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community Why is scalp DHT suppression lower than systemic?

in Finasteride/Dutasteride 11 upvotes 1 year ago

Dutasteride reduces DHT more effectively in hair follicles than finasteride, but some individuals still experience hair loss despite treatment. Combining oral and topical finasteride may improve results, and some users experiment with topical dutasteride despite uncertainties about its absorption.

community Any treatment not nuking systemic DHT levels?

16 upvotes 6 months ago

Hair loss treatments that avoid significantly lowering systemic DHT levels, focusing on topical options like dutasteride mesotherapy, minoxidil, and ketoconazole. The user is exploring alternatives like KX-826 and RU58841 due to concerns about hormone levels.

community Napkin math: are we using 100x more topical finasteride than necessary?

in Finasteride/Dutasteride 4 upvotes 4 months ago

Topical finasteride concentrations are likely much higher than necessary for effective follicular DHT suppression, with current standards being 100-1000 times above the theoretical minimum. Lower concentrations (0.001-0.0025%) might still work locally while minimizing systemic exposure.

community Propylene Glycol vs Glycerin in topical finasterside?

2 upvotes 10 months ago

Switching from propylene glycol to glycerin in topical finasteride may reduce systemic absorption and side effects while maintaining local scalp DHT suppression. Concerns exist about glycerin's ability to deliver the full dose to hair follicles.

community Transitioning from fin to RU58841 + Oral Minoxidil - how long until I lose all my fin gains?

in Update 3 upvotes 1 year ago

The user transitioned from finasteride to RU58841 and oral minoxidil to maintain hair gains while avoiding systemic DHT suppression. They have not experienced increased shedding or side effects since stopping finasteride and hope RU58841 will preserve their hair.

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Research

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research ORAL AND TOPICAL FINASTERIDE IN THE TREATMENT OF MALE ANDROGENETIC ALOPECIA – NARRATIVE REVIEW

February 2026 in “Archiv Euromedica”

In this narrative review, researchers reported that oral finasteride significantly improved hair count and density in male androgenetic alopecia but had higher systemic exposure and potential side effects compared to topical formulations, which provided similar efficacy with lower systemic DHT suppression.

research Registrars and Fellows Update Session 2

April 2017 in “Australasian Journal of Dermatology”

This article presents a planned trial comparing radiotherapy and imiquimod for lentigo maligna treatment, noting a lack of direct evidence supporting current therapies, and aims to inform future treatment guidelines.

The Impact Of Perioperative Use Of Dutasteride (Oral And Mesotherapy) On Aesthetic Outcomes Of Hair Transplant: A Literature Review

research O IMPACTO DO USO PERIOPERATÓRIO DA DUTASTERIDA (ORAL E MESOTERAPIA) NOS RESULTADOS ESTÉTICOS DO TRANSPLANTE CAPILAR: UMA REVISÃO DE LITERATURA

March 2026 in “Revista Ibero-Americana de Humanidades, Ciências e Educação”

This study reports that perioperative use of dutasteride, both orally and through mesotherapy, may enhance hair graft survival and reduce shock loss in patients undergoing hair transplantation for androgenetic alopecia.

research FINASTERIDE IN MODERN MEDICINE: THERAPEUTIC APPLICATIONS AND SYSTEMIC HEALTH IMPLICATIONS

March 2026 in “RS Global journals (RS Global Sp. z O.O.)”

This review reports that while finasteride effectively treats androgenetic alopecia and benign prostatic hyperplasia, persistent adverse effects on sexual, psychological, and metabolic health have been noted, highlighting the need for ongoing research and careful risk assessment for safer clinical usage.

A Novel Finasteride 0.25% Topical Solution for Androgenetic Alopecia: Pharmacokinetics and Effects on Plasma Androgen Levels in Healthy Male Volunteers

research A novel finasteride 0.25% topical solution for androgenetic alopecia: pharmacokinetics and effects on plasma androgen levels in healthy male volunteers

50 citations , July 2014 in “International Journal of Clinical Pharmacology and Therapeutics”

This study found that both topical and oral finasteride significantly reduced plasma DHT after one week, with lower finasteride plasma exposure for the topical formulation.

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Learn

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learn Neem Oil

natural substance from Neem tree with medicinal and pesticidal properties

learn Bicalutamide

Can bicalutamide stop DHT from shrinking your hair follicles? Bicalutamide blocks androgens at the receptor rather than lowering DHT, and some dermatologists prescribe it off-label for women with pattern hair loss. The published evidence is retrospective case series and one small pilot study, with no randomized trial; it is a prescription drug that requires liver monitoring and is contraindicated in pregnancy.

learn TDM-105795

How does TDM-105795 differ from more established hair loss ingredients when included in experimental or emerging treatments? TDM-105795 targets thyroid hormone receptors, differing from established treatments like minoxidil and finasteride.

learn Clascoterone

a novel topical treatment that inhibits DHT on androgen receptors

Can I use clascoterone if I'm undergoing gender-affirming hormone therapy? No published clinical trial has tested clascoterone in people on gender-affirming hormone therapy, so its safety in that group is unknown. The FDA label reports low systemic exposure and no described effect on blood testosterone, but it also records HPA-axis suppression and raised potassium in a small minority of subjects.

learn Pyrilutamide

highly targeted anti-androgen that might have minimal systemic effects

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