I ran into that thesis a couple of weeks ago, it's interesting for sure and lends more credibility to the idea that topical dutasteride might actually be promising.
After reviewing all the literature I could find for last couple of weeks, this is basically what I'm thinking:
1. Lack of data and experience: Topical dutasteride has never really been properly researched or experimented with. There are some studies from India I believe, but they're not very reputable as far as I'm concerned. Essentially, finasteride has taken the spotlight, and even proper studies into topical finasteride - and it's effect on scalp and serum dht - are rare. There are the Polichem studies by Caserini et al, but it's not much. Exactly because the consensus in the literature is that finasteride and dutasteride taken orally are relatively safe and only rarely lead to side effects (which I personally no longer believe at this point), ways of reducing systemic exposure have never been the primary focus for researchers. Although there has been somewhat of a shift recently.
2. Dutaseride's half-life: Many people dismiss topical dutasteride as a possibility out of hand because they believe the half-life of 5-6 weeks is too long. However, as I've mentioned before, I believe the half-life is dose-dependent. Less dutasteride in serum leads to a quicker clearance rate.
3. Anecdotal reports of side-effects: Many people who have personally experimented with topical dutasteride note side effects. However, this is not surprising because they almost always apply it daily or every other day. Probably using regular vehicles. If it penetrates, it's likely that dutasteride starts accumulating, which actually increases the halflife in a way which wouldn't happen with finasteride. The body not only has to clear more dutasteride from the system, but the rate at which it is able to do so decreases as the amount in the blood increases. This leads to a snowball effect. The inevitable outcome is significant inhibition of 5-alpha-reductase type 1 & 2, and thus dht.
4. The 500 Dalton rule: The 500 Dalton rule is not a hard limit, but it does probably mean that dutasteride has more trouble permeating the skin. This may lead to reduced systemic absorption. Dutasteride may also have other characteristics we're not aware of that lead to reduced systemic absorption compared to finasteride.
5. Liposomal vehicles: It is possible that special vehicles, like liposomes, would reduce systemic absorption as well.
Taking all of the above into account, I'm hoping that dutasteride, taken topically, preferably with a special vehicle to reduce systemic absorption as much as possible, has a much greater effect in the scalp and follicles in relation to the rest of the body. The Polichem studies by Caserini et al show that this is the case for finasteride: localized application leads to a greater degree of dht-inhibition in the scalp compared to serum. I would expect this to be the same for dutasteride.
Unfortunately, I do not understand exactly how the body replenishes 5-alpha-reductase; and especially how the body and scalp compare to one another. I also do not know whether dutasteride behaves differently in serum compared to the skin. As far as I know, drugs have a different half-life in the skin. The body cannot act upon it as it would in the bloodstream. What I do know however is that 5-alpha-reductase turnover is a slow process. I'm hoping that Vincent's (and Mustang's) success is due to the fact that applying it every 7-10 days gives the body enough time to clear (most or all) dutasteride from the system, while 5-alpha-reductase in the scalp remains mostly inhibited due to the slow turnover rate of these enzymes. The key, then, is ensuring that only a miniscule amount hits the bloodstream. This is why I would recommend using a liposomal vehicle. As a safety precaution, it might also be wise to take a break every couple of months to guarantee that the body has time to clear everything from the system, so that the snowball effect doesn't occur.
Take all of the above with a grain of salt. I'm not an expert in this field and this is just the best I could come up with based on the literature as I was able to understand it. I hope that more people trying it out (and hopefully getting bloodwork) will shed more light on it.
This is a very comprehensive post. I salute you and concur.
However, I am critical and dispute point 1.-
"1. Lack of data and experience: Topical dutasteride has never really been properly researched or experimented with. There are some studies from India I believe, but they're not very reputable as far as I'm concerned"
There are many of us who have experimented, tested our scalp DHT and plasma DHT with Topical Dutasteride, most of us with a non Liposomal preparation (I tested it with both). I even posted my numbers and another forum member from the Spanish forum numbers on here.
How hard is it to buy some, apply it and measure your levels?
As easy as taking a finasteride pill and doing the same.
It's pretty straightforward and I can't undestand why people are overcomplicating this so much.
Facts:
1) Topical Dutasteride reduces less plasma DHT than oral finasteride, topical finasteride and oral dutasteride.
2) Topical Dutasteride reduces more scalp DHT than oral finasteride and topical finasteride.
3) Topical Dutasteride has the least chance of side effects. There are dozens of us using it without any.
Now go get some. Test it and be happy. If it doesn't work the I guess dutasteride mesotherapy or RU58841 would be your last chance.
It's the best hair loss treatment available today without or minimum sides. Take it from someone who had horrible sides with EVERYTHING.