Dutasteride and finasteride have similar risk profiles despite Dutasteride blocking more types of 5AR in the brain. Some users report no mood issues with either drug, and it is suggested that Dutasteride's larger molecular size may limit its ability to cross the blood-brain barrier.
Topical finasteride that doesn't penetrate the skin could potentially treat hair loss without side effects. Current challenges include finding a formulation that remains on the scalp without increasing blood levels.
The conversation discusses the potential benefits of creating a hydrophobic version of finasteride to reduce systemic side effects while maintaining scalp health. It compares this idea to fluridil, which is designed to be hydrophobic and has less systemic absorption.
A permanent hair loss solution could involve reprogramming hair follicles to resist DHT using mRNA and siRNA. However, high costs, safety concerns, and the pharmaceutical industry's preference for ongoing treatments over one-time cures are major obstacles, with finasteride and minoxidil remaining standard treatments.
Hair loss is linked to cellular physiology and the IGF-1 to TGF-B1 ratio, not just androgen sensitivity. The theory lacks evidence, while finasteride and minoxidil are effective treatments.