In recent years there have been many anecdotal reports of topical finasteride resulting in similar or greater increases in hair count compared to oral finasteride. The topical finasteride is typically in gel or solution form, while the oral one is in pill form. It is hoped that the former will have fewer rates of side effects.
2018 update: A systemic review of topical finasteride shows consistent reduction in hair loss. Both scalp and plasma DHT levels decreased significantly.
Although the manufacturer of Propecia (Merck) applied for a patent for topical finasteride in 2002, 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 due to some users suffering from long-term sexual side effects.
Topical Finasteride: Polichem’s P-3074
The reason I am posting about this subject now is because an important clinical trial/study for P-3074 (a new topical finasteride solution with hydroxypropyl-chitosan as film-forming agent) was just completed in Switzerland at the end of May 2014. The study was funded by Swiss company Polichem, which primarily specializes in dermatological and gynecological products.
The interesting thing about this study was that four different doses (ranging from 0.25 mg to 1 mg) of finasteride were tested among 32 study participants (with 8 of those 32 getting a placebo dose). One negative thing about the study was that only a 7-day dose of the topical P-3074 solution was administered, and there will therefore be no long-term measurement of the effectiveness of P-3074.
In any event, it will be interesting to see the results of this study regarding yet one new product in our arsenal to fight hair loss until a cure comes out.
One other thing of note is that a similar trial (although at just one dosage level of 0.25 mg per day) for P-3074 was conducted in the past and its findings were presented last year at the 7th World Congress on Hair Research (WCHR 2013). The conclusion of that 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, while 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 though.
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 finasteride, especially via nanocarriers.
It should also be noted that the original Merck patent for Propecia has a number of sentences in there that discuss 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 when taken in pill form, is that type I 5α-reductase isoenzymes are more prevalent on the scalp, while 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 (such as the famous Hasson & Wong in Vancouver, Canada) are also rumored to have developed their own topical finasteride solution, probably in tandem 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.
Update: I got an e-mail from Dr. Hasson & Wong’s office on June 17 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.”