Which Drugs Are the Most Effective for Preventing Hair-Loss?

This article was written by user ‘Modified’ of Lookism.net

Norwood scale

The Norwood Scale is a set of images that depict the different stages of male pattern hair loss.

norwoodscale_hr23

Numerous safe, effective treatments now exist for balding. In most cases, balding can now be completely stopped. In some cases it can be reversed and entirely cured. If you start good treatments for hair loss at an NW1-2, there is no reason in your lifetime to ever end up a NW7. Some of us can likely maintain NW0 for life.

Basics of Hair Loss

In order to stop and reverse hair loss, it is important to first have to understand how it happens. Hair on the top of the head in most men is sensitive to androgens. The primary androgens are dihydrotestosterone (DHT) and testosterone. DHT is made from testosterone by an ezyme called 5-alpha reductase. DHT is generally most important in puberty. After that its primary known effects are hair loss and enlarging prostates (why old guys have trouble peeing).

Both DHT and testosterone can bind to hair follicles, but DHT binds much more powerfully. Synthetic androgens like tren and winstrol, etc. can bind as powerfully as DHT or more.

When androgens bind to hair follicles, they trigger the follicles to begin miniaturizing. The average hair cycle is around 5 years. Once they start suffering androgen damage, follicles will start growing for shorter and shorter cycles, and with thinner and thinner diameter, until eventually they stop growing altogether.

How this happens on a biochemical level is still being learned. Newest research shows it is mediated by changes in prostaglandins (messenger molecules) in the scalp. Good prostaglandins which promote hair growth get downregulated. Bad prostaglandins which promote inflammation and hair damage get upregulated. The scalp becomes toxic to the hair follicles, and the follicles die. This is where the ‘prostaglandin protocol’ comes from.

So in summary:

  • Androgens trigger the cascade.
  • Good prostaglandins get dowregulated.
  • Bad prostaglandins get upregulated.
  • Inflammation occurs.
  • Inflammation and hostile environment causes hair to miniaturize and fall out.
  • Hair stem cells go quiet or die off

Knowing that this is how the process works allows us to understand that there are at least a few levels at which hair loss can be fixed.

Anti Androgens

The absolute most important part of any hair loss treatment is anti-androgenic therapy. Androgens are the root cause of hair loss in genetically susceptible men. If you are not doing something effective to block androgens, you are fighting a losing battle.

Finasteride & Dutasteride

finasteride-1mg-tablets
Both fin and dut are 5-alpha reductase inhibitors. Ie. They inhibit the enzyme which turns testosterone into DHT. By blocking the production of DHT, they reduce the damage to the hair considerably, and in most people that’s actually enough to stabilize the hair for a decade or more. Even with no DHT in your system, plain testosterone can still bind the follicles, which is why hair loss may still very gradually progress with these agents.

Finasteride 1 mg daily usually decreases DHT by 70%. Dutasteride 0.5 mg daily reduces DHT by over 95%. The cheapest way to get finasteride is to buy 5 mg tablets and cut them into quarters (1.25 mg daily).

Studies show significant regrowth on both by 6 months, and max regrowth by 1 year. Dutasteride generally results in 50% greater hair regrowth by one year vs fin. So if you want the best result, try dut, but with slightly higher side effects possibly due to the greater DHT reduction.

Side effects on both according to SCIENTIFIC PLACEBO-CONTROLLED LITERATURE are minimal, mild, and reversible. In studies, both people taking the meds and people taking placebo had sexual side effects. Placebo is strong. Don’t underestimate it. I don’t have the exact numbers as I am not interested in going back to the studies to find them. But it was roughly only about 2-3% more guys on the meds than on placebos had sexual side effects. So the sexual side effect rate is ~2-3% for both meds ie. pretty minimal. As I said, in all scientific studies, this has been 100% reversible. One study I read suggested a 1/200 (0.5%) risk of gynecomastia with these meds, but another did not confirm it.

Notice I have specified SCIENTIFIC PLACEBO-CONTROLLED LITERATURE. I have no interest in debating or basing my decisions in life on what people anecdotally say on Internet forums. There are a lot of crazy people in this world. That is why science exists. There is no science to support claims like “I took one pill of finasteride and it ruined my life!” These meds have been tested and studied extensively. Both fin and dut have been prescribed to millions of men for many years for enlarged prostates and still found safe. You can make up your own decision. Like I said, I don’t care to debate it.

In my opinion, anyone losing their hair should start by trying fin or dut. They are simple and easy. Finasteride 1-1.25 mg will work for 90% of men. Dutasteride 0.5 mg works for >95% of men.

In my case, these meds didn’t work for me for an unknown reason. I tried brand versions of both. I even went up to 2.5 mg daily dutasteride (5x the usual dose) and my DHT levels didn’t drop at all. There are a few other people online reporting this. But it seems to be freakishly rare. Some form of genetic resistance to how they work I think. If you want to be sure the med is doing what it is supposed to, check your DHT level before and after starting. You should see a major drop while on the medication.

Then give it a year, and see what your hair looks like. If you’re anything like 90-95% of men, it will be the same or better.

RU58841

ru-solution1
RU58841 is my favorite hair loss compound in existence. It has been a life saver to me. It worked for me when fin & dut didn’t. I have been on it 5 months and it has been incredible for me. I am growing back steadily from a NW2. The entire area of balding at each corner/temple is covered with fuzz, and little by little the hairs there are becoming terminal. My density on top went from ~80% full  to back to 95%+ full density (perfect or near perfect to my eyes).

RU58841 has numerous drawbacks however. It is more complicated to use and use safely. If you want to get the best result, you will have to mix it yourself. It takes a bit of work to get all the stuff you need to do this. And there is no long term safety data. This is why I still suggest everyone should start with fin/dut first. However, if you’re not afraid of a little learning/work at the start, using RU becomes a pretty simple routine. It takes me 5 minutes a day to mix and apply. And it is absolutely effective.

How RU58841 works:
RU58841 is an experimental anti-androgen developed in the 1990s for anti-acne and anti-hair loss topical applications.

It is one of the most powerful anti-androgen molecules out there. It binds directly to the androgen receptors in the skin and hair and BLOCKS them so that no other androgen can bind. In this way, it can block both testosterone and DHT from damaging hair. It can also theoretically block synthetic androgens like Tren/Winstrol/etc. though how well it blocks these synthetic androgens has never been studied.

RU58841 is related in structure/function to powerful anti-androgens like flutamide, which are usually used as tablets to fight androgen-sensitive diseases like prostate cancer. A drug like flutamide will functionally neuter you when you take it orally. RU58841 is about as strong, but with unique differences that makes it useful for skin/hair use.

First of all, when used on the skin, very little RU gets absorbed in the body. Second, and most importantly, of what does get absorbed, 99% gets broken down instantly into inert molecules with no effect on the body. Only 1% of the breakdown product acts as a systemic anti-androgen. Based on the amount a typical user will apply for the scalp, how little absorbs, and how little of what absorbs has any biological effect, it would be almost impossible to experience any side effects on RU58841. If you do claim to get sides, I’d bet they’re placebo effect.  I have never noticed any side effects from RU, no matter how much I use.

Why can’t I buy RU58841 in stores?
The rights to RU58841 have traded hands between a bunch of pharmaceutical companies over the years. None of them have brought it to market. Over all this time, it has also never had big published human studies. All of this is because RU58841 is not commercially viable.

The first reason it is not commercially viable is it is not stable in solution long term. Once it’s mixed into a liquid form, it begins to break down. No one knows how quickly as it was never published. But most say it should be mixed at most 1-3 weeks in advance of use. This means it would go bad too quickly sitting on a shelf in a pharmacy waiting to be sold. Kane says you can go up to a few months but I wouldn’t do this.

The second and bigger reason RU58841 will never be commercially viable is it could be theoretically dangerous to pregnant women or children. As a topical anti-androgen, it could be transferred to children or a pregnant woman, ie. if they were running their hands through your hair (or if you did and didn’t wash your hands after). Most likely it wouldn’t damage a child or baby’s development from such small transfers, since anything that gets absorbed into their bodies will also be 99% broken down and inert. But if a wife had a retarded baby, there would be no way to prove it wasn’t from the husband’s RU, and the company selling it would be sued to oblivion.

So there will never be a commercial form of RU58841. No legit company will take that risk.

To avoid the risk of transfer to others, I never touch my hair once it’s in. If I do, I wash my hands with soap and water. No one touches my hair. I’d suggest the same precautions if you’re using it. Be extra careful if you’re around pregnant women.

As far as your own safety is concerned, like I said, there are no long term studies on RU58841. No safety issues were found in the animal studies or limited human studies that were done that I am aware of. But without proper research, it’s technically a gamble. I’m comfortable with that knowing what I know about how it works and what it is. But that’s your decision again for you.

Personally, I know I’d fucking kill myself if I went bald, so that’s not even an option. Given that fin and dut failed me, and RU is working beautifully, I intend to be on RU for life.

How to use RU58841:
Given the stability concerns about RU58841 when premixed, as well as cost and lack of customizability of solutions when buying premixed, I prefer to make my own solution. However, if you’d like to try it more simply to start, premixed solutions are available from Kane. You’ll see as I explain how I mix RU, how I also incorporate minoxidil and azelaic acid. I’ll briefly cover the mechanisms of action and rationale for minoxidil and azelaic acid later.

Things I use for mixing my RU solutions:

  • Dipropylene glycol – easy to buy online. You can also use propylene glycol, but dipropylene glycol is gentler on the skin. So that’s what I’ve always used. lotioncrafter.com sells it cheap as do lots of other sites.
  • 95% ethanol (eg. Everclear). This will be used with dipropylene glycol to make the solvent. Can be bough from places that sell 95% Everclear. Otherwise can be bought from chemical supply stores. You can say it is for making fragrances.
  • A jewelery scale. Available on ebay for $10.
  • RU58841 powder. I buy from Kane. Not cheap but worth every penny. Good customer service so far.
  • Minoxodil powder. Can be bought on ebay at $60 for 50 grams which will last forever. Search ‘minoxidil powder’..
  • Azelaic acid. Optional. Can also be bought on ebay. Search ‘azelaic acid powder’.
  • 100 mL tinted glass bottles. Also available on ebay for a few dollars from China. Search ‘100 mL tinted glass bottle’.
  • 1-2 mL eye dropper. I use the eye dropper I got from a bottle of Spectral DNC because it has mL graduations on it. But you can buy plastic/glass ones on ebay again for a few dollars. Search ‘eye dropper’.
  • Mini Measure shot glass. Search ebay for ‘mini measure shot glass’.
  • Smidgen measuring spoon. Search ebay for ‘smidgen measuring spoon’.
  • Mini funnel. Search ebay for ‘mini funnel’.

Mixing it up:
The first step is to mix up some solvent. I just do this approximately. It doesn’t have to be perfect. Pour 20 mL of dipropylene glycol into the mini measure shot glass. Pour this into your 100 mL tinted glass bottle (using the funnel). Then measure 30 mL of ethanol in the shot glass, and also pour this also into your 100 mL tinted bottle. You now have 50 mL of 60/40 ethanol/dipropylene-glycol solution. If you want more, repeat this process once more into the same bottle and you have 100 mL which will last almost 2 months.Use your pipette and draw up ~2 mL of the 60/40 solvent. Put it in the shot glass. You will be mixing your day’s application in this shot glass in this way each day.

A dose of 100 mg RU58841 daily works well for me and seems to be generally accepted. You can go as low as 50 mg if you’re lucky. I have been going up to around 125-150 mg daily since I got back on roids just to be safe. One flat smidgen spoon of RU58841 works out to almost exactly 50 mg. When I started I would measure by mg on the jewelery scale. Now I just take 2-3 flat smidgens of RU58841 and know that’s close enough.

Same goes for measuring the minoxidil. 50-100 mg minoxidil will do the trick. One-two flat smidgens are good enough. Ditto again for azelaic acid if you are using it too.

Dump all those flat smidgen scoops (or measured amounts) of your powders into the shot glass containing 2 mL solvent. Swirl it to mix. Letting it sit 5-10 minutes often helps. You may find with the amounts I listed it doesn’t all dissolve and you still have some white powder floating in the shot glass. I do this on purpose. That way it guarantees the solvent is fully saturated, also you can still apply that undissolved powder to your scalp when you apply it, so you’re only getting more of everything which is good.

Next once it is fully mixed, use the dropper to draw up ~0.25 mL of solution at a time and apply to scalp, one area at a time. Rub it in each time to spread it around. You’ll want to make sure you especially get the frontal hairline, temples, corners, and crown. I find 2 mL is just enough to get a good coverage. If you want to be sure you are covering well enough, 2.5 mL is good too. I am using that more lately on roids.

Wash your hands and you are done.

So on a day to day basis, once you have your stuff set up, it’s as simple as:

  • Put 2 – 2.5 mL solvent into shot glass
  • Add 2 flat smidgens RU, 2 flat smidgens minox, 1-2 flat smidgens azelaic acid.
  • Swirl and leave sitting a few minutes.
  • Apply to scalp.As I said, it takes me ~5 minutes per day, and has not only stopped but is reversing my hair loss when dut and fin failed.

Prostaglandin Analogs

As stated at the beginning of the post, androgens start the cascade, but prostaglandins work as intermediaries to actually cause hair growth or loss. Therefore compounds that work through prostaglandin pathways can complement antiandrogens to get better results. This is the basis for Swiss Temples’ now well known “prostaglandin protocol”.

Minoxidil

best-hair-loss-fixes-minoxidil

Buy Minoxidil
Minoxidil is the most important of the prostaglandin acting compounds. It works by increasing healthy prostaglandins in the scalp. For standard isolated minoxidil use (ie. Over the counter), you want Rogaine foam 5% or a generic form. Applying once or twice a day will do the trick.

Some people say minoxidil causes bloating, wrinkles, and bags under the eyes. I haven’t noticed anything of that sort. Before you let fear-mongering scare you off minoxidil, keep in mind minoxidil is the only PROVEN growth stimulant in big trials and in combination with fin/dut, it has been proven to do even better than any of these treatments alone.

I look at it like this:

  • Antiandrogens like fin/dut/RU turn off the red light.
  • Minox turns on the green light.

Winning combination.

Castor oil

original

Buy Castor Oil
Castor oil’s primary component is ricinoleic acid which activates one prostaglandin receptor favorable for promoting hair growth. So there actually is a basis to suggest castor oil will work. The problem with castor oil is it is slick/sticky as fuck and will make you look like a wet rat. It takes up to 2-3 showers to get out of your hair, so I wouldn’t recommend it at all.

Swiss Temples even takes this shit orally (1/4 teaspoon per day I think) which I tried for a while, but holy shit it gives you diarrhea and cramps. And I didn’t notice any hair differences. So I stopped both topically and orally. Give it a try  if you like though. In my opinion there are much better options.

Nizoral

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Buy Nizoral
Nizoral shampoo is now thought to also work as a mild prostaglandin stimulator. I used it for years and maybe it helped slowing things down. However, I stopped bothering with this shit completely once I started mixing my own stuff. I figure it can’t probably be that effective as you only apply it for 5 minutes at a time. I wouldn’t bother with it again. Better options exist.

Other Approaches

Azelaic acid

No one knows exactly how azelaic acid works to promote hair growth. It’s not really proven to be too effective either. But it’s used as an anti-acne agent and has been known to increase collagen production, so it can’t hurt you. Some people say it works as a mild 5-alpha reductase inhibitor. I’m not sure, but I use it anyway in my solution as above. Partly I use it for the pro-collagen effect because I figure if minoxidil truly is bad for my collagen, this should counteract its negative effects and even that out.

Dermaneedling

Needling the scalp works to stimulate stem cells and increase hair regeneration. Swiss Temples does this once a week in his protocol with lithium chloride applied after as an adjunct. I have bought the same needler he uses but never used it as I am happy with my results so far without needling, and it seems like a pain in the ass. I will probably try this at some point.

Neogenic

There are other products like Neogenic which are thought to stimulate stem cells. But that shit is expensive and in my opinion unproven. It also can’t be bought in powder form, so I don’t bother with it, as I am again happy with my own protocol.

PUTTING IT ALL TOGETHER

This is a lot of information. Perhaps it may be overwhelming for some. So to conclude, I will summarize the best ways I think guys should address their hair loss depending on their general circumstances/goals.

Average guy

For the average guy just starting to lose his hair I would suggest either fin or dut combined with over the counter 5% minoxidil once or twice daily. This will solve 90-95%+ of guy’s hair loss problems. It is easy, safe, and simple.

Alternative approach would be to use just the topical homebrew RU58841/minox/azelaic acid solution described above. This is the only thing I am using and as stated it is working beautifully for me. I can’t predict how well it will work for others though as there isn’t enough data.

Lastly, if you want to be hardcore, you could use fin or dut PLUS RU58841/minox/azelaic (home brew as above). If you do this approach as an average guy, I think it would be physically impossible to go bald.

On steroids

For guys going on steroids, I would absolutely recommend using fin/dutasteride  WITH an RU58841 solution. RU58841 is critical for guys on steroids because as stated earlier: it is the only agent which can block synthetic androgens and also high levels of plain testosterone from binding to your hair follicles and killing them. Fin/dut won’t work against these causes of baldness.

I have done well so far on just on my homebrew RU58841/minox/azelaic solution with up to 380 mg test-e per week. When I went up to 500 mg test-e per week, I felt like I started getting more shedding. So while a topical only approach is probably sufficient for guys on low dose steroids, if you’re on the hard stuff, it may still not be completely enough.

Buying Finasteride

I use allthegear@tutanota.com – they stock pharmaceutical grade Finasteride. Shipping to the UK usually takes 1-2 days and they do ship internationally too. Just send them an email explaining that you got their email address from this website and ask for a price list and they will send over a full list of products and prices.

Conclusion

Well that’s it. That’s everything I have to say about treating hair loss. I hope it’s helpful. I’m impressed if you read this far.

The most important closing thought I’d share is DON’T WAIT TO TREAT. It is way easier to prevent hair loss than it is to grow back lost hair. If you notice your hair falling out, pick a treatment and get on it ASAP.

Good luck and happy non-Norwooding.

6 Responses

  1. Jim

    The RU58841 strategy seems to difficult to do here in Canada. Sucks that the best option is the most work/confusing/hard to acquire. I started balding when I was 20. Now 25 and its pretty bad.

    Like

  2. Tharayman

    Wow. That is the most information I have ever been able to find on RU! Is it right that there is only one source for it out there? What do you think of topical S5 cream? It would at least be a safer alternative than RU!

    Like

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