Topical Finasteride For Hair Loss: How to Use and Where To Get It
Summary
TLDRIn Episode 34 of The Hair Loss Show, Dr. Vikram Jayaprakash and Dr. Russell Knudsen discuss the topical version of Finasteride, a treatment for hair loss. They compare it to the oral version, which has been in use since 1997 and has known side effects. Topical Finasteride is applied directly to the scalp to minimize systemic side effects, with typical concentrations of 0.1% to 0.25%. The podcast highlights the ongoing debate about its effectiveness and side effects, emphasizing the need for more scientific research beyond anecdotal evidence. The doctors also stress the importance of proper compounding for topical Finasteride.
Takeaways
- 👨⚕️ Dr. Vikram Jayaprakash and Dr. Russell Knudsen discuss hair loss treatments, focusing on Finasteride.
- 💊 Finasteride was released in the U.S. in 1997 for oral use to treat hair loss, with 23 years of experience.
- 🔎 Side effects of oral Finasteride have been discussed in previous podcasts, including episode number four.
- 🧪 Topical Finasteride has been developed to apply medication locally and potentially reduce side effects.
- 🧠 The original theory for oral Finasteride was to block 5 Alpha Reductase Enzymes in the liver to reduce DHT levels systemically.
- 🚦 Finasteride partially blocks the enzyme, lowering DHT by about two-thirds, not completely.
- 🧴 Topical Finasteride is typically dosed at 0.1% or 0.25% and is applied daily to thinning areas, not bald spots.
- ⚖️ There's ongoing debate about whether topical Finasteride completely eliminates side effects, as some patients still experience them.
- 🔄 Topical Finasteride must be compounded by a professional to ensure a stable and reproducible solution.
- 📉 Doctors generally prefer oral Finasteride but will consider topical alternatives for patients concerned about side effects.
- 🔬 Future research is needed for controlled studies on topical Finasteride to provide more scientific evidence.
Q & A
What is the primary topic discussed in The Hair Loss Show Episode 34?
-The primary topic discussed in The Hair Loss Show Episode 34 is the use of topical Finasteride as a treatment for hair loss in both men and women.
Since when has oral Finasteride been used to treat hair loss in the U.S.?
-Oral Finasteride has been used to treat hair loss in the U.S. since 1997.
What is the theory behind using oral Finasteride instead of topical treatments like Minoxidil?
-The theory behind using oral Finasteride is that 5 Alpha Reductase Enzymes exist in the liver, and by taking it orally, it can block the enzyme in the liver, reducing the amount of DHT delivered to the scalp.
How does Finasteride work in the context of hair loss?
-Finasteride works by inhibiting the 5 Alpha Reductase Enzyme, which converts Testosterone into Dihydrotestosterone (DHT). By lowering DHT levels, it helps prevent hair follicles from miniaturization and hair loss.
What is the proposed advantage of topical Finasteride over oral Finasteride?
-The proposed advantage of topical Finasteride is that it is applied directly to the scalp, which may reduce the risk of systemic side effects by keeping the effect localized.
What are the typical concentrations of Finasteride used topically?
-Typical concentrations of Finasteride used topically are around 0.1%, although in some cases, it can be as high as 0.25%.
Why is it important to compound topical Finasteride properly?
-Topical Finasteride needs to be compounded properly to ensure a stable and reproducible solution that can be consistently used over time.
What is the current stance of the doctors on the podcast regarding the use of topical Finasteride?
-The doctors on the podcast prefer patients to use oral Finasteride as the first choice, but they are willing to prescribe topical Finasteride for those who are concerned about or experiencing side effects from oral use.
Are there any reported side effects from using topical Finasteride?
-Yes, there are reports of side effects from using topical Finasteride, even at low doses, indicating that some patients may still be susceptible to side effects.
What is the difference between a scientific study and an anecdotal study as mentioned in the podcast?
-A scientific study is a controlled and systematic investigation that provides evidence-based results, whereas an anecdotal study is based on personal accounts or individual experiences, such as 'Joe tried it and it worked,' without rigorous scientific methodology.
What is the future outlook for research on topical Finasteride according to the podcast?
-The podcast hosts express hope that more research, specifically controlled scientific studies, will be conducted in the coming years to provide more definitive information on the effectiveness and side effects of topical Finasteride.
Outlines
💊 Topical Finasteride for Hair Loss Treatment
Dr. Vikram Jayaprakash and Dr. Russell Knudsen discuss the topical version of Finasteride as a treatment for hair loss in both men and women. They explain that Finasteride, which has been available orally since 1997, is now being used topically to potentially reduce side effects. The theory is that applying it directly to the scalp could localize its effect and minimize systemic exposure. The doctors also touch upon the original rationale for oral Finasteride, which was to block the 5 Alpha Reductase Enzyme in the liver to reduce DHT levels systemically. They discuss the typical dosages for topical Finasteride, which are around 0.1% to 0.25%, and the importance of compounding the medication properly for stability and reproducibility. The conversation also includes the ongoing debate about the effectiveness of topical Finasteride in eliminating side effects, with some patients still experiencing them even with low doses.
🔬 The Future of Topical Finasteride Research
The doctors express a desire for more research on topical Finasteride to provide controlled studies rather than relying on anecdotal evidence. They emphasize the importance of finding the minimum effective dose to reduce DHT levels without causing side effects. The summary highlights the need for scientific studies to validate the efficacy and safety of topical Finasteride in the coming years. The conversation concludes with the doctors' intention to keep their audience updated on new research findings and their thanks for watching the episode.
Mindmap
Keywords
💡Hair Loss
💡Finasteride
💡Topical Finasteride
💡Side Effects
💡5 Alpha Reductase Enzymes
💡Dihydrotestosterone (DHT)
💡Male Pattern Hair Loss
💡Compounding
💡Titration
💡Anecdotal Studies
Highlights
Introduction to The Hair Loss Show: Episode 34 with Dr. Vikram Jayaprakash and Dr. Russell Knudsen.
Topical Finasteride is discussed as an alternative to oral treatment for hair loss.
Oral Finasteride was released in the U.S. in 1997, with 23 years of experience and known side effects.
The theory behind topical Finasteride is to apply it locally to reduce side effects.
Finasteride works by blocking the 5 Alpha Reductase Enzyme, which converts Testosterone into DHT.
DHT is responsible for miniaturizing hair follicles, leading to hair loss.
Finasteride partially blocks the enzyme, reducing DHT by about two-thirds.
Research on topical Finasteride has been conducted with doses around 0.1% to 0.25%.
Topical Finasteride is applied daily to thinning areas, not bald areas.
There is a debate on whether topical Finasteride completely abolishes side effects.
Some patients have experienced side effects even with low-dose topical Finasteride.
Dr. Knudsen prefers patients to use Finasteride orally but acknowledges the option of topical formulation.
Topical Finasteride needs to be compounded properly by an experienced pharmacist.
Dr. Jayaprakash does not consider topical Finasteride as the first choice for most patients.
The doctors discuss the importance of titrating the dose to find the minimum effective dose.
The need for more research and controlled studies on topical Finasteride is emphasized.
The podcast concludes with a call for more scientific studies in the coming years.
Transcripts
relating to hair loss and the medical and surgical treatment of hair loss in
both men and women.
Hi everyone and welcome to The Hair Loss Show: Episode number 34. My name is Dr.
Vikram Jayaprakash - I'm Dr. Russell Knudsen, welcome - Right
well, today's topic, this one is, we've had a lot of requests for, a lot of
people have asked about this. You know, our podcast on Finasteride and
side-effects of Finasteride have been very, very popular but today we're going
to talk about the topical version of Finasteride and just a little bit about
that as well - Okay so Finasteride orally to treat hair loss was released
in the U.S. in 1997. So to put that in context, we basically have 23 years of
experience with it. We know there have been patients with side effects, we see
them in our own practice and we've discussed it in detail in other podcasts.
So if you want more depth about oral Finasteride, go and have a look at those,
for example, the episode number four is devoted to the side effects of
Finasteride. But in recent, couple of years people started using topical
Finasteride and the theory behind topical Finasteride is that if you only
apply it locally to the area, you should keep the effect relatively local and
therefore lessen the risk of getting side effects. Now let me put this back in
context. The original theory behind using Finasteride and using it orally rather
than topically like Minoxidil was that the 5 Alpha Reductase Enzymes also exist
in the liver and so, if you are converting Testosterone into DHT in the
liver and the blood supply from the liver is going through your scalp, you're
delivering DHT to the scalp. So the original philosophy was, you take the
tablet orally so you could block the enzyme in the liver as well and make
sure that the DHT, the less amount of DHT was being delivered to the
susceptible hair follicles - Basically just going through that again,
Testosterone gets converted into Dihydrotestosterone or DHT and then
there's the 5 Alpha Reductase Enzyme that causes that,
causes a conversion and so, if you have a lot of that in the system or certainly a
lot of that at the level of the hair follicle, then it causes the
hairs to miniaturize and fall out and that's what causes Male Pattern Hair Loss - and let's just
remind people that it's a partial block of the enzyme, its lowers DHT by about
two thirds, okay, so it doesn't knock it completely out, it lowers it by
two thirds. But because of people either getting side-effects from using it
orally or being worried about getting side-effects from using orally, the
theory was if we use topical Finasteride, we could avoid the side-effects but get
the effect. So this has been, there's been a bit of research being done on this in
the last few years and the dosing percentages for Finasteride topically
applied typically err around about 0.1 of a percent but in some cases 0.25 of a
percent. So the idea is to use a low dose and again on a daily basis, topically, to
the thinning area. There's no point putting it on a bald area, that's not going to work,
put it on a thinning area and see if you can get the effect without the side
effect. There's a bit of dispute at the moment about whether it really does
abolish the side effects because it appears that there are some patients who
were even susceptible to low-dose topical Finasteride to get the side effects. So I
think that if, my general feeling is I would prefer patients to be on it than
not. If they won't contemplate doing it orally, I'm happy to prescribe it in
a topical formulation but I don't promise them that there's no risk
of side effects, we're still going to find out whether that's going to be
something that's going to work for them - So the other thing to mention is that
unlike Finasteride which is, you know, you can get generic forms etc, topical
Finasteride needs to be compounded so you - and it needs to be compounded properly
which means that it has, you have to go to someone who's experienced at
the compounding to make sure that you've got a stable solution, a reproducible
solution that you could use going forward. So yes, it's a variation
that we can use if, as I said, if the patient really doesn't want to use oral,
I'm going to go to topical but I don't think that
topical is my first choice for most patients - No that's right, so generally speaking, we
would start people on a oral version of Finasteride and see how they got,
got on and if they, you know, were concerned about side effects or were
experiencing side effects and really had this inclination to switch to a
topical version, then we could get that compounded and trialing that and
but as you said, you know, we've had people on, you know, a small dose, 0.25%
Finasteride that are getting side effects with that. So it again, it is
about titrating, much like with the oral dose, you've got to titrate to find what
is that minimum effective dose that is going to, you know, lower that level
enough but not, you know, getting the side effects associated with that - Okay so,
hopefully some more research will be performed over the next couple of years
and we'll be able to report back to you with some controlled studies rather than
anecdotal studies and anecdotal study means oh Joe tried it and it worked.
That's not a scientific study. So hopefully we'll have some scientific
studies performed the next couple years that we report on - Thanks again very
much for watching, I hope this has helped explain the current interest in
topical Finasteride and we look forward to talking to you next time - See you next
time, thank you very much - Bye.
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