Clinical and Hormonal Effects of the 5 Alpha-Reductase Inhibitor Finasteride in Idiopathic Hirsutism

Finasteride's effectiveness and side effects may vary based on male phenotypes, with some users noting differences in response related to body and facial hair characteristics. Some users report success with lower doses, while others experience side effects, suggesting individual variability in response to the treatment.

A 21-year-old experienced hormone changes after using self-made topical finasteride for hair loss, including a 20% decrease in DHT, a 47% increase in testosterone, and a 39% increase in estradiol. The user previously used minoxidil and microneedling but is now seeking ways to balance hormones, possibly through supplements or dosage adjustments.

Finasteride can increase body and facial hair growth due to increased testosterone, despite its intended use to reduce hair loss on the scalp. Some users consider trying topical finasteride for less systemic impact, while others report mixed results and side effects.

A 20-year-old female is using finasteride 5mg and spironolactone 100mg for severe hirsutism and is experiencing minor side effects like water weight loss and irregular periods. She is concerned about potential future side effects and hair regrowth on her scalp.

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.

Caffeine may promote hair growth and potentially inhibit 5-α-reductase activity in hair follicles, but its effectiveness and systemic impact remain unclear. Users discuss using topical caffeine solutions, with some experiencing no side effects compared to finasteride.