The conversation discusses how different factors can stimulate type 1 and type 2 isoforms of 5-alpha reductase, which are enzymes linked to hair loss. Specific treatments mentioned include oral Dutasteride and topical Finasteride.
Topical dutasteride is suggested as a low side-effect treatment for hair loss, with a proposed dose of 0.025% 1ml/day. It is considered better than finasteride due to its even inhibition of DHT isoforms and lower systemic absorption.
The user has been on 1mg finasteride for a year, experiencing low libido and moderate erectile issues. They are considering using Cialis daily with finasteride long term to address these side effects.
Switching from finasteride and minoxidil to dutasteride and minoxidil can potentially lead to over 40% improvement in hair thickness in some cases, especially in young individuals who have plateaued after initial success. Generally, a 20% improvement is expected after six months.
Painkillers like Aspirin may reduce Minoxidil's effectiveness by inhibiting the enzyme PGHS-1, which is crucial for hair growth. Using NSAIDs that inhibit COX-2 or combining Minoxidil with PGF2/E2 analogues or retinoids may enhance its efficacy.