Over the years, I have written numerous posts on topical finasteride for hair loss. However, when it comes to the stronger DHT inhibitor topical dutasteride, this is the only post. I try to update it every year.

Update: December 18, 2022

Interesting advice via Twitter from Dr. Kyle Gillett. He confirms that topical dutasteride will not absorb much systemically. However, I was a bit confused by his analysis of the faster half life of the topical formulation. The half life of oral finasteride is 6 hrs, and the half life of oral dutasteride is five weeks. He replied to me in that Tweet and explained his reasoning.

Also note that clinical trials for topical dutasteride started in Spain in October 2022 and will end in April 2024.

Update: September 2023 — Moogene Medi (also called Mujin Medi) signed a business agreement with AddPharma for the joint development of its topical dutasteride male pattern hair loss treatment (Hutera) that can be applied directly to the scalp. Thanks to “Theo” for the information. This unique topical product makes use of Moogene’s independently developed lipid nanoparticle (LNP) technology. See further below.

Update: May 7, 2022

Topical Dutasteride from Moogene Medi

Topical Dutasteride Hutera. — Moogene Medi’s Hutera topical dutasteride. Microbubble ultrasound delivery.

A few days ago, there was another important new update from Naver in regards to a South Korea company. This time it is Moogene Medi and its highly unique ultrasound microbubble delivered topical dutasteride.

This new topical dutasteride product will be known as “Hutera”. Note that this brand name is not mentioned on the company’s website. Surprisingly, neither is the word dutasteride. The latter is also why I never took this company seriously till this week.

According this latest update, Hutera topical dutasteride will have:

“About 20 times higher dermal drug delivery efficiency than the existing oral dutasteride.”

This 20x seems hard to believe. However, I do not doubt that this topical will be significantly better than the oral at local scalp DHT inhibition.

Also of note, the likelihood of systemic side effects will be negligible since Hutera will have:

“A lower blood concentration of 1% compared to oral dutasteride.”

The original Korean study on this ultrasound activated mechanism also mentions a CRISPR-Cas9 based delivery mechanism. However, the latest Naver article does not mention CRISPR anywhere.

Make sure to also read the patent on this nanoliposome-microbubble encapsulated drug delivery for treating hair loss. Also make sure to keep track of Moogene’s official Naver page in case “Ben” takes a day off!

This is all very exciting and I have e-mailed the study authors for more information. It seems like the product will still have to undergo 6 month human clinical trials and will be released in 2023. Note that that normal 3-4 year duration trials are not required since this is an existing already approved drug. South Korea and Japan are the only two countries where oral dutasteride is approved to treat hair loss.

Update: January 22, 2022 — A great new video presentation from Dr. Rachita Dhurat and other doctors from India. Covers both topical and oral dutasteride. Includes before and after photos and Q&A session.

Watch this video on YouTube

Update: Make sure to check out the great Topical Dutasteride Assessment (TDA) Discord Group run by “sonictemples”. Also see the Reddit thread on success stories.

Oral dutasteride (brand name Avodart) is significantly more effective than oral finasteride (brand name Propecia) in treating hair loss. I therefore assume that topical dutasteride is also more effective than topical finasteride in growing hair.

Update: July 2020 (Brazil): Novel iron oxide nanocarriers loading topical dutasteride for androgenetic alopecia.

Limited Interest in Topical Dutasteride

What surprises me is that there is so little interest in topical dutasteride in comparison to topical finasteride. Both on the part of hair loss sufferers as well as on the part of hair transplant surgeons, dermatologists and physicians.

Even mesotherapy and dutasteride treatments have not becoming as popular as I would have guessed last year. Surprising, when so many people are worried about the potential side effects from oral dutasteride.

Local compounding pharmacies will often make topical finasteride (cream, lotion, solution or gel) for hair loss sufferers. However, they rarely get requests to make topical dutasteride for hair loss.

In the private sector, Almirall (previously Polichem) will soon release a rigorously tested topical finasteride. They have worked on this product for more than five years. Unfortunately, no major pharmaceutical company is close to conducting clinical trials for topical dutasteride.

Some smaller companies do make topical dutasteride. However, I am not sure how effective their product is, nor whether they sell globally. I am guessing that none of these companies have conducted expensive clinical trials for their products. Several readers have posted links to such sellers in the comments to this post.

Perhaps one reason for this lack of interest among all parties is due to the fact that dutasteride is much more expensive then finasteride. Both generic and brand name versions of the former are pricier than the latter.

It should also be noted that dutasteride has only been officially approved to treat hair loss in South Korea and Japan. In the US, the FDA has not approved its use for androgenetic alopecia (aka male pattern baldness). Doctors have to prescribe it off-label for patients with pattern hair loss.

Hair Transplant Surgeon Offerings

While I would like to see a private company manufacture topical dutasteride that has been clinically tested, this is not happening anytime soon.

However, during the past 2-3 years, some hair transplant surgeons have started prescribing and offering their version of topical dutasteride. Most such doctors will only prescribe topical dutasteride in person to their own patients. Or after at least doing a remote online video consultation.

I have talked with a couple of other hair transplant surgeons about the significant potential of making money by offering topical dutasteride. One of them might jump on board later this year, although the chances are slim at present.

Topical Dutasteride Buying Options

A number of relatively new online companies (or pharmacies) now sell topical dutasteride. These include:

Strut.
Happy Head.
XYON Health.

I will update this list each year. Hair loss product subscription based companies such as “Hims” and Keeps were not offering this product as of early 2022.

My Topical Dutasteride Experiment

Over the years, I have read of many instances where people take oral hair loss medications and crudely convert them into topical ones. Warning: This type of experimentation can be dangerous, especially for pregnant women.

They first break open the capsules to get to the solution or material inside. In the case of tablets or pills, they grind them down into powder form. Then they rub the resulting liquid or gel or powder on to their scalps. Sometimes after mixing it with other hair growth promoting ingredients such as Retin-A.

Microneedling and Topical Dutasteride — Nada, Essam & Sharkawy, Reham & Abd Elmaged, Wafaa & Elmagd, Marwa. (2018). Topical dutasteride with microneedling in treatment of male androgenetic alopecia. Sohag Medical Journal. 22. 387-400.

Wet scalps possibly absorb the medication better than dry scalps. Topical hair loss products in combination with microneedling might also be more effective when it comes to absorption.

I have always been skeptical about this amateur method of converting oral drugs into topical drugs. Is it possible for the scalp to absorb any of the resulting topical ingredients? I assume that the molecule size has to be small enough for the scalp skin to absorb the medication. Do the ingredients get damaged upon exposure to the air?

Note: Since Rogaine Foam is easily absorbed by the scalp and also quite effective, I do not doubt that topical hair loss medications can work well. See how does Minoxidil (Rogaine) work?

Test Run and a Surprise

Last week, I decided to make my own crude version of topical dutasteride. Even if 20-30 percent of the medicine was absorbed by my scalp, it would be worth the effort and expense. Oral dutasteride was very effective for me in stopping my hair loss for several years. It possibly even regrew some crown hair. However, the effectiveness has worn of lately. So I am very keen on directly applying a topical version of dutasteride to my scalp. Especially on the crown.

When I split open my generic dutasteride capsule (see earlier photo) with scissors, I got a shock. There was almost nothing inside the capsule. Upon closer examination, I noticed a very small amount of thick transparent liquid on the scissors and on my finger. This fluid is not visible in the earlier photo I posted.

I hope that my Camber Pharmaceutical made generic dutasteride is legitimate. The transparent liquid type content was quite limited in volume, but perhaps this is normal for all capsules? In any case, I managed to put some of this thick liquid on my crown. Warning: It is dangerous if you get such medicine into your eyes or mouth.

I do not intend to continue this experiment on any kind of regular basis. I will pour the limited contents of oral dutasteride capsules onto my scalp once in a blue moon. It makes me feel like I am doing something useful. Hopefully, I get more than just a placebo effect when it comes to hair growth.

Extra Strength Minoxidil: 10% or 15%?

April 27, 2022 admin 89 Comments

Most people never try using extra strength Minoxidil to regrow their hair. Results from high strength prescription Minoxidil will be greater than from using regular store bought 5% Rogaine.

Update: April 27, 2022

Four new interesting items made me update this post.

During my recent update on online topical Finasteride buying options, I noticed that most vendors were adding higher strength Minoxidil into the mix. Usually ranging from 6-8%.
Dr. Bhanusali of Hairstim Labs posted an interesting update on Instagram today. He claims that 7% Minoxidil made all the difference in comparison to 6% Minoxidil for one of his patient’s hair regrowth. Note that this doctor is affiliated with Follica, which plans to treat hair loss with Minoxidil and wounding.
One of the participants in our hair loss chat just posted very impressive before and after hair growth photos of his scalp. He is using a new compounded prescription product from Dr. Powers called “Hair Regrowth Serum V 5.0”. While it contains Minoxidil 8%, it also includes Dutasteride 0.2% and spironolactone 0.25%. So it is hard to tell what portion of the regrowth is due to extra strength Minoxidil alone.
Dr. Donovan published an interesting article on whether higher concentrations of Minoxidil work better, and the findings are mixed. Minoxidil starts precipitating out of the solution once you go beyond 7 -8% if propylene glycol is the vehicle. For higher strengths, one needs to use other vehicles.

2% and 5% Strength Rogaine

When Minoxidil was first approved by the US FDA to treat hair loss in 1988, it came in a 2% topical solution format under the brand name Rogaine. The product had already been used for many years prior to approval as an off-label hair loss treatment. In 1997, the FDA approved a higher strength version of Minoxidil in the form of a 5% topical solution that could only be obtained via a prescription, although that requirement was soon thereafter waived in 1998.

After Rogaine’s patent ran out, newer generic versions of Minoxidil such as Walmart Equate and Costco Kirkland have come onto the market. More importantly, the topical version (thought still available) has been superseded by a drastically superior foam version. The latter does not run down onto one’s face, sometimes leading to tiny hair growth on the forehead or cause major itching. Note that some people use Minoxidil for beard growth.

I hated using topical Minoxidil, but love using the foam version as it acts like a mild gel and is not as messy. Minoxidil 5% foam has definitely helped my hair. Moreover, within an hour of foam application, I find that my hair feels significantly thicker and fuller. I am certain that this is not a placebo effect. While you are supposed to use Minoxidil twice a day, many people just use it once a day.

Note that Minoxidil is also used by females and women’s 5% Rogaine foam was launched in 2014. Also of significance, Minoxidil still remains one of only two ingredients (the other being Finasteride) that have ever been FDA approved to treat hair loss.

10% and 15% Extra Strength Minoxidil

While 5% Minoxidil was initially considered to be a high strength version of the product, this is no longer true. A number of companies sell 15% (and in some cases, 10% Minoxidil) versions of the product, but I have never tried those. I assume most of these companies will require a prescription before they can sell it to you (and maybe it might even be illegal for them to sell in some countries such as the US).

Minoxidil was originally used as a blood pressure medication. So if you ever use very high strength Minoxidil, make sure you measure your blood pressure regularly. Also keep track of your heart health, since the topical product does get absorbed systemically.

When on Minoxidil 5% to treat hair loss, some people have complained about various side effects such as skin problems, an increase in body hair, water retention and more. Such side effects will probably be exacerbated when on 15% Minoxidil.

Two of the better known companies that currently sell Minoxidil 15% are Xandrox (based in Canada) and MinoxidilMax (brand name Dualgen-15). While the latter has some bad quality pages on its site with missing information, their 10 most popular questions section at the bottom of the home page is worth a read.

Dr. Richard Lee: Minoxidil 15% plus Azelaic Acid

The original extra strength Minoxidil guru was a US-based doctor by the name of Richard Lee. I heard about his name on a regular basis on hair loss forums throughout the 2000-2010 period. He compounded an extremely popular high-strength 15% version of Minoxidil in the 1990s and added azelaic acid to it due to the latter’s anti-DHT (dihydrotestosterone) properties. Update: Azelaic acid also promotes hair growth through the upregulation of Gli1 and Gli2 mRNA and Shh protein.

Since he got an online presence very early on in the internet’s infancy, Dr. Lee’s business took off with a flourish and he had zero competition. However, in 2011, the at-the-time 72-year-old Dr. Lee started having problems with the US FDA and had to close his Regrowth LLC company. Case details here.

Note that another company named Perfect Image Solutions had similar issues with the FDA in 2012 and was forced to cease operations. They were selling a 15% Minoxidil product that also included azelaic acid 5% and Retin-A. One of our chat members said that this product was highly effective for him and he wishes he could find a replacement. Strangely, this Perfect Image Solutions extra strength Minoxidil product still has a detailed review on Amazon.

Getting back to Dr. Richard Lee, check out this video from the old Discovery Channel in which he makes an appearance.

Dr. Oscar Klein: Minoxidil 15% plus Tretinoin (Retin-A)

Another US-based doctor by the name of Dr. Oscar Klein also became extremely popular for selling a reputable extra strength Minoxidil 15% product that also contained Tretinoin (more widely known in the hair loss world by its trade name Retin-A). While Dr. Klein unfortunately passed away in 2014, his Hair Growth MD company still sells his Remox brand products.

A video of Oscar Klein from a 2003 NBC interview:

Watch this video on YouTube

Even Higher Strength

Polaris Research Labs’ NR-10 product contains 16% Minoxidil. The company’s website does not mention where it is headquartered, but does say that the product is not available for sale in the US. I would try to learn more about this company before considering a purchase.

Update: Per one reader comment, this 16% Minoxidil product is now sold as Follics FR 16 cream and also contains Finasteride, Adenosine and Procapil.

The Medical Wellness Center online pharmacy supposedly offers up to 30% Minoxidil content lotions and creams. Belgravia Centre in the UK offers “extra strength” Minoxidil. Please check with a physician before ordering such products to ensure legality and safety.

You can also go to local compounding pharmacies and they might be able to compound 20% or higher Minoxidil for you. However, this may not be particularly safe for long-term use, and there is a chance that 20% will not be any more effective than 15%.

Also of interest, a 2020 study from Iran found that a combination of minoxidil 20% (plus microneedling) and “carboxytherapy mediated by needling” led to increased hair growth. They call this novel hair growth method Minoxidil Carboxygas.

In the News

Minoxidil has been in the news recently, with companies either: experimenting using it in their main product offering (Follica); or actually using it (RiverTown Therapeutics). Moreover, oral Minoxidil is becoming increasingly popular.

Sometimes it is easy to forget that the combined effect of Finasteride and Minoxidil (see before and after photos) has essentially been a hair loss cure for numerous people. Especially when used in the earlier stages of hair loss.

Hair Loss Cure 2020

Topical Dutasteride for Hair Loss