Topical Finasteride + Minoxidil

[HairsGone]

What are peoples thoughts / experiences on Topical Finasteride + Minoxidil combination solution? I was advised this by a Transplant Clinic and sent a journal paper with research study data. The conclusion states that if you have been on oral Finasteride for 2 years then change to this combination...

 

"A majority of patients in this study who discontinued oral finasteride and adopted topical minoxidil fortified with finasteride showed a minimal decline in hair density reaching a plateau phase, after which there was no further decline in the hair density. Furthermore, it was well tolerated with no psychological fear of oral medication and good compliance. The five patients who had discontinued the treatment for a period of 8-12 months when resumed on topical minoxidil and finasteride combination showed good improvement in hair density. The combination of topical minoxidil and finasteride can thus be considered as a beneficial treatment strategy to maintain hair density after achieving initial improvement with oral finasteride, thereby obviating the use of oral finasteride indefinitely."

Indian Dermatol Online J.pdf

[Shyguy]

I've never even heard of topical Finasteride. Will ask my doctor about this. Would love to go off of oral Propecia and not worry about losing more hair

[KD2020]

Thanks for posting the article, I looked on the forum for this topic after seeing it basically copied here: http://www.defymedical.com/resources/health-articles/325-topical-minoxidil-fortified-with-finasteride-an-account-of-maintenance-of-hair-density-after-replacing-oral-finasteride

 

I too would be interested in learning more about this and if it is available. Anyone?

[mav23100gunther]

Hasson & Wong prescribe it, but you have to go to Vancauver to get a perscription.

[Swooping]

Topical finasteride pretty much goes 100% systemic. So you might as well pop the pill.

[KD2020]

Thanks. Too bad if that's true as it prevents me from donating blood (must wait 1 month before donating for finasteride, and 6 months for avodart).

 

Thanks

[Spidey]

Topical finasteride pretty much goes 100% systemic. So you might as well pop the pill.

 

a source for that comment would be nice.

[Swooping]

a source for that comment would be nice.

 

Yeah topical finasteride is basically sort of a gimmick it goes systemic anyway. Here is one study (I had another study but can't find it atm. It does confirm the same fact though);

 

Pharmacodynamic of P-3074 (finasteride 0.25% topical solution) in subjects with androgenetic alopecia

 

A new proprietary topical formulation, P-3074, containing finasteride 0.25% as active ingredient and hydroxypropyl-chitosan (HPCH) as film-forming agent, was developed for androgenetic alopecia. The present study was aimed at investigating the pharmacodynamic profile of finasteride in terms of dihydrotestosterone (DHT) concentrations in the scalp and in serum after multiple topical application of P-3074 or oral finasteride intake in subjects with androgenetic alopecia. Eighteen healthy men were randomly allocated to P-3074 or oral treatment after providing written informed consent. Twelve volunteers applied P-3074 topical solution for 7 days: six subjects once daily (o.d.) in the morning and the others twice daily (b.i.d.) in the morning and in the evening. The third group of six volunteers was administered 1 mg oral finasteride once daily in the morning for 1 week. Scalp (vertex) biopsies were collected at baseline and 6 hours after last dose administration, while serum samples were collected at baseline, before last administration, and 6 and 12 hours after the last multiple dose. A marked decrease in scalp DHT levels was observed: by 47.22% with P-3074 b.i.d., from 1.91 (±0.54) to 1.01 ng ml−1 (±0.39), by 71.20% with P-3074 o.d., from 1.52 (±0.41) to 0.44 ng ml−1 (±0.08), and by 51.11% with the oral formulation, from 1.39 (±0.25) to 0.68 ng ml−1 (±0.34). Serum DHT was reduced by 69.3–74.0% with P-3074 b.i.d., 67.6–80.4% with P-3074 o.d., and 69.7–76.1%with the oral formulation. These results showed a similar inhibition of serum DHT after 1 week of finasteride administration with the three dose regimens and were consistent with the results obtained in a previous P-3074 PK study. These findings show that DHT concentration in the scalp, after 7-day treatment course of P-3074 o.d., was more reduced (about 40%) than after 1 mg oral finasteride administration for the same treatment period.

[Spidey]

Hmmm. If FINgoes systemic from topical application, wouldn't all other topicals go systemic as well? Or is that determined by the carrier used? I know HW stopped prescribing their old formula and are awaiting their new formula coming out in about a month.

[Swooping]

Well the carrier is one part of the story. Some ingredients in the carrier may enhance permeability and some might slow it somewhat to make it stay more "local". Hydroxypropyl-chitosan for example in the above study is a filming agent which supposedly should make it stay more "local".

 

However that's not the most important aspect. The most important aspect is the chemical itself. See pharmacokinetics; https://en.wikipedia.org/wiki/Pharmacokinetics.

 

Apparently finasteride as a drug itself just goes systemic if applied topically. No carrier will change that. Definitely don't buy into stories of a topical finasteride that doesn't go systemic, because it will.

[mahhong]

The evidence does seem pretty clear that finasteride goes systemic even if applied topically. And because only a small amount of finasteride is needed to inhibit a relatively large amount of DHT, even a topical application would likely have similar effects to an oral medication.

 

I think I'm right in saying applying finasteride topically MAY (repeat, may) make it more effectively locally (i.e in the follicle) and slightly weaker systemically - so there may be a slightly better balance. But I think that's mostly conjecture and, it doesn't stop the bottom line being that it will go systemic.

 

Like Swooping said, I don't think a carrier will make much of a difference.

 

Most drugs go systemic even when applied topically. What usually happens, though, is that the drug is much more active locally and its systemic effects are weaker (minoxidil being a case in point). Because finasteride is quite a potent AR2 inhibitor, it would appear not to make much of a difference.

 

H&W have said those patients claiming they had side effects on the oral medication have not had side effects on the topical. This could be a placebo effect or there could be something in it, but I'm not sure they're going to look into that rigorously.

[HairsGone]

Thanks for posting the study. It doesn't make any sense why a decrease in scalp DHT levels was more in once daily compared to twice daily topical. (47.22% twice daily topical, 71.20% with once daily topical, and by 51.11% with the oral formulation). Serum DHT levels were fairly similar.

 

The likely reason for this was due the small size of the study as a study size of 18 patients is not sufficient to make any scientific conclusions.