TLDR Some dermatological medications can impair male fertility, so consult a doctor before trying to conceive.
The document reviewed the effects of various dermatological medications on male fertility, finding that methotrexate, finasteride, and ketoconazole could impair fertility, with recommendations for discontinuation before conception attempts. Oral retinoids, cyclosporine, azathioprine, and TNF-α inhibitors did not adversely affect fertility. There was limited and conflicting evidence for the effects of glucocorticoids, TNF-α inhibitors, acitretin, isotretinoin, antibiotics, spironolactone, chloroquine, and antihistamines, leading to no clear recommendations for their withdrawal. The review emphasized the importance of counseling male patients on the potential reversible effects of these medications on fertility.
36 citations,
February 2011 in “Fertility and Sterility” Finasteride use may cause sperm damage and infertility, stopping it can improve sperm health.
34 citations,
January 2004 in “Revista do Hospital das Clínicas” Finasteride may worsen infertility in men with existing issues, but stopping it can improve sperm health.
2 citations,
December 2001 in “PubMed” 
104 citations,
October 1999 in “The Journal of Urology” Finasteride doesn't harm male fertility or sperm quality, but may slightly reduce ejaculate volume.
37 citations,
January 1991 in “Reproductive Toxicology” Finasteride reduces male rat fertility by causing issues with copulatory plug formation.
22 citations,
October 2020 in “Anais Brasileiros de Dermatologia” The Brazilian Society of Dermatology agrees that oral isotretinoin is effective for acne and other skin conditions, and it's safe when monitored, but more research is needed on dosing and duration.
May 2017 in “InTech eBooks” Some hair loss disorders cause permanent loss due to scarring, and treatments like steroids don't always work well.
October 2018 in “InTech eBooks” The most effective treatments for hair loss are minoxidil, finasteride, PRP, and hair transplants, with steroids and immunosuppressants for autoimmune types.
January 2016 in “Springer eBooks” Understanding drug interactions, side effects, and patient-specific factors is crucial for effective dermatological care.
5 citations,
December 2022 in “Annals Academy of Medicine Singapore” Some skin medications can have harmful interactions with the COVID-19 drug nirmatrelvir-ritonavir, but not with molnupiravir.
