Synthesis and Evaluation of 2'-Substituted 4-(4'-Carboxy- or 4'-Carboxymethylbenzylidene)-N-Acylpiperidines: Highly Potent and In Vivo Active Steroid 5α-Reductase Type 2 Inhibitors

A 15-year-old is concerned about hair loss, possibly at Norwood 2 or 3, and is using shampoos and conditioners recommended by a trichologist. Suggestions include considering topical minoxidil and consulting a doctor about topical anti-DHT treatments like finasteride or RU58841, but avoiding 5-alpha-reductase inhibitors at this age.

The conversation discusses the side effects of finasteride, including low libido and erectile dysfunction, and the possibility of these effects being permanent, known as post-finasteride syndrome (PFS). Some users report personal experiences with PFS and debate whether the condition is real, with varying opinions on the reversibility of side effects and the role of individual biology.

A 25-year-old who has been using minoxidil and finasteride for 4 years to treat hair loss, underwent a successful FUE hair transplant in Mumbai, India, in April 2023. The user reported positive results, including increased hair density and reduced frizziness, and plans to continue treatment for further growth.

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.

A 28-year-old male experiencing hair thinning is considering minoxidil and finasteride. Minoxidil helps regrow hair, while finasteride prevents further loss; both are usually lifelong treatments.

Finasteride and dutasteride are discussed for hair loss, with concerns about their effects on neurosteroids and potential side effects like depression. Alternatives like topical estrogen and lifestyle changes are considered, with varying opinions on mental health and hair regrowth.