Powerful results,
custom protocol

Topical tretinoin enhances the response to minoxidil in individ uals with low follicular sulfotransferase activity, the enzyme required for converting minoxidil into its active form. Increased sulfotransferase activity following tretinoin application resulted in 43% of initial nonresponders becoming responders. Tretinoin allows for once daily minoxidil application. Twice a day application of minoxidil yields better results without tretinoin

The addition of tretinoin to minoxidil therapy does not increase the incidence of adverse effects compared to minoxidil alone. Reported side effects, such as pruritus or local irritation, occurred at similar rates in both treatments

Fexofenadine, a second generation antihistamine, reduces inflammation through its H1 receptor antagonism, potentially mitigating inflammatory responses implicated alopecia. Chronic scalp inflammation contributes to hair follicle miniaturization in various forms of alopecia, and fexofenadine’s ability to suppress histamine driven inflammation may help
address this underlying factor.

Melatonin, most known for its role in mediating the wake sleep cycle, has actually been shown to increase the hair count 40% after six months of application.

Microneedling (with minoxidil) increases mean hair count 4.1x compared to minoxidil alone.

Topical minoxidil 5% is significantly more effective than the 2% formulation, with studies showing greater increases in hair density, thickness, and regrowth. Patients using the 5% concentration experienced approximately 45% more hair regrowth compared to baseline, while the 2% formulation produced more modest improvements.

The 10% formulation caused marked irritation and worsened psychosocial stress due to increased shedding and adverse effects, which negatively impacted patient satisfaction. In contrast, the 5% concentration provided robust hair regrowth with better tolerability and fewer side effects

Efficacy of Dutasteride (0.5 mg): Dutasteride at a daily dose of 0.5 mg significantly increases hair count and thickness compared to placebo and finasteride. In a 24-week study, hair count in a 2.54 cm diameter circle improved by 40.6 hairs with dutasteride, compared to 12.2 hairs with finasteride and a decrease of 7.6 hairs in the placebo group. Dutasteride’s dual inhibition of both type 1 and type 2 5-alpha-reductase enzymes enhances its ability to reduce scalp dihydrotestosterone (DHT) levels by 79%, exceeding finasteride’s 64% reduction.

Scalp and Serum DHT Reductions: Dutasteride suppresses serum DHT levels by 92% and scalp DHT by 79% at a dose of 0.5 mg. This greater suppression compared to finasteride is linked to improved hair regrowth and restoration of terminal hair.

Safety Profile: Dutasteride 0.5 mg was well tolerated, with adverse events, including sexual side effects (e.g., decreased libido, erectile dysfunction), reported in approximately 5% of patients, comparable to finasteride. No serious adverse events or dose-dependent increases in side effects were observed, underscoring its safety when used within the therapeutic range.

Superior Dosing with 2.5mg: The 2.5 mg dose of dutasteride demonstrates significantly greater efficacy in treating androgenetic alopecia compared to the 0.5 mg dose. Over 24 weeks, the 2.5 mg dose increased hair count by approximately 109.6 hairs in a 1-inch target area, compared to 94.6 hairs with the lower dose. It also achieved 79% scalp DHT suppression and 96% serum DHT suppression, surpassing the reductions seen with 0.5 mg. Expert and investigator assessments consistently rated the higher dose more favorably, with marked improvements in both vertex and frontal scalp regions. While the 2.5 mg dose was associated with a slightly higher incidence of mild sexual side effects (e.g., decreased libido in 13% of patients), these effects were generally transient and resolved over time.