The Long-Term Effect of Specific Type II 5α-Reductase Inhibition With Finasteride on Bone Mineral Density in Men: Results of a 4-Year Placebo-Controlled Trial

Topical Finasteride doesn't directly reduce 5ar enzyme on scalp and has the same mechanism as oral, needing to go through the liver. Users debate the accuracy of this information and discuss various studies and experiences.

Finasteride can impact neurosteroids, potentially causing depression and other side effects in some users. Despite these concerns, many continue using it for hair loss, with some switching to topical applications to mitigate side effects.

The conversation discusses the effectiveness of hair loss treatments, specifically finasteride and dutasteride. The conclusion is that dutasteride significantly reduces DHT levels and may be more effective than finasteride for long-term hair retention, with some users reporting personal experiences and side effects.

Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

FCE 28260 (PNU 156765), an under-explored 5α-reductase inhibitor, showcases promising results in research by Giudici et al., outperforming well-known treatments like Finasteride in reducing the conversion of testosterone to DHT. Its superior efficacy, demonstrated through lower IC50 values in both natural and human recombinant enzyme studies, suggests it could offer more effective management of DHT-related conditions. Additionally, its lower molecular weight hints at better potential for topical application, potentially offering advantages in treating conditions such as androgenic alopecia. Despite its potential, it has not advanced in development, possibly due to financial limitations, leaving its therapeutic prospects and side effect profile largely unexplored.

Creatine may increase scalp DHT without affecting serum DHT, potentially speeding up male pattern baldness (MPB) for those genetically prone. Treatments mentioned include Minoxidil, finasteride, and RU58841.