Can topical treatments work better than oral for some people?

[Jim1973]

I've been on oral Finasteride and topical Minoxidil for roughly 7-8 years. It maintained for a while but stopped working. I switched to oral Minoxidil (5mg/day) and oral Dutasteride (.5mg/day) 9 months ago and my hair loss continues to get worse. Its absolutely doing nothing for me (positive or negative). My hair continues to become thinner and weaker. Most people state that oral should always work better than topical but I'm wondering if there have been situations (stomach issues) where topical may work better. I'm also considering Pyrilutamide or RU58841 as a topical but not sure how effect (or safe) that would be. If anybody has any thoughts on the matter, I'd love to hear. Thanks.

 

[Bicyclegirrl]

*Wow, I am sorry to hear that your hair loss issues are getting worse. Are you seeing a dermatologist for this at all? (I am not sure if you can get all of these medications over the counter). If not, that would be my first suggestion. Aside from that, perhaps you have developed some additional medical conditions that are thinning your hair/making it weaker?

I can tell you that I have multiple issues that cause my hair loss. Two of them are Seborrheic dermatitis (dandruff) and atopic dermatitis. The treatment I was told to do (I think it is for both conditions) alternate between three different shampoos: ketonazole 2% (strength only by prescription in US), a shampoo with salicylic acid, and a shampoo like head and shoulders or Selsom blue (there may have been other options too). I was told to wet my fingers, apply it to a dry scalp and leave on for 10 minutes, rinse in shower, and follow with a conditioner.

As far as the oral medications go, are you saying that you have had stomach issues and you think the medicine may have been expelled from your body before it had a chance to work? If so, I would say this is entirely possible. But as I previously stated, a doctor, preferably a dermatologist would be the best person to ask. I would even do so if you were interested in trying the shampoo strategy I am using. Just because something is over the counter, doesn't mean that it won't do you any harm.

*I saw that this post was from five months ago; I responded as if this post was new, in case I could still be of some help. How are you doing now? Take care!

 

[Jim1973]

Thanks for the reply. I've never had dandruff and have been seeing my derm and my scalp is free from any type of dermatitis and I've also had a scalp biopsy performed to ensure no underlying scalp conditions (even though I have this periodic itch that is worse in the morning before I wash my hair). I do use the shampoos you mention to eliminate the itch and they work. Regarding using oral meds, I'm wondering if I move back to brand name and away from generic, if that would make a difference or not. I feel the oral Minoxidil is working as I have thicker hair all over my body (where I have hair - arms, legs) but because the oral Dutasteride isn't holding the hair on my head, I'm not seeing any positives on my scalp. That's why I was considering using topical Fin or Dut along with Min.

 

[Bicyclegirrl]

Thanks for the reply. I've never had dandruff and have been seeing my derm and my scalp is free from any type of dermatitis and I've also had a scalp biopsy performed to ensure no underlying scalp conditions (even though I have this periodic itch that is worse in the morning before I wash my hair). I do use the shampoos you mention to eliminate the itch and they work. Regarding using oral meds, I'm wondering if I move back to brand name and away from generic, if that would make a difference or not. I feel the oral Minoxidil is working as I have thicker hair all over my body (where I have hair - arms, legs) but because the oral Dutasteride isn't holding the hair on my head, I'm not seeing any positives on my scalp. That's why I was considering using topical Fin or Dut along with Min.

What was happening with the oral fin and topical minoxidil? Were you getting thick hair that was staying in? Also, I think your body is supposed to change every 7 or 8 years; maybe that is why the medicines stopped working?

 

[Jim1973]

@Bicyclegirrl During the 7-8 year timeframe, my existing hair stayed in place. I hardly lost any hairs in the shower, pillow, etc. So although no regrowth, the products were def helping me maintain what I had, which was good enough for me, especially since a 3a-4a. I've heard mixed reviews on whether products stop working after so many years or after catching Covid. Either way, I def need to switch to either name brand oral drugs (no more generic) or switch to topical. Not sure.

 

[Bicyclegirrl]

Yeah, I can see things getting mixed reviews. I think this is because hair loss is complicated. ;( I hope you are seeing a dermatologist or some other type of doctor for this. At the very least, to make sure what you are taking is safe. If you have stomach issues, I would try the topical brand name minoxidil first. Then switch to the oral, brand name if that doesn't work for you. Good luck! Please let me know how things go.

 

[MPBsucks1234]

It would depend on which topicals you are using, take minoxidil for example, it is poorly absorbed topically and not everyone has enough of the enzyme to convert it to its active form so oral works alot better.

 

[Jim1973]

I know Min needs the enzyme to work but as far as I know both topical Fin or topical Dut can work almost as well as oral versions. I may stay on oral Min but switch to topical Dut or topical Fin.

 

[MPBsucks1234]

I know Min needs the enzyme to work but as far as I know both topical Fin or topical Dut can work almost as well as oral versions. I may stay on oral Min but switch to topical Dut or topical Fin.

I have been trying to find an answer to topical fin and working as well as orals but have not been able to find evidence to point in that direction. Although scalp DHT gets reduced by topical it does not impact serum DHT as much so is possibly not having a great effect at blocking it from the blood.