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Originally Posted by 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.
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.
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