We have been using oral finasteride in our clinic for over 20 years . Over this period it has been clear that it is by far the most effective treatment for male pattern baldness (MPB) available . There is very little attenuation of its effectiveness as long as treatment is maintained.
Approximately 3-4 years ago it became clear that post Finasteride syndrome was a very real clinical entity . Patients were increasingly reluctant to take Finasteride, and those who were experiencing even mild side effects were very hesitant to continue with the drug for fear that the side effects may become permanent.
To me as a physician it was very difficult seeing patients having to make such a potentially life altering choice with virtually no other options.
There had been discussions between physicians whether topical Finasteride applied directly to the scalp would be effective. The thought was that there would still be exposure of the scalp to circulating DHT( which would not be affected by the topical ) , so it may not be effective .
Nevertheless, we decided to try compounding the Finasteride in a simple excipient (PEG) and see if those patients who were unable to tolerate oral Finasteride would still have side effects using the topical Finasteride.
Surprisingly most of the patients were able to tolerate the topical and very importantly the topical seemed to be as effective clinically as the oral . However there were still a few patients having side effects on the topical .
Clearly with this topical preparation the drug was going systemic (being absorbed into the body) . Our goal was clear, we had to create a topical preparation which would be absorbed into the scalp and stay in the scalp!
At the time we would never have guessed that our quest would lead us to the worlds top scientists, collaboration with major university laboratories and running our own clinical trials .
Since February we have been using our third generation topical Finasteride. At this stage we could not be more enthusiastic about what we have been able to accomplish. University laboratory studies have been confirmed by our clinical pharmaco- kinetic studies in our patients.
We currently have approximately 800 patients using our topical Finasteride . The effectiveness is at least equal to the oral finasteride , with thus far no patients experiencing adverse effects .
Our Topical Finasteride
Our current topical Finasteride (patent pending) is a liposomal formulation which has been modified by the attachment of silicone particles to the liposomes .
The silicone is unabsorbable and forms a fine mask -like structure on the scalp . The technology is not unlike medical patch technology. The finasteride forms a depot in the scalp with a slow even release into the scalp . There is little of the peak and trough pattern as seen with the oral form .
Serum Finasteride levels are reduced by approximately 94% compared with the oral form . Serum DHT levels are reduced in the order of 30% (compared with 70% with oral).
We will be posting some of our patients results with the topical Finasteride. Hopefully you will soon be as enthusiastic as we are with this new treatment option .