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The user has been using liposomal topical finasteride since late 2022, progressively increasing the dose, but DHT serum levels remain largely unchanged. Despite using finasteride, minoxidil, microneedling, and ketoconazole, hair condition has neither improved nor worsened.

Washing hair less frequently is unlikely to cause hair loss due to sebum buildup, and using finasteride can help reduce DHT levels. Minoxidil is suggested for application after washing with a good shampoo.

Reducing sebum can indirectly lower DHT levels, with treatments like accutane, tretinoin, and green tea extract acting as DHT blockers. Accutane can lower DHT levels by reducing 5α-reductase activity, but its impact on hair varies.

Dutasteride is often taken daily despite its long half-life because consistent dosing maintains optimal serum levels for effective DHT suppression. Some users report success with less frequent dosing, such as three times a week, but effectiveness can vary based on individual response and professional advice.

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.