Day: January 1, 2023

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Topical Finasteride & Minoxidil (photo)

This man took topical finasteride with minoxidil and applied it to the frontal hairline for 3 months and already has reversed some of the balding


2021-02-04 09:58:02Topical Finasteride & Minoxidil (photo)

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Topical finasteride and Minoxidil, used in combination

At a meeting in Manchester UK (which I attended this past week), there was a wonderful presentation about the combined use of topical finasteride and minoxidil. The presenting doctor from Italy, Chiara Insalaco, showed some wonderful results on men of varying ages for thinning and balding both on top of the head where thinning may have occurred as well as in the crown. Sometimes it took a year or more to get some amazing results which she demonstrated. While I was there, I sourced the topical finasteride which seems to cost about $60/month. According to her presentation, the sexual side effects from the pill, which drove the patients to her treatment approach, were significantly less or absent in many of the men she treated. When I return to Los Angeles, I will inquire into the ‘tele-medicine’ rules that may allow me to prescribe this through a telephone consultation. If this can be done, I might consider offering this avenue of treatment to people who link to me on this blog, those who are not within traveling distance to one of my two Southern California offices. For my own existing patients or those who can visit me, this will not be a restriction on what I can do and will most likely offer it to my patients. I asked Dr. Insalaco to write up a post for me which I will make available to my readers and bloggers. Stay Tuned!


2019-06-08 23:03:35Topical finasteride and Minoxidil, used in combination

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Topical finasteride and depression

So three months ago, I decided to hop on a min/fin 0.1% formula that made my derm (my anxiety and depression were still strong during this time). I applied it once a day in the mornings. The formula really works, in only these three months, I have recovered a lot of my hair to the point that it looks/feels like my hair from last year.

But my anxiety has been the worst, my derm says it is not possible or common.

Can a low dose of topical fin exacerbate these symptoms?

Topical finasteride at a dose of 0.1% will be absorbed systemically and can add to depressive symptoms that you already have. The alternative, if you want to take finasteride, is to take the liposomal topical finasteride, which largely stays in the scalp, This is a compounded medication made specifically to your specifications. I often prescribe it to people who can’t take oral finasteride.

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Topical Estrogen and Hair Loss

You recently wrote “Yes, any hormonal manipulation can cause hair loss”. can topical estrogen or estradiol cause hair loss in other parts of the body such as eyebrows & if so what are the chances that it would grow back.

Using estrogens, as in topical anti aging creams, has minimal systemic absorption and should not affect hair growth. Having said that, using topical estrogens for a long time or on a large area of the body may produce enough serum concentration and act like systemic drug. Estrogen is generally considered a protective hormone and hair loss is seen with its withdrawal, but playing with one hormone impacts other hormones and they might contribute to hair loss in special circumstances with some particular genetics influences (eyebrows or lashes). We know, for example, that female genetic hair loss is often not protected by estrogens.

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Topical DHT Blocker?

Hi there – I am a 22 year old who is just now noticing a receding hairline. Just a year ago this wasn’t a problem for me so I think it has progressed since January of this year. My dad and one of my brothers went bald, with only hair on the sides of their heads. My other brother just has a receding hairline with a large forehead. Obviously I have some concerns since it runs in my family.

I know you recommend Propecia but I am scared to take it because of the side effects. I suffered from a small case of gynecomastia growing up and got surgery to fix it. I am scared that taking Propecia would bring this condition back, or bring other unwanted side effects. I currently use a topical solution that claims to be the “topical version of Propecia” and is a DHT blocker. It is hard to tell if it’s working or not. What are the risks of taking Propecia?

There may be no connection between the youthful gynecomastia you had as a child and the side effects of this drug. You are worrying about something that has not happened to you yet. If you take Propecia and have any problems with it, stop it and the drug will be out of your system in days, along with any side effects like gynecomastia (risk is less than 1 in 500 patients).

There is no topical Propecia (finasteride). Also, the ability to absorb this drug through the skin is not reported anywhere I have read.

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Topical DHT Blocker as Effective as Propecia with Less Side Effects?

An earlier question brought up an article about a topical DHT inhibitor at HairLossTalk:

The doctor interviewed in the article made some pretty impressive claims. Paraphrasing:

  1. His topical DHT blocker is as effective as Propecia as long as you could apply it to the affected area
  2. Downside of topical: It’s more of a pain to apply. It would be really difficult to apply to entire scalp, whereas Propecia blocks DHT everywhere.
  3. Upside of topical: it only blocks DHT near the scalp, having less of an affect on serum DHT levels. This decreases the chances of side-effects.

The claims seem to make sense to me, but this kind of stuff can sometimes be counterintuitive.

  1. Do you agree with his general evaluation of topical vs. serum DHT blockers?
  2. Do you have an opinion on the specific topical solution he is talking about?

We have written about topical DHT blockers before here. The doctor in the article you referenced is a web-based provider of compounded, off-label medicaments for hair loss. The use of spironolactone has been a mainstay as a treatment for female hair loss when taken orally, but there is no real evidence that it works and many studies show the controversy, saying either it works or does not work. It is tied to the belief of the doctor, but you must keep in mind that doctors who recommend it profit from its use. When you take such medications and convert it to skin (topical) use, there is no guarantee that it works, if it is absorbed through the skin and just where the medication works (if it does work at all). It is easy to make such compounds and when a doctor puts his concoction into a cream or topical, there is an implication that it is safe and effective. Spironolactones are known antiandrogens and as such should work in men, but if taken orally, men will have significant secondary sexual side effects, such as loss of libido and problems with sustaining erections (when and if they get them). The question one should ask is whether this medication has sexual side effects. Without proper scientific studies, we really can not tell.

I never understood why men chase this stuff when the rare sexual side effects from Propecia (finasteride) have been measured. I would guess that if spironolactone was taken orally, they would dwarf the side effects of Propecia in men, yet men somehow want to experiment and may find themselves swamped with side effects or ineffective treatment losing valuable time on fixing hair loss with what is known to work. Topical spironolactone has a bad smell associated with it which is claimed to have been successfully addressed by this doctor, so I don’t know if this medication stinks from the aroma or its success and without good science behind it, it becomes a real gamble with the belief of one doctor who makes his living putting topical medications together.