Skip oral fin and go straight to Topical Dut..?

[follically challenged]

Background: Thinning hair, very fine hair. No HT...yet. Not on any medication...yet

I'll be honest, I'm not so open to getting on oral finasteride. That is just my personal feeling. I don't like the idea of messing with my hormone profile for the rest of my life. I'm not here to cause an argument about it, it is just my personal feeling..

I have heard that TOPICAL finasteride, however, while there are no side effects, the positive effects in thickening existing hair and keeping hairloss at bay, aren't that great...

So, I'm wondering if it would be possible to jump straight to TOPICAL Dutasteride...?

As far as I know, Dr. Mwamba already offers such a topical treatment, and Dr. Wong seems to have something in the pipeline also, so, my questions is, would there be any downsides for me going this route...?

I appreciate all constructive answers. Thanks, guys!

[Melvin- Admin]

Have you tried the oral version? My friend takes the oral with zero sides. I got sides, but that’s not a guarantee you will. Now, if you were to do something, I’d say topical fin 6x per week and topical dut 1x per week

[follically challenged]

I haven't tried the oral version. But if i did, even with no sides, isn't it still reducing sperm count and potentially doing other stuff we may not have discovered yet...?

Overall, the systemic hormone altering approach doesn't sit so well with me...

[HairRun]

I'm still trying to figure out why dut may not cause side effects when fin can, considering that dut effects both Type I and Type II of 5-alpha reductase;

[Future Hair Doc]

You should try oral finasteride first and if you're getting side effects, switch to topical finasteride or topical dutasteride. The chances of side effects from oral finasteride are about 5% based on published data. My personal experience with my patients coincides with the published data as well. 

[yesplease]

3 hours ago, Dr. Suhail Khokhar said:

You should try oral finasteride first and if you're getting side effects, switch to topical finasteride or topical dutasteride. The chances of side effects from oral finasteride are about 5% based on published data. My personal experience with my patients coincides with the published data as well. 

Although I appreciate you sharing your anecdotal experience within your practice, and I am familiar with the published data, my personal opinion is that the incidence of side effects from oral fin is higher than 5%. There have also been a number of informal polls in this community that reflect this, although I acknowledge that that isn’t scientific data.

Additionally, there IS scientific data that suggests that topical finasteride reduces serum/systemic DHT to a similar extent as oral finasteride. So it is not as simple as saying topical = no side effects. Not that this is what you’re specifically stating, but I feel that those who aren’t medically savvy and may be considering topical fin should be aware of that fact. 

[bald-and-bearded]

13 hours ago, follically challenged said:

Background: Thinning hair, very fine hair. No HT...yet. Not on any medication...yet

I'll be honest, I'm not so open to getting on oral finasteride. That is just my personal feeling. I don't like the idea of messing with my hormone profile for the rest of my life. I'm not here to cause an argument about it, it is just my personal feeling..

I have heard that TOPICAL finasteride, however, while there are no side effects, the positive effects in thickening existing hair and keeping hairloss at bay, aren't that great...

So, I'm wondering if it would be possible to jump straight to TOPICAL Dutasteride...?

As far as I know, Dr. Mwamba already offers such a topical treatment, and Dr. Wong seems to have something in the pipeline also, so, my questions is, would there be any downsides for me going this route...?

I appreciate all constructive answers. Thanks, guys!

I understand you. So you aren't interested in taking oral Finasteride even if you don't get side effects because you're still altering your hormones systemically.

Unfortunately, there are no peer reviewed studies that indicate less systemic absorption with topical Finasteride or Dutasteride. Everyone (I mean doctors) is making their own topical Fin and Dut and there is no guarantee on systemic absorption. The whole process seems a little "broscientific" to me at this point.

Until there is a standard topical product studied properly there is always going to be a risk of systemic absorption.

[Melvin- Admin]

15 hours ago, follically challenged said:

I haven't tried the oral version. But if i did, even with no sides, isn't it still reducing sperm count and potentially doing other stuff we may not have discovered yet...?

Overall, the systemic hormone altering approach doesn't sit so well with me...

Fin has been around for over 20 years, many on it for that long. Yes lower sperm count can be an issue, but I would imagine you’d stop while you’re trying to conceive. Unfortunately, inhibiting DHT is the best treatment to date. Breezula is a possibility in the future.

[deeznuts]

12 hours ago, Dr. Suhail Khokhar said:

You should try oral finasteride first and if you're getting side effects, switch to topical finasteride or topical dutasteride. The chances of side effects from oral finasteride are about 5% based on published data. My personal experience with my patients coincides with the published data as well. 

Is there a reason you wouldn't just do topical dut from the start? I mean if there are less side effects like claimed, then wouldn't it be superior?

[gillenator]

On 7/30/2021 at 9:32 PM, Dr. Suhail Khokhar said:

You should try oral finasteride first and if you're getting side effects, switch to topical finasteride or topical dutasteride. The chances of side effects from oral finasteride are about 5% based on published data. My personal experience with my patients coincides with the published data as well. 

I completely concur with this.