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Some individuals experience side effects from 5AR inhibitors like finasteride and are considering hair transplants without these medications, with some opting for surgeons like Dr. Zarev. Others are exploring alternative treatments and waiting for new medications in development, while some discuss managing side effects through lifestyle changes or additional medications.

The conversation discusses diffuse unpatterned alopecia (DUPA) and its possible causes, including sensitivity to DHT, not being androgenic alopecia, being diffuse alopecia areata, or hormonal issues. Treatments mentioned include topical melatonin, Clobetasol Propionate for alopecia areata, and the lack of results from using finasteride, dutasteride, and minoxidil.

Concerns about finasteride affecting sperm quality and embryo abnormalities during IVF. The user plans to stop finasteride for 6 months and use minoxidil, microneedling, a red light cap, and saw palmetto shampoo to manage hair loss.

Clascoterone in Winlevi, a topical AR antagonist, is being re-examined due to concerns about HPA axis suppression in adolescents, but it's unlikely to be banned for adult use in androgenetic alopecia (AGA). The European Medicines Agency recommended refusing Winlevi for acne vulgaris, but this may not affect Breezula's approval for AGA.

Long-term use of finasteride and dutasteride may be linked to health risks like fatty liver disease, insulin resistance, type 2 diabetes, dry eye disease, and potential kidney disease. Some users believe the risks are low and the medications are generally safe.

Follicum discovered that their drug FOL-005 increased hair count by 12 hairs per cm2 in patients with less than 255 hairs per cm2 and is planning a phase 2b trial. They are currently fundraising for the trial, and the drug may also be effective for women.

The conversation discusses whether baby hairs observed after using finasteride and minoxidil will grow into terminal hairs, with mixed experiences and opinions shared on the effectiveness of these treatments for hair regrowth. Some users report positive results, while others are skeptical about the potential for significant change.

The conversation discusses the safety study of PP405, emphasizing that early trials focus on safety rather than efficacy, and that any efficacy data from such a short study should be viewed skeptically. It also highlights that the information released is primarily for securing funding, and that meaningful efficacy results are expected in later phases.

A user with AGA uses topical spironolactone 2% due to side effects from the oral form and is concerned about its use during conception and breastfeeding. They seek alternatives to prevent AGA relapse while planning pregnancy and after childbirth.

A user claimed to cure their baby's baldness by using finasteride, minoxidil, ketoconazole, dermarolling, scalp massages, and headstands to increase blood flow. Commenters responded with humor, suggesting various exercises and questioning the legitimacy of the transformation.

A husband experiencing hair loss is considering treatments like topical minoxidil and finasteride but is concerned about their effects on his pregnant wife and future child. Alternatives suggested include oral finasteride, which is considered safe if hands are washed after use, and exploring natural methods like oils.

Starting hair loss treatment early is crucial for better results. Dutasteride and finasteride are effective, with dutasteride often considered superior, while oral minoxidil shows better gains than topical.

Micronutrient testing and deficiencies related to hair loss, particularly androgenetic alopecia (AGA). Discussion includes the impact of iron, selenium, zinc, copper, folate, B12, vitamin E, vitamin D, amino acids, and fatty acids, alongside treatments like dutasteride or finasteride.

PP405's phase 2a trial results were presented, focusing on safety and pharmacokinetics, with a future meeting planned to share the full dataset. The trial includes a randomized controlled portion and an open-label extension, with no indication of phase 2B completion.

The user experienced severe hair shedding despite using oral finasteride, minoxidil, dutasteride, and RU58841, and was diagnosed with Non-Alcoholic Fatty Liver Disease (NAFLD). They are considering switching to topical treatments due to the ineffectiveness of their current regimen.

Avixis Alfatradiol is a topical 5-alpha reductase inhibitor available in Latin America and Germany, but its effectiveness is questioned. A user reported worsened hair loss after using it and recommended finasteride instead due to its proven effectiveness and lower cost.

A user humorously discusses their 10-month-old's hair loss, suggesting treatments like microneedling, minoxidil, finasteride, and RU58841. Replies include various satirical and exaggerated suggestions, emphasizing the post's satirical nature.

A 27-year-old male with diffuse hair loss, including the donor area, did not respond to finasteride, dutasteride, or minoxidil. He suspects his hair loss may be linked to a mild connective tissue disorder, possibly affecting the structural support of hair follicles, rather than being purely hormonal.

User discusses Alfatradiol (17a-Estradiol) as a potential hair loss treatment with mixed results. Concerns include low dosage, receptor theory, and possible increased aromatase activity on scalp.

The user is seeking help with using Ell-Cranell for hair loss treatment. They are unsure about the correct application method and dosage. They also inquire about combining microneedling with topical alfatradiol and question a study that referred to alfatradiol as a hair growth inhibitor in male mice.

Finasteride users discuss potential side effects, including Post Finasteride Syndrome (PFS), with varying opinions on its legitimacy and impact. Some users report side effects like changes in semen consistency and reduced pre-ejaculate, while others emphasize the rarity and reversibility of side effects.

Concerns about a potential ban on finasteride and dutasteride due to side effects, with users advocating for continued access and informed choice. Alternative treatments like pyrilutamide are also mentioned.

New hair loss treatments PP405 and VDPHL01 are discussed with skepticism and hope, alongside existing treatments like minoxidil and finasteride. Users express frustration over limited progress since the 1980s but remain cautiously optimistic.

Fucoidan may help regrow hair and reduce inflammation in androgenetic alopecia. It is unclear if simply mixing fucoidan powder into a serum for application is effective.

FCE 28260 (PNU 156765), an under-explored 5α-reductase inhibitor, showcases promising results in research by Giudici et al., outperforming well-known treatments like Finasteride in reducing the conversion of testosterone to DHT. Its superior efficacy, demonstrated through lower IC50 values in both natural and human recombinant enzyme studies, suggests it could offer more effective management of DHT-related conditions. Additionally, its lower molecular weight hints at better potential for topical application, potentially offering advantages in treating conditions such as androgenic alopecia. Despite its potential, it has not advanced in development, possibly due to financial limitations, leaving its therapeutic prospects and side effect profile largely unexplored.

A 36-year-old male had a 3000-graft FUE hair transplant in Turkey, with 2000 grafts to the front and 1000 to the crown. Post-operation, he experienced nausea, dizziness, itching, and pain, but saw hair growth and plans to take pictures once redness subsides.

The conversation discusses a new model for understanding androgenetic alopecia (AGA), linking it to dietary and lifestyle factors similar to PCOS, and highlighting the role of DHT, vascular damage, and inflammation. Treatments mentioned include Minoxidil, finasteride, and RU58841.

The FDA warned that topical finasteride can cause serious side effects like sexual dysfunction and brain fog, similar to oral finasteride. Compounded topical formulations pose additional risks due to lack of regulation.

Finasteride is effective for DHT/AR-driven hair loss but not for chromosome 20-driven cases, where treatments like minoxidil, prostaglandin analogs, and low-level laser therapy may be more beneficial. Genetic testing can help determine the underlying cause of hair loss to tailor treatment effectively.

High frequency ultrasonography and HR-MRI can help identify hair shedding causes like inflammation and fibrosis. The conversation discusses the potential of using these technologies to evaluate treatments like Verteporfin for hair regeneration.