Scalp DHT, Propecia, and Androcur

Dear Dr. Rassman,

Article at hairlosstalk.com includes the following statement of “Spironolactone effectively prevents DHT from attaching to the receptor sites on the hair follicles. As a result, the follicles no longer atrophy and can mature again to their normal size. And it does so without decreasing the circulating levels of DHT in the body.”

1. Is it sufficient just to block scalp DHT levels, or serum DHT reduction also necessary to combat MPB? If scalp DHT inhibition is sufficient for MPB, is serum DHT inhibition dangerous for the body as claimed by this doctor?

2. You’ve told in one of your comments that propecia is a anti-androgen, but the prospectus states that it does not have an anti-androgenic effect. Could you please clarify?

3. It’s mentioned that Androcur is the best against MPB. Is this the case?

Your reply will be much appreciated.

Finasteride needs to go through the blood stream to get to the hair follicles. When it gets to the hair follicle it then fixes to the tissue and blocks the DHT. Finasteride is not dangerous to the scalp.

Finasteride blocks DHT and when it does this, the testosterone levels often rise. If the body would not produce testosterone in response to a DHT block, then one would say it is anti-androgenic, but it is foolish talk like that because testosterone needs to be present to have DHT made by the body (DHT being a byproduct of testosterone).

Drugs like Androcur are good blockers of androgens and can produce major side effects on the male sex drive, something I would not recommend for patients with male patterned genetic balding.