Topical Dutasteride

[BurnieBurns]

This talk sounds like it pokes holes in Derek from More Plates More Dates theory that side effects only hit those with borderline low testosterone. Suppose it's almost impossible to know who will get hit 

[Curious25]

5 hours ago, BurnieBurns said:

This talk sounds like it pokes holes in Derek from More Plates More Dates theory that side effects only hit those with borderline low testosterone. Suppose it's almost impossible to know who will get hit 

Whilst I think what derek theorised in that video was for the most part quite likely to be spot on, you all have to remember that individuals are individuals, and their bodies will react, feel, and perform totally different to the next person, regardless of a generic level and/or ratio of androgens, and the ever evolving changes to this throughout a course of their lifetime. 
 

Managing taking 5AR inhibiting medication is an art of trialing and erroring what dosage and frequency works for you personally, in achieving good efficacy, and maintaining bodily performance and functioning. 
 

Some people can develop ED from lack of sleep, poor diets, drug and alcohol abuse, whilst some people can continue perfectly fine whilst adopting all of these poor lifestyle habits - why? Because people are different. 
 

The key is finding what works for you. 

[Follicle1984]

The more I read, the more my belief is that the battle for hairloss should be fought at the follicle. 

I avoided 5ARs like the plague for about 10 years. I tried every natural approach imaginable over that time. I'm on TRT. Perhaps something slowed things slightly. Most likely nizoral shampoo and the periods I was on minoxidil had the greatest effect, really didn't see any decrease in shedding with other stuff. Most I class as a waste of money and or time.

I eventually took the plunge with finasteride as hairloss was really depressing me. I started topically at low doses and didn't notice much at all (side effect wise). I upped the dose feeling a little invicible. I learned the hard way the sides are real. I'm still unsure what may have happened if I kept the topical fin dose very low. But I'd read a lot of people have tried the "Mazarella" 0.005% BD approach and it still caused sides. Interesting the study indicated no one had sides there though. Would be interested in people's thoughts/experiences about this? (Ie very low dose fin...0.1mg per day). I know any lower is likely not efficacious. 

I think what is really interesting are the reports of dutasteride mesotherapy with super low frequency. I've read some get good effect with 0.1mg dut meso every 1-3 months. Surely, if this is the case, shouldn't we be trying topical dut at this kind of frequency? There are enough people here with either hard scientific evidence topical dut is going through the scalp (blood work or scalp DHT level reductions) or anecdotal and subjective reports (nipple sensitivity, ED, reduced libido), which I think have value also. I wonder if we could get similar results as the dut mesotherapy with topical dut application every month? And keep the serum DHT reductions even lower than those Mustang reports with weekly or biweekly applications? (About 20% I believe if I've read correctly?).

I now have some ethanolic topical dut at 0.05%. I am tempted to try a low dose every month. In truth, I'm just a little apprehensive, as the fin sides were horrible. I've just recovered after retrying oral fin 3 weeks ago. After 4 doses I stopped due to nipple pain. Things downstairs took 3 weeks to get going again. I am now finally convinced the fin sides are indeed real and it's not all just nocebo. Not saying that isn't an aspect that can occur too. I'm just know what's going on for me now. It's the long dutasteride half life that bothers me, as I would hate to have to wait months or even a year or more for recovery if it all goes wrong.

Also...I read a concerning study this morning about the potential longer term microstructural effects that can occur in tissues after periods of prolonged DHT reduction. Happy post it if people are interested. Granted it was a rat study. And doses may be higher. It showed however, that fibrosis occurred in the corpus cavernous with reduction in smooth muscle content. With shorter courses of dut, things largely reversed. Longer courses lead to changes which did not reverse. I grant it may not be fully applicable in humans, but it does seem a little concerning. It seems recovery on dutasteride if you get sides could just take a very long time. 

I definitely want to keep serum DHT level reductions to an absolute minimal.

Interested in people's thoughts on very low frequency topical dutasteride anyway? I apologise as I realise my post is a little long and rambling. Just nice to talk to people in the same boat tbh.

 

Edited September 5, 2022 by Follicle1984

[RTC]

I have resumed at 0.05% every two weeks. Morning wood back to normal within a week, don't know if it was due to dut but gonna give it another go

[Follicle1984]

RTC...have you measured any DHT levels before and after?

Glad you feel OK again after just a week. Good to know you can restore things that quickly if it was indeed due to dut.

If I try it, as I say, may go 0.1-0.5mg every month at first. Basically assess from very low dose and frequency and stop and back down the frequency if any sides occur. The good thing for me is the nipple sensitivity almost serves as a warning light on the dashboard for me now.

I hope low dose dut with pyrilutamide may be the answer. The phase 2 results looked very promising, even if the systemic levels were checked and could be detected. 

[RTC]

56 minutes ago, Follicle1984 said:

RTC...have you measured any DHT levels before and after?

 

I have not, very expensive to do so here in the UK

[Follicle1984]

1 hour ago, RTC said:

I have not, very expensive to do so here in the UK

I agree. It's not easy here to get DHT levels. Many labs don't run them. And yes...not cheap. 

I guess that is where when you learn your body's little alarm signs, it can be very useful, and sometimes, it's all we have to go on. Even if we can get false alarms sometimes.

It's a shame there are not more studies on topical and mesotherapy dutasteride so there wasn't so much guess work. It does feel like playing with fire at times. 

[win200]

Not try to derail the discussion going about DHT testing, but just giving a data point. I restarted topical dut in June after having no 5ari for eight months, and had a moderate shed for a few months. Nothing severe, but definitely noticeable. The shed has wound down now after almost exactly three months, just in case anyone is starting and wants a sense what type of shed they might encounter.

[Follicle1984]

12 minutes ago, win200 said:

Not try to derail the discussion going about DHT testing, but just giving a data point. I restarted topical dut in June after having no 5ari for eight months, and had a moderate shed for a few months. Nothing severe, but definitely noticeable. The shed has wound down now after almost exactly three months, just in case anyone is starting and wants a sense what type of shed they might encounter.

Cheers Win. Good to know. Yeah my take and understanding is pretty much any hair treatment that is doing something positive can potentially cause a shed.

May I ask what your dosing regime is (dose and frequency) with topical dut? 

Also...did you mean you were on topical dut and then stopped and had 8m off...or that you were on another form of 5AR at that point (oral dut or fin)? How come you stopped for those 8m?

Thanks 

Edited September 5, 2022 by Follicle1984

[win200]

5 hours ago, Follicle1984 said:

Cheers Win. Good to know. Yeah my take and understanding is pretty much any hair treatment that is doing something positive can potentially cause a shed.

May I ask what your dosing regime is (dose and frequency) with topical dut? 

Also...did you mean you were on topical dut and then stopped and had 8m off...or that you were on another form of 5AR at that point (oral dut or fin)? How come you stopped for those 8m?

Thanks 

Yup, I was on oral dut until August 31, 2021. I was on topical dut at that time. I dropped both on 9/1/21 and didn't use any 5ari until restarting topical dut this June. TBH I didn't seem to be losing hair during that gap but didn't want to push my luck.

I apply once a week, no dermaroller. 

[BurnieBurns]

21 hours ago, Follicle1984 said:

The more I read, the more my belief is that the battle for hairloss should be fought at the follicle. 

I avoided 5ARs like the plague for about 10 years. I tried every natural approach imaginable over that time. I'm on TRT. Perhaps something slowed things slightly. Most likely nizoral shampoo and the periods I was on minoxidil had the greatest effect, really didn't see any decrease in shedding with other stuff. Most I class as a waste of money and or time.

I eventually took the plunge with finasteride as hairloss was really depressing me. I started topically at low doses and didn't notice much at all (side effect wise). I upped the dose feeling a little invicible. I learned the hard way the sides are real. I'm still unsure what may have happened if I kept the topical fin dose very low. But I'd read a lot of people have tried the "Mazarella" 0.005% BD approach and it still caused sides. Interesting the study indicated no one had sides there though. Would be interested in people's thoughts/experiences about this? (Ie very low dose fin...0.1mg per day). I know any lower is likely not efficacious. 

I think what is really interesting are the reports of dutasteride mesotherapy with super low frequency. I've read some get good effect with 0.1mg dut meso every 1-3 months. Surely, if this is the case, shouldn't we be trying topical dut at this kind of frequency? There are enough people here with either hard scientific evidence topical dut is going through the scalp (blood work or scalp DHT level reductions) or anecdotal and subjective reports (nipple sensitivity, ED, reduced libido), which I think have value also. I wonder if we could get similar results as the dut mesotherapy with topical dut application every month? And keep the serum DHT reductions even lower than those Mustang reports with weekly or biweekly applications? (About 20% I believe if I've read correctly?).

I now have some ethanolic topical dut at 0.05%. I am tempted to try a low dose every month. In truth, I'm just a little apprehensive, as the fin sides were horrible. I've just recovered after retrying oral fin 3 weeks ago. After 4 doses I stopped due to nipple pain. Things downstairs took 3 weeks to get going again. I am now finally convinced the fin sides are indeed real and it's not all just nocebo. Not saying that isn't an aspect that can occur too. I'm just know what's going on for me now. It's the long dutasteride half life that bothers me, as I would hate to have to wait months or even a year or more for recovery if it all goes wrong.

Also...I read a concerning study this morning about the potential longer term microstructural effects that can occur in tissues after periods of prolonged DHT reduction. Happy post it if people are interested. Granted it was a rat study. And doses may be higher. It showed however, that fibrosis occurred in the corpus cavernous with reduction in smooth muscle content. With shorter courses of dut, things largely reversed. Longer courses lead to changes which did not reverse. I grant it may not be fully applicable in humans, but it does seem a little concerning. It seems recovery on dutasteride if you get sides could just take a very long time. 

I definitely want to keep serum DHT level reductions to an absolute minimal.

Interested in people's thoughts on very low frequency topical dutasteride anyway? I apologise as I realise my post is a little long and rambling. Just nice to talk to people in the same boat tbh.

 

My thoughts exactly. The frequency isn't adding up to me either. How would mesotherapy be some at 4 month intervals and get results and topical can't? 

There's so much talk about 'losing' efficacy. But look. There are many guys out there with horrible sides that would do anything just to maintain

Edited September 6, 2022 by BurnieBurns

[Follicle1984]

So from the research I've done, it seems 0.1mg of oral dutasteride is as potent as 5mg oral finasteride in its ability to suppress serum dht (~70%). I believe 0.1mg oral dut will suppress scalp DHT by about 32%. 0.5mg will suppress scalp DHT about 51%.

I would assume these reductions could be noticed from one single dose of the soft gel, as with finasteride.

Given topical finasteride has been shown in studies to suppress more scalp dht than equivalent oral doses, one would assume a similar pattern (hopefully) with topical duasteride.

Mustang mentioned he got scalp biopsies done with topical dut and had about 80-90% suppression. Which seem plausible (ie slightly better than scalp reductions with oral).

It seems scalp reductions of about 50% dht seem to have measurable outcomes ie reduction in shedding and even regrowth.

Given 5AR enzyme levels can take about 30 days to replenish by half (a sort of reverse/replenishment enzyme half life), you could theorise that if you suppress scalp dht to about 80-90% with one application of topical dutasteride (0.1mg actually reaching the follicles, or whatever dose you need to cause 80-90% scalp dht reduction), then after 30 days you may still have approximately 40% dht suppression. This likely will still be providing benefits. This would fit with the mesotherapy data of monthly injection frequency. How they get results with only 3 monthly injections does seem to get a little more sketchy to me. But I can totally see why 0.1mg every month could work. 

It would obviously mean lower total drug exposure. So theoretically lower incidence of sides.

I would worry dutasteride topically or mesotherapy at a application frequency above the 5AR enzyme 'half life' or above the half life of the dutasteride, may be able to slowly increase your risk of sides as the drug will slowly build up beyond the regeneration time of 5AR (great at the scalp but not elsewhere).

Surely if you reduced topical or dut mesotherapy to a frequency of once every 5 weeks (half life of dut) the chance of getting LATE sides, ie not straight away (which would be caused from an initial dose which is too high), but several weeks or months later (a reported effect even with very low dose daily topical fin) would be very unlikely. And theoretically with dut you may not need more than one application every month or 5 weeks (if you get to 90% scalp dht suppression with that one dose).

The key for me is getting the initial dose right (not to high as to cause immediate sides) and the frequency right (not too often as to allow build up and late sides).

Caveats would be there are many variables here. Firstly skin absorption rates different in different individuals. Secondly spill over rates different ie some people having greater systemic absorption from topical dut than others. Thirdly, 5AR regeneration rates. Perhaps some people regenerate much quicker and require more frequency dosing, others more slowly and less frequent dosing. Fourthly peoples threshold for side effects (dependent on serum or target tissue hormone levels) will vary (from some not getting sides at all even with nuked serum dht, all the way to even mild reductions causing issues).

I think many could avoid sides from topical fin by preventing build up of drug by following similar principles of dose and frequency reductions. However, likely finasterides reduced affinity for type 2 5AR would mean higher doses are needed to get good hair outcomes, therefore more systemic spill over will occur. And it becomes harder for many to get the balance right of enough drug to reduce and keep dht to around 50% reduction without the systemic spill over. 

I hope my train of thought is well explained here.

Edited September 7, 2022 by Follicle1984

[mustang]

I've been off for 9 months (personal reasons, won't disclose)

Before and After getting off Topical Dutasteride 0.1% once a week

 

After

[stephcurry30]

11 minutes ago, mustang said:

I've been off for 9 months (personal reasons, won't disclose)

Before and After getting off Topical Dutasteride 0.1% once a week

 

After

Wow what a difference. How have you guys places topical dutasitirde on your scalps? What's the easiest way? 

[Follicle1984]

Wow that is quite a difference mustang.

Are you going to go back on topical dut?

What I did find slightly concerning about topical dut was that in dut mesotherapy with low doses every week or two weeks or even monthly, there were some reductions in sperm count and motility. Suggesting even with lowish doses with low frequency it does likely go systemic. I think they recovered in 3m. (Better than the reductions with oral dut which were not recovered after 6m).

I know mesotherapy isn't topical therapy, but given the lack of studies I'm trying to get inferences from whereever I can. 

I'm tempted to just try pyrilutamide instead. I know it's still experimental but the phase 2 study and lack of anti androgenic sides, even despite blood levels of up to 10ng/ml of its metabolite, seems reassuring. Of course who knows how that may effect sperm count and fertility. 

[mustang]

I would try pharma grade CB0301 first, there is also the upregulation issue with Pyrilutamide

It will be my second choice after CB if it doesn't work. So far some really good reports

Of course don't buy Anageninc stuff.

[Follicle1984]

I'm not sure CB is strong enough from what I've read. Pyrilutamide looks like it may be.

I'm not sure I buy the upregulation theory with antiandrogens...although I will do further research. 

It used to be common 'bro theory' that thought anabolic steroids would down regulate the AR. However, it turns out AR is upregulated with higher androgen levels. The reason muscle growth slows is increased myostatin levels. I theorise AR may be down regulated with anti androgens. There seem to be studies validating this.

Mustang...I respect you don't want to talk about why you stopped topical dut...but may I just ask...was this due to side effects cropping up? (No details required). Would just be helpful for us to know, as you've kind of become the figure head of topical dut 🙂...if even you got sides would be helpful to know. 

I'm really on the fence with topical dut. I've heard a few reports of people getting sides now, and evidence mounting it does go systemic. Not sure I can handle the sides again after fin and then start to worry how long it will take for the dutasteride to be out of my system.

[mustang]

If you are careful and don't exceed once a week at 0.1% you have a better chance of not experiencing sides.

I can't assure you won't nor recommend you try it. I can say it worked wonders for me and I had no side effects as I did with Topical Finasteride or Oral Finasteride but I was very careful to use the least amount possible

Bloodwork also confirmed very little of it went systemic in my case. Trial and error I guess 

If you use it daily I am pretty sure you will end up with sides just like any other 5AR.

I will also say that I am a mega responder to it cause it really changed my head entirely in a matter of months. It was SUPER effective from the get go, others don't respond at all and other's have only maintenance.

You really can't say but it's definitely much safer than Finasteride.

 

[Follicle1984]

Thanks mustang. I really appreciate your reply and your honesty.

Agreed. It's all a bit of a gamble and people may react differently.

Its good at least we have people like yourself and Win so at least we have some people giving good anecdotal feedback on topical dut.

Mustang, from your experience do you think the fact my topical dutasteride is ethanolic this will be problematic? I didn't end up getting the Dr Mwamba product in the end.

I am currently trying out some latanoprost and minox + tretinoin + microneedling. Hoping that will give some regrowth on top of the preventative anti androgen/5AR back bone...when I eventually begin.

Edited September 9, 2022 by Follicle1984

[Follicle1984]

Anyone any ideas about how important the vehicle is when it comes to topical dutasteride?

I believe my topically compounded dutasteride is ethanol based. Is this vehicle considered a major factor one way or the other? 

I know most people seem to be using the trichosol based, Dr Mwamba version. I think I did read mustang mentioned liposomal proved to give too much systemic absorption.

Anyone with any opinions about this I'd be really interested to hear.

Also, if anyone has encountered sides with topical dutateride, or oral dutasteride for that matter, may I please ask how long they took to resolve? It seems rather frightening how long some parameters take to resolve with oral dutasteride. I believe serum DHT was not fully back to baseline for 86 days with 0.5mg dutasteride oral (only within 25% of baseline values). Serum DHT back to baseline at 12 weeks with 0.1mg dut. So even if a small amount of dut goes systemic its going to presumably take a long time to reset if one reacts badly to the drug.

We desperately need more studies here.

Beginning to wonder if just low dose topical finasteride is safer, given duts long half life and super potency. At least there are studies showing the efficacy and decent/improved scalp reductions in DHT of low topical doses even down to ~ 0.1-0.2mg (around 0.2mg topically reducing scalp DHT about 40-50% which is about the same as what 0.5mg oral dut gives at the scalp). And if it does go wrong and you get sides, it's a shorter time for the fin to be out of your body. I know many reports online of sides with topical fin, just taking time to develop. I presume slow build up of the drug, despite its short half life, which I still find slightly puzzling. Thoughts?

Edited September 12, 2022 by Follicle1984

[mustang]

15 minutes ago, Follicle1984 said:

Anyone any ideas about how important the vehicle is when it comes to topical dutasteride?

I believe my topically compounded dutasteride is ethanol based. Is this vehicle considered a major factor one way or the other? 

I know most people seem to be using the trichosol based, Dr Mwamba version. I think I did read mustang mentioned liposomal proved to give too much systemic absorption.

Anyone with any opinions about this I'd be really interested to hear.

Also, if anyone has encountered sides with topical dutateride, or oral dutasteride for that matter, may I please ask how long they took to resolve? It seems rather frightening how long some parameters take to resolve with oral dutasteride. I believe serum DHT was not fully back to baseline for 86 days with 0.5mg dutasteride oral (only within 25% of baseline values). Serum DHT back to baseline at 12 weeks with 0.1mg dut. So even if a small amount of dut goes systemic its going to presumably take a long time to reset if one reacts badly to the drug.

We desperately need more studies here.

Beginning to wonder if just low dose topical finasteride is safer, given duts long half life and super potency. At least there are studies showing the efficacy and decent/improved scalp reductions in DHT of low topical doses even down to ~ 0.1-0.2mg (around 0.2mg topically reducing scalp DHT about 40-50% which is about the same as what 0.5mg oral dut gives at the scalp). And if it does go wrong and you get sides, it's a shorter time for the fin to be out of your body. I know many reports online of sides with topical fin, just taking time to develop. I presume slow build up of the drug, despite its short half life, which I still find slightly puzzling. Thoughts?

I would assume if you encounter sides from TD they would resolve sooner than the oral version due to the lack of metabolites avoiding first liver pass.

Nobody knows unfortunately, I have taken it orally and topically and one messed me up quite badly while the other didn't do any damage but I was VERY careful with spacing and dosages.

[Follicle1984]

Thanks for the reply.

Last question then I won't keep bothering you mustang...just to ask again...do you think an ethanolic vehicle for topical dutasteride is a bad move? Should I not use it and try and get the Dr Mwamba trichosol instead? It's just it cost me ALOT! Would be a shame not to be able to use it. 

Edited September 12, 2022 by Follicle1984

[mustang]

6 minutes ago, Follicle1984 said:

Thanks for the reply.

Last question then I won't keep bothering you mustang...just to ask again...do you think an ethanolic vehicle for topical dutasteride is a bad move? Should I not use it and try and get the Dr Mwamba trichosol instead? It's just it cost me ALOT! Would be a shame not to be able to use it. 

I don't think it makes a difference as long as it doesn't have any penetration enhancement (like Minoxidilmax)

Strut is a good source in the US.

Just make sure you avoid MinoxidilMax

[Follicle1984]

Is tretinoin a penetration enhancer? A doctor and his clinic formulates my products. I have a separate 5% minoxidil with tretinoin, caffeine and melatonin from him. Also a separate latanoprost foam. The topical 0.05% dut is ethanolic I believe. I have emailed him to confirm. 

I was planning on adding a small amount of the topical dut, starting at about 0.1mg of dut (about 10 drops I've worked out) to either the minoxidil mentioned above or just some loreal stemoxydine I still have. 

[Mark Wolfer]

Don't buy any topicals from @FUECLINICor angenica.com because you'll never get what you ordered. You'll get a lot of run around and excuses, and no product. That's been my experience now for more than six weeks since I made payment.

Dr. Mwamba and his clinic should be embarrassed.