Regular Member alopie Posted December 20, 2023 Regular Member Share Posted December 20, 2023 I had to switch to topical finasteride due to some side effects (mainly testicular pain and longer term concerns) My current routine: - 2mg oral minoxidil daily - 5% topical minoxidil 0.75ml daily (stubborn areas) - 0.1% topical finasteride ~0.8-1ml daily - Ketoconazole 2% 3x/week, some biotin supplements and LLLT cap 3x week I am concerned that since I stopped oral finasteride (I used to take 1mg daily), there might not be enough androgen inhibition. Is topical finasteride 0.1% enough? How about microdozing oral (let's say 0.5mg MWF + 0.5ml of 0.1% topical daily)? Link to comment Share on other sites More sharing options...
Senior Member FinallyHT Posted December 20, 2023 Senior Member Share Posted December 20, 2023 Microdosing MWF of fin or dut is probably better. What is your age and hair loss so far? Age: 40 Hairloss began at age 23. Oral Finasteride 1mg daily since 2006, Topical Minoxidil since 2012. Hair transplant 3,400 grafts 2019. Second hair transplant 2,400 grafts in 2023. Link to comment Share on other sites More sharing options...
Senior Member duchaine Posted December 20, 2023 Senior Member Share Posted December 20, 2023 39 minutes ago, alopie said: I had to switch to topical finasteride due to some side effects (mainly testicular pain and longer term concerns) My current routine: - 2mg oral minoxidil daily - 5% topical minoxidil 0.75ml daily (stubborn areas) - 0.1% topical finasteride ~0.8-1ml daily - Ketoconazole 2% 3x/week, some biotin supplements and LLLT cap 3x week I am concerned that since I stopped oral finasteride (I used to take 1mg daily), there might not be enough androgen inhibition. Is topical finasteride 0.1% enough? How about microdozing oral (let's say 0.5mg MWF + 0.5ml of 0.1% topical daily)? You are not using anti androgens, except a little bit of fina on your scalp. Link to comment Share on other sites More sharing options...
Administrators Melvin- Admin Posted December 20, 2023 Administrators Share Posted December 20, 2023 Check out this video. Might be a good idea: I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice. Check out my final hair transplant and topical dutasteride journey: View my thread Topical dutasteride journey Melvin- Managing Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog. Follow our Social Media: Facebook, Instagram, Linkedin, and YouTube. Link to comment Share on other sites More sharing options...
Senior Member mustang Posted December 20, 2023 Senior Member Share Posted December 20, 2023 Always prefer topical than oral Fin. You bypass the liver avoiding metabolite accumulation and long term side effects. Link to comment Share on other sites More sharing options...
Regular Member alopie Posted December 20, 2023 Author Regular Member Share Posted December 20, 2023 25 minutes ago, Melvin- Admin said: Check out this video. Might be a good idea: Low dose oral dutasteride is an interesting one, but what I want to achieve is to lower the scalp dht by ~50-70% without lowering my serum dht by that much. If low dose dutasteride achieves the same result as 1mg oral finasteride daily without side effects, that does not necessarily mean that the serum dht levels are lower. The androgen-estrogen is what might cause gyno, breast cancer, or even high-grade prostate cancer in the long run. Urologists and dermatologists are concerned when I tell them that I am planning on using finasteride for more than 10 years. This is because there are not many studies beyond 10 years and they would not take that risk, especially considering the rare side effects it has been causing on me. Transplant surgeons are less concerned because they prfioritize short term results, and patient satisfaction, knowing that in the unlikely scenario a cancer is caused due to long term use of anti-androgens they won't be responsible. Link to comment Share on other sites More sharing options...
Regular Member alopie Posted December 20, 2023 Author Regular Member Share Posted December 20, 2023 27 minutes ago, mustang said: Always prefer topical than oral Fin. You bypass the liver avoiding metabolite accumulation and long term side effects. Sure, that's what I thought, but is 0.1% 1ml enough? Some people use 0.3% or even 1% when it comes to gels. I also think that topical application will never be perfect, I will miss some areas, or the solution might not be equally distributed within the bottle, so I might end up putting 2mg one day and 0.1mg the next day 🤷♂️ Link to comment Share on other sites More sharing options...
Senior Member mustang Posted December 20, 2023 Senior Member Share Posted December 20, 2023 I will use 0.01% so 0.1% is just fine Link to comment Share on other sites More sharing options...
Regular Member alopie Posted December 20, 2023 Author Regular Member Share Posted December 20, 2023 2 hours ago, FinallyHT said: Microdosing MWF of fin or dut is probably better. What is your age and hair loss so far? Is 0.5mg MWF better than 0.1% 1ml topical daily? I am 29y, had a hair transplant and went from NW3 to a NW1, so pretty good, but I am concerned I will lose ground if I switch to topical completely. I used fin 1mg for 5 years and I have been having testicular pain so I decided to take a brake for 3 weeks and now I switched to topical. Link to comment Share on other sites More sharing options...
Senior Member FinallyHT Posted December 20, 2023 Senior Member Share Posted December 20, 2023 testicular pain can be something else. Did you see a doctor? Age: 40 Hairloss began at age 23. Oral Finasteride 1mg daily since 2006, Topical Minoxidil since 2012. Hair transplant 3,400 grafts 2019. Second hair transplant 2,400 grafts in 2023. Link to comment Share on other sites More sharing options...
Senior Member FinallyHT Posted December 20, 2023 Senior Member Share Posted December 20, 2023 You will likely need another HT down the road given your age. I just had my second one. Age: 40 Hairloss began at age 23. Oral Finasteride 1mg daily since 2006, Topical Minoxidil since 2012. Hair transplant 3,400 grafts 2019. Second hair transplant 2,400 grafts in 2023. Link to comment Share on other sites More sharing options...
Regular Member alopie Posted December 22, 2023 Author Regular Member Share Posted December 22, 2023 On 12/20/2023 at 9:03 PM, FinallyHT said: testicular pain can be something else. Did you see a doctor? I did, all clear, they think it might be a hypermobile testicle and not related to finasteride. But all my doctors mentioned that they wouldn't want me to take finasteride for more than 10 years accumulatively. Only HT doctors are fine with it, not regular urologists or dermatologists. The question is, is 0.1% topical finasteride as good as 1mg oral? Or will I lose ground because I switched to topical? Link to comment Share on other sites More sharing options...
Senior Member FinallyHT Posted December 22, 2023 Senior Member Share Posted December 22, 2023 I've been on finasteride for 17 years. I don't think topical 0.1 percent is as strong at 1mg oral. I'm not sure though. Age: 40 Hairloss began at age 23. Oral Finasteride 1mg daily since 2006, Topical Minoxidil since 2012. Hair transplant 3,400 grafts 2019. Second hair transplant 2,400 grafts in 2023. Link to comment Share on other sites More sharing options...
Senior Member duchaine Posted December 22, 2023 Senior Member Share Posted December 22, 2023 On 12/20/2023 at 5:56 PM, mustang said: Always prefer topical than oral Fin. You bypass the liver avoiding metabolite accumulation and long term side effects. hair growth is a side effect of a drug created for prostate enelargment. If a durg doesn't have dises, that means that doesn't work (Dan Duchaine*) * D. Duchaine it is not me, he was the steroids guru. Link to comment Share on other sites More sharing options...
Regular Member alopie Posted December 22, 2023 Author Regular Member Share Posted December 22, 2023 16 hours ago, FinallyHT said: I've been on finasteride for 17 years. I don't think topical 0.1 percent is as strong at 1mg oral. I'm not sure though. Are you concerned about the long term effects that anti-androgens might have on your body? (high-grade prostate cancer, breast cancer, PFS) My understanding is that topical finasteride 0.1% 1ml (~1mg oral) achieves the same amount of scalp DHT inhibition but with roughly 1/10th of the serum dht inhibition Link to comment Share on other sites More sharing options...
Senior Member FinallyHT Posted December 22, 2023 Senior Member Share Posted December 22, 2023 Finasteride actually prevents prostate cancer. It also slows the aging process. I’m 40 and just this past week, three people thought I was 25 years old. Age: 40 Hairloss began at age 23. Oral Finasteride 1mg daily since 2006, Topical Minoxidil since 2012. Hair transplant 3,400 grafts 2019. Second hair transplant 2,400 grafts in 2023. Link to comment Share on other sites More sharing options...
Senior Member mustang Posted December 22, 2023 Senior Member Share Posted December 22, 2023 19 minutes ago, FinallyHT said: Finasteride actually prevents prostate cancer. It also slows the aging process. I’m 40 and just this past week, three people thought I was 25 years old. yes and no. Link to comment Share on other sites More sharing options...
Regular Member alopie Posted December 22, 2023 Author Regular Member Share Posted December 22, 2023 58 minutes ago, FinallyHT said: Finasteride actually prevents prostate cancer. It also slows the aging process. I’m 40 and just this past week, three people thought I was 25 years old. It prevents prostate cancer but it increases the chances of high-grade prostate cancer and male breast cancer in the long run. It's long term hormone modification and all urologists that I visited so far told me that I should not be taking it for longer than 10 years. Dermatologists are conservative too, but HT doctors tend to prescribe dutasteride without a doubt, it boosts HT results... Link to comment Share on other sites More sharing options...
Regular Member arthurSam Posted December 23, 2023 Regular Member Share Posted December 23, 2023 On 12/22/2023 at 10:25 PM, alopie said: It prevents prostate cancer but it increases the chances of high-grade prostate cancer and male breast cancer in the long run. It's long term hormone modification and all urologists that I visited so far told me that I should not be taking it for longer than 10 years. Dermatologists are conservative too, but HT doctors tend to prescribe dutasteride without a doubt, it boosts HT results... Same here I talk About finasteride with 2 urologists and they tell me it induce prostate cancer Minoxidil : 5% topical 1ml/day Follicular androgen receptor inhibitor : {Fluridil + CosmeRNA} Exosome Mesotherapy 1mm (See here for explanations & results) : ASCE+ HRLV Link to comment Share on other sites More sharing options...
Senior Member BaldReaper Posted December 23, 2023 Senior Member Share Posted December 23, 2023 36 minutes ago, arthurSam said: Same here I talk About finasteride with 2 urologists and they tell me it induce prostate cancer Not true Link to comment Share on other sites More sharing options...
Senior Member mustang Posted December 24, 2023 Senior Member Share Posted December 24, 2023 2 hours ago, arthurSam said: Same here I talk About finasteride with 2 urologists and they tell me it induce prostate cancer It doesn't. Period. What it does however is hide a very aggressive form of prostate cancer that might be non detectable because of Finasteride. 1 Link to comment Share on other sites More sharing options...
Regular Member alopie Posted December 24, 2023 Author Regular Member Share Posted December 24, 2023 20 hours ago, mustang said: It doesn't. Period. What it does however is hide a very aggressive form of prostate cancer that might be non detectable because of Finasteride. My urologist told me that it is likely that it does nothing, even after 10 or 20 years, but there are no studies regarding long term efficacy and side effects at that level and he does not want to take a risk, so I can get it for 10 years, and then stop or hope that we have a longer term study or another solution until then. It may cause high-grade prostate cancer and there are some reports regarding this, but it is rare. Link to comment Share on other sites More sharing options...
Regular Member DermMD Posted December 24, 2023 Regular Member Share Posted December 24, 2023 21 hours ago, mustang said: It doesn't. Period. What it does however is hide a very aggressive form of prostate cancer that might be non detectable because of Finasteride. Correct. Simply put, once you start getting your PsA testing your primary needs to know you're on finasteride or dutasteride as it can decrease the value of this test (missing early changes). if they know this, they should essentially double the PsA number to put it more in line with possible changes seen not on the medication. Link to comment Share on other sites More sharing options...
Regular Member Electric Posted December 25, 2023 Regular Member Share Posted December 25, 2023 I've been prescribed Propecia and researching the best I can, if it's safe to use. I found a site, Propeciahlep.com. There are stories of horrible permanent side effects. I want to take it but am fearful of side effects that sound even worst than the balding. Any help and feedback would really be appreciated. I've been told that I'm not a candidate for surgery in the crown area which seems to be balding pretty fast all of a sudden. So the Dilemna is whether or not to get started on Propecia? What have people done who are in similar situations? Link to comment Share on other sites More sharing options...
Senior Member mustang Posted December 25, 2023 Senior Member Share Posted December 25, 2023 9 hours ago, Electric said: I've been prescribed Propecia and researching the best I can, if it's safe to use. I found a site, Propeciahlep.com. There are stories of horrible permanent side effects. I want to take it but am fearful of side effects that sound even worst than the balding. Any help and feedback would really be appreciated. I've been told that I'm not a candidate for surgery in the crown area which seems to be balding pretty fast all of a sudden. So the Dilemna is whether or not to get started on Propecia? What have people done who are in similar situations? Chances of permanent sides are very small but real. It has been scientifically proven. I was left with some long lasting sides but recovered from most if not all. If you are scared of using Finasteride then Topical Finasteride is much safer, start at a very low dose or consider other natural alternatives. The majority of people do not experience permanent side and if dose sensibly most don't experience sides at all. Taking a mg daily orally is absolute overkill. Link to comment Share on other sites More sharing options...
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