Why Use Oral Finasteride if Topical Works Better for Me?
Hi doctor, I used oral finasteride for many years but never stop my MPB progress and give me hard side effects. So after stopping the drug, i started with topical finasteride and after 3 months it appears to me that there is regrowth and including the temples (a tough place to get results).
I believe that topical finasteride reduced much more topical DHT than oral, so that neither produces more sebum on the scalp. Why even prescribe oral finasteride giving serious side effects, if topical is much better?
In the United States, I am not aware of an FDA approved form of topical finasteride. If there was a topical form of this drug sold commercially, the FDA would have to review it for safety and effectiveness, which would likely take years before coming to market. Unless you’re buying a compounded topical lotion or shampoo from a licensed pharmacist, anyone today who is claiming to supply a topical finasteride is violating the FDA regulations and would be open to FDA sanctions or prosecution.
I don’t know what you’re using (brand or dosage), nor do I know of its safety or effectiveness. That said, the reason I prescribe oral finasteride as opposed to a topical is that the oral is a prescription drug that is available for sale in any pharmacy. I don’t know of any topical finasteride sold here. If you’re outside the US, the rules may be different… but I’m a US-based physician.
Topical finasteride is used in many compounded lotions available outside the US and advertised on the Internet (but not available for mailing to US citizens). The safety and efficacy of this approach is untested, and several animal studies published in reputable scientifc journals suggest topical finasteride has systemic absorption. On the other hand, the experience of use of oral minoxidil for alopecia was touted on this blog by a foreign contributing physician because it was presumably cheaper than topical use – without any criticism as if his anecdotal (positive) experience replaced controlled scientific studies. Same as topical finasteride. Both examples of something commonly used outside the US (although oral minoxidil probably legal as off -label in US) with a similarly untested and (in my view) unfavorable risk-benefit profile.