Topical Finasteride Here by 2021

I originally wrote this post on topical finasteride in June 2014. Now updated.

Almirall ALM12845

It finally looks like Spain-based Almirall will release its ALM12845 topical finasteride in 2020 or early 2021. Note that this product was previously known as Polichem’s P-3074. Almirall purchased Polichem in 2015.

The company filed for a Marketing Authorization Application (MAA) with the European Medicines Agency (EMA) in September 2019. The ALM12845 product is described as a cutaneous spray solution for the topical treatment of men with androgenetic alopecia. First national phase approval is expected in 2020 or early 2021. I am not sure if they will be able to get FDA approval to market in the US as yet. The pipeline chart below only shows an EU flag:

Almirall ALM12845
Almirall ALM12845 topical Finasteride. Previously called Polichem P-3074.

Topical Finasteride for Hair Loss

Recent reports suggest that topical finasteride results in similar increases in hair count compared to oral finasteride. Topical finasteride is typically compounded in gel or solution form. The oral version can come in pill, capsule or tablet form. It is hoped and likely that the topical version has fewer side effects than the oral version.

2018 update: A systemic review of topical finasteride shows consistent reduction in hair loss. Both scalp and plasma DHT levels decreased significantly.

Topical Finasteride
Topical finasteride for hair loss.

The manufacturer of Propecia (Merck) applied for a patent for topical finasteride in 2002. However, the company has to date never tried to develop an actual product. This is all the more surprising when considering that Propecia has been getting significant negative publicity of late. Many users suffering from long-term sexual side effects have filed a class-action lawsuit against Merck.

Polichem’s P-3074

I am writing this post today because an important clinical trial/study for P-3074 was just completed in Switzerland. 2019 Update: P-3074 final trial results are now published.

P-3074 is a new topical finasteride solution with hydroxypropyl-chitosan as the film-forming agent. The study was funded by Swiss company Polichem, which primarily specializes in dermatological and gynecological products.

The interesting thing about this study is that four different doses (ranging from 0.25 mg to 1 mg) of topical finasteride were tested. The study entailed 32 human participants, with 8 of those 32 getting a placebo dose. One negative thing about the study is that only a 7-day dose of the topical P-3074 solution was administered. There will therefore be no long-term measurement of the effectiveness of P-3074. It will be interesting to see the results of this study regarding yet another new hair loss product.

Note that a similar trial (although at just one dosage level of 0.25 mg per day) for P-3074 was conducted in the past. Its findings were presented last year at the 7th World Congress on Hair Research (WCHR 2013). The conclusion of this trial was quite significant:

“These findings show that DHT concentration in the scalp, after 7-day treatment course of P-3074 once daily, was more reduced (about 40%) than after 1 mg oral finasteride administration for the same treatment period.”

Topical Finasteride Side Effects

The main reason that people are so excited about topical finasteride is because of potentially fewer side effects in comparison to oral finasteride. Serum dihydrotestosterone (DHT) inhibition in the blood is significantly less with topical finasteride versus oral finasteride. At the same time, scalp DHT inhibition will remain similar with both delivery mechanisms.

However, it should be noted that different formulations will result in different levels of DHT inhibition. It is therefore imperative to be very careful if you are purchasing this product from any compounding pharmacy. Some of the below collected sources indicate that sexual side effects will be less likely with topical finasteride. At the same time, hair growth benefits will be similar for oral versus topical.

References and Studies

There have been other studies done in the past that concluded favorable results from topical finasteride. For example, a 2009 study from Iran concluded: “the therapeutic effects of both finasteride gel and finasteride tablets were relatively similar to each other.” Nothing is mentioned regarding side effects in the abstract of that study.

A more recent 2012 study from Thailand concluded that a 3% minoxidil plus 0.1% finasteride lotion (“MFX”) was superior to just 3% minoxidil (“MNX’). There is also an increasing amount of new research on better ways to deliver topical hair loss drugs, especially via nanocarriers.

It should also be noted that the original Merck patent for Propecia has a number of sentences mentioning topical formulations as also likely being effective.

What I am really hoping for are future studies on topical dutasteride. The main reason for this, besides dutasteride’s superior results to finasteride, is that type I 5α-reductase isoenzymes are more prevalent on the scalp. Type II 5α-reductase isoenzymes are more prevalent in the prostate.

Finasteride primarily inhibits type II 5α-reductase, while dutasteride also inhibits type I 5α-reductase. I would therefore not be surprised if topical dutasteride’s superiority over topical finasteride is even greater than the superiority of dutasteride pills over finasteride pills. Hopefully, there will also be fewer side effects even after accounting for some systemic absorption via the scalp.

A few hair transplant surgeons have developed their own topical finasteride solution, usually in partnership with local pharmacies. If you happen to have heard more on this, please post in the comments section below this post. Some hair loss forum participants seem to have tried to develop their own topical finasteride or even topical dutasteride. Something I would not recommend. The science of topical medication delivery is a bit too complex for the vast majority of us to be experimenting with on ourselves.

Other Sources of Topical Finasteride

A number of clinics and many local pharmacies can already compound topical finasteride for you. However, such localized products will never be substantiated by clinical studies, as is the case with Almirall’s product. Moreover, a large company such as Polichem has devoted years of research in perfecting its drug delivery system. They also have to prove limited to no side effects from their product during the rigorous clinical trial phases.

Update: I got an e-mail from the Hasson & Wong clinic on June 17, 2014 stating the following:

“Dr. Hasson is prescribing topical finasteride to some of his patients and it is being prepared at a pharmacy close to our clinic. To date the results have been very similar to the oral finasteride.”

Why Does DevaCurl not Kill Body Hair?

In recent months, my Google Alerts have been filled with news related to DevaCurl causing scalp hair loss in women. DevaCurl is a renowned hair care product for women with curly hair. The brand makes shampoos, conditioners, gels and more that are readily available at salons and on Amazon.

Instagram influencers and Youtube celebrities have been at the forefront of the backlash against DevaCurl:

DevaCurl Lawsuit
DevaCurl Hair Loss Lawsuit.

DevaCurl Hair Loss Class Action Lawsuit

Apparently, DevaCurl has damaged the scalp hair of a number of female users of the product. Some have claimed that this is due to a possible change in ingredients in a new formulation. Hair texture changes, dandruff, rashes and frizzy hair are other complaints. In 2020, a class-action lawsuit was filed against DevaCurl. More details here.

Every couple of years, we hear about hair shampoos, dyes or styling products suddenly damaging scalp hair. Several years ago, a major scandal involved WEN hair products by Chaz Dean (marketed by Guthy-Renker) causing scalp hair loss and irritation. When people get scalp hair loss from such products, I hope that it is temporary and not permanent in most cases.

Why is it Easier to Destroy Scalp Hair than Body Hair?

Whenever I read about hair care products such as DevaCurl destroying scalp hair, I am always 100 percent certain that the same product will never destroy body hair.

I assume that the people who use these hair care products get at least some of it dripping onto their eyebrows and eyelashes. If male, they probably get some of it on their mustaches, beards, wrist hair and hands when applying the product. After washing the scalp hair, some of the product surely makes contact with the whole body during showering.

Yet, I have never heard someone complain about even temporary body hair loss from these products.

DevaCurl and Body Hair

If DevaCurl is destroying curly and wavy scalp hair in some people, why has no-one tried using it on body hair? Curly beard hair or curly chest hair could be prime targets for hair removal purposes with a low-cost product. My guess is that DevaCurl or any other such product will never destroy body hair. Our apelike ancestors disapprove of any further advancement in the naked ape theory.

I have yet to hear even ONE single case where someone has filed a lawsuit or complained that a product damaged or killed their body hair.

Many men complain that certain harsh shampoos are causing increased scalp hair loss. However, these same men never see the same damaging shampoos killing their wrist area body hair. When one lathers the shampoo while washing one’s hair, the product and its residue are clearly in frequent and consistent contact with the wrist region. Yet, how many people do you ever see walking around with patchy wrist and hand area hair?

Note: Make sure to read my post on why men with excessive body hair tend to go bald at much higher rates.

The only way to destroy body hair is via very slow and tedious electrolysis. Or via expensive laser hair removal procedures, which can cause skin discoloration and damage, especially in darker skinned people. Moreover, laser hair removal is never guaranteed to work.

Hair removal products such as Nad’s, Nair and Vaniqa also have weak results despite years of research behind their ingredients. As far as I can tell, most such products act like waxing, and hardly ever permanently remove body hair.

Conclusion

If body hair is so much stronger than scalp hair, the answer to life is not 42. Rather, it is very clearly body hair to head hair transplants (BHT).

I would love to see much slower and less dense beard growth. One of these days, I hope that there will finally be a class-action lawsuit against some moisturizing cream destroying body hair as a side effect. I will buy the product asap.

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