Topical Finasteride bad if DHT is still high?

[JacksonCu]

Hello all,

I have very high DHT on TRT cream. (>290!, @ Quest, range 12-65)
I've titrated to 20% T, 1 click (50 mg cream) every morning, and 1 click in the evening 3x/wk.
(I know I should probably switch to 15% cream and apply 2 clicks a day)
I've been getting some acne on my face, shoulders and back.

EDIT: My goals are:
-- Bring DHT down to 1-2x the max of the reference range (from 5x(!))
----- in order to stop the acne
-- improved hair re-growth would be a huge bonus (see below)

I'm thinking of starting topical Finasteride because it DOES leak into the blood SOMEWHAT, and I have been losing my hair for 15 years. So it would be a two-fer.

EDIT: As per this study, topical application produces MUCH LESS serum Finasteride levels and a concomitant SMALLER REDUCTION in DHT, with the same hair regrowth:

Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial - PubMed

Topical finasteride significantly improves hair count compared to placebo and is well tolerated. Its effect is similar to that of oral finasteride, but with markedly lower systemic exposure and less impact on serum DHT concentrations.

pubmed.ncbi.nlm.nih.gov

Do the bad side effects of Finasteride appear even if DHT is in the high normal range during use?
IOW are the bad side effects only when DHT is reduced below normal, and nonexistent if DHT remains high?

Funny though that my hair loss has actually started reversing recently with microneedling + 15% Minoxidil. I've been applying T cream on insides of thighs and elbows, and backs of knees. I stopped applying some of it on the scrotum because it may have caused PSA to spike to 4 (which went down some now, to 2.5). Urinary flow is good except if I drink too much water and need to go bad at 4 AM with a woody, then it's a bit slow.

All other blood markers are good: total and free T high normal, E2 mid high, Prolactin low normal, SHBG mid-hi normal, hematocrit slightly up, LDL and HDL about the same; BP moved up to 120/80, ferritin good. Trigs <70, HDL=65. hs-CRP <0.3, A1c 5.2, fasting insulin <4.

Otherwise healthy. Workout regularly, eat carnivore-ish, moderate stress, sleep well, 11% bodyfat, I look lean with a good 6-pack and a bit muscular when shirtless, no other health issues. Early 50s. Libido and performance good, mood good, decent tent pitching during sleep

 

[Systemlord]

I'm thinking of starting topical Finasteride because it does leak into the blood

It’s thought that topical Finasteride doesn’t get into the blood stream and only has a localized effects in the scale. This is wrong, it does make it into the blood stream if your seeing improvements in your hair.

Think about it, if we were talking about topical testosterone, if it doesn’t make it into the bloodstream, you don’t feel the effects.

There’s a study out of Boston showing how Finasteride blocks and or affects the conversion of chemicals that covert to neural steroids -> allopregnanolone or the bodies valium or anti-stress hormone.

Taking Finasteride is the stupidest f****** thing you could do, even dumber for someone trying to optimize your hormones, like a marathon runner shooting himself in the foot before the marathon.

 

[JacksonCu]

It’s thought that topical Finasteride doesn’t get into the blood stream and only has a localized effects in the scale. This is wrong, it does make it into the blood stream if your seeing improvements in your hair.

I DID say it DOES get into the bloodstream. Kindly re-read.

However as per this study, topical application produces MUCH LESS serum Finasteride levels and SMALLER REDUCTION in DHT, with the same hair regrowth:

Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial - PubMed

Topical finasteride significantly improves hair count compared to placebo and is well tolerated. Its effect is similar to that of oral finasteride, but with markedly lower systemic exposure and less impact on serum DHT concentrations.

pubmed.ncbi.nlm.nih.gov

My goals are:
- BRING DHT DOWN from 5x the reference range max to maybe 1-2x.
--- stop the acne
- better hair regrowth would be a huge bonus

AGAIN are the issues with Finasteride ONLY the result of bringing DHT down TOO LOW?
IOW would Finasteride use but with serum DHT remaining HIGH be healthy?

There’s a study out of Boston showing how Finasteride blocks and or affects the conversion of chemicals that covert to neural steroids -> allopregnanolone or the bodies valium or anti-stress hormone.

Thanks, I'm gonna look this up.
The next question in my mind is, does topical F produce this effect, in patients with VERY HIGH DHT from TRT?

And, this article:

Finasteride Dose: What's the Best Daily Dosage? | Hairguard

Finasteride is a prescription hair loss medication used by millions of men worldwide. The standard dosage for hair loss 1 mg. Sometimes, however, doctors can prescribe lower doses. These can often provide the same hair growth with fewer side effects. This article will compare finasteride 1 mg to...

www.hairguard.com

...shows that 0.2 mg daily finasteride is almost as effective in reducing hair loss as the common 1mg dose, with LESS reduction in DHT. So the natural Q will be, would 0.2 mg (or better, a smallish dose of topical F prevent the ill side effects?

 

[Systemlord]

I DID say it DOES get into the bloodstream. Kindly re-read.

The way you worded it, gave the impression that you meant to say, doesn’t get in the bloodstream, because no one decides to take a medicine simply because it gets in the bloodstream, that’s not a thought process, because if it didn’t get in the blood stream, nothing would happen.

 

[Systemlord]

Do the bad side effects of Finasteride appear even if DHT is in the high normal range during use?

The common misconception about Finasteride is the belief that one must have very low DHT to get PFS. There were men who regularly tested DHT throughout the course of treatment, always maintaining DHT in the mid normal ranges.

Not only do these PFS suffers have healthy DHT also once off the medicine, they also have PFS continuing symptoms for decades.

It’s the interruption, altering of the hormone pathway (5 alpha reductase) that has downstream effects, because the medicines is stopped and the DHT levels are high but the effects of the hormone is lost.

Finasteride can cause adverse DNA changes and can damage DNA.

 

[JacksonCu]

Wow.

 

[Systemlord]

 

[Cataceous]

...
Finasteride can cause adverse DNA changes and can damage DNA.

Not DNA. The changes are epigenetic. And even so, the dose makes the poison. Topical application appears relatively safe. I developed side effects from oral finasteride, but seem to do fine with a topical application.

 

[JacksonCu]

There were men who regularly tested DHT throughout the course of treatment, always maintaining DHT in the mid normal ranges.

I've been looking for these studies and couldn't find them ... ??

And Dutasteride does the same thing?

 

[Systemlord]

I've been looking for these studies and couldn't find them ... ??

These are members firsthand accounts backed up by labs.

 

[JacksonCu]

These are members firsthand accounts backed up by labs.

Before Finasteride they had very high DHT, way above the reference range?

 

[Systemlord]

And Dutasteride does the same thing?

It’s an 5 alpha reductase inhibitor, same as Finasteride.

 

[Ribeye]

It’s thought that topical Finasteride doesn’t get into the blood stream and only has a localized effects in the scale. This is wrong, it does make it into the blood stream if your seeing improvements in your hair.

Think about it, if we were talking about topical testosterone, if it doesn’t make it into the bloodstream, you don’t feel the effects.

There’s a study out of Boston showing how Finasteride blocks and or affects the conversion of chemicals that covert to neural steroids -> allopregnanolone or the bodies valium or anti-stress hormone.

Taking Finasteride is the stupidest f****** thing you could do, even dumber for someone trying to optimize your hormones, like a marathon runner shooting himself in the foot before the marathon.

finasteride is not a good drug for men. period. When you think about it, it concentrates in the prostate, where it does a lot of damage by shutting down T or DHT effects in penile tissue. Evidence shows it turns your penis into fat, and kills erections. nuff said.

 

[zancek0]

Not DNA. The changes are epigenetic. And even so, the dose makes the poison. Topical application appears relatively safe. I developed side effects from oral finasteride, but seem to do fine with a topical application.

Do you perhaps make your own topical finasteride? If so - what's the "recipe"?

 

[electrify]

Finasteride doesn't just affect DHT in the blood. It messes with allopregnanolone which is critical. And lowering allopregnanolone can lead to all sorts of other stuff like gut inflammation issues: Gut Inflammation Induced by Finasteride Withdrawal: Therapeutic Effect of Allopregnanolone in Adult Male Rats

 

[markusbdc]

Not DNA. The changes are epigenetic. And even so, the dose makes the poison. Topical application appears relatively safe. I developed side effects from oral finasteride, but seem to do fine with a topical application.

where does one obtain topical finasteride?

 

[Cataceous]

Do you perhaps make your own topical finasteride? If so - what's the "recipe"?

I add 0.2 mg/mL to a 5% minoxidil solution. For luck I throw in 0.2 mg/mL dutasteride as well. I doubt this is as effective as oral administration, but the oral side effects are intractable.

where does one obtain topical finasteride?

One such brand is MinoxidilMax. I haven't tried it so can't vouch for it. The operation is perhaps a little shady—because offering finasteride OTC is questionable. If you want something completely legitimate but pricey then you might look at Empower Pharmacy's offering.