Switching from oral to topical treatments (Minoxidil, Finasteride, Dutasteride)

[jim1973]

I'm a NW4a currently taking oral Finasteride (1mg daily since 2014), oral Dutasteride (.5mg once/week since Aug 2022) and oral Minoxidil (2.5mg daily since Oct 2022 – had been using topical Minoxidil since 2014 previously but scalp can be sensitive so wanted to cut back on itchiness). On these oral meds, I’m not seeing any benefits and am still losing ground (daily hair loss in sink more than in previous years/months, hair miniaturization). Because I haven’t seen any stabilization since 2020, I’m going to begin microneedling my scalp. I have read that Microneedling helps absorption of topical application of some of these meds (not sure if just one, two or all three) but I feel like going topical with everything would be my next best chance to at least stop hair loss even if no re-growth. Also, I'd like to minimize how much of each of those meds gets into my entire system outside of my scalp (On these oral meds, I didn’t notice sides initially but now have have typical sides like lower libido, soft morning wood but not completely gone, which is not great and can be tolerable to an extent but only seems worth it if I were getting obvious benefits in my hair, which I’m not).

Usually people are apprehensive about switching from topical to oral but I don’t see many posts with experiences about going from oral back to topical for any of the 3 meds I mentioned. In going topical Minoxidil is easy to find over the counter and as for the other 2, I probably don’t need to use both FIN and DUT so just need to pick one. I know Finasteride can still go systemic (if dose too high). Dutasteride isn’t supposed to go systemic because of molecular weight but that leaves me wondering how it reaches the hair follicles and if it will work as well. Curious as to how others chose topical FIN or DUT over the other and what their experiences were. Does anyone have good/bad experiences with using topical MIN/DUT or MIN/FIN together at the same time? Is there a MIN/DUT or MIN/FIN combo properly dosed and distributed (not sure what recommended doses are for each; as for distribution, Liposomal silicone based vehicles seem to be the best option) that exists already from in from one of the big boys available in the US (Hims, Keeps, Happy Head, Strut, Musely, etc.) or should I have compounded from independent pharmacy?

Once I convert to topical should I apply everything at same time before bed? I’m wondering if I should simply start topical and stop oral on same day or if there should be overlap to not jar my system? Should I expect a large shed in making these changes? If anybody has experience going from oral to topical, I'd love to hear our experience (or if you recommend that I don’t make the change with some reasoning behind it), I’d appreciate it. Thank you.

[arthurSam]

Make a DNA test from fragon to get all the medicine which work best for you. Perhaps you are taking medicine that did not work for you, that's all...

[jim1973]

@arthurSam I am not able to find anything related to "fragon"

[Melvin- Admin]

I have to say, I don’t believe there’s any benefit from switching from oral to topical unless its due to side effects. 

Sounds like you’re experiencing mild sides. I doubt you’d experience any sides on the topical version. You could try topical dutasteride for a month. 

The benefit I see is that topical dutasteride is 2% which is equivalent to 2mg. That’s a high dose, so it would be a lot more than your current .5mg. I’m still unsure whether it would be more effective, but you probably wouldn’t experience any sides. 

My morning wood, libido is all good using it 3-4x a week. I got very bad sides from the oral version.