Finasteride Non Responders In Studies

Texhnolyze · Nov 3, 2018

Hey guys. I know there is a lot of research on finasteride. In all of these studies, there are non-responders who continued to lose hair. So, I have two questions:
1) What do you think, why finasteride does not help them? Their baldness is too strong?
2) Without finasteride, would they be balder?

abcdefg · Nov 3, 2018

1) It could be an issue of sensitivity where they are too sensitive to androgens where the 30 percent of remaining DHT is enough to progress male pattern baldness. It could be an issue of timing. The cascade of male pattern baldness is well underway if you see visible major balding at which point there are a hundred things going on beyond DHT. Castrated men never go bald, but their baldness does not reverse, and it might not always stop if you removed androgens far enough into the process. Timing is important.
The real answer is we just dont know we can only guess.
2) impossible to say. how do you tell this? genetics might play a role, but what does this even mean? no one can explain how this works exactly so what does it matter?

Retinoid · Nov 3, 2018

The nonresponders probably do not respond for various reasons. Two of which is:
1) When people bald it is a hormonal+immune (prostaglandin I'm balance, increased inflammation)+structural change response (fibrosis).

While Finasteride will reduce DHT follicularly the hair loss cascade of immune and structural change is still ongoing and slows LATER--for some people this process may have been too far along where the hormonal intervention was too weak/too late. This is why a multipronged approach is best.

2) Some people just do not genetically respond to certain things as well as others. Duasteride may be better for these nonresponders for example.

Texhnolyze · Nov 4, 2018

Thanks for the answers guys.
I would like to share my thoughts:
In the Russian forum there is a guy who started taking finasteride on NW1.5 when he was 18 years old. He is now in Minoxidil / Finasteride / Dutasteride / Dermaroller. Now he is NW3 (he added dutasterid before he became NW3) to his 22. He says that without all this he would already be a bowling ball lol. He also has a very bad genetics, because all the men in his family (both grandfathers, all uncles, cousins) were NW6-7 in the mid 20s. So I think that non-responders are all the same people who are very aggressive baldness and finasterid / dutasteride definitely helps them.
Such people are very few.. For example, in a 10-year study out of 113, only 7 people were below baseline (4 of them were slightly below baseline, that is not bad i think

), this is 6% (in this study there was also one strange case: after 5 years of finasteride, the guy was much lower than baseline and after 10 years he was equal to baseline, so maybe sometimes it gets worse before it gets better).
And for example in the Japanese study (the Japanese seem to me less aggressive genes) out of 2561 subjects after three years, only 11 of them were slightly below than baseline