Desmond -- Update us on your topical fin experiment?

[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;

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).

[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.

[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 ...

[Desmond84]

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!

[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.

[Swooping]

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.

Well that is why these studies should be neglected , or looked at with a grain of salt. Merck did perform studies with hair count changes up to a 5 year basis. Also several studies have been conducted of minoxidil which looks at hair counts.

Finasteride is mostly a gimmick to me. Sure people might find a "sweet" spot to avoid side effects with topical finasteride but the same could be said for oral finasteride. Also, DHT does function primarily in a paracrine/autocrine fashion but does function as a endocrine one too. Therefore both local tissue levels and serum levels contribute to AGA. Serum of a less important fashion, but still.

Bottom line is that even near saturation of 5ar2 through finasteride topically is just not possible without it not going systemic and reducing serum DHT heavily.

And if you manage to find a topical dosage that limits total systemic activity it's simply going to be way less effective, not only because of the endocrine serum DHT part, but also because you will be a long way from saturation of 5ar2 in local scalp tissue (like for example the topical 0.005% dosage).

That being said, yes doing something is always better than doing nothing.

[Swooping]

Correction *topical finasteride is mostly a gimmick to me. Guess we just need something better in 2016 than a goddamn topical finasteride. Kinda comical and sad at the same time.

[nobs]

Well that is why these studies should be neglected , or looked at with a grain of salt. Merck did perform studies with hair count changes up to a 5 year basis. Also several studies have been conducted of minoxidil which looks at hair counts.

Finasteride is mostly a gimmick to me. Sure people might find a "sweet" spot to avoid side effects with topical finasteride but the same could be said for oral finasteride. Also, DHT does function primarily in a paracrine/autocrine fashion but does function as a endocrine one too. Therefore both local tissue levels and serum levels contribute to AGA. Serum of a less important fashion, but still.

Bottom line is that even near saturation of 5ar2 through finasteride topically is just not possible without it not going systemic and reducing serum DHT heavily.

And if you manage to find a topical dosage that limits total systemic activity it's simply going to be way less effective, not only because of the endocrine serum DHT part, but also because you will be a long way from saturation of 5ar2 in local scalp tissue (like for example the topical 0.005% dosage).

That being said, yes doing something is always better than doing nothing.

Topical minoxidil works pretty well and is almost undetectable in the blood stream after application. Then again, it is not a lipophilic molecule like finasteride. The idea of liposomal finasteride is a suspended release of the drug, as hasson and wong describe, as well as the other studies I have found on pubmed.

[Seuxin]

What about this FOAM vehicle ? it's a foam yeah,but it's a "simple" vehicle no ? Absorption is good ? You tell that it can be used for CB too, but what about Versapro or HRT...what is the better for CB ? This foam, HRT Cream , Versapro ?

Thanks

[timmay9000]

Thanks so much Desmond! I've read many of your posts and found them quite helpful. Appreciate your insight.

My wish is to remain hopeful, but the recent study you posted seems to be at odds with other data. If you search for user "joestes" on another forum back in 2008/2009 you will find he did a similar experiment at concentrations of even less than 0.005%. Some at 0.0016% even! Basically, a 1mg finasteride tab dissolved into a 60ml minox bottle. That's 1mg / 60ml = 0.0016% concentration.

He also had his DHT tested before and after, and sadly it did seem to go systematic. Which seems to be at odds with the "revealed no relevant change in plasma levels of total testosterone, free testosterone or dihydrotestosterone" part of the study. *edit* there were some questions on the confidence in his DHT numbers. Just for the record*

Just trying to figure out the conflict here.

[Swooping]

Topical minoxidil works pretty well and is almost undetectable in the blood stream after application. Then again, it is not a lipophilic molecule like finasteride. The idea of liposomal finasteride is a suspended release of the drug, as hasson and wong describe, as well as the other studies I have found on pubmed.

For what it's worth some people have trialed that solution already who had side effects on oral finasteride and suffered from similar side effects with the H&W formulation.

[nobs]

For what it's worth some people have trialed that solution already who had side effects on oral finasteride and suffered from similar side effects with the H&W formulation.

Who exactly? Is there a thread on this?

[robodoc]

Fin solution compounding

Des is right on but let me add a couple of things:
1. Finasteride is fully soluble in isopropyl alchohol 70%
2. A lot of alc is not necessary. I dissolved 500mg in 20ml.
3. Although readily soluble I let the fin and alc set for 30 minutes to assure solubility.
4. Filter thru a funnel you can buy on line or perhaps kitchen section of home store.
5. Pharmaceutical filters are usually less porous so I use 2 coffee cone filters that trap most of the fillers in the crushed fin in alc solution.
6. Once you have the filtered product add Espumil to desired concentration.
7. You don't have heat or stir vigorously like in the minoxidil demo.
8. To calculate your desired strength remember per cent is calculated as number of grams of material per 100ml. So a 5% solution would have 5 grams in 100mls, 1% is one gram in 100ml. You can do your math to calculate the concentration you want which apparently according to Des gets results at various concentrations.

And your local pharmacy or compounding pharmacy may be gracious enough to order Espumil for you.

Hi brother I've been meaning to update everyone here on topical finasteride but never got the chance to. So here it goes:

We have been compounding topical finasteride for over a year now for a lot patients. Over this time, I've done a lot of research, so here's all you need to know. Making topical fin, CB, Minox or even RU is so easy you would not believe! All you need is:

1. Your active ingredient
2. Suitable solvent
3. Espumil foaming solution

Here's the link to Espumil:

https://www.fagron.com/en/product-innovations/espumiltm

That's all. For example to make topical fin:
Crush your Finasteride tablets
Dissolve in alcohol (solvent)
Filter using a filter paper
Add to Espumil solution
Poor into a foaming bottle.
Voila

Thats it. It works and at least 20 ppl that I personally know of are using it.

Here's a video to help you do it:

Hope that helps everyone if you have questions about calculations, how much to put in, etc let me know and I'll post a thorough step by step protocol.

Cheers,

Des

[WangMQ]

I read that fin beat the hell outta minox in terms of sales even though it has a much higher rate of unacceptable sides. That shows that apart from us maniacs on these hairloss forums, the majority of MPB sufferers prefer to pop up a pill each day rather than taking the trouble to apply a topical solution (which also makes your hair look actually bad). That might explain why Merck released propecia as an oral drug instead of topical.

That being said, I am also curious about the same thing as swooping pointed out: can we actually make topical fin work without it going systemic? Desmond, did your patients achieved their success on topical fin without sides? Supposed that you only block the 5AR in your scalp, the DHT in your body can still reach hair follicles via blood flow? That's my personal speculation and I'd really like to see someone to shed some light on it!

[WangMQ]

But maybe blocking all the 5AR in your scalp is simply enough?

Also, it's hard to tell exactly how much drugs go systemic when you're doing topicals. It might vary from person to person. RU is a much stronger AA drug. It's nearly impossible no to have sides with it going systemic largely. Yet some people can use it safely while some unlucky guys, like myself, suffer from almost immediate sides after applying, suggesting quick systemic absorbtion.