It is well established that oral finasteride (as Propecia with 1mg dose) can help prevent male pattern hair loss by blocking intracellular conversion of testosterone to DHT by 5alpha reductase. It is also well established that finasteride does not block the intracellular testosterone receptors. Dutasteride should theoretically work better since it is more efficient in blocking the Type 1 5ARase which are prevalent in scalp hair follicles whereas finasteride blocks this only weakly (compared to Type 2 in the prostate), and experimental evidence does help support this. However dutasteride has a plasma half life of approx 8 days whereas finasteride's half life is a few hours, which may be of concern when preventing libido side effects in young males.
A significant proportion of people report sexual dysfunction on finasteride1mg/day. Sometimes this appears long-lasting and may even be permanent, and has been reported as Post-Finasteride Syndrome. Thus, potentially at least, a topical preparation of finasteride or dutasteride is an attractive idea to prevent the systemic side effects. This has been explored with finasteride-0.1%/minoxidil-5% with reasonable results. However there is less published about the use of topical dutasteride, and it is of concern that with such a long half-life one has to be very careful with the dosing to prevent systemic build-up and concomitant sexual dysfunction, especially since plasma DHT levels do drop with topical application of both finasteride and dutasteride
Either way it seems a reasonable working hypothesis that there is a significantly higher local drug concentration with topical application to the scalp so that one can reduce the systemic drug concentrations and the systemic reduction in DHT
This leads to several questions that I hope the readers may be able to help with in examining the local mode of action and the optimal dose
Some useful references relating to finasteride/dutasteride are included below
http://www.hindawi.com/journals/isrn/2011/241953/
http://www.hairlosscure2020.com/category/dutasteride/page/3/
Article Mesotherapy using Dutasteride-Containing Solution in Male Pa...
Sir, with all due respect, in my opinion finasteride does not have any effect on sexual function
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2840927/
An interesting point of view! Significantly it is largely equating sexual function with the ability to have an erection, as measured by nocturnal erectile tumescence. Testosterone levels may well rise slightly when conversion to DHT is blocked and the paper mentioned does accept that it is generally accepted that there is a loss in sexual function, which is greater in Dutasteride, where a greater reduction in DHT is seen
I agree that Post-Finasteride Syndrome is both uncommon and not accepted by all, but the reality is that Finasteride and Dutasteride are powerful drugs. Both drugs act intracellularly to block 5ARase and the principle of my question is to explore ways of reducing the systemic exposure to either drug and find out a way to effectively administer them topically in a way that is effective for hair loss.
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