How does it work ?

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Online companies sell topical finasteride products to treat hair loss, but how effective are they compared to other treatments? Agrobacter/Getty Images
  • Popular men’s wellness websites like Keeps, Hims, and Roman sell topical finasteride products to treat hair loss.
  • The pill form of this medication is an FDA-approved treatment for hair loss in men.
  • Studies have shown that men who applied 1ml of finasteride topical solution to their scalp once a week had similar results to men who took 1mg of finasteride by mouth for seven days.

If you’re a man of a certain age and you’ve noticed thinning hair, bald spots, or a receding hairline, you’re definitely not alone.

According to the US National Library of Medicine (NLM), over 50% of all men over the age of 50 will be affected by male pattern baldness to some degree.

If you’ve been suffering from hair loss for a while, you’ve probably heard of a treatment called finasteride.

The pill form of this drug is an FDA-approved hair loss treatment for men only. And now, more and more telehealth brands, like Hims, Keeps, and Roman, are selling topical Finasteride products.

Many formulas are mixed with Minoxidil, a synthetic drug believed to promote hair growth, and sold through telehealth marketplaces.

They claim to support hair health, stimulate regrowth and fight hair thinning when applied to the scalp.

According to Hims, a men’s wellness marketplace, their Finasteride and Minoxidil topical spray targets hair loss and bald spots by combining “two clinically proven ingredients in one no-mess spray — no pills needed.”

Men’s telehealth company Roman makes similar claims about its topical finasteride treatment, stating that with consistent daily treatment, hair loss should have been significantly slowed or even completely stopped within six months.

So how do topical treatments like this work and are they really an effective hair loss solution?

“Traditionally, finasteride was taken in oral form, but now it is also used topically in liquid form and applied directly to the scalp,” says Dr. Furqan Raja, an expert hair transplant surgeon at the private clinic.

He thinks products like these are more accessible to hair loss patients who don’t like taking oral medications. Topical finasteride formulations can also be a good choice for men who want to avoid some of the side effects associated with the tablet form.

“In a small percentage of patients, oral finasteride can cause side effects, such as erectile dysfunction,” said Zoë Passam, consultant trichologist at Philip Kingsley.

For hair loss, finasteride works by neutralizing the effects of DHT, which is a broken down form of testosterone that plays a major role in hair loss. Too much DHT can cause hair follicles to shrink and eventually fall out.

“Finasteride can also stimulate regrowth in thinning areas, and I’ve certainly seen this in my own cohort of patients,” says Raja.

As for the benefits of mixing Finasteride with Minoxidil?

“Minoxidil is a medically approved topical treatment for male pattern hair loss. It dilates blood vessels, which can aid in the delivery to the scalp of other ingredients applied at the same time,” says Passam.

In other words, Minoxidil can improve the effectiveness of Finasteride by allowing it to penetrate deeper.

How would the two experts rate the effectiveness of topical finasteride?

“We know finasteride has been shown to be clinically effective in 90% of men with male pattern baldness, and about two-thirds of men who take finasteride regularly experience hair regrowth,” Raja notes.

He says finasteride is his first-line non-surgical treatment for patients with hair loss or thinning. If they are having a hair transplant, he says it can help maintain existing native hair, which can provide a longer-lasting result.

Or, if they are experiencing the early stages of hair loss, he says finasteride can significantly slow this process.

However, Raja says it’s premature to say whether the topical solution is as effective as the tablet form.

“The topical solution is a relatively new app, so we don’t have as strong data as we have for the tablet, which has been available for decades,” he notes.

A study published in the International Journal Of Clinical Pharmacology and Therapeutics in 2014 found that men who applied 1ml of finasteride topical solution to their scalp once a week had similar results to men who took 1mg of finasteride. finasteride orally for seven days.

In the study of 24 men with androgenetic alopecia, scalp DHT was reduced by 68-75% with topical finasteride treatment and 62-72% with oral finasteride.

It’s certainly promising.

However, Passam says the stage at which patients start treatment is an important factor.

“If the hair loss is very old, there is less chance that there will be a significant number of viable hair follicles from which new hair can grow,” she points out.

For this reason, topical finasteride will work best if you start treatment early. Although results will likely vary from person to person.

Nevertheless, Passam is optimistic about the effectiveness of these solutions.

“Although topical finasteride does not reduce blood DHT levels as much as the oral form, the benefits for hair appear to be equal, but with a reduced risk of side effects,” she says.

“Topical finasteride can help increase hair density and slow hair loss by reducing the amount of DHT locally in the hair follicle, which in turn can help slow down the shrinkage of the follicle that underlies it. type of hair thinning,” she notes.

With most treatments – topical or otherwise – there are side effects to consider. Topical finasteride is no different.

Although Passam claims there may be fewer side effects with topical finasteride compared to the oral form, there are still risks to consider.

“Men with a female partner who is pregnant or may become pregnant should not use topical finasteride because if a pregnant woman comes in contact with it, it can cause abnormal genital development in a male fetus,” Passam warns.

There is also a risk of itching, irritation and dandruff.

Raja says it is important to consult carefully with an experienced surgeon when using any non-medical treatment to ensure it is effective and any side effects are managed accordingly.

So if you’re considering topical finasteride as a hair loss treatment, what should you look for?

There are different percentages available, but most will usually fall between 0.1 and 0.25%.

If you choose to use Finasteride topical products, it’s a good idea to manage your expectations.

“As with all hair loss treatments, noticeable improvement may take up to six months, and all types of male hair loss treatments must be used continuously to maintain their effects,” emphasizes Passam.

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