NikosHair

You should get your serum DHT levels tested. While 0.25 mg per day sounds small and is only a quarter of a 1mg tablet, studies have shown even at that level, serum DHT is significantly reduced by 50-60%. It really emphasises how potent finasteride is at reducing DHT. If you still get sides at that level I would try 0.125 mg each day or taking 0.25mg every other day.

Can you show us the studies that support that? The efficacy of a hair restoration product is if it grows hair not how much it reduces scalp DHT levels. In the experiment I suggested, we would create two groups with the same serum DHT levels, but only one group would have the topical fin applied to their scalp. If it works, we should see significantly better results than the group with the topical fin applied to their neck. If we get similar results, then we can conclude it's the action of the systemic DHT.

Lovely result - I'm not sure I could stop myself from having a 2nd procedure, given how well that went.

'You', in this context, are the companies charging $100+ Apologies for not making that clearer.

Scalp DHT proves nothing. Just as they did in the study you initially cited, they were interested in comparing hair growth and serum DHT levels.

No need for a biopsy - have another read of what I wrote:

Cost has never been more important than now with the cost of living crisis. The answer to the question of the most 'cost effective' is more nuanced than just cost or cost per ml. It's the second requirement, 'effective', that is far more difficult to compare. In fact, the whole efficacy of topical as an alternative to low-cost low-dose orals is unproven. You might want to take a look at a poll I started and the discussion that followed.

Given the simplicity of the test (as above), it brings us neatly back to the poll question. Perhaps if you are raking $100+ dollars a month off each subscriber, let the hype train keep rolling and leave it as a convenient unknown🙄

It should be simple enough to test without an invasive scalp biopsy. Conduct a double blind study. Split the patients into two groups. Group 1: Application of topical finasteride to the scalp and a placebo application to another part of the body eg. neck. Group 2: Application of placebo to the scalp and second application of topical finasteride to another part of the body eg. neck. We would expect serum DHT levels to be the same but with different levels of hair growth if the application of topical finasteride to the scalp was actually yielding results.

We can't cherry-pick the bits of the studies we like and that support our position while discarding the bits that aren't supportive. It isn't very scientific and gets a bit silly. The more interesting question from the study ... Is the systemic blocking of DHT by topicals the only reason for the results? The localised effect of rubbing stuff on your scalp would then just be marketing mumbo jumbo.

Those figures are incorrect. From the study: We know that if you reduce the dose of oral finasteride, you can have less impact on DHT levels. The study used a 1mg tablet.

The other significant finding from the study was how much topical finasteride effects systemic levels of DHT. DHT serum levels dropped by 34.5% from base line. That's HUGE. Many people will be considering topical fin, will be sensitive to low DHT and the resulting sides. They want the blocking of DHT to be localised in the scalp and for it to not go systemic. This study debunks that claim.

For the record, I've never used topicals but regularly take oral meds. If you do get side effects from the orals then it is worth reducing your dose significantly. Finasteride is a potent DHT inhibitor. The reduction in DHT isn't directly proportional to the dose, ie. if 1mg reduces DHT by 50-70% it does not follow that 0.5mg will reduce it by 25-35%. You could take a tenth of a 1mg dose and still get a significant drop in serum DHT levels.

I'm not posting from a point of authority, I'm just a regular Joe like the rest of us. You cited a (very good) study and I wanted to see if topicals are a credible cost-effective alternative to oral drugs. And the difference between the placebo group and the oral group is only 2%. Hence the conclusion by the researchers that the results were 'similar'. Nothing HUGE was found.

Thanks for your contribution. In the interest of transparency, which product do you use? do you pay full price for it or get it free?

You need to understand how the mean average feeds into the overall percentage to understand why they are irretrievably linked. I'm quoting from the study. They didn't say this! The difference is 1.5% between the topical and oral groups. This is below the threshold of what is called statistically significant. In other words, the researchers could not predict with any certainty that if they ran the study again, they would not get a result that showed a higher percentage for topical than oral. It's just too close to call. This isn't what the pharma company funding the study wanted to hear (or anyone else shilling topicals). They would have liked to have seen low levels of side effects in the topical group and a *much* larger percentage in the oral group.

It's really important we are accurate with the information we provide. Guys that experience sexual side effects with oral finasteride are desperate to find a way to hold on to their hair (and still perform between the sheets😊). The study (you cited) concluded (and you know what comes next): 'There were no significant differences between topical finasteride and placebo in mean scores for any item on the Sexual Dysfunction Questionnaire at week 12 or 24. Mean scores for all items were similar between topical finasteride and oral finasteride at weeks 12 and 24.' There was no statistical significance between topical & oral. I get it doesn't fit your narrative but contradicting the study (unless you can show me otherwise) doesn't advance the discussion.

That was the study you cited. Do you have a study which is randomized, double-blind, double dummy, parallel-group, 24-week study, conducted in adult male outpatients with AGA at 45 sites to support your product? In the interest of transparency, do you pay $129 a month?

This is a very topical question (see what I did there🙄) I've been looking at the extortionate prices for topical finasteride/dutasteride. By my calculations, you are looking at between $300 - $360 for a 3-month supply Vs $25 (delivered) generic oral finasteride. With reference to the study @Melvin- Moderator kindly cited. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9297965/ The study does nothing to support the case for using topical finasteride, other than it was better than using nothing (placebo). It would be interesting to hear your views and the study is a good starting point to support your views, either way.

Yet there were no statistical significance in the reported sexual side effects between the topical vs oral groups. That's really important because many people will be interested in using topical fin because of sexual side effects with oral fin. Based on that study, they need to keep on looking or better still reduce their oral fin/alternate days. If you want to burn $129 a month for some fin mixed in an alcohol solution. That fails to prevent the systemic reduction of DHT and shows no statistically significant improvement in side effects. What's not to love😊 (Oh you get fancy packaging and a nice bottle)

Do you have a photo of your juvenile hairline pre-hairloss? It's quite common to have a naturally higher hairline. EDIT: Just looked again at your 1st post. Looks like a regular hairline in your aged 15 but drifting back slightly at 23. 500 grafts per 1cm lowered (or slightly less) seems on the low side. Measure the distance of the hairline (on most people, this would be in the range of 15 - 17cm), then multiply by 50 (number of grafts per cm2) What is the distance from your glabella to your hairline? I agree lowering it by 1cm is modest and is unlikely to set off any alarm bells, especially as you are working with a top-tier surgeon.

I agree with @HairFunk great result and a very satisfying improvement on your pre-HT photos. I would caution against lowering the hairline in your next procedure. Another 2500 graft will create a very complete and natural appearance, albeit with a higher hairline than you desire. The issue with creating a lower hairline is two fold. Costly in grafts. This one is more subtle. When we look at someone with a lower hairline subconsciously we process the overall look and decide if it looks natural. You need sufficient density in the temple points and behind the hairline to make it look legit. Bringing the hairline down makes the hairline more prominent. In essence it raises the bar across the whole of your head to pull off the look. It would be interesting to hear Dr BF's feedback and how many grafts it would take to achieve the desired look.

The report (you cited) has different results from the ones you are presenting: 'DHT concentration was lower (34.5 vs. 55.6%), with topical vs. oral finasteride' If you want to block less DHT use a lower dose of oral fin and save yourself a fortune. So the difference between the topical Vs oral was 1.5%. Yet 2.8% of patients who were given a placebo reported Sexual side effects, and they got ZERO fin! The researchers evaluate the findings and determine if the results are statistically significant. Rather than putting our own spin on the results, look at what the researchers concluded: 'There were no significant differences between topical finasteride and placebo in mean scores for any item on the Sexual Dysfunction Questionnaire at week 12 or 24. Mean scores for all items were similar between topical finasteride and oral finasteride at weeks 12 and 24.'

I'm saying: $300 for a mix of fin & alcohol is a rip off. The study (you cited) is saying: Both topical and oral finasteride produced similar results in the Sexual Dysfunction Questionnaire. I'm saying: Both topical and oral finasteride reduce DHT. If you are having side effects with oral fin, then try dropping your dose.

So the question has to be ... if the active ingredient is the same what are you paying the money for? Again, the study answers that: Sounds like a crazy mark-up for a cheap carrier😊