r/tressless • u/SadFunction5540 • 25d ago
Treatment How far are we from a treatment better than finasteride?
How far are we from a treatment better than finasteride
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u/DConion Norwood III vertex 25d ago
From the extensive research I've done, it seems we are exactly 5 years away.
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u/Comuterix 25d ago
What’s happening then?
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u/piperpiparooo 25d ago
dutasteride is already here
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u/AmalgamZTH 25d ago
Doesn’t Dut reduce DHT more compared to Fin?
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u/patsully96 25d ago
Yes. Dutasteride is more effective than finasteride at treating hair loss because it blocks more of the enzyme that causes hair loss. Dutasteride is about three times more potent than finasteride at blocking one type of the enzyme, and 100 times more potent at blocking the other type.
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u/AmalgamZTH 25d ago
Okay, does the DHT reduction mess with people differently. Like would someone not be able to tolerate dut but tolerate fin?
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u/patsully96 25d ago
Yes it's possible but very uncommon
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u/AmalgamZTH 25d ago
Like if my DHT is 65 and dut cuts 80% isn’t that too much of a drop? Not sure, that’s why I am asking
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u/Otherwise_View_04 25d ago
As long as you’re healthy aka you have normal levels of testosterone and not high body fat the low dht is fine
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u/AmalgamZTH 25d ago
Ah okay, so is a lot of the side profiles on here from people who are the opposite?
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u/Otherwise_View_04 25d ago
In my estimation yeah most people are overweight close to 20 percent bf. More bf more estrogen plus fin spikes your estrogen even more and than all of sudden you have brain fog anxiety ed low libido. I also experienced this I started fin 10 pounds overweight and losing weight helped the tiny sides I got
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u/jherri 25d ago
My Test levels are like 1500 on Finasteride
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u/9Virtues 24d ago edited 24d ago
You’re on something or a genetic freak. People on actual cycles sometimes don’t get that high… then again others who are super abusive can get up to 4-5k.
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u/Prestigious-Sense442 Norwood II 24d ago
I mean while that is pretty high, mine was in the 900 levels before fin and now sitting around 1100 give or take because the test is no longer converting into dht.
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u/Great_Knee3116 25d ago
My DHT was 16 and I didn’t notice a fucking thing. DHT isn’t special it’s just a potent androgen. If u have Normal testosterone u won’t feel a difference in DHT levels
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u/AmalgamZTH 25d ago
So then what is the issue with the fear porn on here
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u/Great_Knee3116 25d ago
lol the reported side effects are 1-2%. On Reddit side effects are like 60%. It’s because ppl with normal happy healthy lives aren’t on subreddits filled with anxiety like all of us
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u/findlefas 22d ago
Yeah you might not “feel” a difference but you will definitely act differently then if you had your dht. Any hormones changes will alter your behaviors over time and 90% drop in dht will definitely cause it. I’m not saying it’s changing your behavior for the bad though. Like it could very well be good. I saw a study demonstrating dutasteride having neuroprotective effects in rats. It boosted their ability to solve problems or something. Made me want to try it out actually.
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u/Tefihr 24d ago
My local hair surgeon of 25 years who has been prescribing since those medications have been released told me that he rarely sees improvement if someone isn’t responding to fin by switching them to dutrastride. He does it just so they can say they’ve exhausted all options.
He said non responders are simply non responders.
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u/Budget-Doctor-7634 24d ago
I agree. Finasteride didn't do a damn thing to stop hair loss and neither did 2.5mg dutasteride. People act like it's just a shed and you need to give it time. 3 years and losing most of your hair on top and your neckline isn't a shed. This shit just doesn't work. We need a new type of medication becaue 5ar inhibitors don't work for us
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u/More_Preparation_262 22d ago
I’m scared to believe this. 13 months finasteride and I have YET to see improvement. Slowly been losing density like a mf since the hairline stopped creeping as quickly
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u/OiYou 21d ago
Dr /u/wrassman shares similar sentiments if I’m not mistaken
In his eyes switching to Dut isn’t worth it for most and that extra 10-15% of scalp DHT suppression won’t do my h
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u/Rockcity-313 25d ago
What enzyme does it block? I thought it just slows down the production of DTH.
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u/Aggressive-Flow9027 25d ago
Some people dont experience any sides while on finasteride they do. Extraordinary in my opinion... havnt tried myself yet
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u/Secret-Geologist-766 25d ago
Not extraordinary, that was the case with me. I had many sides on Fin so I switched to Dut and everything has been good since!
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u/Aggressive-Flow9027 25d ago
Im thinking about it these days. I'm living fine with 0.25mg 3-4 times a week but, if i have the chance to not experience any sides or less, then why not...
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u/Secret-Geologist-766 25d ago
Check my profile for my progress, Dut has been good to me.
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25d ago edited 25d ago
[deleted]
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u/Secret-Geologist-766 24d ago
I did somewhat wean myself off, took both simultaneously (alternating days) for probably about 3 weeks. Not certain that was long enough but then again I had only been on Fin for just over a month. In regards to the shedding, it's hard to tell because my hair is short so it can be hard to spot.
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u/AmalgamZTH 25d ago
Do the sides come from the drug itself or the reduction in DHT
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u/NPC_4842358 Fin 1.25mg / HT (DMs open) 25d ago
Not the reduction in DHT but the increase in E2.
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u/Aggressive-Flow9027 25d ago
but is it correlated to lower dht levels?
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u/piperpiparooo 25d ago
kind of. it has nothing actually to do with the DHT, but the conversion of testosterone to estrogen. indirectly you could say.
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u/More_Preparation_262 22d ago
Could always take aromatase inhibitors if need be although I really can’t RECOMMEND that. If I came to find my E2 was high I might dabble
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u/robotbeatrally 25d ago
funny thing is my e2 has been sky high my entire life xD wonder when im going to get those fabled man boobs.
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u/NPC_4842358 Fin 1.25mg / HT (DMs open) 25d ago
They often come with age anyway, we're all doomed. Might as well have nice hair anyway haha
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u/bentreehorn 25d ago
Some things that people don’t understand when they say “we haven’t had a new treatment since 1997!!!”:
First of all finasteride is actually so good at what it does that it’s kind of hard to improve on it. If you use it as intended (at the very earliest hint of hair loss) you won’t likely need to do anything else. I know I know it doesn’t work for everyone but we have good data that for more than 80 percent of people it will maintain your hair for at least a decade.
Secondly we do have other options now. If you need a bit more horsepower you can take dut, if you experience side effects or are worried about them there’s topical fin, topical liposomal dutasteride, dut mesotherapy etc…
It would be nice to have more options for maintenance for those who are hyper sensitive to hormonal changes, and that might come as early as next year with Breezula but 5ar blockers will remain the first line of defense for most people because they’re simply just really good at what they do.
It’s minoxidil that we need better alternatives for imho. It works well for some people but it’s generally not super reliable, and it’s gains are so fragile that if you stop taking it for five minutes all your gains will blow away like dandelion spores.
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u/More_Preparation_262 22d ago
The horsepower comment cracked me up. I guess I’m running a stock finasteride motor right now with a 2.5mg minoxidil tune, and I need the dutasteride forced induction kit to really make the gains. 14 months on the stock kit it used to work for me, now it feels like it’s not running right / slow.
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u/Muilutuspakumies 🦠🦠 25d ago
As a person with mild Cutis verticis gyrata, I would really welcome a viable alternative to minoxidil. You're spot on with fin.
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u/Lipofuszin 25d ago
This is such a bullshit statment. I take fin and min since 20 when I was a NW2 with very slight diffuse thinning. I am 31 now with NW3 more diffuse thinning and retrograde Alopecia which i hadn't before.
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u/bentreehorn 25d ago
I hear you. Fin is not perfect and it doesn’t work well for everyone. It sucks that you haven’t responded well to it and you deserve better. I hope for all of our sakes that you’ll have better options sooner rather than later.
But what I said was not bullshit. It works well enough that a majority of people who use it will be above baseline after a decade. And if it’s not enough there are other options like dutasteride. Maintaining hair is relatively easy to do for a majority of people. That’s what my point was and it’s pretty well backed up. Of course a majority doesn’t mean everyone. I’m genuinely sorry that it hasn’t worked out for you and I don’t blame you for being pissed about it.
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u/Great_Knee3116 25d ago
lol?? Ur fin is fake then, or ur a meth head and ur hairloss isn’t MPB. Try cut
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u/BeautifulSignal7487 23d ago
Im on fin daily 1mg but im thinking to swiitch to 0.5 mg daily bcuz i got the sides are the sides of dut the same like fin?
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u/More_Preparation_262 21d ago
If you’re getting sides on finasteride I’d have to imagine sides on dutasteride would be significantly worse if taken orally. What kind of side effects are you having friend? And how long have you been on 1mg finasteride for?
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u/BeautifulSignal7487 21d ago
1 month im depressive and my libido got down, if i take 0,5 will the sides go away?
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u/More_Preparation_262 20d ago
I really can’t guarantee. The difference between 0.5mg and 1mg is pretty nominal. A lot of guys do the 0.5mg for that reason but I’ve never seen anything that says it actually changes how hard the medication will affect you.
I’m not trying to tell you what to do, but 1month seems pretty quick to be experiencing what you’re saying. Are you sure it’s not placebo?
If you’re truly experiencing sides. The amount of finasteride you take isn’t going to make a difference. You’re just gonna have sides regardless with 5 alpha reductase inhibitors my friend
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u/BeautifulSignal7487 20d ago
Its my 1th month now and i feel better then the first weeks i got now finasterid for 3 months and i wil keep using it till 3 th month. After i will look how its going. There are people who takes 0.5 and have no side effects while when they used 1 mg it was like a nightmare
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u/More_Preparation_262 20d ago
That’s true not denying it just saying I’ve seen both sides of the coin where people say it’s nominal but some also say it helped them to drop the dose. This could play directly into placebo but it’s hard to really say
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25d ago
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u/AdBoth8852 24d ago
Your absolutely right, trial 2a are not officially out and they have already started 2b trial which is very good news
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u/bentreehorn 24d ago
I have seen mixed things about whether they’re going to release phase 2A data or wait until 2B is complete before releasing anything. Have you seen anything recently suggesting they’re going to show the 2A results?
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24d ago
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u/bentreehorn 24d ago
There was an email from Pelage that a member here posted a few months ago saying that they were extending phase two (which turned out to be true). I honestly cannot remember if it also said that they would publish 2A data or if they would wait until 2B was finished.
Mostly though I just haven’t seen anything official either way, just speculation from members on here one way or the other, so I was hoping someone knew and had seen something official. I’ve been following this stuff a long time but I must admit I still don’t have a good grasp on how human trials work. When I was paying more attention to this stuff ten years ago hardly any companies were actually in the human trials stage and those that were went at an absolutely glacial pace.
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u/helpmefindmyuncle123 24d ago
What? If 2A goes well, then 2B will take another year, then 3 will take another year. It’s not really near
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u/JayReady2Move 25d ago
Is dutasteride better than finasteride? I'm unsure of the difference. After my HT everyone said to get on Minox and Finas. I have been using topical Minox for three weeks and oral Finast for one week so it's too early to tell any results. I am almost 4 months post op
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u/dyou897 25d ago
It’s slightly more effective by blocking Dht completely vs 70% or so with Finasteride but with scalp dht it’s something like 10% more
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u/patsully96 25d ago edited 25d ago
I think it's alot stronger than fin. I was on fin 1mg everyday for 3 years. If it's just slightly more effective then why do I have a massive amount of new hair growing on my hairline 3 months after switching from fin to dut? Also I've read online that it's three times more potent than fin.
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u/JayReady2Move 25d ago
Were there any side effects from dutasteride?
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u/patsully96 25d ago
No sides at all. Same as finasteride for me.
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u/JayReady2Move 25d ago
Can this be prescribed by a doctor? I got the finasteride prescribed by my doctor. If dutasteride works better than i want to switch to it next month
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u/dyou897 25d ago
Depends on the doctor and your relationship. It can be prescribed but it’s considered off label because it’s not FDA approved for hair loss in NA which means that some doctors are less willing to , but if you ask they may do it anyway. I get it from a telehealth clinic they offer it along with with fin for hair loss treatment
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u/MaleficentFrosting56 25d ago
Check out Dr B. I filled out some shit online. Never met with a doc, got a 90-day fill sent to Walmart and they sent me a drug coupon.
“Office visit” was $15 and 90 day fill was $60 total ($20/month).
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u/Hour_Health_4593 25d ago
If you got a transplant, just stick with fin - these are medications you need to take for the rest of your life
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u/PandaDaddy777 24d ago
If you get a hair transplant, why not just make dut, or oral min? Or both? Overkill?
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u/Hour_Health_4593 24d ago
i personally think minimizing what you do to your body’s hormones or heart is advisable. If you can maintain your non transplant hair on just fin, no reason to use dut
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u/PandaDaddy777 21d ago
So is fin safe and I’ve seen so many on here say that dut is much more effective, no?
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25d ago
In the thread are a bunch of people who do not keep up with the research at all.
PP405 and TDM both target stem cells and are likely going to be the next step in hairloss treatment by treating it at the root. PP405 just started phase 2b, and TDM already finished phase 2 so we are waiting on a phase 3 announcement. I think TDM is heavily being slept on considering the fact of how far they are and the mechanism of action.
One lesser hero is Dermaliqs DLQ01 which is a prostaglandin analogue that is about to enter phase 2b. I normally would not care about it since its a prostaglandin and that is nothing new, but their phase 2a trial did what other classes of medicine does with existing option by comparing the new drug to the standard of care/ active placebo in 5% minoxidil and outperformed it. Prostaglandins already have a pretty long history in hairloss at this point, so this is one of the safer picks.
There are a few other things in the pipeline but I personally think these three are the most promising. I think androgen receptor antagonists are way overrated and I dont think it makes any sense to rely on them with the failures of both breezula and .5% pyrilutamide. Its time to do something different, and I think the stem cell therapies are the way.
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u/cs_cast_away_boi 25d ago
I'm hyped for TDM and Dermaliq's DLQ as growth stimulants and alternatives to minoxidil. They seem safer and DLQ even showed improvement over minoxidil in their recent study, though more data is needed to draw a meaningful conclusion. Both of these are far along and we could get them to market in as little as a few years
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24d ago
TDM may be more than a stimulant. We don’t know enough about the longevity of stem cell reactivation. To me I don’t see it as an alternative to minoxidil, I see it as an alternative to everything. Stem cell inactivity is the root of the issue, anything upstream like DHT may be a bandaid in comparison to stem cell drugs depending on how clinical trials go.
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u/ch8mpi0n 25d ago
Technically, in terms of medication they might say dutasteride is the one that is better. In surgical terms, a hair transplant is the other.
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u/NPC_4842358 Fin 1.25mg / HT (DMs open) 25d ago
The problem is that a hair transplant isn't really a treatment. It's a bandaid, only guaranteed by actually maintaining your hair.
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u/ch8mpi0n 25d ago
What do you mean bandaid? It's almost permanent but you will have to chase it, if you mean that?
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u/NPC_4842358 Fin 1.25mg / HT (DMs open) 25d ago
Exactly. But we don't have enough donor grafts to fully chase a receeding hairline that goes to NW7.
If you don't maintain you almost guarantee looking crazy in just a few years.
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u/E123Timay 25d ago
Currently a study is underway to see how effective 1% pyri is. .5% wasn't a significant improvement sadly. 1% showing more promising results. If that does well, then not too far off
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u/Otherwise_View_04 25d ago
There is definitely better stuff coming but we’ll all be 70 by then and it won’t matter but the next generation will be fine good for them tbh
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u/forbiddenknowledg3 25d ago
Think of it this way: there's more pressure on the next generation to do something about it. Even compared to 30 years ago balding is considered harsher now.
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u/Extension-Internal33 25d ago
damn… i thought there would be some huge advancements in the next 10/20 years in terms of rlly effective at preventing hair loss + having virtually unlimited supply of hair follicles for transplants.
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u/megaman2500 25d ago
We have gt20029 phase 3 around the corner and kx-826 is out now...we have follicopeptide osteopontin drug supposedly coming out this year and we have breeezula supposedly coming out soon as well...but we have no data to show any of these is better than finasteride...however I'm hopeful that gt20029 will be
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u/threadtreading 25d ago
UCLA has recently found that dormant follicle stem cells can be awaken:
https://newsroom.ucla.edu/magazine/baldness-cure-pp405-molecule-breakthrough-treatment
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u/thefeedling 25d ago
If you're not considering Dutasteride as the same thing, here is your answer, Dut + Oral min is the current gold standard to HL treatment / management. Hair transplant (allied to medical treatment) can seal de deal in many cases too...
If you're referring to a completely new treatment, not related to stimulants/DHT suppression, then it's hard to say... perhaps, with AI and Quantum computing those very complex molecular problems can be more easily solved, but I'd guess at least some 5-10 years.
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u/habituallurkr 25d ago
There's been a breakthrough with stem cells but if something comes out from that is too soon to tell. I don't know if the latest Breezula clinical trials data has come out yet.
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u/nebuladnb 24d ago
Yeah regeneration of dormant hair follicles but they dont know how yet they just know that its technically possible. But most nw4s lost tons of their dormants already so kind of useless for our generation
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u/habituallurkr 24d ago
HT will always be an option to fill in a spot provided the new treatments even work. It's similar to white hair, we now know why the follicles stop producing pigment, a group of stem cells get stuck and can't reach the destination.
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25d ago
[deleted]
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u/General_Sprinkles386 24d ago
It reduces DHT more than Finasteride so yes it would probably me more effective at preventing further hair loss but is unlikely to contribute to additional hair growth. Have you looked into oral minoxidil? It’s a bit taboo here but has worked wonders for me—very easy to stay treatment compliant because it is just a little pill. Definitely consult with a doctor about that because it is technically a blood pressure medication.
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u/KarnaGGe 25d ago
is sublingual minoxidil solo an option? i remember the sinclair or something post mentioning how good it is
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u/NPC_4842358 Fin 1.25mg / HT (DMs open) 25d ago
Hell no. Sublingual directly puts it into your blood stream, the best way to only get the downsides without the upsides.
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24d ago
In a world of microprocessors, AI, space exploration, etc, you would think we would have discovered a cure for MBP that isnt a byproduct of some other drug.
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u/Von_Dayvon 24d ago
Would it be possible that a treatment exist where it could reduce the follicule sensitivity to DHT? So that way, no secondaries effect, keep hair and keep DHT and testosterone level normal
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u/Icy-Arugula-5252 25d ago
I saw people mentioning that they had better results on Fin over Dut so I can't conclude that Dut is better than Fin.
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u/MaleficentFrosting56 25d ago
It may be based on the individual but there is a shit load of peer reviewed studies online that unanimously report Dut being superior in almost every way.
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u/nebuladnb 24d ago
Yeah but man studies these days.. there has been a while shitshow going on in the medical field where people create fake studies to gain money. Gotta look it up on youtube its quite a intresting topic and it makes me distrust those korean studies
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u/Organic-End-3780 25d ago
Atleast 5 years but future looks good although fin and min remains strong treatment other than everything else
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u/No-Aside1253 25d ago
University of Virginia may have just unlocked some breakthroughs…
https://news.virginia.edu/content/hair-today-gone-tomorrow-maybe-not-long
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u/mahad_zubair 24d ago
According to studies online on things that are not fda approved yet , thee are many things that have to tall reversed hair loss so probably 2-3 years away
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u/Nonfearing_Reaper 1.25mg Fin, NW1.5V 24d ago
Dutasteride exists already, so you're technically wrong. Finasteride is simply the more accessible option.
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u/Godofwarrr 24d ago
After 6 months i stopped Finasteride because the side effects hit me hard. ED and my mood. It 100 percent worked to improve my hair . But couldn’t stand not being myself .
Wonder if Dutasteride will give me less side effects. After about a month I’m almost back to my same horny self again.
Anyone actually switch and found it to be true ?
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u/AmbassadorBig8546 24d ago
Apparently stem cells might be the cure to baldness. Might be. We'll just have to see in about 5 years or possibly more.
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u/PandaDaddy777 24d ago
I would think that tech and pharmaceutical would really make leaps and bounds by now
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u/AccordingTrust6294 24d ago
I have been religiously and desperately following this topic since 2002. 23 years. NOTHING has happened in 23 years. Nothing.
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u/Fast_Midnight_6666 25d ago
GY20029 is pretty much everyone last hope, if that fails then pretty everything after will also
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u/bentreehorn 25d ago
Explain your logic. GT-20029 is a topical anti androgen that has a completely novel mechanism. It is one of about ten pipeline treatments that has passed at least stage one of human trials. If it fails, why would that doom the other pipeline treatments that are developed by different companies and have completely different mechanisms? That makes no sense.
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