I have now received side effects from 3 brands of topical finasteride, Xyon, Farmacia Parati, and California Specialty Pharmacy. Farmacia Parati lasted the longest without sides.

[HairRun]

I guess I'm out of the topical finasteride game for good now. Here is my breakdown of the 3 topical finasteride treatments I've used. 

California Specialty Pharmacy's formulation was .25% if memory serves me correctly. Both Farmacia Parati and Xyon were at 2.5%. 

California Specialty Pharmacy (CSP)

This what Dr William Rassman prescribed. He said it was based off an Italian formulation (which I assume is Farmacia Parati) and he worked work California Specialty Pharmacy to compound the medication. The medication has minoxidil as well. It's the cheapest to get out of the three since it's made in US, if you're shipping to the US. It has an off putting chemical smell, and texture sort of like whipped cream. You need to rub it in well to prevent white cast. 

I tried the recommended dosage at first and got sides, which was 4 pumps a day. Then I did 4 pumps every other day. And then 2 pumps every other day. Then tried 2 pumps a week. For the last dosage, I lasted over a month at least before I got sides. I wish I tracked the specific number of applications, but it was 4-5 applications probably. 

tl;dr, lasted 4-5 applications at 1/10th dosage as Xyon and Farmacia Parati

Farmacia Parati (FP)

This is what Dr Ron Shapiro prescribes, this is something he has researched quite well. I was talking to his patient advocate, Matt Zupan, about my previous trial with California Specialty Pharmacy, and he recommended giving Farmacia Parati a try. From my research, Dr Ron Shapiro has the most indicators that he is the most seen-it-all guy in hair transplantation, so I wanted to give it a try. Like CSP, it also has minoxidil in it. It is 2.5%, which surprised me as it is like 10x of CSP, but he said that's what they start off most people with so I went for it. Unlike CSP, it has a very mild smell, and whatever smell it does have, is actually on the pleasant side, so I can apply it anytime without worrying about my scent. It also has a much better consistency, like lotion, very easy to rub in and no white cast. 

I started with 4 pumps a day, every other day. Got sides, then switched to two pumps a day, every other day. Then finally, 2 pumps a week. After 4 applications I got side effects again, I think about 2 days after my 4th application. So maybe about the same number of applications as CSP, but at 10x the dosage. So from this, maybe the FP formula has a better liposomal formula. 

tl;dr lasted 4 applications same dosage as Xyon and 10x dosage as CSP. 

Xyon

This was a formula Dr Victor Hassan worked on with a pharmacy that I can't remember its name. This formula has the strongest theoretical foundation. This formulation does not have minoxidil in it. My first trials were a disaster because I was trying to juggle this is topical minoxidil, as from my experience, the minoxidil causes fin side effects. I tried a half pump on a Saturday, and then didn't do minoxidil until the following Friday, and shortly after, I got side effects. So it feels like the carriers in the topical minoxidil causes the formulation in the Xyon formula to break down or something, and the fin gets absorbed. 

I didn't want to give up on min, so I just left it in the fridge. After my procedure with Dr Shaprio, he prescribed me oral min. I also didn't want to use topical min because my scalp is healing from the procedure, so this would be a good time to give Xyon a try. 

This time I was doing half a pump 1x a week, so that the dosage would be equivalent to FP. The first may have been off, because it's tricky to do half a pump. But the 2nd and 3rd times, I just took out a full pump and threw away the rest. This time it lasted way longer than the first trials, so maybe I was correct in my theory about topical min interfering with it, but unfortunately the formula still didn't work for me. I has 3 applications, and then 3 days after my last application, got side effects. This one really bummed me out. It was my last chance at being on the most effective medication for hair loss. 

tl;dr lasted 3 applications same dosage as FP and 10x dosage as CSP.

Conclusions

I think the main conclusion for me is that topical finasteride is probably not for me. As for the best formula for others, there may  be some interesting observations but there are probably limits to what you can conclude, since this is one sample size of data. For example, there might be something unique about my physiology that makes the Xyon formula not work with me for some reason. I'm just armchair sciencing it this point but maybe my defensive cells didn't like the formula and attacked it, total armchair science but my point is there could have been other factors rather than it just being a less effect formula. 

For anyone in the topical finasteride game, I highly implore giving Xyon a try, I think you got to. 400$ is a small price to pay to check if a very potent form of retaining hair works for you. If you think about it, say that the formula saves you like 3000 grafts worth of hair, at 8 dollars a graft, from this viewpoint, you gained 16,000 dollars, but these are extra grafts that you get without hurting your donor or anything like that. I would think of it as a low risk, high potential reward investment. 

I also implore giving Farmacia Parati a try as well for this same reason. At least for me, it seems to work about the same or better than Xyon. It'll be interesting to see the results as more reviews come in for people who tried both and found which one is better. 

Next Steps for me

I think I'm out of the fin game. I've been trying various formulas and dosages since 2019. For some people, a microdose may be all that's needed to maintain hair, but for me during this time, I continued to lose it. Most of the time during this period, I has side effects. I didn't have post finasteride syndrome. The side effects went away about 2 weeks, 3 weeks top every time I stopped using it, I just continued to trial it in search for a regimen that might work for me. Perhaps there is a microdose so small of topical that it helps with a small percentage of loss, without noticeable side, but to me it's not worth it. 

There is one more think I can try. topical dut. The theory is that it's a much larger molecule than fin, so it doesn't get absorbed as easily. Perhaps I will try this, but probably not. 

Besides those, I think I might go back to FP for just a pure liposomal min. Dr Hassan said people on Min have weaker skin, and there's a theoretical bases for it, interfering with production of collagen. But just arm chair sciencing it, what if it's the carriers in topical min. They tend to have alcohol, which I think also messes up skin. I read it causes something like glycation of the skin, Advanced glycation end-products in patients with chronic alcohol misuse - PubMed (nih.gov) 
So topical min might help. Also liposomal formulas might help deliver min directly to the follicles better than current formulations. There may be benefit to direct contact, in addition to oral ingestion. Again, totally armchair sciencing it, but it's one of those very low risk, high potential reward things. 

EDIT:

After I posted this, I realized that I may not be accounting for the total dosage of each application. So both FP and Xyon may be at 2.5%, but what if Xyon, since it's more effective, has 2x the total dosage because the amount is higher. So that with FP, it gets a total of 0.5 grams of fin per application, but Xyon gives 1.0 grams. So I may not have been giving an apples to apples comparison. Luckily I still have some FP bottles in my fridge. When I get a chance, I'll need to see if I can calculate is Xyon's dosage is indeed higher. If so, that'll make a lot of sense, since it has a stronger theoretical foundation. 

EDIT 2:

Both are 1 ml

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Edited October 27, 2022 by HairRun

[AfroDan]

Dr. Carlos Wesley offers 0.1% Topical Finasteride with retinol. It works well. It's worth a try before giving up. Or getting it made at a compounding pharmacist in your area.

https://www.drcarloswesley.com/medical-therapy-for-hair-loss/

[WhereIsMyMind]

Farmacia Parati finasteride uses liposomes delivery if im not mistaken right? (which in theory have less systemic absorbtion but penetrate deeper into the hairs)

So thats why you might be experiencing different effects with different brans. The active component is exactly the same, only the vehicle changes. Trial and error is the only way.

Nonetheless, the few topical finasteride studies demonstrate that it actually has a very very high systemic absorbtion. One study found it to be as much as just taking it orally. Others around 30-60% systemic absorbtion. The main reason is that the mollecule size of Fin is very small. On the other hand, topical Dutasteride has a much higher mollecule size that is hard to penetrate skin (over 500 dalton) so unironically it could give you less side effects.

For example, something like topical minoxidil has only around 6% systemic absorbtion. So imo Fin is not the optimal drug to be taken topically, absorbtion is just too high to justify not just taking the pill although its clear some people still think its worth it.

Last alternative could be to try more Fin brands, Breezula or Pyrilutamide once available.

I wouldn't give up just yet.

Edited October 25, 2022 by WhereIsMyMind

[lindros88]

I’m in the same boat as you hair run, it sucks because I notice the finasteride effect on my hair almost immediately. I am just using rogaine foam for now.

[Melvin- Admin]

I thought you weren’t getting sides, besides testicle pain? 

[HairRun]

Update to my last edit, both are 1ml so amount should be the same. 

 

On 10/24/2022 at 11:02 AM, AfroDan said:

Dr. Carlos Wesley offers 0.1% Topical Finasteride with retinol. It works well. It's worth a try before giving up. Or getting it made at a compounding pharmacist in your area.

https://www.drcarloswesley.com/medical-therapy-for-hair-loss/

Perhaps, but I think the best next experiment to try is Dr Mwamba's topical dut. 

On 10/25/2022 at 4:17 AM, WhereIsMyMind said:

Farmacia Parati finasteride uses liposomes delivery if im not mistaken right? (which in theory have less systemic absorbtion but penetrate deeper into the hairs)

So thats why you might be experiencing different effects with different brans. The active component is exactly the same, only the vehicle changes. Trial and error is the only way.

Nonetheless, the few topical finasteride studies demonstrate that it actually has a very very high systemic absorbtion. One study found it to be as much as just taking it orally. Others around 30-60% systemic absorbtion. The main reason is that the mollecule size of Fin is very small. On the other hand, topical Dutasteride has a much higher mollecule size that is hard to penetrate skin (over 500 dalton) so unironically it could give you less side effects.

For example, something like topical minoxidil has only around 6% systemic absorbtion. So imo Fin is not the optimal drug to be taken topically, absorbtion is just too high to justify not just taking the pill although its clear some people still think its worth it.

Last alternative could be to try more Fin brands, Breezula or Pyrilutamide once available.

I wouldn't give up just yet.

Actually, I am going for topical dut next. 

On 10/25/2022 at 4:08 PM, lindros88 said:

I’m in the same boat as you hair run, it sucks because I notice the finasteride effect on my hair almost immediately. I am just using rogaine foam for now.

I've heard topical dut has a less chance of going systemic due to higher molecular weight. 

11 hours ago, Melvin- Moderator said:

I thought you weren’t getting sides, besides testicle pain? 

I wouldn't call it pain, I've seen it called 'ball-ache' so that's the term I've used, it's mildly painful but more annoying than aggravating. But with all three formulations I've tried, it always takes a few weeks for the sexual sideeffects to kick in. I was hoping it wouldn't happen with this one due to the better formulation. All three I've tried are much better than micro dose oral fin btw, where I would get side effects in a week, though I can't really say if I were taking an equivalent dose, since I'm not sure if all of it gets in your skin, I think a fraction sticks onto your hair. But I think for those with finasteride sensitivity, for sure the safer trial is micro dosing on topical finasteride. Luckily I didn't have post finasteride syndrome, but if I were a completely new to fin, I would start with an even lower dose than anything I tried before, say 0.1% or even 0.05% finasteride, do a few weeks of 1 application per week, then a few of 3 applications a week, and slowly build up. In my case, it always takes a few weeks to feel the full effects of the sides. 

 

 

[A Fue Good Men]

I would seriously consider getting blood work before trying topical fin and after to see what’s going on exactly.

[AfroDan]

Had a friend who tried topical Dut, killed his libido (it's a lot stronger than Fin, it kills two forms of DHT, hence the "DU").

Starting with 0.1% of Topical Fin every other day for 1-3 months should be a good test.

[Melvin- Admin]

On 10/27/2022 at 2:26 AM, HairRun said:

Update to my last edit, both are 1ml so amount should be the same. 

 

Perhaps, but I think the best next experiment to try is Dr Mwamba's topical dut. 

Actually, I am going for topical dut next. 

I've heard topical dut has a less chance of going systemic due to higher molecular weight. 

I wouldn't call it pain, I've seen it called 'ball-ache' so that's the term I've used, it's mildly painful but more annoying than aggravating. But with all three formulations I've tried, it always takes a few weeks for the sexual sideeffects to kick in. I was hoping it wouldn't happen with this one due to the better formulation. All three I've tried are much better than micro dose oral fin btw, where I would get side effects in a week, though I can't really say if I were taking an equivalent dose, since I'm not sure if all of it gets in your skin, I think a fraction sticks onto your hair. But I think for those with finasteride sensitivity, for sure the safer trial is micro dosing on topical finasteride. Luckily I didn't have post finasteride syndrome, but if I were a completely new to fin, I would start with an even lower dose than anything I tried before, say 0.1% or even 0.05% finasteride, do a few weeks of 1 application per week, then a few of 3 applications a week, and slowly build up. In my case, it always takes a few weeks to feel the full effects of the sides. 

 

 

Since it takes weeks, I’m wondering if taking it one week on, one week off, would solve the problem. Sounds like the accumulation of finasteride is causing it. But this is just conjecture. 

[WhiteyUK]

26 minutes ago, Melvin- Moderator said:

Since it takes weeks, I’m wondering if taking it one week on, one week off, would solve the problem. Sounds like the accumulation of finasteride is causing it. But this is just conjecture. 

Certainly worth a try… as they say “some is better than none”

[HairRun]

6 hours ago, Melvin- Moderator said:

Since it takes weeks, I’m wondering if taking it one week on, one week off, would solve the problem. Sounds like the accumulation of finasteride is causing it. But this is just conjecture. 

 1 week on, 1 week off sounds like a great idea if you've previously shown sensitivity to finasteride. 

[HairRun]

Update: I'll be trying topical dut. I'll let you guys know as well as I start using it. 

[BaldDude]

On 10/25/2022 at 7:17 AM, WhereIsMyMind said:

Farmacia Parati finasteride uses liposomes delivery if im not mistaken right? (which in theory have less systemic absorbtion but penetrate deeper into the hairs)

So thats why you might be experiencing different effects with different brans. The active component is exactly the same, only the vehicle changes. Trial and error is the only way.

Nonetheless, the few topical finasteride studies demonstrate that it actually has a very very high systemic absorbtion. One study found it to be as much as just taking it orally. Others around 30-60% systemic absorbtion. The main reason is that the mollecule size of Fin is very small. On the other hand, topical Dutasteride has a much higher mollecule size that is hard to penetrate skin (over 500 dalton) so unironically it could give you less side effects.

For example, something like topical minoxidil has only around 6% systemic absorbtion. So imo Fin is not the optimal drug to be taken topically, absorbtion is just too high to justify not just taking the pill although its clear some people still think its worth it.

Last alternative could be to try more Fin brands, Breezula or Pyrilutamide once available.

I wouldn't give up just yet.

But less absorption could mean less results. 

[WhereIsMyMind]

9 hours ago, BaldBobby said:

But less absorption could mean less results. 

Yeah, but once you reach that point you have no choice.

Dutasteride Mesotherapy trials show almost no side effects for patients while injected + similar results to oral dut.

[GoliGoliGoli]

3 hours ago, WhereIsMyMind said:

 

Dutasteride Mesotherapy trials show almost no side effects for patients while injected + similar results to oral dut.

Ya I wish this was more available in the US. If anyone knows any places doing it please list them,