For those individuals who have been looking for a safer way to take finasteride, a topical form is now available. While this preparation may not be perfect it should enable patients to halt the progression of MPH effectively, with very little chance of any unwanted side effects. This will be the cornerstone of treatment for MPH.
Currently only available in Canada.
We’re currently in discussions with a compounding pharmacy in the US, so that we will be able to fill prescriptions throughout the US. We are hoping that prescriptions will be available to US residents, within the next couple of weeks or so (approximately end of March)
*****UPDATE *****(April 21, 2016) We are still working out the logistics so that we are able offer Topical Finasteride to US residents. We will make an announcement here once we have finalized the remaining details. Thank you for all the recent inquiries.
What Is Topical Finasteride?
Over the past few years the drug Finasteride has – in the public domain at least – acquired a reputation for having a high incidence of sexual side effects. This combined with the emergence of “Post Finasteride Syndrome” has resulted in a marked hesitation on the part of many patients to even try this treatment as part of a regimen for treatment of male pattern hair loss (MPH).
5 years ago approximately 50-60% of patients coming to our office were already taking finasteride. Over our last 500 virtual consultations only 18% of patients reported using Finasteride.
While their is little question of how effective Finasteride is in treating male pattern hair loss , it has become clear that fewer patients are willing to take the risk of declining sexual functioning.
An obvious question has been whether the drug can simply applied topically to the scalp to avoid side effect issues?
Finasteride is a lipophylic drug and can be readily absorbed through the scalp when compounded with regular solvents and/or penetration enhancers.
The problem here is not its effectiveness , but the fact that there is nothing to stop the drug from moving from the scalp into the circulation and going “systemic”. While the incidence of side effects is lower than with the oral route of administration , there is no question that they may still occur.
Novel, high tech methods of transcutaneous drug delivery have been examined to see if we can simply “lock” the drug into the scalp and avoid systemic absorption.
For the past few years I have been researching this option. I have joined with a pharmacological company (specializing in transcutaneous drug delivery systems) and the University of Milan, Italy in trying to produce such a topical preparation.
Our current preparation ,which we have been supplying to a group of test patients in Italy is soon to be available worldwide. The effectiveness appears to be equal to oral Finasteride but serum levels are 1/18th that of the oral route. We have had no reports of any sexual side effects in any of the test group (+/- 100 patients). Many of these patients have been on the oral form and had to quit on account of side effects.
This preparation is not FDA approved. It has not been through the FDA approval process which takes years and costs hundreds of millions. You have to have your own physician fill out a prescription for the preparation (see below) and the gel will be individually prepared for you.
While this preparation may not be perfect it should enable patients to halt the progression of MPH effectively, with very little chance of any unwanted side effects. This will be the cornerstone of treatment for MPH.
For those individuals who have been looking for a safer way to take finasteride, a topical form is now available.
This is the prescription that you should present to your physician to be filled out . A prescription should last for 3 months and includes refills to cover you for a year .
Read more about the solution by downloading this PDF prepared by the Universita degli Studi di Milano:
You can also download a PDF prescription form here:
Contraindications / Warnings
Since this topical drug contains the same active ingredient as the oral drug Finasteride the side effects and precautions are the same as the oral form. Learn about Finasteride side effects here
With one very important addition: Pregnant women should not come into contact either directly or indirectly with the topical gel. This may mean stopping the gel for the duration of the pregnancy , or at least exercising extreme caution from contact with the gel.
Other Studies with Topical Finasteride
There are few large scale studies regarding topical finasteride. Here are some that may be of interest:
For some individuals there may be a concern that this formulation has not undergone the rigorous testing of a clinical trial, and is not FDA approved. This point is well known and in the ideal scenario this would have been the case, however, this is not a new drug in any way, only the method of application and delivery system is different. It would be incredibly surprising if there were any new adverse effects – especially since there will be much less systemic exposure.
The only issue of concern is the possibility of inadvertent exposure of a pregnant woman to the topical drug. There will be a warning to this on the drug labeling so as to avoid this risk.
This preparation is not intended to replace oral finasteride as a primary treatment. It was formulated for those patients that were unable to tolerate oral finasteride and wanted to effectively prevent further hair loss. It has since also been used by patients not prepared to risk taking oral finasteride.
It is inevitable that there will be new and better drugs to fight male pattern hair loss. The question is how long before these are available? For those people who need something effective now, and cannot wait, I think this formulation is as good as it is going to get!