Overview.
Oral Finasteride 1mg tablets is a well-established licensed treatment for men with Androgenetic alopecia (AGA) in other words Male Pattern Hair Loss. Many patients are worried about short and long term side effects of Finasteride tablets and often do not accept to start the treatment. Patients mostly worry about sexual side-effects like harder to achieve or maintain election and potential lowered sperm count. Also, patients are worried about psychological impact like increase anxiety, depression and low mood. Those undeniable side effects put off many men from starting the treatment. To overcome this issue laboratories have developed a topical Finasteride solution that can be applied onto the scalp and act directly at the hair follicles locally to avoid systemic absorption.
Does topical Finasteride solution work?
In theory if medication is applied locally instead of taking it orally, the absorption into the blood stream is much lower and therefore the probability of side-effects should be reduced. That’s a positive point. However, the question is whether it actually works on the hair growth. Clinical studies show that topical finasteride solution significantly improves hair count compared to placebo. Most patients find it easy to apply Finasteride solution and treatment is well tolerated. The results of the treatment are similar to oral Finasteride as per study. From my practice the results from topical Finasteride solution are weaker compared to Finasteride tablets, but still satisfactory.
What side-effects can you experience from Topical Finasteride solution?
From topical Finasteride solution you can potentially experience all the same side-effects as from oral Finasteride 1mg tablet as the medication is the same. Saying that, the systemic absorption from topical Finasteride is significantly lower, therefore it has markedly lower impact of DHT concentration in the blood. As a result, the chance of side-effect to happen is significantly lower of topical Finasteride solution compared to oral Finasteride tablets.
Most common site effects of Finasteride are:
- Erectile dysfunction
- Ejaculation disorder (including decreased volume of ejaculate)
- Testicular pain
- Anxiety
- Depression
Why hair growth from topical Finasteride solution is less?
There is a skin barrier that prevents topical Finasteride solution from absorption directly to the level of the hair follicle.
How can we overcome skin barrier?
If we can inject the medications directly to the plane of the follicles location to overcome a skin barrier, then this is a very effective solution to maximise the concentration of the medication near the hair follicles, but at the same time to reduce systemic absorption. That alternative is Dutasteride intradermal injection. Dutasteride is more potent DHT inhibitor compared to Finasteride. The route of delivery is intradermal injection that gives an opportunity to create a highest concentration of medication at the level of follicle.
Summary.
Many patients are looking for affective DHT blockers treatment for Male Pattern Hair Loss with minimum size-effects and maximum hair growth. The oral medications like Finasteride tablets and Dutasteride tablets are proven to be a very effective treatment for male hair loss, showing fantastic results in hair growth. Saying that, the potential undesirable side-effects prevent patients from starting the treatment on the first place or to continue long term. To overcome those side-effect we need to deliver medication locally. There are two ways that can be done, which are less potent topical Finasteride solution or more effective Dutasteride intradermal injections.