Effect of MK-386, a Novel Inhibitor of Type 1 5 Alpha-Reductase, Alone and in Combination with Finasteride, on Serum Dihydrotestosterone Concentrations in Men

The conversation discusses finding a finasteride dosage that reduces DHT by about 25% to minimize side effects, with considerations for topical versus oral formulations. Alternatives like dutasteride mesotherapy and topical treatments are explored, with concerns about systemic absorption and potential impacts on athletic performance and hormone levels.

A 30-year-old man experienced significant hair regrowth and improved libido after using finasteride and dutasteride for androgenetic alopecia, with no adverse effects. He plans to reduce dutasteride dosage when trying to conceive and has been using topical minoxidil since 2015.

Topical androgen receptor antagonists may not be necessary if 5-AR inhibitors like finasteride or dutasteride effectively reduce DHT levels. Combining a 5-AR inhibitor with a topical androgen antagonist could potentially enhance treatment, but oral use of androgen antagonists is too risky due to severe side effects.

RU58841 combined with finasteride or dutasteride is more effective than RU58841 alone for hair loss. Users suggest combining these with minoxidil and microneedling for better results.

Dutasteride may inhibit androgen receptors in addition to reducing DHT, potentially explaining its effectiveness over finasteride for hair loss. Concerns about its impact on muscle growth are debated, with some suggesting no significant effects.

A 19-year-old used a 0.01% topical finasteride formula, which unexpectedly lowered DHT levels significantly. They are considering reducing the dose further and exploring alternatives like ketoconazole shampoo, KX826, and CB to manage hair loss while minimizing systemic absorption.