>>That would be great because of the absence of side effects, but I have always wondered about the efficacy of topical alpha-5 reductase inhibitors. Granted there is evidence that DHT is manufactured in the scalp and hair follicle, and this no doubt contibutes to the damage, but what about DHT manufactured elsewhere and carried to the hair via the bloodstream?<<
In my opinion, serum DHT *does* have an effect on hair follicles, but it's a relatively minor one compared to the effect of the DHT that's manufactured right there inside the follicles.
Why do I believe that? Mainly because of some very convincing animal evidence: topical 5a-reductase inhibitors have a VERY potent effect in standard animal models like the hamster flank-organ and ear pinna. Indeed, those topical substances that have no systemic effect whatsoever are able to produce nearly castration-like effects in the animals' sebaceous glands (hair follicles, too, apparently) where they're applied. So what happens when you try to make your very same argument about the animals?? The animals' sebaceous glands are exquisitely sensitive to the effects of androgens (and DHT in particular), too, and yet they shrink right up when you apply topical 5a-reductase inhibitors to them! That proves that locally-produced DHT is more important than serum DHT, at the very least in those animals; and there's no particular reason not to think that the same is true in humans. In fact, I can cite a *human* study where the researchers concluded that sebaceous glands are not responsive to serum DHT.
Bryan