Dear Dr. Rassman:
I have a question about finasteride as a topical solution. There is much speculation that topical usage of finasteride is as effective as oral administration. I even heard that some chemists are grinding finasteride and dutasteride into some vehicle like alcohol and apply it topically. There is also a company (www.hairgrowthmd.com) selling combined minoxidil and finasteride as a spray product and claiming the success with no side effects. Considering the fact that finasteride has large molecule size ( C23H36N2O2 with a molecular weight of 372.549), it is hard to predict that the topical form is to have any effect on the hair follicles (they have to penetrate the epidermis and enter the capillaries in the dermis and subcutaneous layer). As far as I know, FDA has approved only oral administration for 1mg a day for male patterned hair loss.
Do you have any opinion or suggestion regarding to use finasteride in a topical form?
P.S. There is also one publication on this: “Hajheydari Z, Akbari J, Saeedi M, Shokoohi L. Comparing the therapeutic effects of finasteride gel and tablet in treatment of the androgenetic alopecia. Indian J Dermatol Venereol Leprol 2009;75:47-51”
I would like to believe that the problem is solved with topical finasteride, but I need a good solid peer reviewed article to make these claims credible. The study you mentioned does conclude with, “Finally, we suggest replication study of more samples, with longer period and assessment of patients’ satisfaction after treatment.” — and I agree that it needs more work done before one could reasonably conclude that a topical finasteride is as good as the oral treatment. The problem I see is that if it is not effective and you take the topical preparation instead of the oral proven medication, you will lose hair irreversibly the longer you delay treatment.