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Mostly agree with what you said but just to clarify, I don't think it is appropriate to call that Universiry of Milan work a published study. It is in reality an excel plot and a table with the stamp of the University placed on it. It is severely lacking in descriptions of methods and results, on top of not having a clear design of experiments. It has no discussion of whether or not it is appropriate to assume a simple 1-D Fickian diffusion model to estimate the plasma concentration in vivo (they did not measure it directly) (source: I am a chemical engineer). And most importantly, it is obvious that this work has not been peer reviewed. In other words, it meets none of the standards of science, as presented. The Caserini study on the other hand is totally different. It was published in a peer reviewed journal, and that work is the foundation for PoliChem's product, and most importantly, the vehicle they use is likely different from H&W, and we know that it took Caserini several studies to come up with something that shows promise. I have no objective reason to trust H&W or that University based on the quality of the work. I'm sure the gel grows hair. Put finasteride in ethanol and it will work. Then there are the issues of finasteride's lipophilicity and steep dose response; it will accumulate in tissues and often lead to a saturation response. Localizing finasteride is not a trivial problem, as we know.Maybe I can help in this thread.
As you may know, the italian forum BelliCapelli is linked tight to Hasson&Wong. Indeed, the founder BOLA is the private consultant of the two canadian surgeons. Scrolling back on the forum, I read the initial discussion, which dates back to 2015. After a bunch of posts, it ended for years; I remember some users of this forum (HairLossTalk.com) tried and reported their experience on some threads, basically saying that at the end the systemic absorption was cumulative, and so a lot of them experienced the same sides as Propecia's ones and Proscar's. Neither on BelliCapelli nor on IESON this product gained a spot on the suggested therapies, until 7 months ago, when BOLA, after getting some data from Hasson, revived that discussion saying that after seeing the extraordinary results from the gel on Hasson's patients, he decided himself, after 10 years of Propecia, to switch to the gel.
It seems that originally the formulation was totally made by the surgeons' clinic, and was created because after the last researches about the risks of finasteride, a lot of their patients were abandoning the therapy or chickening out on their transplant. So it was given under a special prescription to them. Then, after the consults here in Italy in the last years, he decided to try to market it also in Europe. He gave the formulation to Farmacia Parati in Milan, and because he did not file a patent for that, the product could only have been - and still is - a galenic. Then, the pharmacy, after carrying some studies on it, elaborated a new formulation, using the liposomes (yes, the kind used by Brotzu for his lotion) to avoid systemic absorption and to enhance effectiveness in situ. Studies were carried in vivo by the italian University of Milan, results published in this study:
https://3pfizs243h34c09mn6s0ul69-wp...evaluation-finasteride-solution-DR-HASSON.pdf
And another study on the pharmacokinetics of the gel:
https://3pfizs243h34c09mn6s0ul69-wp...mic-of-p-3074-finateride-topical-solution.pdf
Then we have to remember that finasteride in that gel is at 2.5% which is an incredibly high dose. The pharmacy said the doctor gave them the quantities of Finasteride to use, and asked them for something that could reduce systemic absorption, so the pharmacy thought of liposomes. There was also a misunderstanding about the quantities absorbed: at 2.5%, the doctor said it was like taking 1 pill of Propecia per week, while the study clearly show it is in reality equivalent to one pill every 3,42 days. Liposomes are really important, because, since maths is not an opinion, at 2.5% of concentration, with 1ml you're putting on your head 25mg of Finasteride per dose, almost equivalent to an entire pack of Propecia...
Also, as far as I know, initially this gel was created only for those who suffered from sides using the oral version: the same Hasson said this, and he was still prescribing the traditional Propecia to his patients. Then, after seeing the results of the few who were using the gel, both BOLA and Hasson, who used Propecia for 10 years and Proscar for 16 years respectively, decided to switch to the gel, mainly because they thought the gel gave even better results to few -- even though this point was debated a lot. It seems that the liposomal version enhanced also the "timing" of the results, many patients said they saw improvements after two months. The posology is 3 days per week generally (not even everyday).
This incredible data were given 7 months ago when BOLA revived the discussiom on the forum; he also wrote an arcticle providing some photos given by Hasson himself. For what he says, the surgeon had in cure almost 300 patients who all experienced sides on the oral version. The doctor said nobody experienced sides with the gel. Unfortunately, this is in contrast with numerous witnesses of this forum users and also with some of BC: it seems that a lot of users who tried the gel suffered from the same sides, even though more time was needed to notice them than the traditional Propecia. The surgeon always repeated his patients had no sides while on it.
Also, as far as I've read, Hasson does not recommend the gel to those who still have a lot of density, and says that the oral version should always be the first choice. If he is now only prescribing the gel, is, in my opinion, overmonetizing the small market he obtained, also because the price of 1 month of the gel from Parati is 50€, plus 13€ for transport fees (which is WAY OVERPRICED for both the costs of the substances and for the time needed to create it). In Italy we say that the doctor is really "marching on the price"
The official arcticle WITH SOME PHOTOS written by BOLA is here, there's the option for the English language on top of the page:
https://bellicapelliforum.com/farmacologia/finasteride-topica-2/
What is wrong with all of this stuff, is the fact we have like zero feedbacks from the users. In this forum, I remember it was abandoned totally since 2 years ago when a lot of users confirmed the same side effects; I do not know however if the formulation was already enhanced by the incapsulation into liposomes. But even on the italian forums we lack anecdotes on this gel. Some are trying, some abandoned, others are doing fine with no photos and only one or 2 are happy and provided some more photos:
View attachment 69114
View attachment 69115
I have to say that those results are similar to the few best responders of Applemets Hair's test of IESON - which I will summarize for you when it will end and the discussion on this site will be reopened by the mods.
However, back to the gel, in my opinion 63€ per month is too f*****g much, also because the sides' aspect is not well known since we lack users' experiences. Now, since I am a student and I don't have any personal incomes, I don't feel good with myself with spending another 200€ to get a prescription (is strictly needed!!) and to try for some months this gel, also because since I had major sides with the oral version, I don't feel safe anymore to experiment on myself anything Finasteride-related. But what I think is that this undoubtedly works on an extent; since we need experiences from the forums, I would encourage who is disposed/desperate to try this stuff and create a log here in the apposite section. Also, on a side note as requested by many users who send me PMs, because our Androgenetic Alopecia does not wait anyone, not FIDIA, nor Shiseido, nor Tsuji, and I am more interested about having anecdotes of actual treatments already working and available now or soon than a review of the bullshits throwed out or published by Cotsarelis and that Follica joke about the new explanations of the delays of their dermaroller+Minoxidil 2.0.
So if anyone is interested in biting this bullet, it should read the two big discussions and reports on BelliCapelli, here are the links for everything, please read before jumping on the gun:
http://bellicapelli.forumfree.it/m/?t=73923099
http://bellicapelli.forumfree.it/m/?t=70535572
http://bellicapelli.forumfree.it/m/?t=70492073&st=75#lastpost
http://bellicapelli.forumfree.it/m/?t=71111355&st=210
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