Questions About Topical Hair Loss Treatments

Dr. Rassman,

I have several questions about hairloss. I´m 22 and have receding hairline and thining hair, less than NW2. Please tell me about preparations containing minoxidil with liposomes and topical finasteride.

1. What are exactly liposomes? How do they work?
2. Topical finasteride, effectiveness? Would be effective a home made lotion mixing crushed up proscar pills (i read about how to make it in a blog)and “shake” the bottle? I think that´s a
   waste of money. But adding liposomes in the same or a similar lotion could make the finasteride worked topically. I´m right?
3. I´m currently applying minoxidil 5% twice a day and 15-20 minutes after night application y apply retin-a cream (0.05%) only at temples and hairline. I agree with you that tretinoin burns
   the scalp so I prefer apply it separately from minox and only on temples at night. Do u think it´s a safe way to use tretinoin?
4. And finally, is nizoral 2% the best way to keep you scalp free of sebum? Does minoxidil penetrate better on this way?

I ask your advice also after being on propecia for 1 month I quit the medication because typical side effects, but fortunately they disappeared and i´m going to go back on 0.5 mg propecia EOD (every other day) within a pair of month. What do u think about this issue? Thanks Dr. Rassman, I hope your answer and it helps to other people.

If your hair loss is less than a Norwood 2, are you sure what you’re seeing is actually hair loss and not just a mature hairline?

1. According to Wikipedia, “A liposome is a tiny bubble (vesicle), made out of the same material as a cell membrane. Liposomes can be filled with drugs, and used to deliver drugs for cancer and other diseases.”
2. Some have marketed topical finasteride, but I have yet to see a good study that indicates if it even works. It is a good way to sell a product to those who do not want to (or are too scared to) take it orally. Don’t let liposomes fool you, but in my opinion it is a brilliant marketing idea.
3. I do not think tretinoin (Retin-A) helps with any hair loss treatment. Some use it with minoxidil apparently for better absorption, but I don’t know if that is truth or wishful thinking. I do not recommend doing this.
4. Nizoral is a shampoo. They did a great marketing campaign to promote it to people with hair loss. There are various shampoos that work for removing the oily sebum from the scalp, but I can’t say which one is better than the other. I haven’t seen a study that shows minoxidil works better after a shampoo.

I am sorry to hear you had side effects while taking Propecia, but I am glad your side effects are gone. As you said, you can try 1/2 dose or take it every other day and see if it helps. You might also wish to try 1/4 of a pill each day instead of 1/2 a pill every other day, as the half life of the drug is about 4-5 hours.