Finasteride (oral / topical)
Skin/Hair · 5-alpha reductase inhibitor (type II)
Tier A-
What this is
Topical formulations aim to reduce systemic exposure and sexual side effects; emerging RCT data (Piraccini 2022) shows similar efficacy with lower systemic DHT reduction. PFS (post-finasteride syndrome) is a real patient complaint pattern, though incidence debated — reasonable to counsel. Women of childbearing age must avoid due to fetal risk.
Mechanism
Selective inhibitor of 5-alpha reductase type II; reduces DHT ~70% systemically (oral) or locally (topical); preserves/regrows hair in androgenetic alopecia; also FDA-approved for BPH
Dose & route
Oral: 1 mg/day (AGA) or 5 mg/day (BPH); topical 0.25-0.5% solution (compounded)
Citations
- https://pubmed.ncbi.nlm.nih.gov/36106481/
- https://pubmed.ncbi.nlm.nih.gov/9777765/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8953751/
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This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.