If you're losing your hair, you have no doubt come across the name Propecia (finasteride). Finasteride has been the most effective drug for combating male pattern baldness since the turn of the century. Unfortunately, finasteride has a lot of negative connotations surrounding the drug due to the side effects. Naturally, it's normal to assume that applying the medication topically would reduce the risk of side effects, so why isn't topical finasteride more popular? And why doesn't a large pharmaceutical company distribute it? Keep reading.
Compounding Finasteride Doesn't Require A Prescription
It may come as a shock to many of you reading, but it's true. Anyone can compound topical finasteride through a compounding pharmacy. The cost of compounding topical finasteride is significantly higher than buying oral medication. The price for 30 grams of compounded 0.1% finasteride is approximately USD 53—the cost doubles for 0.25% topical finasteride. It's tough for any company to get behind selling this product at these prices, as the cost of production is already double the oral version cost. Plus distribution expenses, shipping, and inventory costs.
Now, you can get topical finasteride/dutasteride compounded in China or India for pennies on the dollar. But keep in mind there is little to no regulation. It would be virtually impossible to know whether the concentration is correct or even if the medication is legitimate. You don't want to be buying unknown substances from an underground lab.
Does Topical Finasteride Work?
A recent PubMed review examined literature ranging from 1992 to January 2020. There were thirty-three articles reviewed, and twenty-eight of them pertained to topical finasteride. Multiple studies showed positive results with favorable safety profiles. However, the number of clinical studies and participants is significantly lower than oral finasteride.
The main allure of topical finasteride is the belief that the drug will not go systemic, meaning it could work locally by stopping hair loss on the scalp without removing DHT from your system. However, there will always be a portion of the medication that enters the bloodstream. There is a lot of anecdotal evidence online that suggests that topical finasteride can still cause side effects, but admittedly at a lower rate.
Topical Finasteride May Never Be Sold Commercially
There is no patent for topical finasteride. Pharmaceutical giants Merck created finasteride and originally sold it under the brand name Proscar. Initially, Merck developed the drug to treat benign prostatic hyperplasia (BPH). By accident, they discovered that the drug stopped genetic hair loss. Afterward, they patented Propecia and received approval from the FDA to distribute the drug as a hair loss medication. For years, you could only buy Proscar or Propecia due to their patent.
Patents are essential to pharmaceutical companies because they guarantee profit. Drug companies spend millions of dollars developing a drug. They need to ensure that they are the only ones who can market and distribute the drug once it is approved. Now that Merck no longer holds a patent for finasteride, generic versions can be sold and distributed, and now pharmacies can compound finasteride for anyone. There's no longer a guarantee that the company would make a profit. In other words, it's not worth developing.
At this point, topical finasteride is more of a supplement. The FDA does not regulate supplements, so buyers beware. Buying some cheap compounded finasteride from an unknown source online may sound like a good idea, but you have no clue whether you're buying the correct amount or if the drug is even legitimate. It's best to buy topical finasteride from a trusted source and shell out the extra cash. Several elite hair transplant surgeons are compounding this medication themselves and distributing it to their patients.
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