Topical Customiser

What it is: Dutasteride is a prescription medicine that reduces the conversion of testosterone to dihydrotestosterone (DHT). DHT is a key driver of androgenetic alopecia (pattern hair loss).

How it can help hair: By lowering DHT activity in the scalp, dutasteride can reduce follicle miniaturisation and support thicker, stronger regrowth over time. In topical form, the goal is to target the scalp while minimising effects elsewhere.

Who it may suit: People with pattern hair loss where DHT is a contributing factor, particularly if they have not achieved their desired response with non hormonal options alone.

When you might notice results: Hair cycles are slow. Many people assess progress at 3 to 6 months, with fuller changes often taking 6 to 12 months.

Potential side effects: Possible effects include reduced libido, erectile dysfunction, reduced ejaculate volume, mood changes, and breast tenderness or enlargement. With topical use, these may be less common, but they can still occur.

Important contraindications and cautions:

• Pregnancy risk: Dutasteride must not be used in pregnancy. It can cause harm to a developing baby. Women who are pregnant or may become pregnant should avoid exposure to product residue on skin or surfaces.
• Women of childbearing potential: Not suitable unless specifically prescribed with appropriate safeguards.
• Liver disease: Use with caution and disclose any liver problems.
• PSA monitoring: Dutasteride can lower PSA levels. If you have prostate screening, tell your clinician you use a 5 alpha reductase inhibitor.

If you notice persistent sexual side effects, mood changes, breast changes, or any new concerning symptoms, stop and seek medical advice.

What it is: Finasteride is a prescription medicine that reduces the conversion of testosterone to DHT by inhibiting the type II 5 alpha reductase enzyme. DHT is strongly linked to follicle miniaturisation in pattern hair loss.

How it can help hair: By reducing DHT in the scalp, finasteride can help slow further loss and support regrowth or thickening in people with androgenetic alopecia. Topical finasteride aims to provide scalp targeted activity while potentially reducing systemic exposure compared to oral use.

Who it may suit: People with pattern hair loss where DHT is a major driver, including those who want a DHT reducing option but prefer a topical approach. Suitability depends on individual risk factors and clinician review.

When you might notice results: Like most hair loss treatments, changes are gradual. Many people review progress at 3 to 6 months, with best assessment at 6 to 12 months.

Potential side effects: Possible effects include reduced libido, erectile dysfunction, reduced ejaculate volume, breast tenderness, and mood changes. These are typically discussed more often with oral therapy, but topical use can still cause systemic effects in some people.

Important contraindications and cautions:

• Pregnancy risk: Finasteride must not be used in pregnancy. It can cause harm to a developing baby. Avoid exposure to residue on skin or surfaces if pregnant or trying to conceive.
• Women of childbearing potential: Not suitable unless specifically prescribed with appropriate safeguards.
• Liver disease: Use cautiously and disclose liver problems to your clinician.
• PSA monitoring: Finasteride can lower PSA levels. Tell your clinician before prostate testing or screening.

If you experience mood changes, persistent sexual side effects, or breast changes, stop and speak to a clinician.

What it is: Minoxidil is a well known hair growth stimulant used for androgenetic alopecia. It supports the hair cycle and can increase the duration of the growth phase (anagen).

How it can help hair: Minoxidil can improve hair density and thickness by supporting follicle activity. Higher strengths are sometimes used in compounded formulas where clinically appropriate.

What to expect: It is common to see increased shedding in the first weeks as older hairs are pushed out and new growth begins. This is usually temporary.

When you might notice results: Many people notice early changes around 8 to 12 weeks, with stronger results typically at 4 to 6 months and beyond.

Potential side effects: Scalp irritation, itching, dryness, flaking, and redness can occur. Unwanted facial hair growth may happen if the product spreads beyond the scalp. Rarely, systemic absorption can cause dizziness, fast heart rate, ankle swelling, or headaches.

Important contraindications and cautions:

• Heart and blood pressure conditions: Speak to a clinician if you have heart disease, arrhythmias, low blood pressure, or take blood pressure medicines.
• Pregnancy and breastfeeding: Avoid unless specifically advised by a clinician.
• Broken or inflamed scalp: Avoid applying to broken skin as absorption may increase.

If you develop chest pain, fainting, severe dizziness, shortness of breath, or rapid heartbeat, stop and seek urgent medical advice.

What it is: Tretinoin is a retinoid (vitamin A derivative). In hair formulations it is commonly used to support scalp turnover and may help improve minoxidil response in some patients.

How it can help hair: Tretinoin can help normalise scalp shedding and may improve delivery and conversion of minoxidil to its active form in the skin for certain people. It can also help reduce buildup that may interfere with topical application.

Potential side effects: Dryness, irritation, burning, stinging, redness, peeling, and sensitivity can occur, especially at the start. If the scalp becomes very inflamed, it can worsen shedding temporarily.

Important contraindications and cautions:

• Pregnancy: Retinoids are not suitable in pregnancy. Avoid if pregnant or trying to conceive unless your clinician advises otherwise.
• Very sensitive scalp or eczema: Use cautiously and discuss with a clinician.
• Sun sensitivity: Retinoids can increase sensitivity. Protect the scalp from sun exposure where possible.

If you experience severe irritation, stop and seek advice. Your clinician may adjust strength, frequency, or base.

What it is: Melatonin is best known as a sleep related hormone, but it is also present in the skin and hair follicles. In topical hair care it is used for its antioxidant and follicle supportive properties.

How it can help hair: Melatonin may support the hair growth environment by reducing oxidative stress around follicles and supporting the anagen phase. It is often used as an add on in compounded topical formulas.

Potential side effects: Topical melatonin is generally well tolerated. Some people may experience mild scalp irritation depending on the base or other ingredients. Systemic effects are considered unlikely at low topical doses, but sensitivity varies.

Important contraindications and cautions:

• Pregnancy and breastfeeding: Avoid unless specifically advised.
• Hormone sensitive conditions: Discuss with a clinician if you have a history of hormone sensitive cancer or are under specialist care.
• Allergy or sensitivity: Stop if rash or significant irritation occurs.

If you feel unusually drowsy, dizzy, or unwell after starting, stop and speak with a clinician, particularly if you use other medicines that affect sleep or mood.

What it is: Caffeine is a plant derived compound used topically for its potential to support follicle activity and the scalp environment.

How it can help hair: Caffeine is sometimes included to support the overall hair growth plan, especially alongside minoxidil. It may help create a supportive environment for follicles and can be useful for people wanting a broader multi ingredient approach.

Potential side effects: Usually mild. Possible scalp irritation, itching, or dryness, particularly if you have sensitive skin or if the base is high in alcohol.

Important contraindications and cautions:

• Sensitive or inflamed scalp: Use cautiously if you are prone to dermatitis.
• Allergy: Stop if rash, swelling, or worsening irritation occurs.

If irritation develops, your clinician may change the base, reduce frequency, or remove the ingredient.

What it is: Cetirizine is an antihistamine commonly used for allergies. In topical hair formulations it is used for its anti inflammatory properties in the scalp environment.

How it can help hair: Inflammation can play a role in hair shedding for some people. Cetirizine may help calm scalp inflammation and support a healthier follicle environment. It is often used as an add on in compounded hair solutions.

Potential side effects: Possible scalp irritation, redness, or dryness. Systemic effects from topical use are generally unlikely, but if absorbed more than expected it could cause tiredness in sensitive individuals.

Important contraindications and cautions:

• Allergy to antihistamines: Avoid if you have had allergic reactions to cetirizine, hydroxyzine, or related medicines.
• Severely sensitive scalp: Discuss with a clinician if you have a history of contact dermatitis.
• Pregnancy and breastfeeding: Discuss with a clinician before use.

If you notice widespread rash, facial swelling, or breathing difficulty, seek urgent medical help.