Switching from oral to topical treatments (Minoxidil, Finasteride, Dutasteride)

[Jim1973]

I'm a NW4a currently taking oral Finasteride (1mg daily since 2014), oral Dutasteride (.5mg once/week since Aug 2022) and oral Minoxidil (2.5mg daily since Oct 2022 – had been using topical Minoxidil since 2014 previously but scalp can be sensitive so wanted to cut back on itchiness). On these oral meds, I’m not seeing any benefits and am still losing ground (daily hair loss in sink, hair miniaturization). Because I haven’t seen any stabilization since 2020, I’m going to begin microneedling my scalp. I have read that Microneedling helps absorption of topical application of some of these meds (not sure if just one, two or all three) but I feel like going topical with everything would be my next best chance to at least stop hair loss even if no re-growth. Also, I'd like to minimize how much of each of those meds gets into my entire system outside of my scalp (On these oral meds, I didn’t notice sides initially but now have have typical sides like lower libido, soft morning wood but not completely gone, which is not great and can be tolerable to an extent but only seems worth it if I were getting obvious benefits in my hair, which I’m not).

Usually people are apprehensive about switching from topical to oral but I don’t see many posts with experiences about going from oral back to topical for any of the 3 meds I mentioned. In going topical Minoxidil is easy to find over the counter and as for the other 2, I probably don’t need to use both FIN and DUT so just need to pick one. I know Finasteride can still go systemic (if dose too high). Dutasteride isn’t supposed to go systemic because of molecular weight but that leaves me wondering how it reaches the hair follicles and if it will work as well. Curious as to how others chose topical FIN or DUT over the other and what their experiences were. Does anyone have good/bad experiences with using topical MIN/DUT or MIN/FIN together at the same time? Is there a MIN/DUT or MIN/FIN combo properly dosed and distributed (not sure what recommended doses are for each; as for distribution, Liposomal silicone based vehicles seem to be the best option) that exists already from in from one of the big boys available in the US (Hims, Keeps, Happy Head, Strut, Musely, etc.) or should I have compounded from independent pharmacy? Or should I not apply at same time? I’m wondering if I should simply start topical and stop oral on same day or if there should be overlap to not jar my system? Should I expect a large shed in making these changes? If anybody has experience or can show me other threads on this topic or if you recommend that I don’t make the change with some reasoning behind it, I’d appreciate it. Thank you.

 

[Im new here]

To be honest alot do this the other way round.

I would not recommend switching finasteride from oral to topical. There is no where near as much research behind topical finasteride as there is oral. Oral finasteride works in 90% of people and if you have been on it for 8 years it should have been doing something for that time. If you are only just noticing side effects now I would suggest it could just be age related? If you noticed these sides in 2014 then they shouldn't be a problem for you now. I would advise dropping the DUT as that has similar side effects and by not using that you might see it better.

The topical Minoxidil you should be fine to stop oral and start topical without a shed. I asked Dr Bisanga about this when using topical and going to oral and he said if minoxidil is in your system there shouldnt be a shed as its not adding something new.

It up to you and good luck

 

[Filename Arial]

If no sides I see no reason to switch to a topical version. Switching from one to the other can induce a hair shed.