Topical Finasteride from Almirall Finally Here

Topical Finasteride
Topical Finasteride.

I have covered topical finasteride at least ten times on this blog. My original post on this subject got published in 2014, and is updated every year.

I have especially emphasized Polichem’s P-3074 (now Almirall’s ALM12845) hydroxypropyl chitosan (HPCH)-based topical finasteride. This product is now finally being released in the European Union countries. Note that besides chitosan, there are many other potential delivery systems for topical finasteride.

Unlike specialized topical finasteride products offered by local compounding pharmacies or hair clinics, Almirall’s ALM12845 has undergone rigorous three-phase clinical trials. For more information, see Phase 3 trial results of P-3074 as well as this 2015 encouraging update.

Update: March 21, 2023 — Boryung will launch Finjuve finasteride spray in South Korea on March 21. The company secured the exclusive rights for Finjuve Spray from Almirall (Spain) in January 2022.

Note: I am even more interested in topical Dutasteride for hair loss.

Will Topical Finasteride have Fewer Side Effects?

Due to some people getting persistent side effects from oral finasteride, the interest in topical finasteride is extremely high. While there are no guarantees when it comes to fewer side effects from topical finasteride, it is a virtual certainty that there will not be higher rates of side effects.

Speaking for myself, it does give me peace of mind to use something topically rather than ingesting something orally. Moreover, with the topical product, one can use a lot less than the recommended dosage. If you are only losing hair in the crown region, you might start by applying a bare minimum of the spray or lotion in that area.

This is a lot more desirable than ingesting a whole pill. Breaking tiny 1 mg finasteride (Propecia) pills into even smaller pieces and trying to distribute the resulting dosage evenly is not practical. Make sure to also read my post on finasteride and dutasteride dosage discussion.

Note that Hasson & Wong in Canada has been prescribing its own topical finasteride for a number of years, but they have not had to undertake any clinical trials. They use a local compounding pharmacy as well as Farmacia Parati (Italy) to make their product. In the past, they told me that the topical product has fewer side effects than the oral product.

A number of other hair transplant clinics nowadays offer proprietary combination topical products that contain both finasteride and minoxidil. Some doctors prefer oral finasteride to topical for generalized hair loss.

Serum, Plasma and Scalp DHT Level Reduction

Research on dihydrotestosterone (DHT) level reduction by topical finasteride shows varying results. This is obviously impacted by the type of compounded product being used, dosage amount and application frequency.

One study of P-3074 found scalp DHT levels declined by 70% with once a day application of 1 ml (2.275 mg) of P-3074 topical finasteride. By comparison, oral finasteride 0.5 mg/day reduces scalp DHT levels by around 50-70 percent (different results in different studies). However, the P-3074 study showed 50 percent scalp DHT reduction when using lower doses.

Serum DHT was reduced by 60 -70 % for the 1 ml dose of P-3074. Similar to what is seen with oral finasteride. But only 25 percent with the 100 and 200 μL doses; and around 45 percent with the 300 and 400 μL doses.

Interestingly, no relevant changes occurred in serum testosterone readings. By contrast, oral finasteride changes both testosterone and estrogen levels.

Almirall will release ALM12845 in Europe in 2021

A few months ago, I contacted Almirall and they told me that they would release their topical finasteride ALM12845 (or ALM-12845) in Western Europe in 2021. The release date would vary by country. No plans for selling in the US market.

One of this blog’s readers (“Paul”) e-mailed them after me, and he was given the more specific release date statement below:

“Without going beyond the limits of confidentiality, I can confirm you that we expect to launch topical Finasteride by the beginning of 2021 in Europe once the assessment by Health authorities is completed.”

Earlier today, reader “Lesley” made an important discovery. She posted this recent link from Gazzeta Ufficiale (Italy). It has the English translation of part of the content from this pdf. I will discuss the content in more detail further below.

Difa Cooper’s Caretopic Topical Finasteride

Per the above news, it seems like Italy based Difa Cooper (also known as Cantabria Labs Difa Cooper) will produce Almirall’s ALM12845. Per “Lesley”, they will only market it in France and Germany. I cannot tell for sure, but makes sense per below image.

In January 2020, Almirall announced that ALM12845 no longer fits its strategic portfolio. At the time, the company had started looking for a partner to out-license the product. The first partner is now likely Difa Cooper. I am guessing that they will need more partners in other European countries.

Per the earlier mentioned Gazzeta link:

  • The topical finasteride (brand name “Caretopic“) will be in “cutaneous spray, solution” form.
  • Each ml of the solution will contain 2.275 mg of finasteride. Each bottle will contain 18 ml.
  • Each dispersion (spray) amounts to 50 μl, which contains 114 micrograms of finasteride.
Almirall Topical Finasteride (Difa Cooper).
Almirall’s topical finasteride ALM12845 will be sold by Difa Cooper (brand name “Caretopic”).

Finjuve

In November 2021, Almirall and Hikma Pharmaceutical entered into an exclusive licensing agreement. This will allow Himka to commercialize and market Almirall’s topical finasteride via the FinjuveTM brand in certain Middle East and North Africa (MENA) markets. In January 2022, Boryung Pharmaceutical signed a contract with Almirall to sell Finjuve spray-type topical finasteride in South Korea.

Finjuve Topical Finasteride Spray
Finjuve Topical Finasteride Spray from Almirall.

Finjuve is a finasteride spray that is approved in Italy, Germany, Luxembourg and Portugal for the treatment of androgenetic alopecia. Interestingly, Finjuve is meant to be applied to the scalp through a cone. This prevents the spray produce from spreading outside the treatment area, and improves overall safety.

Almirall CEO Interview

There is a new November 2021 interview of Almirall CEO Gianfranco Nazzi. In regards to their topical Finasteride, Mr. Nazzi states as follows (slightly modified quote):

“It is a legacy Polichem product. We have not launched it, but are licensing it out. We do see some small incoming milestone income for this topical Finasteride from Eastern Europe and other countries within Europe. But is not going to be a significant mover of the company. We’re just trying to maximize the value we can get out of it.”

86 thoughts on “Topical Finasteride from Almirall Finally Here”

  1. To ask the obvious, is there any observable likelihood whatsoever that this formulation produces significantly fewer side effects than oral fin? The study seems to indicate that adverse sexual events for both formulations were fewer than 1% which I simply cannot take seriously.

    1. My guess is that a lot will depend on the amount used. If I ever manage to get the Almirall product, I will only try it on my thinning crown initially. Perhaps even at twice the recommended dosage in that single small area of the scalp.

      I find it hard to believe that equivalent dosage topical finasteride would cause similar rates of side effects as oral finasteride.

      I have stopped trying to analyze all the studies, but I am assuming that some suggest similar rates and some suggest lower rates of side effects with the topical. I would be surprised if any study concluded higher rates of sides with the topical.

      In any event, most studies on oral finasteride already show very minimal rates of serious side effects. Online testimonials often doubt these studies, so it will go good to have a topical alternative.

      For me, the psychological benefit will be major.

  2. Curious if this will boost regrowth for those of us on propecia for many years. Plus, does this perform better than already available topical fin from compound pharmacies? Feel like it wont be any better.

  3. Sorry if this has been answered in a previous post, but no chance they looked at DHT levels of this vs placebo in the clinical trials? That would take all the guesswork out of self reporting symptoms. Things like sex drive, brain fog, etc are so subjective that it’s almost pointless to include them. When you’re told something might lower your sex drive, you’re worried about your sec drive and it becomes a problem.

    DHT levels would give a black and white idea of how this is absorbed systemically. I may even consider doing a short experiment myself if I can get my hands on some.

    1. Jack, I agree 100% on the psychology of sides and the only way to know if topical is any different from the oral med. It’d be so easy to do a blood test and see the effects of the topical versus the pill on all testosterone levels in the body. That’s a good idea and we should be able to see those results to know if topical really is any more localized or if it’s just pointless. After all, a nicotine patch on the skin gets into the bloodstream and affects the mind.

  4. Thanks. I was on oral Fin for around two years some years back. It seemed to make very little difference to my hair loss (which is slow in any event), but I had problems with aches in my testicles. I stopped taking some time ago. I’m trying to work out from this whether there might be any point in trying again with topical fin i.e. is it possible that people who do not repond to oral fin might have better results with topical. I don’t seem to respond to minoxidil either, so anything that might help would be most welcome. Grateful for any thoughts.

  5. I have tried a low dose topical finasteride regimen for 6 months. It went systemic after 3 months (ball ache, acne, oily skin, lower libido and soft erections).

    I had to give up after 6 months and a very intense shedding. I regret this experiment.

    Topical finasteride accumulates and causes sides eventually, even at a very low dose (1mL of 0,01% everyday in my case).

    1. Same here, had big hopes thinking there couldn’t possibly be any side effects with topical. But I was wrong and I had all the same effects as oral fin

  6. Followed this one for a while (I make my own DIY version without the chitosan). Some useful detail is in the earlier and phase 3 studies to go with the translated Italian note linked above…

    The translated note says:

    Each ml of solution contains 2,275 mg of finasteride. Every dispensing provides 50 μl, which contain 114 micrograms of
    finasteride;

    In the phase 3 study they used 4 “puffs” of the same concentration. It would be useful to confirm that those phase 3 study “puffs” were the same quantity as these 50 μl dispensings.
    https://www.hairlosscure2020.com/polichem-topical-finasteride-phase-3-results-out/

    4 x 50 μl would be equal to the 200 μl used in the following early study on this product (same concentration and vehicle) that gives detail on the serum DHT effects. μl reduced serum DHT by only 26% after 1 week.
    https://www.researchgate.net/publication/285733679_Effects_of_a_novel_finasteride_025_topical_solution_on_scalp_and_serum_dihydrotestosterone_in_healthy_men_with_androgenetic_alopecia

    The phase 3 study (results in my link above) didn’t measure DHT, but adding up the net difference in the results for each of the 5 sexual function categories in the results gives a significant net win for topical in each question category except for sexual desire where the pill had a slight lead. The topical scalp hair improvements seem to have been about the same as the 1mg pill.

    The only problematic thing I forsee is how to apply just 4 puffs (each one twentieth of a ml) to a scalp that still has significant hair without wasting it landing on the hair instead of skin (I guess just use more / dispense onto finger first and press onto scalp).

    1. Very useful analysis GregB. I am hoping the European users post their experiences on the various European hair loss forums in the coming months.

      1. Thanks Admin, and feel free to use / refer readers to those points in any future post updates if you like (you can probably write it better than me – I’m not so good at explaining things). It’d be especially useful knowledge if the phase 3 study “puffs” were indeed 50μl each (I’m just assuming so). It’s pretty encouraging that they had already shown that 200μl (one fifth of a ml) reduces scalp DHT by 52% with only 26% serum reduction.

        1. Why did they stop measuring after 1 week? For all we know serum DHT could fall 70% by week 3 and we’re exactly back to where we started.

  7. Hey guy, sorry a little off topic but what is the best formulation of minox to use? I’m using Rogaine 5 percent foam but it still irritates my scalp. Can someone recommend a good formulation? Thanks In advance!

    1. I used 2% minoxidil (womens Rogaine) because I was getting sides on 5%, now I’ve been just doing half the regular dose of 5% Rogaine once per day and it’s been fine

      1. I was using Lipogaine Sensitive (no Propylene Glycol in it and does not leave that gross unwashable residiue on the scalp) since it was a bit pricy, I have now ordered DualGen-5 NO PG, so we will see how it goes once the packsge arrives.

  8. Good stuff admin, even if it turns out I cant use it! Hopefully our French and German friends on here will report back with feedback. Take care

    1. That’s pretty amazing imho.

      Fukuda seems like the better Tsuji these days lol.

      Fukuda has a full-blown solution in his stack, and that for years now. Delivering one groundbreaking paper per year his research is top-notch.

      And his way seems to me as the least complicated approach of all.

      Unfortunately he doesn’t pursue a commercialisation. That’s very sad.

    1. I guess that is positive news but especially for a trial that (from what we can tell) doesn’t use a pharmaceutical that hasn’t already been approved, my god they are slow. Frequency Therapeutics started a Phase 2 trial in 2020, will have a 90 day read out in Q1 2021, and started an additional study in 2020………………all while Follica did nothing!

  9. PinotQ, Tomjones, Admin… everyone and anyone!

    Why don’t *WE* release a microneedling integrated system?

    I’ve been very seriously pondering this the last few days and I want your thoughts. The pitch is a sleek micro-needling device (less cumbersome than the derminator, more elegant and luxurious than cheap amazon stuff) made specifically for and marketed toward *US*, combined with our own compounded minoxidil topical, sold through our own website. (This would be a serious, legitimate business. Gotta start somewhere.)

    Much like, say an aroma diffuser that sells both the device and the oil—we sell the device in a slick hipster box packaged with a few months supply of our topical and replacement needles. The website handles subscriptions.

    So far the internet is a mess with people asking about which device and topical; mass disorganization! But the demand is huge; these microneedling youtube videos are getting millions of views each! If we marketed this to ourselves our idea would burn like wildfire through these websites, our word-of-mouth marketing would easily reach millions.

    IMO, Follica is a dud. Full head, 60yo Board of Directors, lol c’mon. Dermatologists selling overpriced tech to dermatologists. “In-office procedure” —pfft— facial microneedling in-office costs $200-800 per session. What do you think Follica will charge per session? Would you pay say $500 per session; go to the dermatologist every two weeks for the rest of your life? Nah! Would you pay say $200 for your own slick looking LED needle with charging dock and then the monthly supplies of replacement needles and topicals. We could very quickly corner the market; become the official hair needling system of blogs and forums. All the needling devices I’ve seen market towards “skin rejuvenation”.

    Okay, so does this sound like something you’d be interested in supporting or purchasing—even just in theory? Provided we put together a superior product. I think a kickstarter could raise a lot. Personally, I would put aside my needling device to buy one from us. Topical too. Really guys, we’re sitting on a multi-million dollar idea…hell, in five years of doing nothing, we’ll still be sitting on a multi-million dollar idea—hair loss isn’t going away anytime soon. *sad reality sets in*. But we’ve got a window of opportunity here to make something for us! and we already have better before / after photos!

    What do you guys think?

    : )

    1. I would be happy to promote your Kickstarter campaign on here and even buy the final product if I decide to start microneedling. But I really cannot devote much time to anything else this year. I was trying to partner with a dermatologist to create topical Dutasteride in the past, but also had to pause that idea for a while. If you follow through on this, maybe you can even ask Dr. Rachita Dhurat to partner with you (and get cheap medical supplies from her contacts in India).

      Just FYI — I helped a friend with his successful Kickstarter campaign in the past and he received around $100,000 to $120,000 across 3 rounds (product improvements in each round). He probably spent 40 hours a week on this for months before starting each campaign. And he had to make many videos too, including personally appearing in some to garner sponsor trust. Then he had to ship out his product when it was released each time to 100s of sponsors, many of whom were mad at delays. And he could not realistically do drop shipping, so had to go to the post office daily! All this was additional work after each Kickstarter was over. The whole initial process took him 2-3 years. One time, one of his parts suppliers went out of business and he almost had a heart attack. Note that Kickstarter will take 10 percent of your funds in fees and payment processing costs.

      My friend is over 50 and super energetic, but to me, this is a young crazy motivated person’s game!

      1. Thanks Admin!

        If there is one thing that is known for making a young person both crazy and motivated, it is in pursuit of the cure. So I might be looking at the right group of people. : )

        Right now I’m just gauging interest — I imagine transparency being one of the key components to this project. i.e. coming up with a microneedle design and posting it on the forums and blogs asking, “Is this something you would buy? Is it cool looking? Will you keep it on your bathroom sink? If we made it waterproof would you run it for five minutes in the shower? What kind of compound would convince you to make the switch? Should we also sell numbing cream and sterilizing solution? This is what I mean by it being ‘our product’ made by us. Our input. Together in one-stop; the best we’ve learned about what we already have. And business will increase as people compound it with soon-to-be topicals like Breezula, Samumed (both of which are not effective enough to be a cure alone but perhaps in combination).

        Again, it’s whether or not the interest is there. Certainly the motivation to find the cure is. We all know that!

          1. Thanks for the support Admin! I’ll continue to mull this idea over and maybe survey the response more deeply when the covid dust has settled.

      2. Tocatta, there is definitely a market. I’d be happy to be a part of the team. I nominate you the CEO. Pinotq is a very bright man fyi, so if you can get him on board, you have have a heavy hitter.

    2. Toccata if you’re micro needling device doesn’t regrow a full head of hair on a NW7 then you won’t become a millionaire or a billionaire. Better get to work. :)

      1. Recovering a NW7, especially on someone older, requires a longer commitment, a longer timescale. I suspect in the next few years we’ll see more and more positive testimonials (and these are honest people, across different races, age ranges, and norwood degrees), and then a ‘tipping point’ will occur in which it becomes undeniable that microneedling in addition to the big 3 is the best fight we’ve got. The question to you is whether you buy a device and start working on your NW5 or start saving a hundred thousand dollars and hope for Replicel, Tsuji, and Stemson? This is your well-being alone you’re gambling with?

        The next generation of topicals (Samumed, Breezula, Follicum) will come out over the next ten years. If I recall correctly, Breezula had a $200 a month price estimate years ago. If the rest are similar it could cost you $600 a month outside of what you are already spending—$7200 a year, with no proof demonstrating anything like a full Norwood 7 recovery. And any topical discovered now will need to start that long 15 year march to FDA approval.

        So we either build a big enough soapbox to hold all our self-pity, or build the best chance we’ve got right now. You know?

  10. Toccata, I like your thought process and you raise some great points. I especially like your observation that there are no devices made or marketed specifically for hair……I would love to find one that is rectangular. And businesses like HIMS and Roman suggest you can market and package products that were developed or created by someone else. I think the biggest impediment to this idea is that Follica has a patent on combining microneedling with various topicals which appears to cast a wide net since it attempts to cover not just it’s micro-needling device but all such devises and rollers, not to mention all types of topicals. I have always thought Follica’s control of the microneedling/topical treatment was rather weak (assuming there is no proprietary compound) because although they can probably legally prevent someone from marketing this combination, once they launch and all of the details come out, the elevated level of efficacy that they claim to have achieved will probably be easily duplicated at home on an individual to individual basis in a way they can’t prevent…….as we already see now at a more random level of protocol. And the more expensive they make their treatment, the more they will drive customers to do it themselves. But in trying to turn what you are correctly identifying as a potential business opportunity, there is a potentially lethal hidden cost should they decide to try and shut you down, after investing the time and money to get it off the ground. The more successful this business would become, the more motivated they would be to shut it down. That said, I am interested in seeing this conversation continue.

  11. Thanks for the measured response PinotQ,

    You’re right and I’ve thought about this and what Follica’s “proprietary device” and “exclusive license” would prohibit given companies are already selling Minoxidil & Dermarollers together (Lipogaine being one such company). My belief is that so long as we remained within the already published guidelines set by Dhurat’s study and FDA for daily minoxidil, we’ll have made no infringements (after all, we’re streamlining and modifying existing products to make them better for us without developing a full FDA-approved protocol). I’m far too risk-averse to let an issue like this go unresolved, so I’d say a lawyer could clarify this well in advance. Additionally, I’m not American which may have its advantages.

    On the topic of Follica, they began in 2006, made some waves, fell off the radar until 2016, planned a release in 2018, fell of the radar again. Now it’s 2021 and they are still off the radar. I don’t trust them. In-office procedure strikes me as incredibly tone-deaf. Many bald guys won’t leave the house without a hat. Many look for every excuse not to leave at all! Social anxiety is a core component in the sufferer’s psyche, it separates him from guy that says ‘no hair, don’t care’. A five minute procedure will quickly lose its allure when its tallied with waiting room and traveling times and costs a premium, not to mention (but mention I must) that the trials have only been on the crown (from what I recall), and that this is a lifetime treatment: you leave / you lose. And most obviously, which doctors will offer this treatment? I live in a small town in the country so I’m out just like that. Perhaps they know as much already which is why its been 15 years and why they will delay for another 7-8 years and then once it’s released we’ll never hear anybody that actually stuck with it long enough.

    So I ask myself, ‘What’cha gonna do?”

    (But my town is under lockdown. Small business are being destroyed. It’s best if I spend 2021 on something stable and entertain this idea later)

    Take hair guys!
    …I mean care.

      1. I think I know what adds up…

        Look at Replicel (creator of the shelved RCH-01) and their executive compensation listing:

        David Hall – $396,000
        Rolf Hoffmann – $189,762
        Darrell Panich – $171,490
        Gemma Fetterley – $158,907
        R. Lee Buckler – $157,950
        Kevin McElwee – $53,571
        Peter Jensen – $20,250
        (https://wallmine.com/tsxv/rp)

        No hair… don’t care… about us.

  12. It takes on average 12 to 15 yrs for fda approval. So it looks like follica is still on track. We think it takes shorter time because we think hairloss treatments should take faster but it doesn’t. No drug gets approved faster that I know of in this space. I think they started trials in 2008 I believe so 12 to 15 yrs makes it 2020 to 2023. I believe samumed started in 2011 if I am not mistaken. 12 to 15 yrs would bring it to 2023 to 2026 for market release. Seems to be on track. These companies go through a bunch of bs regulations. The delays are normal and things happen. The question we should be asking is this follica and samumed treatments going to really grow dense hair or we lookikg at 12 hairs that make no difference….my biggest fear is we wait and wait all these years just for a new version of the same results of the big 3.

    1. Mjones you said it perfectly. Really there’s no injectable stem cell cures that I see in my opinion which is a correct opinion. That will give you a at least 80% density back, RCH-01 was only getting between 8 % to 12% with 10% being the mean average. Pfffff that’s nothing and we’re all waiting around and hoping for these companies were just wasting energy and time putting all our hopes in these marginally affective new treatments that will take decades to come to the market. We need an update from Dr tsuji, WTF Dr tsuji is not embarrassed that his life’s work came out to look like pseudoscience High School lab experiment ? I would be.

  13. I find it odd that follica has been stating for a while now that they would start phase 3 when the optimisation trial is finished…its been finished for a while now and yet it may take them until the end of 2021 to begin phase 3. I dont get it.

    1. I agree! Maybe they are waiting so they don’t bring down the average time to approval.☺ Regardless of those averages, this is a treatment that uses nothing that isn’t already FDA approved so averages shouldn’t apply. And averages shouldn’t stop you from starting a trial when you already had 280 patients enrolled for Phase 3, not to mention positive FDA feedback on the study design. I get the endless number of optimization trials to figure out what protocol works best but there must be some other factor at work now. If Frequency Therapeutics can start 3 clinical trials in 2020, each using 2 unapproved molecules never before trialed on humans, despite a delay caused by the pandemic, you would think a capitalistically motivated company with a cosmetic product would have the incentive to similarly move forward as quickly as possible. Maybe it has to due with funding, maybe they are on the verge of a new topical, maybe they are questioning their business model…..who knows but at this rate my expectations are later rather than sooner.

  14. not really sure what to think about SM. Looking at there Facebook page and twitter account, they seem to be really pushing there knee program going into phase 3.. No real excitement on finishing phase three for aga, I figure they would show a little more excitement then what they have. Hoping for the best as always

  15. Hello everyone. I’ve been reading for years now but this is my first post.

    Many say just go for the HT. And yeah, if you can then I agree, it’s better than waiting for some topical that a) likely won’t do much and/or b) will take another decade to come out. The problem is, I don’t have the donor hair. I may have enough for 4k (that’s pushing it – one doc told me 3,500 tops) but this isn’t going to cover my head. Or even close. Especially given time, as hair continues to fall out (yes, yes I’m aware of the meds available to keep that from happening) and even donor hair can eventually thin. I have a feeling many are in the same boat. And really, 3k to 4k covers a lot less than people think.

    While some have thick sides, many who don’t have much on top have thin sides as well, making a HT difficult, depending on your intended outcome. Even those with decent sides – how decent? Sure you can pull a few thousand but depending on how little you have on top, this may not be enough.

    Ensuring enough donor hair (either though others being able to donate somehow or by cloning etc) would be a game changer. I’d gladly pay for the surgery – several, if need be. I bet others would too. Since HTs are already happening, finding a way to obtain massive or substantial donor hair is really the key. Even if you spread the HTs over a decade or so – one every few years – it would eventually allow you to cover what you want (15k+). Yes, a HT is costly but still. We know they work.

    Anyway, I realize I’m not saying anything new. Just adding to the complaints. Throwing in my two cents.

    1. Max, I understand your pain. I’m NW7 with very fine hair (fell out in my teens). My solution was 3 hair transplants plus subtle SMP underneath. I buzz my head to 1/8″, and the hair transplants give the SMP a 3D look that is touchable and very very soft and natural looking. I now have something darker up top to frame my face, and the horseshoe bald pattern and bald spot is gone. I look much younger. My hair transplants are about 1/3 the density of the natural hair on the sides, but the SMP supplement makes the buzzed hair on top look to match the darks of the buzzed hair on the sides (all tangible 3D and natural looking). In my opinion, hair transplants plus SMP is nearly a baldness cure, so long as you’re willing to clip it short and the SMP is done by a professional. Keep the SMP behind the real transplanted hairline so that it looks soft. I feel much younger, better looking, and more secure to have no more male pattern. And my final advice… never ever let the surgeon talk you into FUT strip scar for expediency. The scar can never be fully hidden when clipping hair short, and you’ll always want the option to clip hair short and feel younger and stronger looking. Please don’t ever get a linear scar. Good luck!

        1. Yeah, and for some a few thousand works wonders (sometimes that’s all someone needs). I guess my point is that some don’t have a few thousand to donate and for others those few thousands, if they do have it, just isn’t enough. Say, for example, someone is 90% shiny on top. Well, even 6-8k isn’t going to fix that. Too much space to cover.

          I’m at the point where 3500 won’t do much, or else enough. I just don’t have the donor hair I need. I can do the 3500, and I might, and it may look a little better but I have a lot to cover…so really it’s a short term solution until/unless I find a way to get more donor hair.

          It all depends on where you’re at. For some, one HT with 3-4k grafts will fix everything. For others, it won’t make a dent. I need a heck of a lot more than 3-4k, unfortunately.

          Sadly, HT just isn’t the answer (or the ideal answer) for those that don’t have the donor hair and/or have too much head to cover. I’m not a scientist, but you’d think cloning your own hair follicles would be something they could do (easier, you’d think, than trying to come up with some magical goop that either never gets past trials or doesn’t do what it promises).

        2. I’ve read about body hair transplants but I’m skeptical. The hair looks different on chest and arms etc. but I guess if it goes in back or used in the right way it can work. I wonder if the price is different.

          One thing I read on it is there are less hairs for each graft. One graft on the side of your head may have two or three hairs but arms and chest it’s one for one. You’re getting less for the same price, basically. But if you’re out of donor hair I guess there’s no other options.

      1. Hi Slick – I have always thought short hair (remainder of real and/or HT) along with high-end SMP could look great. Glad to read that you like it. Can you share a pic somewhere? I daydream of a similar solution that uses 3D printing to place/attach/glue short hairs with digital accuracy directly to the scalp. The short hair would allow the computer controlled printing system to observe thinning areas and add hairs as needed. I have thought about a low tech approach that could use a static grass applicator. Have not bought one and experimented. I tried a HS in my 30s and it was pathetic. I often consider a HT but I get bummed as I review the BEST before and after pics and think they don’t look worth $10k. And… what if my scalp rejects some or a lot of the hairs – still bald and out $10k!

        1. Chris.. Good SMP just looks like dark 5’oclock shadow, and that is enough to make clipped transplant hair on top look as dense as clipped hair on the sides. Reducing scalp contrast is huge (I’m naturally pale skin tone). The SMP is grayish brown and looks natural even if I razer blade my transplanted hair away. I’ll see about getting a picture out there. I can email Admin. Good luck.

    2. I’m in a similar position. Minox and Fin haven’t worked for me. I’ve been told I have around 1k hairs for a transplant. I’ve decided to wait in the hope some new way of stimulating what I’ve lost comes; or, more likely, we have hair multiplication. Not least as the hair I have may thin some more…Stemson looks potentially very exciting. I know this is seven years off (if we are lucky).. Unfortunately my head shape is all wrong for cutting it short. And I can’t face the idea of a HS. So it’s hats for me for a few years. Elton John wore them for ten years before getting a HS. But I’m fortunate in that I no longer need to work. Not an option for everyone. Anyway, try and keep positive. I’m nearing 60 and wish things had looked this bright back in the 80s when my hair first started to thin.

  16. Almirall response to me on Feb 16, 2021:

    “Our product has got the regulatory approval in Luxembourg and Italy and we are waiting for some additional approvals in some few countries in the European Union. Effective launch date is not yet confirmed.”

  17. I wonder how the hydroxypropyl chitosan formulation compares to a liposomal version?

    Anyone knows if it’s out in Europe already?

  18. Formula 82D aka Dutoxidil
    Reviews seem good and reliable. The formula has the latest compounds, including the Dutasteride, but in topical form (less all the side effects known). What do you guys think? Is it a viable option?

      1. I’ve been using Formula 82D for 3 months and I think I’m seeing improvement, another 3 months should tell the story. For context, was on oral and topical fin for 20+ years with topical minox. Switched to oral dut about 7 years ago. Went on oral minox about 3 years ago which really helped a lot. Went on a different topical Dut about a year ago and cut oral down to 1x per week, lost some ground. Appear to be regaining the ground I lost using 82D…plus it doesn’t make you fat! ;-)

        1. Thanks Yoda, very useful. I will try topical Dutasteride or topical Finasteride this year for the first time. Supplementing my now once every three days oral Dutasteride 0.5 mg.

          1. Admin, will be curious of the brand, I believe it makes a difference. I was using .05% from Regrowth Labs, the .75% Formula 82D seems to be more effective.

      2. No noticeable sides, so I gradually increased dosage from 1-2 to 3-4 pumps. It’s difficult for me to objectively say if I got the expected results, but I keep on using it, even though it’s very expensive. It’s convenient to use, and I appreciate that the cone allows consistent application (same distance from scalp) but there’s a drawback: since you must apply it in non-overlapping circles, the shape formed by two or more contiguous circles is always unnatural. Maybe it doesn’t matter because it somehow spreads around but I wouldn’t know that… The leaflet should give more realistic use examples instead of only showing a single-circle application in the crown…

    1. Where do you get it? it seems really hard to find unless you can walk into a pharmacy in maybe Italy and request it?

  19. Hi again, I’m still using it, still not sure about results but it is very convenient to use. On the Italian forums, some dislike the cone and recommend to remove it but in my view they haven’t actually tried it, otherwise they would have realized that without the cone it is extremely difficult to apply the product in a consistent manner. Only with the cone you can control direction, distance, and area covered. Also, you can use the cone to move aside some hair before to apply the product, which is helpful if you still have some density, not to mention that it avoids product dispersion (and the product can be toxic for certain individuals).

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