study that topical finasteride has the same efficacy as oral with less sides.

http://www.ncbi.nlm.nih.gov/pubmed/19172031

This shows it as similar efficacy but doesn't go into much about systemic absorption (only side effects were 1 topical user had erythema and 1 oral user had decreased libido.

http://www.ncbi.nlm.nih.gov/pubmed/23193746

This shows that minoxodil with finasteride topical is better than just minoxidil (small sample size though).

We really don't know how much is systemic. We've heard reports of hair transplant doctors offering topical to hundreds of people with very little reported sides, when there should be at least a few percent experiencing the normal side effects.

This also gives a good summary of topical fin: http://hairlosscure2020.com/category/p-3074/ It mentions a study where scalp DHT is 40% more reduced using topical fin (with the same plasma DHT levels for both). I think it's the same formulation used in the study you posted.

[cthulhu2]

http://www.ncbi.nlm.nih.gov/pubmed/19172031

This shows it as similar efficacy but doesn't go into much about systemic absorption (only side effects were 1 topical user had erythema and 1 oral user had decreased libido.

http://www.ncbi.nlm.nih.gov/pubmed/23193746

This shows that minoxodil with finasteride topical is better than just minoxidil (small sample size though).

We really don't know how much is systemic. We've heard reports of hair transplant doctors offering topical to hundreds of people with very little reported sides, when there should be at least a few percent experiencing the normal side effects.

This also gives a good summary of topical fin: http://hairlosscure2020.com/category/p-3074/ It mentions a study where scalp DHT is 40% more reduced using topical fin (with the same plasma DHT levels for both). I think it's the same formulation used in the study you posted.

Theoretically topical finasteride could work. There have been several studies involving crystalline nanoparticles with encapsulated finasteride but none of them have transitioned into a successful legitimate real world study with humans. By real world study I mean measurements of serum dht and scalp dht of participants taking oral finasteride vs topical. If you search nanoparticles finasteride into pubmed you will get over 20 recent in vitro studies but no human studies. My guess is either finasteride is too readily absorbed in the blood stream, it needs to reach the blood stream to be effective, or the crystalline nanoparticle technology is too expensive or unsuccessful in humans. Simply creating an ethanol vehicle with water or some other basic vehicle won't cut it, and you mine as well just take it orally.

[Justinian]

Theoretically topical finasteride could work. There have been several studies involving crystalline nanoparticles with encapsulated finasteride but none of them have transitioned into a successful legitimate real world study with humans. By real world study I mean measurements of serum dht and scalp dht of participants taking oral finasteride vs topical. If you search nanoparticles finasteride into pubmed you will get over 20 recent in vitro studies but no human studies. My guess is either finasteride is too readily absorbed in the blood stream, it needs to reach the blood stream to be effective, or the crystalline nanoparticle technology is too expensive or unsuccessful in humans. Simply creating an ethanol vehicle with water or some other basic vehicle won't cut it, and you mine as well just take it orally.

Yeah, you may be right. I'm thinking about starting it and getting testosterone/DHT blood tests done before/after to see if it's going systemic at all.

Also, interesting about the nanoparticle stuff. I didn't know they did all that.