BASICS OF HAIR LOSS
In order to stop and reverse hair loss, it is important to first have to understand how it happens. Hair on the top of the head in most men is sensitive to androgens. The primary androgens are dihydrotestosterone (DHT) and testosterone. DHT is made from testosterone by an ezyme called 5-alpha reductase. DHT is generally most important in puberty. After that its primary known effects are hair loss and enlarging prostates (why old guys have trouble peeing).
Both DHT and testosterone can bind to hair follicles, but DHT binds much more powerfully. Synthetic androgens like tren and winstrol, etc. can bind as powerfully as DHT or more.
When androgens bind to hair follicles, they trigger the follicles to begin miniaturizing. The average hair cycle is around 5 years. Once they start suffering androgen damage, follicles will start growing for shorter and shorter cycles, and with thinner and thinner diameter, until eventually they stop growing altogether.
How this happens on a biochemical level is still being learned. Newest research shows it is mediated by changes in prostaglandins (messenger molecules) in the scalp. Good prostaglandins which promote hair growth get downregulated. Bad prostaglandins which promote inflammation and hair damage get upregulated. The scalp becomes toxic to the hair follicles, and the follicles die. This is where the ‘prostaglandin protocol’ comes from.
So in summary:
- Androgens trigger the cascade.
- Good prostaglandins get dowregulated.
- Bad prostaglandins get upregulated.
- Inflammation occurs.
- Inflammation and hostile environment causes hair to miniaturize and fall out.
- Hair stem cells go quiet or die off.
Knowing that this is how the process works allows us to understand that there are at least a few levels at which hair loss can be fixed.
ANTI-ANDROGENS
The absolute most important part of any hair loss treatment is anti-androgenic therapy. Androgens are the root cause of hair loss in genetically susceptible men. If you are not doing something effective to block androgens, you are fighting a losing battle.
Finasteride & Dutasteride
Both fin and dut are 5-alpha reductase inhibitors. Ie. They inhibit the enzyme which turns testosterone into DHT. By blocking the production of DHT, they reduce the damage to the hair considerably, and in most people that's actually enough to stabilize the hair for a decade or more. Even with no DHT in your system, plain testosterone can still bind the follicles, which is why hair loss may still very gradually progress with these agents.
Finasteride 1 mg daily usually decreases DHT by 70%. Dutasteride 0.5 mg daily reduces DHT by over 95%. The cheapest way to get finasteride is to buy 5 mg tablets and cut them into quarters (1.25 mg daily).
Studies show significant regrowth on both by 6 months, and max regrowth by 1 year. Dutasteride generally results in 50% greater hair regrowth by one year vs fin. So if you want the best result, try dut, but with slightly higher side effects possibly due to the greater DHT reduction.
Side effects on both according to SCIENTIFIC PLACEBO-CONTROLLED LITERATURE are minimal, mild, and reversible. In studies, both people taking the meds and people taking placebo had sexual side effects. Placebo is strong. Don't underestimate it. I don’t have the exact numbers as I am not interested in going back to the studies to find them. But it was roughly only about 2-3% more guys on the meds than on placebos had sexual side effects. So the sexual side effect rate is ~2-3% for both meds ie. pretty minimal. As I said, in all scientific studies, this has been 100% reversible. One study I read suggested a 1/200 (0.5%) risk of gynecomastia with these meds, but another did not confirm it.
Notice I have specified SCIENTIFIC PLACEBO-CONTROLLED LITERATURE. I have no interest in debating or basing my decisions in life on what people anecdotally say on Internet forums. There are a lot of crazy people in this world. That is why science exists. There is no science to support claims like “I took one pill of finasteride and it ruined my life!” These meds have been tested and studied extensively. Both fin and dut have been prescribed to millions of men for many years for enlarged prostates and still found safe. You can make up your own decision. Like I said, I don't care to debate it.
In my opinion, anyone losing their hair should start by trying fin or dut. They are simple and easy. Finasteride 1-1.25 mg will work for 90% of men. Dutasteride 0.5 mg works for >95% of men.
In my case, these meds didn’t work for me for an unknown reason. I tried brand versions of both. I even went up to 2.5 mg daily dutasteride (5x the usual dose) and my DHT levels didn't drop at all. There are a few other people online reporting this. But it seems to be freakishly rare. Some form of genetic resistance to how they work I think. If you want to be sure the med is doing what it is supposed to, check your DHT level before and after starting. You should see a major drop while on the medication.
Then give it a year, and see what your hair looks like. If you’re anything like 90-95% of men, it will be the same or better.
RU58841
RU58841 is my favorite hair loss compound in existence. It has been a life saver to me. It worked for me when fin & dut didn't. I have been on it 5 months and it has been incredible for me. I am growing back steadily from a NW2. The entire area of balding at each corner/temple is covered with fuzz, and little by little the hairs there are becoming terminal. My density on top went from ~80% full to back to 95%+ full density (perfect or near perfect to my eyes).
RU58841 has numerous drawbacks however. It is more complicated to use and use safely. If you want to get the best result, you will have to mix it yourself. It takes a bit of work to get all the stuff you need to do this. And there is no long term safety data. This is why I still suggest everyone should start with fin/dut first. However, if you're not afraid of a little learning/work at the start, using RU becomes a pretty simple routine. It takes me 5 minutes a day to mix and apply. And it is absolutely effective.
How RU58841 works:
RU58841 is an experimental anti-androgen developed in the 1990s for anti-acne and anti-hair loss topical applications.
It is one of the most powerful anti-androgen molecules out there. It binds directly to the androgen receptors in the skin and hair and BLOCKS them so that no other androgen can bind. In this way, it can block both testosterone and DHT from damaging hair. It can also theoretically block synthetic androgens like tren/winstrol/etc. though how well it blocks these synthetic androgens has never been studied.
RU58841 is related in structure/function to powerful anti-androgens like flutamide, which are usually used as tablets to fight androgen-sensitive diseases like prostate cancer. A drug like flutamide will functionally neuter you when you take it orally. RU58841 is about as strong, but with unique differences that makes it useful for skin/hair use.
First of all, when used on the skin, very little RU gets absorbed in the body. Second, and most importantly, of what does get absorbed, 99% gets broken down instantly into inert molecules with no effect on the body. Only 1% of the breakdown product acts as a systemic anti-androgen.
Based on the amount a typical user will apply for the scalp, how little absorbs, and how little of what absorbs has any biological effect, it would be almost impossible to experience any side effects on RU58841. If you do claim to get sides, I'd bet they're placebo effect. I have never noticed any side effects from RU, no matter how much I use.
PROSTAGLANDIN ANALOGS
As stated at the beginning of the post, androgens start the cascade, but prostaglandins work as intermediaries to actually cause hair growth or loss. Therefore compounds that work through prostaglandin pathways can complement antiandrogens to get better results. This is the basis for Swiss Temples' now well known "prostaglandin protocol".
Minoxidil
Minoxidil is the most important of the prostaglandin acting compounds. It works by increasing healthy prostaglandins in the scalp. For standard isolated minoxidil use (ie. Over the counter), you want Rogaine foam 5% or a generic form. Applying once or twice a day will do the trick.
Some people say minoxidil causes bloating, wrinkles, and bags under the eyes. I haven’t noticed anything of that sort. Before you let fear-mongering scare you off minoxidil, keep in mind minoxidil is the only PROVEN growth stimulant in big trials and in combination with fin/dut, it has been proven to do even better than any of these treatments alone.
I look at it like this:
- Antiandrogens like fin/dut/RU turn off the red light.
- Minox turns on the green light.
Winning combination.
Castor oil
Castor oil’s primary component is ricinoleic acid which activates one prostaglandin receptor favorable for promoting hair growth. So there actually is a basis to suggest castor oil will work. The problem with castor oil is it is slick/sticky as fuck and will make you look like a wet rat. It takes up to 2-3 showers to get out of your hair, so I wouldn’t recommend it at all.
Swiss Temples even takes this shit orally (1/4 teaspoon per day I think) which I tried for a while, but holy shit it gives you diarrhea and cramps. And I didn’t notice any hair differences. So I stopped both topically and orally. Give it a try if you like though. In my opinion there are much better options.
Nizoral
Nizoral shampoo is now thought to also work as a mild prostaglandin stimulator. I used it for years and maybe it helped slowing things down. However, I stopped bothering with this shit completely once I started mixing my own stuff. I figure it can’t probably be that effective as you only apply it for 5 minutes at a time. I wouldn’t bother with it again. Better options exist.
OTHER APPROACHES
Azelaic acid
No one knows exactly how azelaic acid works to promote hair growth. It’s not really proven to be too effective either. But it’s used as an anti-acne agent and has been known to increase collagen production, so it can’t hurt you. Some people say it works as a mild 5-alpha reductase inhibitor. I’m not sure, but I use it anyway in my solution as above. Partly I use it for the pro-collagen effect because I figure if minoxidil truly is bad for my collagen, this should counteract its negative effects and even that out.
Dermaneedling
Needling the scalp works to stimulate stem cells and increase hair regeneration. Swiss Temples does this once a week in his protocol with lithium chloride applied after as an adjunct. I have bought the same needler he uses but never used it as I am happy with my results so far without needling, and it seems like a pain in the ass. I will probably try this at some point.
Neogenic
There are other products like Neogenic which are thought to stimulate stem cells. But that shit is expensive and in my opinion unproven. It also can’t be bought in powder form, so I don’t bother with it, as I am again happy with my own protocol.
PUTTING IT ALL TOGETHER
This is a lot of information. Perhaps it may be overwhelming for some. So to conclude, I will summarize the best ways I think guys should address their hair loss depending on their general circumstances/goals.
Average guy
For the average guy just starting to lose his hair I would suggest either fin or dut combined with over the counter 5% minoxidil once or twice daily. This will solve 90-95%+ of guy’s hair loss problems. It is easy, safe, and simple.
Alternative approach would be to use just the topical homebrew RU58841/minox/azelaic acid solution described above. This is the only thing I am using and as stated it is working beautifully for me. I can't predict how well it will work for others though as there isn't enough data.
Lastly, if you want to be hardcore, you could use fin or dut PLUS RU58841/minox/azelaic (home brew as above). If you do this approach as an average guy, I think it would be physically impossible to go bald.
On steroids
For guys going on steroids, I would absolutely recommend using fin/dutasteride WITH an RU58841 solution. RU58841 is critical for guys on steroids because as stated earlier: it is the only agent which can block synthetic androgens and also high levels of plain testosterone from binding to your hair follicles and killing them. Fin/dut won't work against these causes of baldness.
TLDR:
Average guy
On steroids
In order to stop and reverse hair loss, it is important to first have to understand how it happens. Hair on the top of the head in most men is sensitive to androgens. The primary androgens are dihydrotestosterone (DHT) and testosterone. DHT is made from testosterone by an ezyme called 5-alpha reductase. DHT is generally most important in puberty. After that its primary known effects are hair loss and enlarging prostates (why old guys have trouble peeing).
Both DHT and testosterone can bind to hair follicles, but DHT binds much more powerfully. Synthetic androgens like tren and winstrol, etc. can bind as powerfully as DHT or more.
When androgens bind to hair follicles, they trigger the follicles to begin miniaturizing. The average hair cycle is around 5 years. Once they start suffering androgen damage, follicles will start growing for shorter and shorter cycles, and with thinner and thinner diameter, until eventually they stop growing altogether.
How this happens on a biochemical level is still being learned. Newest research shows it is mediated by changes in prostaglandins (messenger molecules) in the scalp. Good prostaglandins which promote hair growth get downregulated. Bad prostaglandins which promote inflammation and hair damage get upregulated. The scalp becomes toxic to the hair follicles, and the follicles die. This is where the ‘prostaglandin protocol’ comes from.
So in summary:
- Androgens trigger the cascade.
- Good prostaglandins get dowregulated.
- Bad prostaglandins get upregulated.
- Inflammation occurs.
- Inflammation and hostile environment causes hair to miniaturize and fall out.
- Hair stem cells go quiet or die off.
Knowing that this is how the process works allows us to understand that there are at least a few levels at which hair loss can be fixed.
ANTI-ANDROGENS
The absolute most important part of any hair loss treatment is anti-androgenic therapy. Androgens are the root cause of hair loss in genetically susceptible men. If you are not doing something effective to block androgens, you are fighting a losing battle.
Finasteride & Dutasteride
Both fin and dut are 5-alpha reductase inhibitors. Ie. They inhibit the enzyme which turns testosterone into DHT. By blocking the production of DHT, they reduce the damage to the hair considerably, and in most people that's actually enough to stabilize the hair for a decade or more. Even with no DHT in your system, plain testosterone can still bind the follicles, which is why hair loss may still very gradually progress with these agents.
Finasteride 1 mg daily usually decreases DHT by 70%. Dutasteride 0.5 mg daily reduces DHT by over 95%. The cheapest way to get finasteride is to buy 5 mg tablets and cut them into quarters (1.25 mg daily).
Studies show significant regrowth on both by 6 months, and max regrowth by 1 year. Dutasteride generally results in 50% greater hair regrowth by one year vs fin. So if you want the best result, try dut, but with slightly higher side effects possibly due to the greater DHT reduction.
Side effects on both according to SCIENTIFIC PLACEBO-CONTROLLED LITERATURE are minimal, mild, and reversible. In studies, both people taking the meds and people taking placebo had sexual side effects. Placebo is strong. Don't underestimate it. I don’t have the exact numbers as I am not interested in going back to the studies to find them. But it was roughly only about 2-3% more guys on the meds than on placebos had sexual side effects. So the sexual side effect rate is ~2-3% for both meds ie. pretty minimal. As I said, in all scientific studies, this has been 100% reversible. One study I read suggested a 1/200 (0.5%) risk of gynecomastia with these meds, but another did not confirm it.
Notice I have specified SCIENTIFIC PLACEBO-CONTROLLED LITERATURE. I have no interest in debating or basing my decisions in life on what people anecdotally say on Internet forums. There are a lot of crazy people in this world. That is why science exists. There is no science to support claims like “I took one pill of finasteride and it ruined my life!” These meds have been tested and studied extensively. Both fin and dut have been prescribed to millions of men for many years for enlarged prostates and still found safe. You can make up your own decision. Like I said, I don't care to debate it.
In my opinion, anyone losing their hair should start by trying fin or dut. They are simple and easy. Finasteride 1-1.25 mg will work for 90% of men. Dutasteride 0.5 mg works for >95% of men.
In my case, these meds didn’t work for me for an unknown reason. I tried brand versions of both. I even went up to 2.5 mg daily dutasteride (5x the usual dose) and my DHT levels didn't drop at all. There are a few other people online reporting this. But it seems to be freakishly rare. Some form of genetic resistance to how they work I think. If you want to be sure the med is doing what it is supposed to, check your DHT level before and after starting. You should see a major drop while on the medication.
Then give it a year, and see what your hair looks like. If you’re anything like 90-95% of men, it will be the same or better.
RU58841
RU58841 is my favorite hair loss compound in existence. It has been a life saver to me. It worked for me when fin & dut didn't. I have been on it 5 months and it has been incredible for me. I am growing back steadily from a NW2. The entire area of balding at each corner/temple is covered with fuzz, and little by little the hairs there are becoming terminal. My density on top went from ~80% full to back to 95%+ full density (perfect or near perfect to my eyes).
RU58841 has numerous drawbacks however. It is more complicated to use and use safely. If you want to get the best result, you will have to mix it yourself. It takes a bit of work to get all the stuff you need to do this. And there is no long term safety data. This is why I still suggest everyone should start with fin/dut first. However, if you're not afraid of a little learning/work at the start, using RU becomes a pretty simple routine. It takes me 5 minutes a day to mix and apply. And it is absolutely effective.
How RU58841 works:
RU58841 is an experimental anti-androgen developed in the 1990s for anti-acne and anti-hair loss topical applications.
It is one of the most powerful anti-androgen molecules out there. It binds directly to the androgen receptors in the skin and hair and BLOCKS them so that no other androgen can bind. In this way, it can block both testosterone and DHT from damaging hair. It can also theoretically block synthetic androgens like tren/winstrol/etc. though how well it blocks these synthetic androgens has never been studied.
RU58841 is related in structure/function to powerful anti-androgens like flutamide, which are usually used as tablets to fight androgen-sensitive diseases like prostate cancer. A drug like flutamide will functionally neuter you when you take it orally. RU58841 is about as strong, but with unique differences that makes it useful for skin/hair use.
First of all, when used on the skin, very little RU gets absorbed in the body. Second, and most importantly, of what does get absorbed, 99% gets broken down instantly into inert molecules with no effect on the body. Only 1% of the breakdown product acts as a systemic anti-androgen.
Based on the amount a typical user will apply for the scalp, how little absorbs, and how little of what absorbs has any biological effect, it would be almost impossible to experience any side effects on RU58841. If you do claim to get sides, I'd bet they're placebo effect. I have never noticed any side effects from RU, no matter how much I use.
PROSTAGLANDIN ANALOGS
As stated at the beginning of the post, androgens start the cascade, but prostaglandins work as intermediaries to actually cause hair growth or loss. Therefore compounds that work through prostaglandin pathways can complement antiandrogens to get better results. This is the basis for Swiss Temples' now well known "prostaglandin protocol".
Minoxidil
Minoxidil is the most important of the prostaglandin acting compounds. It works by increasing healthy prostaglandins in the scalp. For standard isolated minoxidil use (ie. Over the counter), you want Rogaine foam 5% or a generic form. Applying once or twice a day will do the trick.
Some people say minoxidil causes bloating, wrinkles, and bags under the eyes. I haven’t noticed anything of that sort. Before you let fear-mongering scare you off minoxidil, keep in mind minoxidil is the only PROVEN growth stimulant in big trials and in combination with fin/dut, it has been proven to do even better than any of these treatments alone.
I look at it like this:
- Antiandrogens like fin/dut/RU turn off the red light.
- Minox turns on the green light.
Winning combination.
Castor oil
Castor oil’s primary component is ricinoleic acid which activates one prostaglandin receptor favorable for promoting hair growth. So there actually is a basis to suggest castor oil will work. The problem with castor oil is it is slick/sticky as fuck and will make you look like a wet rat. It takes up to 2-3 showers to get out of your hair, so I wouldn’t recommend it at all.
Swiss Temples even takes this shit orally (1/4 teaspoon per day I think) which I tried for a while, but holy shit it gives you diarrhea and cramps. And I didn’t notice any hair differences. So I stopped both topically and orally. Give it a try if you like though. In my opinion there are much better options.
Nizoral
Nizoral shampoo is now thought to also work as a mild prostaglandin stimulator. I used it for years and maybe it helped slowing things down. However, I stopped bothering with this shit completely once I started mixing my own stuff. I figure it can’t probably be that effective as you only apply it for 5 minutes at a time. I wouldn’t bother with it again. Better options exist.
OTHER APPROACHES
Azelaic acid
No one knows exactly how azelaic acid works to promote hair growth. It’s not really proven to be too effective either. But it’s used as an anti-acne agent and has been known to increase collagen production, so it can’t hurt you. Some people say it works as a mild 5-alpha reductase inhibitor. I’m not sure, but I use it anyway in my solution as above. Partly I use it for the pro-collagen effect because I figure if minoxidil truly is bad for my collagen, this should counteract its negative effects and even that out.
Dermaneedling
Needling the scalp works to stimulate stem cells and increase hair regeneration. Swiss Temples does this once a week in his protocol with lithium chloride applied after as an adjunct. I have bought the same needler he uses but never used it as I am happy with my results so far without needling, and it seems like a pain in the ass. I will probably try this at some point.
Neogenic
There are other products like Neogenic which are thought to stimulate stem cells. But that shit is expensive and in my opinion unproven. It also can’t be bought in powder form, so I don’t bother with it, as I am again happy with my own protocol.
PUTTING IT ALL TOGETHER
This is a lot of information. Perhaps it may be overwhelming for some. So to conclude, I will summarize the best ways I think guys should address their hair loss depending on their general circumstances/goals.
Average guy
For the average guy just starting to lose his hair I would suggest either fin or dut combined with over the counter 5% minoxidil once or twice daily. This will solve 90-95%+ of guy’s hair loss problems. It is easy, safe, and simple.
Alternative approach would be to use just the topical homebrew RU58841/minox/azelaic acid solution described above. This is the only thing I am using and as stated it is working beautifully for me. I can't predict how well it will work for others though as there isn't enough data.
Lastly, if you want to be hardcore, you could use fin or dut PLUS RU58841/minox/azelaic (home brew as above). If you do this approach as an average guy, I think it would be physically impossible to go bald.
On steroids
For guys going on steroids, I would absolutely recommend using fin/dutasteride WITH an RU58841 solution. RU58841 is critical for guys on steroids because as stated earlier: it is the only agent which can block synthetic androgens and also high levels of plain testosterone from binding to your hair follicles and killing them. Fin/dut won't work against these causes of baldness.
TLDR:
Average guy
- Fin or Dut + 5% minox = solves 90–95% of cases.
- RU58841 + minox (+ azelaic) topical only.
- Fin or Dut + RU58841 + minox.
- Basically impossible to go bald.
On steroids
- FIN/DUT ALONE = NOT ENOUGH.
- MUST use RU58841 to block synthetic androgens.
- Otherwise enjoy NW3 speedrun.
