The genetic condition Male Pattern Baldness
is the most common cause of hair loss worldwide.
There are currently two clinically-proven treatments for this that are officially recognised by both the UK and USA's medical regulatory boards, being licensed by the MHRA and FDA-approved, respectively. However, partly due to the size of the market given how many men are affected, drug companies and researchers are constantly trying to develop new ways to treat this type of hair loss
Recently a number of studies have been conducted into potential finasteride alternatives, with the latest coming from King Abdulaziz University in Jeddah, Saudi Arabia and Minia University in Egypt, which explored the possibility of a topical gel formulation of the popular antiandrogen.
What is finasteride and how does it work?
The current one-a-day oral form of finasteride 1mg
was first released in 1997 after being developed from an existing higher strength form of the drug used to treat enlarged prostates. Following prostate patients' surprising hair growth - and regrowth - this type II 5α-reductase inhibitor drug was found to be able to hinder production of dihydrotestosterone (DHT
). DHT binds to the hair follicles along the top of the scalp, from crown to hairline and temples, in men with a genetic predisposition to Male Pattern Hair Loss, causing progressively thinning hair
and can lead to baldness. Therefore, by blocking DHT formation, the hair had a better chance of growing normally.
When it was first released as a male hair loss treatment
, finasteride in 1mg oral doses was known by its initial brand name Propecia
which was produced exclusively by pharma company Merck. Despite this exclusivity expiring in 2013, and many other brands of finasteride now being available, some people still refer to finasteride as Propecia, regardless of the actual brand name - akin to referring to vacuum cleaners as 'Hoovers' or non-brand cola as 'Coke'.
Although there are small risks of side effects associated with finasteride use, affecting around 2 per cent of users, it is widely considered safe, effective and tolerable
. Because this possibility does exist however, and some of the potential side effects - which will usually wear off once treatment is stopped - include mood disturbance, decreased libido and erectile dysfunction, some men wish to follow minoxidil-only treatment
courses. For more information on possible adverse effects of Propecia, the Patient Information Leaflet (PIL) which is provided inside boxes of Propecia can be found here
In order to bring a third option to the table, researchers hope to develop a topical finasteride solution as the side effect profile of drugs applied directly to the skin tend to have less risks than those taken orally.
Recent clinical trials into topical finasteride include studies in Italy - a drug known as clascaterone
- and those from Swiss pharmaceutical company Polichem
, which anticipates having a finasteride lotion ready to release in 2020.
Finasteride gel trial
Publishing its work in the Drug Design, Development and Therapy Journal
under the title 'Finasteride nano-transferosomal gel formula for management of androgenetic alopecia: ex vivo investigational approach', the Middle Eastern team aimed to improve the delivery of finasteride whilst minimising potential side effects.
Three different nano-transferosomal (NTF) gel formulations of finasteride (FIN) were prepared with each - F1, F2 and F3. These were compared to a raw finasteride gel's results, used as a control.
Results were reported as follows, 'FIN encapsulation efficiency percentage was 69.72 ± 8.36, 89.43 ± 6.82, and 93.1 ± 1.93 for F1, F2, and F3, respectively. FIN-NTF average vesicle sizes were 299.6 ± 45.6, 171 ± 25.6, and 197.4 ± 29.1 nm for F1, F2, and F3, respectively. FIN-NTF formulations (F13) showed enhancement and improvement in the amount of FIN permeated compared with raw FIN gel formula. The NTF formula revealed uniform fluorescence (rhodamine) intensity across rat skin, which indicated improved delivery through skin layers compared with control gel formula.'
Study authors reached the conclusion was drawn that using an NTF-FIN gel formula could boost the drug's delivery in terms of skin absorption, potentially providing a viable alternative to the oral option. Although this appears to be the case, far more testing and investigations into the long-term effects and tolerability via large-scale clinical trials needs to be done before such a drug could be considered by the relevant medical regulatory boards.
What will be particularly interesting to see is whether or not topical finasteride hair loss solutions are able to treat a receding hairline
; this is not a claim the oral tablet form is able to make at present, having not been tested for this specific pattern of shedding.