Q: What are your thoughts on topical finasteride? I am hesitant to use this because I cannot find any good studies on this let alone what the potential side effects may be with prolonged use.
A: Although there are no controlled studies to date, our sense is that topical finasteride in the right formulation may be a good therapeutic option. Long-term it should be at least as safe as the oral formulation.
However, presently, we don’t use topical finasteride for the following reasons:
- The dosing and efficacy have not been worked out.
- The topical formulations are not regulated and therefore not consistent in dose.
- In order to be effective, topical finasteride must be absorbed to some extent in the bloodstream and so a similar side effect profile may exist as with the oral version.
- It is not clear that using it topically can increase the efficacy/side effect ratio (i.e., depression of serum DHT levels may be important for its effect).
- It may inadvertently be used by pregnant women.