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Hair Loss Treatments

What Is Topical Finasteride and Is It as Effective as Pills for Hair Loss?

Finasteride is the active ingredient in the clinically proven and FDA approved hair loss drug Propecia. Though known for its ability to slow the progression of male pattern baldness and regrow hair, it is also known for producing mild to serious sexual side effects in about 2% of users according to its manufacturer Merck.

In recent years, a few hair restoration clinics such as Canada’s Hasson & Wong have offered their patients a topical alternative to finasteride tablets. But, is there evidence to show that topical finasteride is as affective as oral finasteride or that a topical produces fewer side effects? Drugs taken in tablet form are “systemic”. In other words, they affect the entire body. Topical medications work “locally”.  In theory, a topical should only affect the area of the body it is applied to. However, finasteride is a lipophilic drug meaning it easily combines with or dissolves in lipids or fats. Thus, there is nothing to stop the drug from moving from the scalp into the circulation and going systemic.

According to Hasson & Wong’s website, “The effectiveness appears to be equal to oral Finasteride but serum levels are 1/18th that of the oral route. We have had no reports of any sexual side effects in any of the test group (+/- 100 patients). Many of these patients have been on the oral form and had to quit on account of side effects.”

It's important to note that topical finasteride preparations have not been through the FDA approval process and therefore are not FDA approved hair loss treatments. Currently all the evidence to support the efficacy of topical finasteride appears to be anecdotal. Many years of testing and trials are necessary before the topical replaces pills.

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