Lack of Effect of Topical Finasteride Suggests an Endocrine Role for Dihydrotestosterone

DHT is essential for androgenetic alopecia, not testosterone. Treatments like finasteride and dutasteride reduce DHT, halting hair loss.

Dihydrotestosterone (DHT) impacts various skin conditions, including Androgenetic alopecia and seborrheic dermatitis, by causing overactivity in sebaceous glands. Topical medications Tacrolimus and Clobetasol can reduce these inflammatory conditions, and treatments like RU58841, Minoxidil, and Finasteride may also be beneficial.

DHT may inhibit hair growth by affecting mitochondrial function, leading to hair follicle miniaturization. Treatments like minoxidil and PP405 may promote hair growth by altering metabolic pathways, potentially counteracting DHT's effects.

The conversation discusses doubts about the effectiveness of topical finasteride for hair loss, suggesting that DHT could be produced elsewhere in the body and affect the scalp. It proposes that androgen receptor antagonists like spironolactone and clascoterone might be more effective as they could prevent this potential bypass mechanism.

Androgenetic alopecia is affected by scalp DHT levels, not sensitivity, with treatments like finasteride and dutasteride aiming to optimize these levels. Personalized DHT management is crucial for effective hair growth.

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.