alopie

Thanks, but do you think that 0.5mg daily finasteride is enough? Most people talk about 0.8mg being the optimal dose

I had to lower the dose to my current regime, so here's how I ended up: - 0.5mg oral finasteride daily - 2.5mg oral minox daily - 3x week Ketoconazole 2%, wash with Klorane, Alpecine Caffeine the rest of the days - a few drops of 5% topical minox and a few drops of 0.1% topical finasteride to stubborn areas, 3x week - LLLT 3x week, occasional dermaroller Are those good enough for maintenance in the long run? I just want a safe, stable regime as I just had a hair transplant.

That's great, thanks for your time! Do you have the sources of those papers? It looks like a 0.2% concentration would outperform or be equivalent to 1mg orally. Could that be true?

Honestly, if someone could guarantee that 0.2mg oral fin lowers dht by 61% vs only 50% for 0.1% topical, I would definitely go for the oral version

if 20% of finasteride is absorbed, does that mean that using a 0.5% 1ml topically (translates to 5mg of oral finasteride), then 1mg would be absorbed and therefore equivalent to the oral version? That's probably why hims and others choose to go for 0.3% topical finasteride. The issue is that finasteride has a smaller molecular weight, so comparing it to minoxidil in terms of absorption may be incorrect, but this subject is interesting. Regardless, even if I get 0.2mg from it, it's still better than swallowing 0.2mg orally and metabolising it through the liver. It is difficult for me to evaluate the efficacy of topical finasteride since I am also using oral minoxidil 2mg daily, which on its own may postpone the process by decades.

I was on finasteride for 4.5 years, 1mg oral daily, no side effects. It is my assumption that testicular pain is now caused due to accumulation of finasteride in my system. But it is position dependent, and it might be irrelevant, it does not happen when I stand up, or walk. "Just google it" is by no means better than a professional urologist. I visited three urologists in the last year, they all prescribed urological tests, but no one reported in their practice the side effect of testicular pain, even when prescribing higher doses for bhp. Are you using topical or oral?

Are we sure about it? 0.1% topical finasteride (1ml) means roughly 1mg of finasteride daily on the scalp. The net amount of finasteride is more with the topical solution. So are we saying that 0.25mg orally will be more effective than 0.1% 1ml topical? My urologist said it is very unlikely that finasteride is causing testicular pain, especially at the low dose of 1mg orally. He does not want me to use finasteride beyond 10 years as there are no solid studies about its effects. He is optimistic and says that the overall safety profile is good, but he would not want to risk it on me. (I saw high-grade prostate cancer, gyno and male breast cancer mentioned, that is due to the imbalance of estrogens to androgens in the long run) -- so topical is good

I have been on 1mg oral finasteride for 5 years. Last year I started having some testicular pain, and, after stopping for a month the discomfort went away. Now I want to find the sweet spot. So I am thinking of doing the following: 0.25mg oral fin: every Monday, Wednesday and Friday 0.1% topical fin 1ml: every Tuesday, Thursday, Saturday and Sunday Would that be more effective than 0.1% topical fin daily?

The androgens miniaturize hair, telogen effluvium or any other stress related hair loss won't be permanent. There are no clinical studies that suggest that stress can cause anything more than a simple telogen effluvium, and if that ever happens it will be due to prolonged, intensive stress, not a couple of weeks of daily stress or palpitations. I suffered from social anxiety disorders, to the point where I had to take oral medication (SSRIs) to manage my stress levels, had weekly sessions with psychiatrists for years. Still, my hair loss occurred years later and it was due to androgens and when I started finasteride all hair loss stopped.

I know this, but is topical 0.1% 1ml (~equivalent to 1mg oral) good enough for maintenance?

I am 29yo, I was a NW2.5 and had a hair transplant two years ago, pleased with my hair now. I was on oral fin, and minox, dermaroller, ketoconazole, LLLT and biotin. I recently switched to topical finasteride 0.1% 1ml daily. Is this still good enough to maintain my hair in the long run? Some people say that oral is more potent, but I find it hard to believe that my follicles can miniaturize while on 2.5mg oral minox, 5% topical minox, 0.1% 1ml finasteride, LLLT, ketoconazole and biotin. 🤷‍♂️

Oral minoxidil is not an anti-androgen, it might, to a really small degree, disrupt dht pathways, but no one reliess on minoxidil for dht inhibition. Viagra/Cialis are prescribed by some HT doctors to accelerate the healing process. This is because they are vasodilators and they do speed up hair cycles, meaning your hair might grow somewhat faster. Note that you do not want to overdose on vasodilators as you may have low blood pressure, heart palpitations or other heart related issues. If it happens that you need Viagra or Cialis for sex-related issues, that's a welcome addition, but you should not rely on those pills for hair growth. Oral minoxidil and/or topical minoxidil are clinically proven, and most likely superior to the rest of the vasodilators with insignificant side effects.

No, stress or anger cannot affect the outcome of your HT, unless you pluck your hairs out during the first 10 days post-op without realising you are doing it. Extreme stress, and we are not talking about daily stress, could potentially, at most trigger telogen effluvium, but even that is not clear and it might happen after months, if it happens at all. Stress cannot affect male pattern baldness or the outcome of the HT. Some people think that it accelerates mpb, but they only say that because at a superficial level they get stressed and they are under the impression that temporary hair fall means baldness, which is not true. If you are on minoxidil, telogen effluvium can't really happen or at least you won't notice anything because new hairs will sprout quickly, stop stressing or thinking about it.

My urologist told me that it is likely that it does nothing, even after 10 or 20 years, but there are no studies regarding long term efficacy and side effects at that level and he does not want to take a risk, so I can get it for 10 years, and then stop or hope that we have a longer term study or another solution until then. It may cause high-grade prostate cancer and there are some reports regarding this, but it is rare.

In what sense is this nonsense? If it accumulates then it should be as good as the oral one regarding DHT inhibition. If not, then it should be safer, but it would not be prescribed by dr. Zarev if it was nonsense.

It prevents prostate cancer but it increases the chances of high-grade prostate cancer and male breast cancer in the long run. It's long term hormone modification and all urologists that I visited so far told me that I should not be taking it for longer than 10 years. Dermatologists are conservative too, but HT doctors tend to prescribe dutasteride without a doubt, it boosts HT results...

Topical application depends on the agents, concentration and way of application. It is nearly impossible to apply 1ml equally distributed on the scalp, but the oral one is always the same. Long term hormone modification does not sound safe though... what do people do after 10 years, or when finasteride is no longer as effective?

The studies for topical finasteride are pretty limited, and cover very short periods of time (2-week dht differences) I am wondering if there are people in this forum that have experience with both topical and oral and what they think the optimal concentration is, compared to 1mg oral daily. I switched to topical 0.1%, but I am concerned that it's not enough. Think about minoxidil of 5% topical being weaker than 1mg oral...

Are you concerned about the long term effects that anti-androgens might have on your body? (high-grade prostate cancer, breast cancer, PFS) My understanding is that topical finasteride 0.1% 1ml (~1mg oral) achieves the same amount of scalp DHT inhibition but with roughly 1/10th of the serum dht inhibition

I did, all clear, they think it might be a hypermobile testicle and not related to finasteride. But all my doctors mentioned that they wouldn't want me to take finasteride for more than 10 years accumulatively. Only HT doctors are fine with it, not regular urologists or dermatologists. The question is, is 0.1% topical finasteride as good as 1mg oral? Or will I lose ground because I switched to topical?

Is 0.5mg MWF better than 0.1% 1ml topical daily? I am 29y, had a hair transplant and went from NW3 to a NW1, so pretty good, but I am concerned I will lose ground if I switch to topical completely. I used fin 1mg for 5 years and I have been having testicular pain so I decided to take a brake for 3 weeks and now I switched to topical.

Sure, that's what I thought, but is 0.1% 1ml enough? Some people use 0.3% or even 1% when it comes to gels. I also think that topical application will never be perfect, I will miss some areas, or the solution might not be equally distributed within the bottle, so I might end up putting 2mg one day and 0.1mg the next day 🤷‍♂️

Low dose oral dutasteride is an interesting one, but what I want to achieve is to lower the scalp dht by ~50-70% without lowering my serum dht by that much. If low dose dutasteride achieves the same result as 1mg oral finasteride daily without side effects, that does not necessarily mean that the serum dht levels are lower. The androgen-estrogen is what might cause gyno, breast cancer, or even high-grade prostate cancer in the long run. Urologists and dermatologists are concerned when I tell them that I am planning on using finasteride for more than 10 years. This is because there are not many studies beyond 10 years and they would not take that risk, especially considering the rare side effects it has been causing on me. Transplant surgeons are less concerned because they prfioritize short term results, and patient satisfaction, knowing that in the unlikely scenario a cancer is caused due to long term use of anti-androgens they won't be responsible.

I had to switch to topical finasteride due to some side effects (mainly testicular pain and longer term concerns) My current routine: - 2mg oral minoxidil daily - 5% topical minoxidil 0.75ml daily (stubborn areas) - 0.1% topical finasteride ~0.8-1ml daily - Ketoconazole 2% 3x/week, some biotin supplements and LLLT cap 3x week I am concerned that since I stopped oral finasteride (I used to take 1mg daily), there might not be enough androgen inhibition. Is topical finasteride 0.1% enough? How about microdozing oral (let's say 0.5mg MWF + 0.5ml of 0.1% topical daily)?

I started at 5mg, then lowered at 2.5, then at 1.5mg. Now using 2mg + a few drops of topical. Anything more than 1mg is sufficient. For every mg you add there will be some thickening of the hair. It will be more evident on vellus hair. 5mg is not advisable because it can can lower your pressure, and in general it amplifies problems. I would suggest sticking with 2.5mg daily and adding a few drops of topical 5% to the stubborn areas.