Dr. Hasson Switches to Topical Finasteride

All my posts on topical finasteride seem to be quite popular. In hindsight, this is not surprising when considering the fact that I get emails about topical finasteride at least several times a month. People really want to ditch oral finasteride and switch to the topical version in order to reduce their chances of systemic side effects.

Local compounding pharmacies in most cities will be able to make topical finasteride for you if you ask. However, most of us are eagerly awaiting two thoroughly tested products that could be available for sale worldwide in the near future.

  1. The first of these two is Spanish (previously Swiss) company Polichem’s P-3074 product, which I have covered on this blog several times in the past. European Phase 3 clinical trials for P-3074 are almost completed, while US Phase 3 clinical trials are expected to be completed in May 2018. Moreover, in 2016, an Italian study found the product (when applied to the scalp twice per day) to have superior results to oral finasteride. Several other favorable studies from prior years have also been covered on this blog in the past. P-3074 is vehicled in Hydroxypropyl-Chitosan.
  2. The second of these two products is Canadian hair transplant clinic Hasson & Wong’s topical finasteride. This product is being manufactured in partnership with Italy’s Farmacia Parati. Without this partnership with a well known reputable pharmacy, I would have not put this product in the same category as Polichem’s product. The Hasson & Wong product is a liposomal formulation that has been modified via the attachment of silicone particles to the liposomes.

Perhaps a third company can develop nanoparticle based finasteride delivery in the future?

Dr. Hasson Topical Finasteride Update

Since 2014, Dr. Victor Hasson has provided this blog with regular updates about the status of his clinic’s topical finasteride (e.g., see here and here). Canadian hair loss sufferers have been able to obtain the product from his clinic. And Europeans have been able to access the product via Farmacia Parati.

However, people in other regions of the world including the US have had no such luck. There are a number of regulatory hurdles that Dr. Hasson has been trying to overcome in order to sell in the US.

Last week, Dr. Hasson called me out of the blue and mentioned some new developments, the gist of which are highlighted in the latest blog post on his website. I did not record his call, but below are some highlights that I recollect:

  • Dr. Hasson will answer any intelligent reader questions if you post them in the comments to this post.
  • Hasson & Wong will no longer prescribe oral finasteride and has entirely moved to topical finasteride.
  • Since February 2017, they have been using their third generation of topical finasteride.
  • Results from topical finasteride (based on analysis of around 800 patients in the Vancouver, BC area over the past several years) have been at least as good as those from oral finasteride.
  • Side effects from topical finasteride have so far been nonexistent.
  • The Hasson & Wong clinic will post a number of updates with patient photos related to this latest development on their website in the coming weeks.
  • US sales should finally become a reality in the near future. Dr. Hasson has selected some pharmacies in the US that will compound his proprietary product.
  • I asked about topical dutasteride (which interests me more than topical finasteride), and Dr. Hasson mentioned that this product is next in line. He talked about some scientific reason that makes the topical dutasteride molecule even more amenable to the scalp and scalp absorption than the topical finasteride molecule. I will ask him to elaborate in the comments to this post.
  • Dr. Hasson mentioned that it has been difficult for him to get his hands on sufficient quantities of dutasteride and therefore their research in that area has lagged. Results from topical dutasteride are superior to those from topical finasteride. This matches what we know regarding the difference in hair growth results between the oral versions of both drugs.

128 thoughts on “Dr. Hasson Switches to Topical Finasteride”

  1. I am currently on minoxidil 12% and 5% azelaic acid cream at night , rogain foam in the morning and dutasteride 0.5 every other day with decent results.

    Can I add this to my regiment ? Will the liposomal interaction with a strong minoxidil dose cause a problem ?

    1. mo
      The delivery system of our topical Finasteride gel is quite technical. The addition of other topical solutions, especially those with absorption enhancers, will almost certainly effect the way our gel works so, I would not recommend using them in combination.

      1. Thank you for your reply Doctor.

        I understand that other topical solutions will interfere with the Finasteride solution. But the sole purpose of some topicals such as minoxidil, caffeine is to enhance blood flow. As an alternative, is it fine to massage the scalp and specifically dutemescence therapy in conjuction with topical Finasteride.

    1. Try PV Pharmacy Services in Idaho. They make liposomal one based on Hassan and Farmacia Parati formula. Much cheaper but do not know turn around time.

    1. Yeah.

      The whole selling point of this is “fewer sides!” which are low on oral fin anyway, but for the hypochondriacs out there this will hopefully encourage them to do something and Hasson knows it….$$$

      In reality, the scalp is a great way of getting drugs into the body, so systemic absorption would absolutely give the same side effects, if you get them at all.

      1. Oral sides are not few and I personally find the side effects unacceptable. The incidence of side effects reported in the literature are a joke.

        1. I became clinically impotent for 6 days straight tried everything to get back scariest moment of my life I cried myself first thing and last before bed. I’m pretty thin now but I’m so excited about topical. My Dr and compound totally abandon me they had no idea about this or what to do ill stay tuned

        1. Yep good topical liposomal formulas with gel agents, soluble silicon, polyacrylamides prevent systemic absorption by not being permeating the dermis.
          If it is not liposomal gel then there will be absorption and the old formulas just allow the systemic absorption.

        2. According to the Hassan study with his liposomal formulas absorption is minimal…..get a liposomal gel.

      2. “Hypochondriacs”? you’re pill pushing affirmation of a drug that you know deep down isn’t healthy is pathetic. 2% is a joke and so is the notion that system DHT suppression is without concequences. If you’re taking propecia and have no side effects whatsoever, consider yourself fortunate, for now.

        1. Sooner or later anyone get side effects from finasteride. You can not reduce 70 % of an hormone that is in normal levels in your body and have not side effects, you can not do it even with cholesterol .

          1. Dr. Broscience is in.

            You will not “sooner or later get side effects” this is purely what you want to believe to justify not taking the meds and losing hair as a result; there is absolutely no science you cite that will show this to be remotely true.

            The number of men taking finasteride — as I’ve discussed with people here before — for hairloss is so insignificant it doesn’t even make a blip on the radar. Many more take it for prostate issues and regardless of what condition you’re treating, there is no shortage of men who’ve taken it for 20+ years with no adverse effects at all.

            Strangely, men who take it for issues not relating to hairloss (and at a higher dose!) don’t seem to report every imaginable side effect and a VERY curious correlation is that the drug does not have an internet hate mob attached to it regarding those issues.

            Finasteride can have bad side effects; likely more often than Merck admits too, but the internet fear culture built around it definitely creates a ton of hypochondriacs who can’t keep their stories regarding side effects straight and just like “minoxidil aged me” claims, these people were 100% of the time, always aware of and afraid of the side effects before taking it — the nocebo effect is real.

            1. Sure but that lies the issue of self reporting. It is completely justifiable to be skeptical of the accuracy of 2%. If his drug is so safe why not take 10mg or more of finasteride. If there is no risk to blocking DHT, then why not more? And why not everyone? Every male over the age of 18 should take finasteride as a vaccine for adrogenetic conditions. This is the hypocrisy of this drug.

              Personally I take topical finasteride at extremely small percentage dose. This stuff does go system but at my dosage I am able to keep my most of my hair while minimizing side effects.

              This s isn’t good for you in the long run and the sooner we have a replacement the better for everyone, Even those who take this piece of shot drug.

              1. More finasteride doesn’t block more DHT by any real amount. The drug has a nearly flat dose response; 1mg is actually almost as potent as 5.

                I brought dosage up because it shows the psychological aspect from another angle: Guys who take 5 times as much finasteride for BPH and stuff seem to report debilitating side effects at least 5 times LESS than guys taking 1mg for hairloss despite fewer people taking the drug for hairloss. You don’t find that the least bit odd?

                I’ve seen people online say that finasteride caused their ED while also admitting to excessive consumption of pornography and trying no fap to combat it. Some who claim they’ve had “PFS”, but then admit to having used other drugs that could’ve caused it and they can’t quite be sure if they even have it. I’ve seen at least one person unironically say that fin gave him crippling ED and he was never touching it again just 8 MINUTES after taking his first pill.

                I’m sorry, but what people are saying on the internet about it is the furthest thing from trustworthy.

                Anyway, I’d prefer to use a topical, but I will not until it’s been out for 5 – 10 years and is proven to effective; until then, I’ll use the pills.

                By then, hopefully I won’t even need fin.

                1. I agree with the nearly flat reponse rate regardless of dosage but they’re still not exactly the same. 5mg of finasteride will Inhibit more 5ar II than 1 mg. 10 mg or higher will do a little more. Merk’s tests just showed that it takes a higher dosage to shrink the prostate versus treating hair loss. But don’t you think that if the drug was so safe they’d prescribe the same dosage for hair loss as they do for the prostate?

                  Again, to my previous post, why isn’t this drug marketed for everyone like a multivitamin package or a vaccine of sorts if reducing DHT is so benign?

                  Why not just take dutasteride if reducing DHT is “just in your head”?

                  If we can agree that blocking the formation of DHT could at least potentially be problematic, than we can agree that this isn’t the safest or most prudent option, unless you care so much about your hair that you’re willing to screw with your hormones and anything downstream that’s adversely affected.

                  From personal experience I’ve tried finasteride in a variety of dosages and no matter what dose, i got side effects. A week or two later coming off the side effects went away. And not just ED, but also nocturnal erections, things you can’t psych yourself into. And all of my side effects arose gradually after taking the drug for 3 years.

                  I didn’t even realize I was having side effects until A group of friends were joking around about Morning Boners and i realized i didn’t even have them anymore, or that my boners in general sucked ass. These side effects were very insidious and i wouldn’t be surprised if they escaped the cognition of many people who take this drug, forgetting what normal is supposed to be, including myself. I just popped the pill everyday and went about my business. I knew the side effects were a possibility, i just didn’t think about them until i realized they were happening already after a few years.

                  This is why I don’t believe in 2%, self reporting is a joke.

      3. A statistically significant 3% risk of known side effects is not insignificant. How many lives do you get that you can gamble like that?

        Nevermind that this is hormone therapy, which affects nearly every function in your body for years to decades down the line. Your typical cancer takes 10 years to develop.

          1. That’s depressing to read, for the people who take it. Glad that I skipped it then! I have enough functional problems as it is lol.

      4. Try reading what they actually said, you’re writing false nonsense. I’m sick to death of reading whinging, skeptical people like you just putting people off everything. I don’t believe these guys care about the ”$$$” as you put it, I simply reckon they pride themselves in doing good work and want to see their patients maintain their results and make more people suffering with this hair loss viable hair transplant candidates. If you have passion in what you do and do it well, money follows.

    2. Farhan
      Yes . The topical gel potentially does have the same side effects as the oral . The purpose of the topical is to reduce systemic exposure to the drug ,and therefore reduce the potential for side effects .In vitro studies, which have been confirmed in our clinical studies , have shown that serum levels of finasteride are reduced by 94% .This is a very significant reduction !
      Clinically , patients who were unable to tolerate oral finasteride have been able to use the topical with no issues . The hair growth with the topical seems to be equivalent to the oral.
      For more info please check out our clinic blog
      https://hassonandwong.com/topical-finasteride-update/

      1. That is a very cool update. Thanks for sharing it with us! Too bad we’ll have to wait a long time to get it here in the US.

      2. Is the topical to be applied to the entire top of the scalp? I’m concerned about the actual application (getting the product down through existing hair and actually into the skin). It seems it would be easy to miss spots. With the oral version, obviously the entire scalp is benefitting from dht reduction.

  2. Would someone who has taken regular 1mg Propecia for 15 years benefit from adding topical finasteride in conjuction with oral? If oral finasteride loses its effects can topical be used to stabilize hair and regrow again?

    1. Great Question! Their product may not have been around long enough to know for sure but I would be interested in their thoughts on why it might be possible.

  3. So, Dr. Hasson,

    Are you saying that even for patients that you have had that have been stable on oral finasteride for years, you still won’t prescribe them oral fin? If so, how do you think your patients will feel about that?

    Thanks.

    1. “That Guy” and others, I will delete most of the comments about side effects of oral Fin (both pro and con) hereon.

      If you have scientific well thought out arguments, I may make exceptions.

    2. If they are happy on the drug , I have no problem keeping them on the oral ( so long as they are informed of the latest publications which explain the risks.)
      Every patient prescribed the topical are made aware of the theoretical risks as well

  4. Question for Dr. Hasson: How did you decide to make the topical 2.5%? It seems like this is 25x stronger than 0.1% (the equivalent of 1 mg per day).

    1. I doubt he decided on anything – that is just what the italian pharmacy produce. According to clinical studies this dosage is way too high.

  5. How would I go about getting a prescription for topical fin from Dr.Hasson if I’m able to drop by his office, and what would it cost for consultation and drug?

    1. I just e-mailed info@farmaciaparati.it and enquired about purchasing topical finasteride. This was the reply.

      Dear Mr Danny ,

      thank you for contacting us.

      To receive Finasteride gel 2,5% you have to send us by email prescription of a doctor, and we can directly ship to you.

      Attached you can find a sample of prescription that your doctor needs to fill.

      The price for one bottle 30 ml is € 50,00 (+ shipping cost).

      Please, tell us also what is your address and phone number for the shipping.

      1. I was living in Austria when I contacted them at first…shipping cost was 12 eur, and thats just north of where they are located. Plus 30 ml isn’t going to last a month…it’s a gel – 5-10% of it won’t leave the package.

        For me, still a bit too expensive and untested to justify purchasing it. Plus my Dr. just laughed at me when I told him that I wanted to try it…

        1. Just looked out the email. Got the same reply you did, followed by following shipping info:

          Dear Mr. Greg,
          usually the gel should be used 2-3 times a week, but for more specific information regarding the frequency of use it is better to directly ask to your doctor.
          One bottle will last more or less for 1 month.
          Shipping to Bolzano is 13,00 € and you can pay directly to the courier, while shipping to Austria is 18,00 € (by bank transfer or paypall).

          Best regards,

          Beatrice

        2. @gbh hey man i am from Austria, and using the Finasteride gel for about 3 months now.
          Are you saying the italian pharmacy told you the 2.5% gel should be applied 2-3 times per week?
          I am using it every day (7times a week)

          1. Thats what it says in the nail, but TBH I would have used it every day too. Did you order from them or do you have another source? Ive just moved from IBK to Germany so shipping gets dearer, although I found d out it has 6 month shelf life so can order in bulk. Gonna order some in Jan. How has your progress been?

      2. Try PV Pharmacy Services or Rengenamax in Puerto Vallarta. Farmacia Parati is very expensive.
        I just read Hassan’s study, all had increased density and new follicular growth.
        I don’t work for Hassan but presume his results are honest.

  6. I would like to know which kinds of small scale studies have been conducted on their 3rd gen liposomal finasteride? Serum DHT, scalp DHT, ?

  7. I am from Europe. (NL) Can anyone explain how to order from Farmacia Parati. I checked their website, it doesn’t say anything about Dr. Hasson’s product.

  8. Finasteride works. Not wanting to start an argument with what I say next, it is probably the only thing that works when you cut through all the fads like PRP, ACell, laser caps, etc.

    Its benefits and side effects, in its original form, are well documented. Based on this, either take it or don’t take it but don’t screw around with it or it becomes a different compound; an untried untested compound with its own side effects.

    1. Ok. I Prefer topical Finasteride 1000 times. Oral finasteride is a shame. Where we can buy topical finasteride? Thanks.

  9. Do topical finasteride and dutasteride help prevent male pattern hair loss, and if so what is the minimum concentration to prevent systemic effects?

  10. From what I’ve read, I believe H&W’s formulation causes the molecule to stay within the scalp, instead of going totally systemic. I could be talking out of my ass though. For those who are savvy, there are topical finasteride formulations from Indian pharma companies.

  11. As for the italian pharmacy, I emailed them a couple years back and it seemed like they were willing to sell them to me (I’m in the US) as long as I provided them with a prescription. The first hurdle is getting a doctor to provide a prescription, but I guess just asking for finasteride (without specifying topical) would be enough. I never followed through because the cost was exorbitant. Don’t know if they’ve changed their policies since then, but if you don’t mind spending the money I’d contact them.

  12. I know next to nothing about science, but here’s a question I have regarding the reduction in side effects: Dr, why do you think you’ve seen a reduction in side effects?

    From my (very limited) understanding, Fin blocks 5ar from converting T to DHT. Does this topical only block 5ar locally in the scalp? If so, are you saying that DHT *produced* in the scalp is the main culprit for hairloss and DHT produced from other areas in your body do not contribute to hair loss?

    Thanks.

    Sorry if this was stupid. As I said, I know next to nothing about science.

    1. My question is much the same.

      Do you think that side effects from finasteride are the result of inhibition of the enzyme elsewhere (such as reproductive tissue and erectile dysfunction) in the body, or from some collateral effect the drug has on other body chemicals? Can you elaborate and provide examples?

    2. This is a very good question ! It was one that were unsure of before using topical finasteride .
      I think that I can say with a fair degree of confidence that it is scalp DHT levels which are mainly a result of 5AR activity locally in the scalp that is of importance in MPH .

    1. Bootlegging!
      Dr. Cole posted some impressive results on hairlosssite of a topical finastride from Italy. I wonder if it’s the same product.

  13. Dr hasson ive been following you for 3 years from america. My dr gave me the permission for a topical prescription but no compounding pharmacy in sc understands how to make this for me. Will there be a website or a phone number contact to link my dr office or compounding pharmacy?
    Thank you for your time.

  14. If serum DHT is decreased by 30% using this (im guessing at 1ml topical) as opposed to 70% with oral, won’t we see an increase in that serum DHT reduction when applying more topical, in return getting close to 70% oral serum reduction and still causing these side effects?

  15. Hi Dr,

    First of all, thank you to make us aware of the product and to take the time to answer some questions.
    Questions:
    – What is the difference between your topical finasteride and other topical finasteride products?
    – Will we see sooner result with the topical version vs the oral version?
    – When will we see some result data and photos?
    – Do you have a timeline for the topical dutasteride to become available?

    Thanks in advance!

    1. Our topical finasteride is designed primarily to reduce systemic absorption of the finasteride while still giving good concentrations of finasteride in the scalp . This we believe is key to reducing the adverse effects associated with finasteride.
      Other topicals are simple solutions of finasteride dissolved in chemicals (excipients)
      which facilitate finasteride absorption through the skin . There is no mechanism here to prevent the finasteride from getting into the bloodstream . So I see no benefit in terms of reduction of side effects.
      In addition our gel has a depot effect , with a slower and more sustained release of finasteride into the scalp . There is considerable benefit here . The sustained release may allow less frequent dosing . This is why on the Farmacia Parati website they mention dosing every 2nd day is possible. If you wash your hair every other day.
      In N. America people usually wash their hair daily , so daily application is necessary.

  16. Hi Dr. Hasson,

    Will applying topical finasteride be a danger if I live with a pregnant woman? Will it be okay for women to come into contact with the topical form of finasteride? What precautions should be taken if I and my wife decide to have a baby? Thanks.

    1. Yup 125cm2 of density. Which is 25 more than follica. Plus riken mentioned FUT in conjuction. I’m not liking the sound of that. If this is the case then follica is going to clean house with money if they bring the same density. 2 years earlier than riken if not more since riken will have to train ht clinics worldwide to use the stem cell therapy. Looking at 5 to 10 years before this gets wide spread availability to us commoners lol . I’m excited for polichem however if it can kick start my propecia effectiveness with stabilizing and thickening of diffuse loss.

  17. Thanks for your post. I didn’t know about current clinical studies for a topical Finasteride solution. You mentioned that Polichem almost finished Pivotal Phase III. Do you have any specific information here? If phase III is completed, do you know how much time they need to lunch the product? Do we talk about months or 1-2 years?

    Thanks a lot.
    Martin

    1. Hi MartinP, one of the links that I have in the post to Polichem’s R&D page says that Polichem is currently doing Pivotal Phase III Trials in Europe.

        1. @Admin: Thanks. I am aware of the current status. But do you know how much time will pass til market launch? The fact it reached phase III makes it more than likely they will offer their solution. Therefore, I am curious whether you or other users may have some research know-how to estimate the time frame for a lunch? I don’t think Polichem will answer e-mails by users as Almirall (their mother company) is listed on the stock exchange.

          @Mutruk: As far as I can say, you are referring to the US clinical trials which seems to be some months behind the European one.

          I further e-mailed the Italian pharmacy for more information. They were so helpful and sent me a sample of prescription that a doctor needs to fill out. I am pretty sure no serious doctor in Germany would do that?

  18. Following from my earlier comment re:Polichem Phase 3 completion, I reckon with a bit of luck we can expect market release in exactly a yes, Xmas ’18

  19. i didnt fully understand what tsuji takashis procedure exactly is. he mixes two type of stem cells together and grow hair follicle out of it, but he is doing it outside the body, but if he can grow hair on a skin outside the body, why he cannot grow hair directly on the scalp? Is it about the safety concerns?
    and about this mice, did they apply stem cells directly into the skin of it, or grew it where else and transplant into the skin of the mice?

  20. I see that much research is aimed at the efficiency of stem cells for laboratory proliferation. I do not know if it is everyone’s knowledge, but one of the challenges of stem cell scientists is exactly how stem cell proliferation maintains its regenerative capacity. For much work this scenario has been changing with some discoveries.

    Recently some research has proven that stem cells proliferated in a 3D environment are much more effective than when proliferated in a 2D environment (laboratory dish). For the formation of a 3D environment researchers are using polymers so that the stem cells do not lose their regenerative properties as well as proliferate much faster and in larger quantities.

    For example, I cite this article:

    https://news.stanford.edu/2017/11/02/gel-helps-grow-large-quantities-stem-cells-limited-space/

    In a new study, Stanford found that stem cells proliferated in laboratory dishes express different genes. The study follows:

    http://med.stanford.edu/news/all-news/2017/11/stem-cells-express-genes-differently-in-lab-dish-than-in-body.html

    Therefore, from such studies the proliferation of stem cells by means of a laboratory dish may not be the most appropriate medium presenting less effective indices than the healing potential of stem cells.

    Finally, I make such observations because one of the difficulties encountered for the cure of hair loss is precisely the difficulty of proliferating some specific cells of the hair follicle without losing their regenerative property. It is one of the difficulties encountered by many scientists in the world, such as RIKEN / Tsuji. Even such discoveries may be the key to a dramatic change in Replicel’s technology delivering better results or even healing, as unfortunately its latest results have been quite frustrating from the point of view of healing.

    As for my English, I’m sorry, but I use a translator.

    1. Yes one of the issues was cultivating/multiplying dermal papilla cells. They were successful w mice early on but not with humans. Recently, they have found it was because mice cells naturally “clumped” more creating a more 3d environment. Now they are making it work w human cells.

  21. How do we know that topical dutasteride is superior than topical fin? Is this an assumption or was there a small study or did Hasson say so? I understand there are more alpha reductase 1 to block in scalp. However it is open to debate.

    Has anyone tried topical dutasteride?

  22. Main question is whether the formulation reduces 5ar sytemically since topical fin never took off since it goes systemic anyways. You can put it in your shampoo. What does the study show? If they didnt even measure this the conclusion should be self evident… They have all the financial incentive as well..

  23. forget finas, lotions, etc

    the only 2 hopes at today: JAK inhibitors and Organ/Riken haircloning…

    fingers crossed the next 2 years

      1. Lobito and Malcolm
        This formulation is not intended to be the definitive treatment for MPH . It is an effective treatment for people who are experiencing hair loss right now and cannot tolerate the oral .
        In the ideal situation everyone would wait for a completely safe and effective treatment . In the real world there are young men experiencing emotionally devastating hair loss right now . They feel trapped having to choose between being bald and a life with sexual dysfunction . For these people this gel may be an option .
        We have many patients happily using the topical with good results and without adverse effects .
        If you are waiting for 100% safety , and can afford to wait a few years ,this is not for you . Others may be more pragmatic

    1. Only apply the gel before work and wash your hair thoroughly when you get home .
      Some patients who can tolerate the oral finasteride will switch to this for the duration of the pregnancy.

  24. Hasson: When will this be available in the US as a prescription? According to the posts above who contacted the Italian pharmacy it seems like this would cost at least $150 a month as one 30ml vial wouldn’t last a full month especially if their prescribed dosage was 2-3x a week when it should be a daily regimen? So would you need 60ml a month plus shipping this would become rather expensive rather quick. Would insurance cover this when US pharmacies begin compounding it?

    1. Probably not because they don’t cover things that are regarded as cosmetic, and Propecia form what I understand is not covered. The funny thing is that 5mg generic finasteride IS covered usually because that dosage is used for enlarged prostrates. Topical finasteride would clearly be cosmetic use.

  25. New Insight Into the Pathophysiology of Hair Loss Trigger a Paradigm Shift in the Treatment Approach.

    Sadick NS, Callender VD, Kircik LH, Kogan S.
    Abstract
    Hair loss affects millions of men and women of all ages and ethnicities, impacting appearance, social interactions, and psycho-emotional well-being. Although a number of options are available, they are limited, carry a potential risk of side effects, and none have proven to be comprehensive for treatment of hair loss. Across the spectrum of hair loss disorders, there has long been a segmentation into distinct mechanisms, driving the main trend in current therapeutics to focus on targeting single molecules or pathways. However, research points to similar dysregulation of intrinsic signaling pathways within follicle physiology that span the hair loss disorder spectrum – with a common inflammatory component identified in most hair loss pathogenesis, including that of androgenetic alopecia (AGA).

  26. This question is for Dr. Hasson.

    Many of us don’t live close to Canada to see a family practice doctor to write the prescription for topical finasteride. Could a doctor from Mexico fill out the prescription form and we have it mailed to us in the USA or Mexico?

    Thanks

  27. I don’t see it anywhere answered, but please answer this, dr Hasson, have any studies been conducted to look at serum DHT using this topical finasteride? What about prostate DHT?

    1. Yes we have measured serum DHT concentration in 2 separate studies . In the first study we conducted we compared serum DHT in oral vs topical finasteride .
      The problem here was that there is very wide variations in normal individuals DHT levels and also some diurnal variation .
      In the second study we performed DHT levels on individuals before starting the topical (so essentially each individual could act as their own control ) and at various times after dosing after 3 weeks of treatment.
      The results of the study are posted on our blog . In addition there are several case studies with BEFORE and AFTER photos .
      This should reassure those who doubt effectiveness of a topical compound which has minimal systemic exposure .

      Our blog :
      https://hassonandwong.com/topical-finasteride-case-studies/

  28. Can’t believe nobody has asked this yet…but Dr Hasson, if you’re still around…

    What effects does the gel have on the aesthetic of the hair? You propose wearing it in the AM for the rest of the day… Is that possible without making hair look thinner/greasy?

    1. And another question while I’m at it…it sounds like you have developed a very effective carrier for the fin which enables it to release slowly and stay local….Surely you are aware of the recent interest in JAK inhibitors in curing AGA …will you be looking at using this carrier with JAK inhibitors in the future?

      1. We are all hopeful that JAK inhibitors will be as effective in AGA as it is in AA . Remember that the hair loss process is fundamentally different in the two conditions.
        I find it hard to determine exactly when it will be available, even for off label use .

        But, at this moment for patients who are experiencing AGA now , I am unaware of any more treatment as effective , with as little chance of adverse side effects .

        1. @Victor Hasson MD: It is really a shame the situation of current treatments to treat androgenetic alopecia. More than 20 years without any new … it’s really pathetic. Current studies show that the post-finasteride syndrome is real.

          Letter to the Editor: “Characteristics of Men Who Report Persistent Sexual Symptoms After Finasteride Use for Hair Loss”

          https://academic.oup.com/jcem/article-abstract/102/6/2117/3861754?redirectedFrom=fulltext

          Neuroactive steroid levels and psychiatric and andrological features in post-finasteride patients.

          https://www.ncbi.nlm.nih.gov/pubmed/28408350

          Post-Finasteride Adverse Effects in Male Androgenic Alopecia: A Case Report of Vitiligo.
          https://www.ncbi.nlm.nih.gov/pubmed/28222425

          Finasteride adverse effects in subjects with androgenic alopecia: A possible therapeutic approach according to the lateralization process of the brain.

          https://www.ncbi.nlm.nih.gov/pubmed/27046152
          All studies are from 2017 and 2016.

          From here we greatly appreciate your involvement to reduce the systemic effects so dangerous that this drug has. Why not sell it worldwide?

        2. True. But even as a carried for AA, your formulation must have huge potential. I am excited to try it and will hopefully do so from January onwards.

    2. There is no greasiness at all . The gel seemingly disappears after a minute or so .
      Remember that you are applying it to the scalp and not the hair.

      1. Hello Dr. H,

        I was on oral 1.mg of Finasteride for approximately 20 years with no sides . It seemed to lose it’s effectiveness about 4 years ago and switched to .5mg of Avodart about 2 years ago. I also use a compounded minox formula with topical finasteride (for close to 15 years in one concoction or another). Sides haven’t been an issue, 55 and still have the “switch blade”. I believe they are overblown on forums and that what’s the data indicates. Do you plan to bring topical Dutasteride to market soon?

        1. Yoda what’s the name of the compound minox you are using? I’m looking for a non foam rogaine. The foam just thinned out my right hairline badly.

          1. MJ, I’ve used it all. Best luck I ever had was Dr. Lee’s Xandrox but he got shut down by the FDA. Since then I’ve used Promox, Murray Ave RX, Minoxidil Laboratory, Dualgen, etc. etc. Murray Ave is legit but it’s expensive and only creams. If you want to try high strength Minox with no additives in liquid form maybe go for Minoxidil Labs 10 or 15%. I think it’s legit. Minox effects on me are not as great as they used to be as I’ve been thinning for over 35 years so hard to tell what’s good anymore.

            1. Thanks yoda. I’m going to use original minox liquid. I used a compound minox liquid a couple years ago that had dht blockers, retina a and 5% liquid minox. Great thickening and growth but short lived since I developed bad scalp scaling and sebhoretic dermatitus. I was picking thick scales from my scalp and my skin got inflamed. I think the liquid gave me growth but the retina gave me inflammation which ruined the growth. Who knows? I’m going to give the plain liquid Rogaine 5% on my right side and it should kick start regrowth again. The foam just thickened existing hairs that were not miniature but tossed out all the weak ones to not return and thin out my right hair line. My left hair line is nw1 and my right side is now heading to nw3. Crazy sht.

              1. Yeah, it’s crazy s to say the least. Give the Rogaine liquid a try, if it doesn’t do the trick send a beam of light to old Yoda if you want some of my “wisdom”. I’ve been at the fight for over 35 years and have tried almost everything.

  29. Hello Dr. Hassan. Thank you for taking the time to answer our questions. Im curious if your new topical finasteride would help me. I’ve been taking oral Propecia for over 15 years. The first 12 years it worked great! After that it started losing effectiveness and I am thinning. Would adding topical finasteride boost or kick start the effectiveness since it blocks more dht at the scalp? I would still continue using oral as well. Attack at both angles.

  30. Admin. A lot of us asked the doctor when the product will be available in US, yet we don’t have answer. I hope the doctor could elaborate more about that.

  31. I crush 5 pills of proscar (5mg) in a bottle of minoxidil, it’s affordable and works wonders with less sides. Next step will be dutasteride with aloe vera which I think is even more effective.

    1. Hi admit, I’m going to start liquid minox. Does adding crushed fin pills provide more regrowth? I’ve been on Rogaine foam with little success. Been on Propecia for over 15 yrs with great success fir 12 years of it. How do you crush the pills? Do you powderize it? Did you try regular liquid rogaine with success or did you start seeing results when you used the crushed Propecia into Rogaine ?

      1. I crunch the pills and add it to a small amount of alcohol sulotion. Let it sit for a day then filter it and add the liquid to the minox bottle. It works! Do this or go with comersialized topical finasteride, to afford it you can always live in a cottage in the woods.

        Just received my Dutasteride. I will mix one pill with either aloe vera OR a few drops of castor oil. Apply it at night before bed. Dutasteride penetrates the skin easily so don’t do it at night if your wife is pragnent. Use common sense and read the user instructions.

        1. Thanks admit! I will give this a try. Did you regrow lost hair? Or thicken up weaker ones? Or is this just maintenance. I bought commercial topical fin/mix with retina. It worked for a bit then I started losing ground. Honestly though I think it wasn’t mixed properly or the retina which caused bad scaling and inflammation counteracted the effects of liquid minox and fin.

  32. We are on discussions with various US pharmacies. Currently we have no real estimate of when it will be available there.
    Sorry.

    1. Dr. H, Possibly you missed my question from Nov 19th in all the noise but the crux is: do you plan to bring topical Dutasteride to market soon with US availability?

  33. Yo, H&W seem to have taken down all of the material on their site related to topical fin including their case studies which looks extremely sketchy. What gives?

    1. Hopefully it’s just a site update. Little sketchy though on the day Brotzu was suppose to publish results lol. However, that seemed to be a possible flop so….. Idk Friday the 13th? Lol.

  34. Hi @admin, Dr. Hasson !
    What about the Topical Dutasteride from the reputable Dr Lupanzula ?

    Many thanks.

    Best.

  35. So, all mention of this topical fin formulation has been erased from the Hasson website? The studies didn’t back the claims?

  36. I just called them and supposedly this isnt legal to sell in the United states. Hassan and Wong is only selling to their surgical patients, canadian citizens that reside in Canada

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