Are topicals just hype and fancy marketing?

[mustang]

On 4/2/2023 at 1:14 AM, olmert said:

Which company does @mustang think gives the best bang for the buck with topical dutasteride and with topical finasteride?  

I only have experience with three of them

1) Parati: Great product and results, only downside is it's very messy to apply if you have longer hair but since it was once a week it was not a problem

2) FUE CLINIC (Shipped by Anagenica): Great product and results, liquid thus easier to apply. Downside is responses are slow but I think they have addressed that.

3) MinoxidilMax: Worst side effects ever. UGL stuff from China. Their dutasteride source is of very bad quality. I always strongly suggest to avoid them.

You have Xyon and Strut as well but I have not tried them.

[12345]

14 hours ago, olmert said:

Are there a  lot of people leaving keto shampoo on for 20 minutes? I think the FDA instructions say 5 minutes. Are there people reporting 20 minutes helping? 

Well, we have to think about what ketoconazole is. It is a type of anti-fungal. It is used to treat seb derm, tinea versicolor, and other head fungal infections. To treat heaf fungus, it needs to be left on the scalp for at least 20 min before washing off. It just happens that this specific fungal medication disrupts the DHT pathway hence why we are even talking about it for hair loss. 

To treat scalp fungal infections, you must keep it on for 20 min. That is why I keep it on for 20 min. I don't think any topical shampoo can be left on the scalp for only 5 min to have any desired effect. You won't put minoxidil on your scalp and then wash it off after 5 min, the same with topical fin or dut. While I think the scalp is very porous, it's not a sponge porous and will absorb medications that quickly.

Honestly, a lot of ppl on these various forums keep saying that a lot of these topicals such as ketoconazole, Pantosin, and Eucapil are "too weak" and "will not do anything" which is just nonsense. I think the majority of them have never actually tried the products and then read about them "being weak" from some other forum member (who probably also never tried them) and then keep passing on incorrect information.

And then you have users, let's take for example ketoconazole shampoo, which washes it off after 5 min before the drug can take effect, and say it is useless.

I can tell you as an actual user of the above products, they actually are being absorbed systemically and are altering your hormone levels. I think they would be good additions for those who are not sensitive to DHT  receptor blockers/DHT enzyme blockers, but I would not recommend them for people who experience sides from DHT blockers/DHT enzyme blockers.

Do I think ketoconazole, Pantosin, and Eucapi are on the same power level as fin? That would require testing of hormone levels to see to what extent DHT is reduced after use, but I will say that I have felt side effects such as ED in as soon as 3 uses with some of the above "Weak" topicals compared to when I was on Fin.

 

 

 

 

 

 

 

[12345]

12 hours ago, Gatsby said:

To be honest you would really need to leave Nizoral 2%, etc, in your scalp for hours and then see after many months of this if it is improving your hair. I personally don't use this anymore. Plus it dries out my scalp and makes my hair look like straw (and it looks like straw in the morning to begin with 😉)!

I can already feel the effects of 1%, no need to double it in my opinion. Sometimes more is not always better.

I also keep my hair low so straw hair doesn't concern me.

Also, let's keep it real, would you rather have straw hair or ED? Staw hair for the win. 

[NikosHair]

20 minutes ago, 12345 said:

And then you have users, let's take for example ketoconazole shampoo, which washes it off after 5 min before the drug can take effect, and say it is useless.

3-5mins as per the instructions on a Nizarol bottle for treating dandruff. 20mins may be fine for some, but the other chemicals they use to formulate a shampoo may irritate. As with so much in the hair loss world, the studies showing it improves AA is sketchy and inconclusive. 

[12345]

1 minute ago, NikosHair said:

3-5mins as per the instructions on a Nizarol bottle for treating dandruff. 20mins may be fine for some, but the other chemicals they use to formulate a shampoo may irritate. As with so much in the hair loss world, the studies showing it improves AA is sketchy and inconclusive. 

the Malassezia fungus that causes tinea versicolor, is the same fungus that causes seb derm which is what the 1% in the bottle is intended for. the 2% which needs a prescription says 15-20 min on the bottle. 

At the end of the day, you all can do whatever you want to do. I am not sponsored by any company, just a forum user sharing his anecdotal reports and thoughts. Everyone can take it with a grain of salt.

Before you call the studies inconclusive. Experiment and put just 1% on your scalp for 20 min a day, and see if you don't start to feel ball pain, and ED. it is def affecting DHT. Do not need a study to tell me that. 

[NikosHair]

15 minutes ago, 12345 said:

the 2% which needs a prescription says 15-20 min on the bottle.

Not on my bottle. No script required (different rules for different countries, I guess).

[NikosHair]

22 minutes ago, 12345 said:

At the end of the day, you all can do whatever you want to do. I am not sponsored by any company, just a forum user sharing his anecdotal reports and thoughts. Everyone can take it with a grain of salt.

Agreed!

[olmert]

3 hours ago, 12345 said:

the 2% which needs a prescription says 15-20 min on the bottle. 

I just looked at my bottle. In the United States, the bottle says the same thing the FDA instructions say: "DOSAGE AND ADMINISTRATION Apply the shampoo to the damp skin of the affected area and a wide margin surrounding this area. Lather, leave in place for 5 minutes, and then rinse off with water."   https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/019927s032lbl.pdf 

 

[mcr7777]

On 3/21/2023 at 11:03 PM, NikosHair said:

This is a very topical question (see what I did there🙄)

I've been looking at the extortionate prices for topical finasteride/dutasteride. By my calculations, you are looking at between $300 - $360 for a 3-month supply Vs $25 (delivered) generic oral finasteride.

With reference to the study @Melvin- Moderator kindly cited. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9297965/

The study does nothing to support the case for using topical finasteride, other than it was better than using nothing (placebo).

It would be interesting to hear your views and the study is a good starting point to support your views, either way.

 

I believe paid around 100 Euros for a 3 month supply of topical dut from Fue Clinic including delivery to the UK.  No issues with delivery. Still more than oral but less than quoted above.  Side effects from oral dut (minimal) are WAY less than I had on FIN after 2 months of using between 1 and 2 ml per week.

[NikosHair]

3 minutes ago, mcr7777 said:

I believe paid around 100 Euros for a 3 month supply of topical dut from Fue Clinic including delivery to the UK. 

Thanks for the info. I was quoting the prices i'd seen on here for the XYON product (site sponsor).

[NikosHair]

8 minutes ago, mcr7777 said:

Side effects from oral dut (minimal) are WAY less than I had on FIN after 2 months of using between 1 and 2 ml per week.

That sounds promising.

Have you seen improvements?

[mcr7777]

10 minutes ago, NikosHair said:

That sounds promising.

Have you seen improvements?

It's only 2 months in and too soon to say - but I'm shedding less miniaturised hair (I have LPP with minaturisation - not sure if it will help for my LPP).  Hair derms I've seen for past years say they only prescribe topicals now - so pretty confident it will help  based on anecdotal feedback and studies. 

Edited April 3, 2023 by mcr7777

[NikosHair]

8 minutes ago, mcr7777 said:

It's only 2 months in and too soon to say

I agree. You really need to give it 6 months to give it a fair chance to make a difference. 

Keep us updated on how it goes. I'm sure there are many on the board that will be interested.👍

[12345]

1 hour ago, olmert said:

I just looked at my bottle. In the United States, the bottle says the same thing the FDA instructions say: "DOSAGE AND ADMINISTRATION Apply the shampoo to the damp skin of the affected area and a wide margin surrounding this area. Lather, leave in place for 5 minutes, and then rinse off with water."   https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/019927s032lbl.pdf 

 

I am referring to the instructions on 2% ketoconazole to treat tinea versicolor. That was the 15-20 min I was referring to, not seb derm.

Also, we must remember, that none of us are using keto for its intended purpose, so we really do not know the correct time on the scalp or the frequency of use. we all can keep posting pics of bottles with the instructions etc, but we are beating a dead horse here. 

It would be better if someone could capture and post the images of the time and frequency of studies where keto is used to address hair loss.

[olmert]

19 minutes ago, 12345 said:

I am referring to the instructions on 2% ketoconazole to treat tinea versicolor. That was the 15-20 min I was referring to, not seb derm.

Prescription bottles in the united states have one pre-printed instructions. They don't have different instructions for different disorders. The pre-printed instructions on every bottle of 2% ketoconazole in the United States says 5 minutes. The pharmacy can manually type in words like "use as directed," as pharmacists sometimes do. 

Edited April 3, 2023 by olmert

[12345]

26 minutes ago, olmert said:

Prescription bottles in the united states have one pre-printed instructions. They don't have different instructions for different disorders. The pre-printed instructions on every bottle of 2% ketoconazole in the United States says 5 minutes. The pharmacy can manually type in words like "use as directed," as pharmacists sometimes do. 

once again, you are beating a dead horse.

Is the pre-printed instruction for the use of ketoconazole to treat androgenic alopecia?

You technically could ask a physician for a script for 2% ketoconazole to androgenic alopecia, but would they or the pharmacy even know how long to keep it on your scalp?

As I said in my original post which you keep ignoring, there is no actual guideline on the time and frequency of use of ketoconazole to address androgenic alopecia.

So can someone please post the instructions from a clinical trial where ketoconazole is the intervention to treat androgenic alopecia? Us going back and forth over a 5 min or 20 min argument is leading us nowhere at this point. 

 

[olmert]

7 hours ago, 12345 said:

To treat scalp fungal infections, you must keep it on for 20 min. That is why I keep it on for 20 min. I don't think any topical shampoo can be left on the scalp for only 5 min to have any desired effect.

Doctors like to say the absence of evidence is not evidence of absence. In other words, most things can't be tested. It is just too expensive. So you rely upon anecdotal evidence. So you prescribe drugs off label. In other words, just because we don't know everything does not mean we should pretend to know nothing. 

Now, if the quoted words above were accurate, they would be anecdotal evidence that ketoconazole for 20 minutes is better for hair loss than ketoconazole for 5 minutes. 

But the clinical trials showed that 5 minutes of ketoconazole works for dandruff and fungus. So at least something is getting in there. If there was much evidence that 20 minutes would do more, they might have aimed for a leave in spray. 

 

 

 

Edited April 3, 2023 by olmert

[NikosHair]

Guys as the official OP can I be the voice of reason (Now we are in trouble😊)

2 hours ago, 12345 said:

I am referring to the instructions on 2% ketoconazole to treat tinea versicolor. That was the 15-20 min I was referring to, not seb derm.

Where are these instructions?

[Gatsby]

We don’t need a script here either. But how does ketoconozole penetrate the scalp in 5minutes? What is it’s mode of action in treating MPB. I think definitely use it if you feel it’s of benefit. It’s just not for me when it's use is in fighting hair loss. All the best. 

[olmert]

1 hour ago, Gatsby said:

We don’t need a script here either. But how does ketoconozole penetrate the scalp in 5minutes? What is it’s mode of action in treating MPB. I think definitely use it if you feel it’s of benefit. It’s just not for me when it's use is in fighting hair loss.

You want a good rationale. Doctors reject that approach. They think biological functions are too complicated for us to figure out rationales. Doctors just look at the data. The little data we have has shown keto helps a bit. We don't have much data. If it were ever researched more, the new data might say the opposite. 

This reminds me of the debates 10 years ago here over laser therapy. Back then, most doctors said lasers do nothing. They even said there is no way the laser can penetrate the scalp. Gradually over the next ten years, studies came out that say lasers work. Today, the majority of doctors think lasers work. 

By the way, in the US, 1% keto is over the counter. 2% is script. It is probably that way everywhere.  

[Gatsby]

It’s over the counter here in Oz. I’m not knocking the shampoo. I just don’t use it for the reasons stated. But if people benefit then that’s great! 👍

Edited April 4, 2023 by Gatsby

[NikosHair]

Interesting discussion on the various emerging treatments for hair loss, which is well worth a listen. More specifically, the subject of the most effective delivery vehicle for topical Dutasteride.

Dr. Sergio Vaño response was 'the best vehicle would facilitate penetration of these high weight molecules'. (from 33mins 35secs)

It's worth noting the doctor uses oral meds on several consecutive days with a break and mesotherapy (injection) of Dutasteride on his patients that experience sides on daily meds.

 

Edited April 6, 2023 by NikosHair

[duckling]

On 4/4/2023 at 12:33 AM, 12345 said:

I am referring to the instructions on 2% ketoconazole to treat tinea versicolor. That was the 15-20 min I was referring to, not seb derm.

Also, we must remember, that none of us are using keto for its intended purpose, so we really do not know the correct time on the scalp or the frequency of use. we all can keep posting pics of bottles with the instructions etc, but we are beating a dead horse here. 

It would be better if someone could capture and post the images of the time and frequency of studies where keto is used to address hair loss.

I have used ketoconazole shampoo in foam version , which you can apply and keep on scalp for 15-20 mins and then rinse with water. I used that for 3 years, 3 times a week and It did help with my dandruff (I always used to have big flakes of dandruff ) but It did not help with hair loss. I got my crown thinning during the time i used this shampoo. So atleast for me it didn't work in terms of controlling hair loss and it caused irritation even after washing it off. ( I have also used ketocanazole lotion directly on wet hair and also diluted with water and then applied to scalp , just to see if they are any different)

I suggest that its not worth it. Use for dandruff but not for controlling hair loss. I have tried caffeine based shampoos too. But they are also hype. Shampoo are just used to keep your scalp clean. I use ketoconazole even now but for dandruff (5 mins max on scalp, 2-3 times max per week) so i don't hate the product. 

[NikosHair]

23 minutes ago, duckling said:

I suggest that its not worth it.

I agree.

There is very little credible evidence it has any effect on hair loss prevention.

If it was effective Nizorol would be able to label it up as a hair loss cure/prevention and cash in.

[NikosHair]

If anyone is still in any doubt that the marketers are all over this. 

The use of a subscription-based is another example. Companies love to sign you up for subscriptions. They understand that customer apathy is real. How many people have signed up for audiobooks, gym memberships, recipe boxes, etc only to find they get very little use/value out of the product/service?

Of course, it's just business and people are free to spend their money as they see fit.