Hormonal Therapy for Acne: Why Not as First Line Therapy? Facts and Controversies

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.

The user has been using oral minoxidil and dutasteride for hair loss without success and is considering adding topical 17α-estradiol, Pyrilutamide, Clascoterone, or cetirizine. They have confirmed low serum DHT levels and are exploring additional treatments due to genetic sensitivity to DHT and prostaglandin D2.

Combining dutasteride and an aromatase inhibitor may increase testosterone levels significantly, potentially enhancing athletic performance but also posing health risks like elevated blood pressure and worsened cholesterol. The user is experimenting with dutasteride, anastrozole, minoxidil, and ketoconazole shampoo to manage hair loss and estradiol levels, while monitoring side effects and hormone levels.

Some users have experienced good hair regrowth with estradiol, cyproterone acetate, spironolactone, and bicalutamide, but these treatments may cause feminization and other side effects. It's advised to consult a doctor before using these treatments, as they can lower testosterone and have significant risks.

Spironolactone, finasteride, and dutasteride are discussed for hair maintenance, with concerns about testosterone and side effects like gynecomastia. Spironolactone is noted for use in both bodybuilding and hormone therapy, with low doses considered for minimizing side effects.

The user plans to switch from minoxidil to finasteride or dutasteride for hair loss, while managing hormones with aromatase inhibitors and SHBG blockers. They seek advice on the best options for these treatments, considering past side effects and future therapies.