Finasteride (Propecia) Hair Lotion or Foam to Treat Hair Loss in Men and Women

[madman]

Topical finasteride for the treatment of male androgenetic alopecia and female pattern hair loss: a review of the current literature

ABSTRACT

Background: Androgenetic alopecia (AGA) is a frequently encountered dermatological concern that impacts a patient’s self-esteem and quality of life. Finasteride is a selective 5-alpha reductase inhibitor that has been approved for the treatment of male AGA and the off-label use in female pattern hair loss (FPHL); however, its adverse effects may limit its use. Topical finasteride is a new formulation that aims to decrease complications caused by oral administration.

Objective: This review assesses the pharmacology, current therapeutic use, and safety of topical finasteride for the treatment of AGA and FPHL.

Methods: A PubMed search was conducted to include all English-language articles on topical finasteride from January 1992 to January 2020. Results: A total of 33 articles including 28 topical finasteride-related articles and 5 AGA-related articles were included in this review. Multiple studies on topical finasteride as the treatment for male AGA and FPHL showed positive results with a favorable safety profile.

Conclusions: Topical finasteride is a promising therapeutic option. We emphasize the importance of continued research for the establishment of a novel therapeutic agent.




Conclusion

This review summarizes the pharmacology, clinical efficacy, and side effects of a topical formulation of finasteride in the treatment of AGA and FPHL. Current data support the therapeutic potential of topical finasteride in increasing hair density and hair diameter while decreasing the systemic adverse effects associated with oral administration. The combination of topical finasteride and minoxidil provides an additional benefit over minoxidil monotherapy and may be a promising treatment option in the future. Despite its proven efficacy, the use of topical finasteride is limited due to a smaller number of studies. Further studies are warranted to determine the most efficacious formulations and to investigate the consequences following the long-term use of topical finasteride.

 

[fifty]

It seems to end up crushing serum dht even when applied topically. Might take longer to tank serum levels than oral finasteride but it will happen. Will drop serum dht by 60-70% over time.

 

[madman]

It seems to end up crushing serum dht even when applied topically. Might take longer to tank serum levels than oral finasteride but it will happen. Will drop serum dht by 60-70% over time.

Regardless of the duration, the dose used would be key to minimizing any impact on serum DHT levels.




Pharmacology of topical finasteride

The topical finasteride formulation aims to locally inhibit the 5α-reductase enzyme and decrease the production of DHT at the level of the hair follicle with minimal disturbance of the serum DHT concentration. The finasteride plasma concentration in blood and the extent of absorption with the topical application are lower than that observed with oral administration. A preliminary clinical trial reported that serum finasteride concentrations after topical application of a combined 5% minoxidil and 0.1% finasteride lipid solution twice daily for 14 days were 10-fold lower than oral finasteride at a similar dosage (12). Another exploratory study reported very low concentrations of finasteride detected in 5 of 11 subjects after a single application of 0.25% topical finasteride; however, multiple applications of topical solution (twice daily for 7 days) resulted in small detectable finasteride plasma concentration in most subjects. Compared to oral tablets (1 mg twice daily for 7 days), the mean maximum finasteride concentration (Cmax) and area under the curve (AUC) of the topical formulation were 15 and 9 times lower, respectively; these were significantly different (13). The reduction in the scalp DHT levels from baseline was similar for 0.25% topical solution twice daily (47%) and oral finasteride 1 mg daily (51%), and significantly lower for daily application once (71%) (14). The suppression of serum DHT level was noted for both oral and topical administrations after 1-week of treatment. Although these confirm the similar inhibitory effects with multiple-dose treatment, the decline in DHT levels seems to be less pronounced with the use of lower-concentration topical formulations. A study with an application of 0.005% topical solution for 16 months did not observe any change in the serum DHT level (15), while in another study, applying 0.1% topical solution for 24 weeks resulted in no detection of finasteride in half of the blood samples (16). Notably, all studies did not observe any significant difference in serum testosterone levels with topical application (13).

A topical formulation with high skin penetration and deposition but low systemic absorption is preferable. According to a study, the application of finasteride solution in doses of 100 and 200 μL once daily seems to be more efficacious than applying it twice daily. On the other hand, increasing the dose up to 300 and 400 μL correlates with higher plasma finasteride concentrations and a possibility of systemic side effects (14). The drug-delivery system plays an important role in the efficacy of topical finasteride. Several compounds have been explored to provide appropriate drug delivery and for biomedical applications including topical solutions, gels, polymersomes, vesicular nanocarriers, vesicular ethosomal carriers, liposomes and niosomes, polymeric nanoparticles, and liquid crystalline nanoparticles (17-24). Among these, a finasteride liposomal gel system containing 2% methylcellulose and a gel system containing poloxamer P407 exhibited the highest skin penetration at the site of application; these may be the ideal future delivery systems for topical finasteride (17)

 

[fifty]

I would like to see studies [15] and [16].

I used 1ml daily of a 0.05% topical fin and it took my dht from the 60s (not on TRT) to 20s on TRT w/ test cyp with levels 1500+ at trough.

Study [15] seems interesting at 0.005%. Study [16], I find incredibly hard to believe.

 

[Nelson Vergel]

Empower now has a few acne and hair related products

Dermatology

Explore Empower Pharmacy's diverse range of Dermatology health medical products designed to support physical, mental, and social well-being.

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I am starting this one tomorrow:

| Empower Pharmacy

Explore our range of commercial and compounded medications, formulated uniquely for individual prescriptions or office use.

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It has finasteride plus latanoprost

More on latanoprost:

Latanoprost : Drug used to grow eyelashes also helps scalp hair growth

There are some conditions that can cause eye lashes to shed faster than they can grow back. Some of these conditions might be temporary, such as stress or thyroid disorder that has not been treated. Or maybe you or someone you know just wants longer and thicker eyelashes. There is a...

www.excelmale.com

 

[fifty]

I am starting this one tomorrow:

| Empower Pharmacy

Explore our range of commercial and compounded medications, formulated uniquely for individual prescriptions or office use.

www.empowerpharmacy.com

It has finasteride plus latanoprost

Sounds expensive.