New topical Finasteride study just published - might be useful for some people.

[JDEE0]

Came across this study on reddit, just released a couple of days ago and thought maybe it might help some people out.

458 randomised participants, double blind, placebo controlled, so methodology all good.

Essentially, topical fin had pretty much the same effect on hair counts as oral, both of which were far ahead of placebo. So, definitely works. At the 6 month mark, plasma concentrations of finasteride itself were 100 times lower than those of oral fin, but serum DHT was still reduced from the topical solution by 34.5% (compared to 55.6% by oral).

However, digging through the study I see they used the standard 1mg dose orally for the participants who were given it, and the equivalent of 0.114 mg of fin per dose topically. Additionally, each participant using topical was instructed to use between 1-4 doses of the topical solution depending on how bald they were, so a maximum of 0.456 mg of finasteride per day for the oral group (and a minimum of 0.114). Doesn't say how many used what dose.

Still, the dosage curve is pretty flat for fin, so even these smaller doses (such as 0.25mg) do generally inhibit a very similar amount of serum DHT as the standard 1mg dose when taken orally. So, as far as I can tell, it seems it does lower DHT a fairly decent amount less than oral, which I was somewhat surprised by to be honest.

Side effects wise, the only one worth mentioning was sexual (as the rest were skin rashes), and occurred in 0.6 percent of people using topical, 2.8 percent on placebo and 4.8 percent using oral. So, good news there, although the occurrence rate in placebo vs topical (which actually lowers DHT significantly still) being almost 5 times higher sort of highlights how much of a grain of salt you have to take these figures and realise that these are people knowingly involved in a study/taking pills (whether placebo or not) and applying a topical solution to their heads (pretty obviously for hair loss I would imagine). There's going to be an intrinsic paranoia and they may already have some bias around hair loss treatments etc.... 

Either way, sounds like good news for topical fin; it works nearly just as well (pretty much the same), lowers systemic DHT 20 percent less than oral (although the doses were different, if someone could find out the systemic inhibition for the equivalent oral dose of 0.114 that would be great to more accurately compare) and had less reported side effects.

Study is linked here: https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.17738

 

[TorontoMan]

Lol the occurrence of sides from oral is so low, why does anyone even bother with the topical stuff. You’re hardly sparing yourself anything realistically 

[JDEE0]

14 minutes ago, TorontoMan said:

Lol the occurrence of sides from oral is so low, why does anyone even bother with the topical stuff. You’re hardly sparing yourself anything realistically 

I'm with you there mate, but you know how it is on these forums or online in general.. I personally think it's just a psychological thing for most people.

Either way, topical still works and if someone is willing to use that and not oral, well maybe this post and study will give them the push they need to take action

[TorontoMan]

Either way, topical still works and if someone is willing to use that and not oral, well maybe this post and study will give them the push they need to take action. 

^ Well said. 

I know for me personally a lot of the things I was percieving were in my head. Two years later now I hardly think about it at all, and that in part is due to a succesfull transplant as well thats just made me overall think less about my hair now. Thank you for sharing. The more data the better, because ppl should be following data more and annecodtes less. Although both have their place of course, but you just cannot defy a double blinded control trial much at all. 

[JDEE0]

33 minutes ago, TorontoMan said:

Either way, topical still works and if someone is willing to use that and not oral, well maybe this post and study will give them the push they need to take action. 

^ Well said. 

I know for me personally a lot of the things I was percieving were in my head. Two years later now I hardly think about it at all, and that in part is due to a succesfull transplant as well thats just made me overall think less about my hair now. Thank you for sharing. The more data the better, because ppl should be following data more and annecodtes less. Although both have their place of course, but you just cannot defy a double blinded control trial much at all. 

Haha, I think we all go through it. I remember first acknowledging that I'm actually going bald about 3.5-4 years ago now, I knew my hairline was pretty shitty for years already and had gotten comments every now and then from people regarding it, but for some reason I didn't actually pay it too much attention and realise that I was balding. It was only then I found out about what the NW scale is, what causes MPB, the likely progression, and so on. 

God knows how I didn't realise before then as my hair was pretty much the exact same then as it is now in (fairly weak, as in, not too severe) NW3 territory and had been for a hot minute even at that point, and I'm all too aware of how much I hate it now! I started researching, found out about fin, was bombarded by horror stories and noped out of that possibility for nearly another 2 years as a result until something in my personal life gave me the push to say f it. Luckily, my loss hasn't really progressed for about 5 years anyway, so I didn't really lose any ground in that time.

You're right though, I was quite paranoid at the start for a while and I think just the general sort of anxiety around finally realising you're losing hair and fearing you're going to go bald, not knowing if fin even works due to ignorance and also not even knowing anything about HT's so thinking that best case scenario is that I get to keep this terrible hair line all just plays a part in getting you down. Once I realised HT's can be amazing, that the meds were nothing to fear, knew I was going to get it sorted and likely be able to move on with a good head of hair for most of my life, it all sort of went away. I'm due to have mine next month, so not quite at the stage of it all being behind me just yet, but I get what you're saying.

And yeah, to your last point, I'm just at the stage where I say my piece when the topic arises and then when people blindly regurgitate things like 'lol keep coping with having to take that poison' when huge amounts of highly controlled data exists, I just sigh to myself a bit and keep it moving.

Edited October 14, 2021 by JDEE0

[Curious25]

11 minutes ago, JDEE0 said:

Haha, I think we all go through it. I remember first acknowledging that I'm actually going bald about 3.5-4 years ago now, I knew my hairline was pretty shitty for years already and had gotten comments every now and then from people regarding it, but for some reason I didn't actually pay it too much attention and realise that I was balding. It was only then I found out about what the NW scale is, what causes MPB, the likely progression, and so on. 

God knows how I didn't realise before then as my hair was pretty much the exact same then as it is now in (fairly weak) NW3 territory and had been for a hot minute even at that point, and I'm all too aware of how much I hate it now! I started researching, found out about fin, was bombarded by horror stories and noped out of that possibility for nearly another 2 years as a result until something in my personal life gave me the push to say f it. Luckily, my loss hasn't really progressed for about 5 years anyway, so I didn't really lose any ground in that time.

You're right though, I was quite paranoid at the start for a while and I think just the general sort of anxiety around finally realising you're losing hair and fearing you're going to go bald, not knowing if fin even works due to ignorance and also not even knowing anything about HT's so thinking that best case scenario is that I get to keep this terrible hair line all just plays a part in getting you down. Once I realised HT's can be amazing, that the meds were nothing to fear, knew I was going to get it sorted and likely be able to move on with a good head of hair for most of my life, it all sort of went away. I'm due to have mine next month, so not quite at the stage of it all being behind me just yet, but I get what you're saying.

And yeah, to your last point, I'm just at the stage where I say my piece when the topic arises and then when people blindly regurgitate things like 'lol keep coping with having to take that poison' when huge amounts of highly controlled data exists, I just sigh to myself a bit and keep it moving.

Where are you getting surgery? 

[JDEE0]

7 minutes ago, Curious25 said:

Where are you getting surgery? 

I'm going to Clinica O' Porto (Dr. Bruno Pinto's clinic) in about 5 weeks time

[Curious25]

Just now, JDEE0 said:

I'm going to Clinica O' Porto (Dr. Bruno Pinto's clinic) in about 5 weeks time

Very nice - Hopefully you will document your case! 

[TorontoMan]

14 minutes ago, JDEE0 said:

Haha, I think we all go through it. I remember first acknowledging that I'm actually going bald about 3.5-4 years ago now, I knew my hairline was pretty shitty for years already and had gotten comments every now and then from people regarding it, but for some reason I didn't actually pay it too much attention and realise that I was balding. It was only then I found out about what the NW scale is, what causes MPB, the likely progression, and so on. 

God knows how I didn't realise before then as my hair was pretty much the exact same then as it is now in (fairly weak) NW3 territory and had been for a hot minute even at that point, and I'm all too aware of how much I hate it now! I started researching, found out about fin, was bombarded by horror stories and noped out of that possibility for nearly another 2 years as a result until something in my personal life gave me the push to say f it. Luckily, my loss hasn't really progressed for about 5 years anyway, so I didn't really lose any ground in that time.

You're right though, I was quite paranoid at the start for a while and I think just the general sort of anxiety around finally realising you're losing hair and fearing you're going to go bald, not knowing if fin even works due to ignorance and also not even knowing anything about HT's so thinking that best case scenario is that I get to keep this terrible hair line all just plays a part in getting you down. Once I realised HT's can be amazing, that the meds were nothing to fear, knew I was going to get it sorted and likely be able to move on with a good head of hair for most of my life, it all sort of went away. I'm due to have mine next month, so not quite at the stage of it all being behind me just yet, but I get what you're saying.

And yeah, to your last point, I'm just at the stage where I say my piece when the topic arises and then when people blindly regurgitate things like 'lol keep coping with having to take that poison' when huge amounts of highly controlled data exists, I just sigh to myself a bit and keep it moving.

Yes exactly, hair transplants are your second chance, they make up for the time you spent ignorant to the issue or in denial.. and the problem is most men discover this after the fact, because of the stigma and lack of communication/education towards the subject. Goodluck on your procedure. And no sense in dwelling on how you were making decisions in the past, you couldn't have known better, and the hesitation with everything is very normal, everyone goes through these stages unfortunately .. thats just how this game goes. I don't regret taking my time with fin either, I could have started 2 years earlier when i first found out, but at the same time I very likely would not have been on it with the peace of mind I have now, so I would have eventually scared myself out of it. So everything has its place and time, and thankfully we have some things we could do about it now, like transplants, meds etc. Our fathers, grandfathers etc would have been hella grateful for these options.. just the education alone is something we take for granted. 

[JDEE0]

5 minutes ago, Curious25 said:

Very nice - Hopefully you will document your case! 

Yeah, I will be. Pinto has lots of patient posted cases on the Spanish forums, I think around about 50 in total now with a fair few also in progress, but only the one on here and he's relatively unknown amongst HRN members as a result.

Hopefully I can bring some more attention to him amongst us lot on here and give some exposure to another great choice for people to consider 

[JDEE0]

15 minutes ago, TorontoMan said:

Yes exactly, hair transplants are your second chance, they make up for the time you spent ignorant to the issue or in denial.. and the problem is most men discover this after the fact, because of the stigma and lack of communication/education towards the subject. Goodluck on your procedure. And no sense in dwelling on how you were making decisions in the past, you couldn't have known better, and the hesitation with everything is very normal, everyone goes through these stages unfortunately .. thats just how this game goes. I don't regret taking my time with fin either, I could have started 2 years earlier when i first found out, but at the same time I very likely would not have been on it with the peace of mind I have now, so I would have eventually scared myself out of it. So everything has its place and time, and thankfully we have some things we could do about it now, like transplants, meds etc. Our fathers, grandfathers etc would have been hella grateful for these options.. just the education alone is something we take for granted. 

Yeah, I think for the most part people really just need to be comfortable in themselves and not care at all what anyone else says or thinks about having a HT or fighting hair loss in general, you really need to be able to brush off all the comments of doubt or people taking the piss that you're bound to get. I think all of this stops a lot of people from even attempting to do something about it, but once you're well informed, know what you're getting yourself into and are confident enough to not care what anyone says, then you're golden in my opinion (assuming you're a suitable candidate of course).

And yeah, I appreciate that man, it is what it is though and I don't dwell on it really, what's done is done and I'm just looking forward to not having to worry about my hair anymore. I followed your thread too and although a slightly different presentation of MPB in your case as your hairline seemed to uniformly recede up in more of a straight line and mine is just temporal areas with the forelock not having moved, the total amount of loss is overall very similar between us, we're pretty much the same age and I require the same amount really to get to a solid NW1-2 at worst hairline. Point is, we're both very lucky to be in the position we're in and be able to have a 2000ish graft procedure, take meds and be able to move on looking like MPB was never an issue for (most likely and hopefully) a long long time. 

Edited October 14, 2021 by JDEE0

[Future Hair Doc]

Thanks for sharing. Very interesting study. I suspected this to be the case as well

[JDEE0]

35 minutes ago, Dr. Suhail Khokhar said:

Thanks for sharing. Very interesting study. I suspected this to be the case as well

No problem! I have always been skeptical to be honest as I've posted before, but seems I was (somewhat at least as it still inhibits a fair amount of serum DHT) wrong.

Problem was that previous studies I've seen have been very short, a couple weeks in duration, and although they have indeed showed lower systemic absorption through measuring serum DHT, I was more convinced that they would match oral levels if they went on for longer. 

6 months is definitely enough time to for the drug to saturate your system and reach it's maximum effect though, and with this study being fairly large scale and carried out to a good clinical standard, it's clear that it doesn't go quite as systemic yet still has the same effects. I'm pretty sure no other studies on topical fin have come anywhere near close to this in terms of reliability and length of duration, so it seems at least there is some conclusive evidence in favour of topical now for those who are weary of oral.

Hopefully someone repeats a similar study for topical dutasteride next, if it's as good as people online are claiming, it could change the game for a lot of people.

[JohnnyR]

Do you have the link to the study?

[JDEE0]

1 hour ago, JohnnyR said:

Do you have the link to the study?

I linked it in the initial post 

[mustang]

This is graph from a previous study.

The safest way to use Topical Finasteride minimizing side effects while being effective is using 1ML at 0.025% EOD.

For example, 1ML Monday, Wednesday and Friday. You only want to wash your hair 3 times a week max anyways so this is quite a comfortable way.

Anything higher than that will lead to the same suppression orally as this molecule is quite light and easy to absorb. You will avoid liver first pass though. Even if dosed higher.

My protocol for maintenance if going back on TRT will probably be Topical Finasteride 0.025% 3 times a week and Topical Dutasteride 0.1% once a week on Sundays.

Alternatively doctors are now prescribing 0.5mg orally EOD (2mg per week) or even 0.25mg orally EOD (1mg a week).

Oral fin always gave me sides, topical fin as well but I was using a much higher dose. I had non of these sides with Topical Dutasteride and I responded better to it as well.

I think with low dose Topical Finasteride and Topical Dutasteride plus a Mesotherapy session every 3-4 months there is no need for oral medication anymore.

It is more expensive but the sides end up ruining your quality of life. Many are lucky and don't have sides on oral dutasteride or fin, I envy them for sure.

I have 3 friends with zero sides on oral finasteride but all 3 are extremely fit. Low body fat, good muscle mass, I think this is key.

[JP28]

4 hours ago, mustang said:

This is graph from a previous study.

The safest way to use Topical Finasteride minimizing side effects while being effective is using 1ML at 0.025% EOD.

For example, 1ML Monday, Wednesday and Friday. You only want to wash your hair 3 times a week max anyways so this is quite a comfortable way.

Anything higher than that will lead to the same suppression orally as this molecule is quite light and easy to absorb. You will avoid liver first pass though. Even if dosed higher.

My protocol for maintenance if going back on TRT will probably be Topical Finasteride 0.025% 3 times a week and Topical Dutasteride 0.1% once a week on Sundays.

Alternatively doctors are now prescribing 0.5mg orally EOD (2mg per week) or even 0.25mg orally EOD (1mg a week).

Oral fin always gave me sides, topical fin as well but I was using a much higher dose. I had non of these sides with Topical Dutasteride and I responded better to it as well.

I think with low dose Topical Finasteride and Topical Dutasteride plus a Mesotherapy session every 3-4 months there is no need for oral medication anymore.

It is more expensive but the sides end up ruining your quality of life. Many are lucky and don't have sides on oral dutasteride or fin, I envy them for sure.

I have 3 friends with zero sides on oral finasteride but all 3 are extremely fit. Low body fat, good muscle mass, I think this is key.

Does topical fina suppresses more scalp dht than oral? 
Cause I remember reading that 5mg oral daily would only get 41% scalp dht. 

[mustang]

I wouldn't think so, maybe similar 

Suppressing 50% is more than enough for many 

[RandoBrando517]

On 10/16/2021 at 1:53 AM, mustang said:

This is graph from a previous study.

The safest way to use Topical Finasteride minimizing side effects while being effective is using 1ML at 0.025% EOD.

For example, 1ML Monday, Wednesday and Friday. You only want to wash your hair 3 times a week max anyways so this is quite a comfortable way.

Anything higher than that will lead to the same suppression orally as this molecule is quite light and easy to absorb. You will avoid liver first pass though. Even if dosed higher.

My protocol for maintenance if going back on TRT will probably be Topical Finasteride 0.025% 3 times a week and Topical Dutasteride 0.1% once a week on Sundays.

Alternatively doctors are now prescribing 0.5mg orally EOD (2mg per week) or even 0.25mg orally EOD (1mg a week).

Oral fin always gave me sides, topical fin as well but I was using a much higher dose. I had non of these sides with Topical Dutasteride and I responded better to it as well.

I think with low dose Topical Finasteride and Topical Dutasteride plus a Mesotherapy session every 3-4 months there is no need for oral medication anymore.

It is more expensive but the sides end up ruining your quality of life. Many are lucky and don't have sides on oral dutasteride or fin, I envy them for sure.

I have 3 friends with zero sides on oral finasteride but all 3 are extremely fit. Low body fat, good muscle mass, I think this is key.

This sounds like the perfect protocol I’ve heard dut once a week is best

[JDEE0]

On 10/16/2021 at 9:53 AM, mustang said:

This is graph from a previous study.

The safest way to use Topical Finasteride minimizing side effects while being effective is using 1ML at 0.025% EOD.

For example, 1ML Monday, Wednesday and Friday. You only want to wash your hair 3 times a week max anyways so this is quite a comfortable way.

Anything higher than that will lead to the same suppression orally as this molecule is quite light and easy to absorb. You will avoid liver first pass though. Even if dosed higher.

My protocol for maintenance if going back on TRT will probably be Topical Finasteride 0.025% 3 times a week and Topical Dutasteride 0.1% once a week on Sundays.

Alternatively doctors are now prescribing 0.5mg orally EOD (2mg per week) or even 0.25mg orally EOD (1mg a week).

Oral fin always gave me sides, topical fin as well but I was using a much higher dose. I had non of these sides with Topical Dutasteride and I responded better to it as well.

I think with low dose Topical Finasteride and Topical Dutasteride plus a Mesotherapy session every 3-4 months there is no need for oral medication anymore.

It is more expensive but the sides end up ruining your quality of life. Many are lucky and don't have sides on oral dutasteride or fin, I envy them for sure.

I have 3 friends with zero sides on oral finasteride but all 3 are extremely fit. Low body fat, good muscle mass, I think this is key.

You're referring to the Caserini study from 2016 where the equivalent of a 0.025 dose (daily, not EOD) only had around a 25 percent serum DHT suppression, but this study only lasted for 7 days - i.e. they had their blood measurements taken after one week of treatment. Maybe the suppression does stay the same at this dose long term, but no one knows. So I don't think it's accurate to say that this is the most effective way to do things whilst still being effective, although I agree it's not a bad strategy if someone is extremely worried or has had sides and this is their last resort sort of approach. 

Also, as for you stating that anything higher than this will dose will simply lead to the same DHT suppression as oral, well the study in question has just shown that this isn't true with a 34% DHT reduction after 6 months of ED application of a much higher dose than 0.025, so I'm confused as to why you say that..

As for your last few sentences, I agree that this is a good treatment approach for those who are either absolutely unwilling to try oral fin or can't seem to shake sides, but I have to disagree that there's no need to take oral anymore when the vast majority of people have absolutely no sides. It makes no sense to unnecessarily go through all the effort of using topicals (and extra cost they incur) when you can just take a pill in 1 second and move on with your day.

It's not that many are lucky and don't have sides, its that a small amount are unlucky and do have them. We've got yet another high quality study here that shows pretty much the exact same thing as every other than has come before it; that sides with oral finasteride occur in lower single digit figures of the participants (as I outlined in my initial post, 2.8% in placebo and 4.8% in the oral group). So I don't think that your statement about being fit is true at all for fin to not have sides; your 3 mates just fall into the 95+ percent of users who have no sides, as does most of the population (although it will help with Estrogen levels yes of course).

I would instead say that there is no need to take oral anymore if you can't tolerate it very well and need to try something else.

Edited October 17, 2021 by JDEE0

[mustang]

3 minutes ago, JDEE0 said:

You're referring to the Caserini study from 2016 where the equivalent of a 0.025 dose (daily, not EOD) only had around a 25 percent serum DHT suppression, but this study only lasted for 7 days - i.e. they had their blood measurements taken after one week of treatment. Maybe the suppression does stay the same at this dose long term, but no one knows. So I don't think it's accurate to say that this is the most effective way to do things whilst still being effective, although I agree it's not a bad strategy if someone is extremely worried or has had sides and this is their last resort sort of approach. 

Also, as for you stating that anything higher than this will dose will simply lead to the same DHT suppression as oral, well the study in question has just shown that this isn't true with a 34% DHT reduction after 6 months of ED application of a much higher dose than 0.025, so I'm confused as to why you say that..

As for your last few sentences, I agree that this is a good treatment approach for those who are either absolutely unwilling to try oral fin or can't seem to shake sides, but I have to disagree that there's no need to take oral anymore when the vast majority of people have absolutely no sides. It makes no sense to unnecessarily go through all the effort of using topicals (and extra cost they incur) when you can just take a pill in 1 second and move on with your day.

It's not that many are lucky and don't have sides, its that a small amount are unlucky and do have them. We've got yet another high quality study here that shows pretty much the exact same thing as every other than has come before it; that sides with oral finasteride occur in lower single digit figures of the participants (as I outlined in my initial post, 2.8% in placebo and 4.8% in the oral group). So I don't think that your statement about being fit is true at all for fin to not have sides; your 3 mates just fall into the 95+ percent of users who have no sides, as does most of the population (although it will help with Estrogen levels yes of course).

I would instead say that there is no need to take oral anymore if you can't tolerate it very well and need to try something else.

After 20 years of performing surgeries and medicating patients with oral Finasteride Dr Mwamba told me has seen an incidence of around 30% at 1mg daily and about 20% at 0.5mg EOD on his patients when it comes to side effects (Gyno, ED, brain fog, Low T), not 4.8% which is saddening but the reality on over 5.000 patients and in line with what other surgeons have told me.

You are correct, the vast majority has not reported side effects but 30% is a significant number, I happen to be within those who experienced it as thousands of others.

I agree that if you have no sides on oral medication it is cheaper and much more practical but you can achieve the same type or similar scalp DHT suppression with topicals so why risk it.

Being fit helps avoiding androgenic sides from Fin. The medical literature indicates acquired secondary hypogonadism on long term finasteride users, the more aromatization you avoid the best chance to have to not end up with low LH, TT and Free T like I did and many others do. 

Some overweight people will not have sides from Fin and some fit people will have them, it's about improving your chances.

[JDEE0]

22 minutes ago, mustang said:

After 20 years of performing surgeries and medicating patients with oral Finasteride Dr Mwamba told me has seen an incidence of around 30% at 1mg daily and about 20% at 0.5mg EOD on his patients when it comes to side effects (Gyno, ED, brain fog, Low T), not 4.8% which is saddening but the reality on over 5.000 patients and in line with what other surgeons have told me.

You are correct, the vast majority has not reported side effects but 30% is a significant number, I happen to be within those who experienced it as thousands of others.

I agree that if you have no sides on oral medication it is cheaper and much more practical but you can achieve the same type or similar scalp DHT suppression with topicals so why risk it.

Being fit helps avoiding androgenic sides from Fin. The medical literature indicates acquired secondary hypogonadism on long term finasteride users, the more aromatization you avoid the best chance to have to not end up with low LH, TT and Free T like I did and many others do. 

Some overweight people will not have sides from Fin and some fit people will have them, it's about improving your chances.

Well, whilst I understand and respect what you're saying, I've also spoken to a number of elite Belgian/Spanish etc doctors who have told me that, in their experience, side effects with their thousands of patients over decade(s) do generally fall in line with the official data. So, that is very interesting indeed that Mwamba says that when people like Bisanga say the opposite. Definitely doesn't match my experience in speaking with doctors, in fact is the opposite of mine. 

And I respect your view, but I'm sorry, I have to follow the data of the many placebo controlled, double blind studies that have been performed with extremely similar results each time over anecdotes from hair loss forums full of confirmation and selection bias all day long. It makes no sense that they're so vastly wrong at this point and no one has a single explanation (at least a good one) as to why this would be

Edited October 17, 2021 by JDEE0

[mustang]

Well, I think you do well following the data of double blind studies.

I will follow my experience and surgeons "data" which is anecdotal but from a great source.

Each to their own

 

[JDEE0]

15 minutes ago, mustang said:

Well, I think you do well following the data of double blind studies.

I will follow my experience and surgeons "data" which is anecdotal but from a great source.

Each to their own

 

Yeah, I respect that and your viewpoint.

But in addition to the clinical data, I am also following the experience of lots of renowned surgeons who as far I as I know generally do agree with the official data.

[SLA]

Thank you @JDEE0- Interesting study for sure.

So as I looked at the study, .114mg equivalent is the .25% concentration and the maximum they were spraying was .2ml daily- .2ml seems like such a small amount to cover someone's entire head, although the spray applicator must have helped. Here is a link I put in another thread which talks about adding another ingredient to the topical finasteride concentration to increase the distribution area. 

https://mattdominance.com/topical-finasteride-2/

I also wonder with the topicals how to address the donor area as that region too can experience thinning.