Selective BET Inhibition as Potential Hidradenitis Suppurativa Treatment

FCE 28260 (PNU 156765), an under-explored 5α-reductase inhibitor, showcases promising results in research by Giudici et al., outperforming well-known treatments like Finasteride in reducing the conversion of testosterone to DHT. Its superior efficacy, demonstrated through lower IC50 values in both natural and human recombinant enzyme studies, suggests it could offer more effective management of DHT-related conditions. Additionally, its lower molecular weight hints at better potential for topical application, potentially offering advantages in treating conditions such as androgenic alopecia. Despite its potential, it has not advanced in development, possibly due to financial limitations, leaving its therapeutic prospects and side effect profile largely unexplored.

The conversation discusses the potential for developing a biologic "DHT sponge" to neutralize DHT in the bloodstream as a treatment for hair loss, suggesting it could be more targeted and have fewer side effects than current treatments like finasteride and dutasteride. Concerns include the complexity, cost, and potential side effects of such a treatment, as well as skepticism about its feasibility and market interest.

Topical dutasteride may have limited absorption due to its higher molecular mass compared to finasteride, potentially affecting its efficacy in suppressing DHT locally. Microneedling might enhance dutasteride absorption, possibly offering stronger local DHT suppression with fewer systemic effects.

The conversation discusses the need for a localized 5-alpha reductase inhibitor that only affects the scalp without systemic side effects, similar to pyrilutamide's approach. Current treatments like topical liposomal finasteride and dutasteride are mentioned, but concerns about their systemic effects and lack of research are highlighted.

The post discusses using a topical tincture containing zinc, azelaic acid, and other ingredients to inhibit 5 alpha-reductase activity for treating hair loss. The user plans to try this natural alternative before using finasteride or RU58841.

The user has been using oral Dutasteride, RU58841, and Minoxidil for three years without success and is considering adding topical Finasteride or Dutasteride to target DHT both locally and systemically. Other users suggest sticking to a consistent treatment plan, exploring different combinations, and considering other factors like potential misdiagnosis or inconsistent medication use.