'Holy Grail' Prescription Formula - Input Welcome from GourmetStyleWellness!

[Dr.]

Hi gourmetstylewellness.com Members,
My clinic is planning on offering a physician-prescribed hair loss solution that you can order online, and I wanted to get input from members of this forum since I know there are a lot of bright & experienced minds here, and a lot of the prescriptions that people want are either 1) not available in the US, 2) not at the dosages people want, 3) cost-prohibitive.

What would you want to see in a 'holy grail' prescription topical foam?

Here's our v1 formula (feedback welcome):
Latanoprost 0.1% (strength used in studies and not commonly available)
Finasteride 0.01% (microdosed to prevent systemic absorption, as we've documented 71% suppressed serum DHT using a stronger 0.25% topical, equivalent to the suppression seen with 1mg oral finasteride).
Minoxidil 8% (Rx strength, since 5% is readily available OTC).

Any other suggestions? (must be an ingredient that a compounding pharmacy can get from an FDA manufacturer)
I've seen the following ingredients in other custom/combination ingredients (feedback welcome):
Retinoic Acid 0.01-0.1%
Azelaic Acid 0.025%
Betamethasone 0.01%
Ketoconazole 2%
Anything else?

 

[TurboFixer]

Really glad to see this man.

A few thoughts:

Caffeine:
Dhurat et al. (2018). An Open-Label Randomized Multicenter Study Assessing the Noninferiority of a Caffeine-Based Topical Liquid 0.2% versus Minoxidil 5% Solution in Male Androgenetic Alopecia. Skin Pharmacol Physiol. 2018 Jan; 30(6): 298–305. A caffeine-based topical liquid should be considered as not inferior to minoxidil 5% solution in men with androgenetic alopecia. An Open-Label Randomized Multicenter Study Assessing the Noninferiority of a Caffeine-Based Topical Liquid 0.2% versus Minoxidil 5% Solution in Male Androgenetic Alopecia - PubMed



Zinc, azelaic acid, B6(P5P):

Inhibition of 5 alpha-reductase activity in human skin by zinc and azelaic acid​

Inhibition of 5 alpha-reductase activity in human skin by zinc and azelaic acid - PubMed

The effects of zinc sulphate and azelaic acid on 5 alpha-reductase activity in human skin were studied using an in vitro assay with 1,2[3H]-testosterone as substrate. When added at concentrations of 3 or 9 mmol/l, zinc was a potent inhibitor of 5 alpha-reductase activity. At high concentrations...

pubmed.ncbi.nlm.nih.gov

Utami, Sheila & Joshita, Djajadisastra & Saputri, Fadlina. (2017). Using hair growth activity, physical stability, and safety tests to study hair tonics containing ethanol extract of licorice (Glycyrrhiza glabra Linn.). International Journal of Applied Pharmaceutics. 9. 44. 10.22159/ijap.2017.v9s1.20_25.
The hair tonics containing 5% and 10% licorice extract had an equivalent activity of hair growth and even better than the positive control containing 2% minoxidil.

(PDF) Using hair growth activity, physical stability, and safety tests to study hair tonics containing ethanol extract of licorice (Glycyrrhiza glabra Linn.)

PDF | Objective: The purpose of this study was to determine the safety, physical stability, and hair growth activity of ethanol extract of... | Find, read and cite all the research you need on ResearchGate

www.researchgate.net

Fluridil: Its off patent if i recall correctly, you may want to try compounding it at a higher percentage than what is often used in eucapil. I believe @FollicleGuardian may be able to comment on this.

 

[resu]

Preparation and evaluation of a multimodal minoxidil microemulsion versus minoxidil alone in the treatment of androgenic alopecia of mixed etiology: a pilot study - PMC

The variable success of topical minoxidil in the treatment of androgenic alopecia has led to the hypothesis that other pathways could mediate this form of hair loss, including infection and/or microinflammation of the hair follicles. In this study, ...

www.ncbi.nlm.nih.gov

Background:​

The variable success of topical minoxidil in the treatment of androgenic alopecia has led to the hypothesis that other pathways could mediate this form of hair loss, including infection and/or microinflammation of the hair follicles. In this study, we prepared a multimodal microemulsion comprising minoxidil (a dihydrotestosterone antagonist), diclofenac (a nonsteroidal anti-inflammatory agent), and tea tree oil (an anti-infective agent). We investigated the stability and physicochemical properties of this formulation, and its therapeutic efficacy compared with a formulation containing minoxidil alone in the treatment of androgenic alopecia.

Conclusion​

All evaluations showed highly significant improvements using the multimodal minoxidil microemulsion in comparison with the minoxidil only formulation which, in turn, was significantly more effective than placebo. The pronounced effects of the multimodal minoxidil formulation compared with minoxidil alone could be attributed to the anti-inflammatory effect of diclofenac in reducing scalp and follicular microinflammation and the tea tree oil in resolving any existing microbial or fungal colonization of the hair follicles. These results indicate that androgenic alopecia is multifactorial and perhaps polygenic in nature. Hence, an effective multimodal microemulsion comprising minoxidil, an anti-inflammatory agent, and an anti-infective agent is recommended as being more promising than minoxidil alone. Diclofenac was used in the multimodal formulation instead of a cortisone derivative to reduce the risk of side effects, and tea tree oil was used on the basis that it is a highly effective natural anti-infective agent.15,16 Further study is planned in a larger patient population for an extended period to monitor the long-term effects in individuals with androgenic alopecia accompanied by hair follicle infection and/or microinflammation.

 

[nick123]

Hi gourmetstylewellness.com Members,
My clinic is planning on offering a physician-prescribed hair loss solution that you can order online, and I wanted to get input from members of this forum since I know there are a lot of bright & experienced minds here, and a lot of the prescriptions that people want are either 1) not available in the US, 2) not at the dosages people want, 3) cost-prohibitive.

What would you want to see in a 'holy grail' prescription topical foam?

Here's our v1 formula (feedback welcome):
Latanoprost 0.1% (strength used in studies and not commonly available)
Finasteride 0.01% (microdosed to prevent systemic absorption, as we've documented 71% suppressed serum DHT using a stronger 0.25% topical, equivalent to the suppression seen with 1mg oral finasteride).
Minoxidil 8% (Rx strength, since 5% is readily available OTC).

Any other suggestions? (must be an ingredient that a compounding pharmacy can get from an FDA manufacturer)
I've seen the following ingredients in other custom/combination ingredients (feedback welcome):
Retinoic Acid 0.01-0.1%
Azelaic Acid 0.025%
Betamethasone 0.01%
Ketoconazole 2%
Anything else?

Love the fact you're including latanoprost. One suggestion would be to make two formulas, one containing finasteride and one not containing finasteride. My reasoning for this is because some people are on oral dutasteride instead and some people still get sides from any percentage of finasteride.

 

[TurboFixer]

Love the fact you're including latanoprost. One suggestion would be to make two formulas, one containing finasteride and one not containing finasteride. My reasoning for this is because some people are on oral dutasteride instead and some people still get sides from any percentage of finasteride.

100% agreed

 

[Dr.]

Thanks for the suggestions.

1) Do you know if topical caffeine absorbs systemically? A lot of patients are sensitive to it.
2) We can't use drugs like Fluridil that aren't FDA approved, but we could use Flutamide if that's interesting?
3) Thanks for the studies. Herbal ingredients like Licorice & tea tree oil are harder for a compounding pharmacy to incorporate. Diclofenac we could look into--are there other studies or anecdotal experiences that make this a must have?
4) What's the likelihood that 0.01% TOPICAL finasteride is going to cause side effects if they're little to none systemic absorption?
5) Would you prefer topical duasteride vs. finasteride? What concentration would guarantee it's not absorbed systemically (e.g. 0.01%)?

 

[Selb]

Thanks for the suggestions.

1) Do you know if topical caffeine absorbs systemically? A lot of patients are sensitive to it.
2) We can't use drugs like Fluridil that aren't FDA approved, but we could use Flutamide if that's interesting?
3) Thanks for the studies. Herbal ingredients like Licorice & tea tree oil are harder for a compounding pharmacy to incorporate. Diclofenac we could look into--are there other studies or anecdotal experiences that make this a must have?
4) What's the likelihood that 0.01% TOPICAL finasteride is going to cause side effects if they're little to none systemic absorption?
5) Would you prefer topical duasteride vs. finasteride? What concentration would guarantee it's not absorbed systemically (e.g. 0.01%)?

Topical dutasteride would have to be something used once weekly. Or less depending on sensitivity. So a daily lotion shouldn’t be the vehicle for it. I would think maybe have one daily finasteride base topical, and a weekly topical with dutasteride inside of it.

 

[TurboFixer]

Thanks for the suggestions.

1) Do you know if topical caffeine absorbs systemically? A lot of patients are sensitive to it.
2) We can't use drugs like Fluridil that aren't FDA approved, but we could use Flutamide if that's interesting?
3) Thanks for the studies. Herbal ingredients like Licorice & tea tree oil are harder for a compounding pharmacy to incorporate. Diclofenac we could look into--are there other studies or anecdotal experiences that make this a must have?
4) What's the likelihood that 0.01% TOPICAL finasteride is going to cause side effects if they're little to none systemic absorption?
5) Would you prefer topical duasteride vs. finasteride? What concentration would guarantee it's not absorbed systemically (e.g. 0.01%)?

like Selb correctly pointed out, the way people have been trying to dodge sides on dutasteride has been applying it in several day intervals.

Also apparently many who are sensitive to finasteride will sadly still get sides even from the 0.01% dosage. I don't know much about this aside from a few anecdotes.

Users like @corkmeister @sonictemples @FilthyFrancis (sorry for the @ folks) may be able to shed some light on the subject as they have been actively researching topical dutasteride as a safer/more efficacious alternative.



Melatonin and Resveratrol are supposed to be good for hair too. A company called triple hair has a OTC drug that uses both of those coming out in a few months iirc

Topical Melatonin for Treatment of Androgenetic Alopecia

In the search for alternative agents to oral finasteride and topical minoxidil for the treatment of androgenetic alopecia (Androgenetic Alopecia), melatonin, a potent antioxidant and growth modulator, was identified as a promising candidate based on in vitro and in vivo ...

www.ncbi.nlm.nih.gov

I don't have a good resveratrol study on hand, but I think there are some good things written about it



Oh also cetirizine is supposed to be pretty helpful topically. Orally it is definitely not sustainable long-term as a hair drug. I don't know if you want to include it alongside the latanoprost, hopefully a wiser user may be able to contribute on this subject

 

[jamesbooker1975]

Hi gourmetstylewellness.com Members,
My clinic is planning on offering a physician-prescribed hair loss solution that you can order online, and I wanted to get input from members of this forum since I know there are a lot of bright & experienced minds here, and a lot of the prescriptions that people want are either 1) not available in the US, 2) not at the dosages people want, 3) cost-prohibitive.

What would you want to see in a 'holy grail' prescription topical foam?

Here's our v1 formula (feedback welcome):
Latanoprost 0.1% (strength used in studies and not commonly available)
Finasteride 0.01% (microdosed to prevent systemic absorption, as we've documented 71% suppressed serum DHT using a stronger 0.25% topical, equivalent to the suppression seen with 1mg oral finasteride).
Minoxidil 8% (Rx strength, since 5% is readily available OTC).

Any other suggestions? (must be an ingredient that a compounding pharmacy can get from an FDA manufacturer)
I've seen the following ingredients in other custom/combination ingredients (feedback welcome):
Retinoic Acid 0.01-0.1%
Azelaic Acid 0.025%
Betamethasone 0.01%
Ketoconazole 2%
Anything else?

add tretinoin 0.01% .
Ketoconazole with time , if you use a lotion, most probable will go systemic. Use it only as shampoo and leave it for 10 to 20 minutes. Of course, if you can do a blood work done before and after , you can try the lotion . It is a great anti androgen ketoconazole.
In my personal experience, even 0.1% Finasteride is much safer than oral 1mg daily . So you can increase the dose . You can also do blood work, and if not, simple check your body hair that is really dependent on DHT . With dutasteride, I had to shave it once per week, without it, every 2-3 days.

 

[Dr.]

1) We're formulating a daily topical, so if duasteride can't be used daily due to it's long half-life and elimination, then we should probably not include it.

2) Can you share any anecdotes about topical finasteride causing side effects even at microdoses like 0.01% (NOT 0.1%). This is 0.1 mg/ml applied topically. We can also use 0.005% (0.05 mg/ml), as this was the dosage used in the original topical finasteride study:

"The first study on topical finasteride in humans was completed in 1997 by Mazarella et al.as a single-blind, placebo-controlled study, including 28 males and 24 females patients with Androgenetic Alopecia. Subjects were randomized to receive either 1.0 mL topical FNS 0.005% solution or placebo twice daily to the affected scalp for 16 months. Pharmacodynamic data revealed no significant change in plasma levels of total testosterone, free testosterone, and DHT between the groups.

A Systematic Review of Topical Finasteride in the Treatment of Androgenetic Alopecia in Men and Women

3) We can include topical melatonin. I've seen formulations that use 0.0033% that don't seem to have significant systemic effects:
"Treatment with the cosmetic melatonin solution was shown to be well tolerated because no significant changes were detected in the various laboratory tests and circulatory system parameters nor were any effects on the central nervous system identified in comparison with placebo." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3681103/

4) We can include tretinoin 0.01%. Any downsides to doing so?

5) Anything else?

 

[Selb]

1) We're formulating a daily topical, so if duasteride can't be used daily due to it's long half-life and elimination, then we should probably not include it.

2) Can you share any anecdotes about topical finasteride causing side effects even at microdoses like 0.01% (NOT 0.1%). This is 0.1 mg/ml applied topically. We can also use 0.005% (0.05 mg/ml), as this was the dosage used in the original topical finasteride study:

"The first study on topical finasteride in humans was completed in 1997 by Mazarella et al.as a single-blind, placebo-controlled study, including 28 males and 24 females patients with Androgenetic Alopecia. Subjects were randomized to receive either 1.0 mL topical FNS 0.005% solution or placebo twice daily to the affected scalp for 16 months. Pharmacodynamic data revealed no significant change in plasma levels of total testosterone, free testosterone, and DHT between the groups.

A Systematic Review of Topical Finasteride in the Treatment of Androgenetic Alopecia in Men and Women

3) We can include topical melatonin. I've seen formulations that use 0.0033% that don't seem to have significant systemic effects:
"Treatment with the cosmetic melatonin solution was shown to be well tolerated because no significant changes were detected in the various laboratory tests and circulatory system parameters nor were any effects on the central nervous system identified in comparison with placebo." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3681103/

4) We can include tretinoin 0.01%. Any downsides to doing so?

5) Anything else?

Castor oil might be something to consider too

 

[sonictemples]

Thanks for the suggestions.

1) Do you know if topical caffeine absorbs systemically? A lot of patients are sensitive to it.
2) We can't use drugs like Fluridil that aren't FDA approved, but we could use Flutamide if that's interesting?
3) Thanks for the studies. Herbal ingredients like Licorice & tea tree oil are harder for a compounding pharmacy to incorporate. Diclofenac we could look into--are there other studies or anecdotal experiences that make this a must have?
4) What's the likelihood that 0.01% TOPICAL finasteride is going to cause side effects if they're little to none systemic absorption?
5) Would you prefer topical duasteride vs. finasteride? What concentration would guarantee it's not absorbed systemically (e.g. 0.01%)?

You have to use 3% or above caffeine for it to work. It made my hair darker

 

[Capone]

Elk semen, failing that, some duta

 

[corkmeister]

1) We're formulating a daily topical, so if duasteride can't be used daily due to it's long half-life and elimination, then we should probably not include it.

2) Can you share any anecdotes about topical finasteride causing side effects even at microdoses like 0.01% (NOT 0.1%). This is 0.1 mg/ml applied topically. We can also use 0.005% (0.05 mg/ml), as this was the dosage used in the original topical finasteride study:

"The first study on topical finasteride in humans was completed in 1997 by Mazarella et al.as a single-blind, placebo-controlled study, including 28 males and 24 females patients with Androgenetic Alopecia. Subjects were randomized to receive either 1.0 mL topical FNS 0.005% solution or placebo twice daily to the affected scalp for 16 months. Pharmacodynamic data revealed no significant change in plasma levels of total testosterone, free testosterone, and DHT between the groups.

A Systematic Review of Topical Finasteride in the Treatment of Androgenetic Alopecia in Men and Women

It's right there in the quote: 0.005% twice daily, so that'll be comparable to 0.01% once daily. Or at least that's how I've always understood it. I don't have them on hand but there are plenty of anecdotes of people getting side-effects with these dosages, despite Mazzarella's results. As I've mentioned many times before, I personally believe 0.01% daily is somewhere around the upper limit of what many people can handle without systemic effects accumulating over time.

I mean this with all due respect, but I find it questionable that that you're representing a clinic and you're trying to create a 'holy grail' prescription formula (for financial gain, I would assume), but simultaneously have so little knowledge about what you're putting into the formula that you have to ask these types of questions on a hairloss forum. You would have found those anecdotes yourself if you did some research, for example. No offense.

 

[nick123]

1) We're formulating a daily topical, so if duasteride can't be used daily due to it's long half-life and elimination, then we should probably not include it.

2) Can you share any anecdotes about topical finasteride causing side effects even at microdoses like 0.01% (NOT 0.1%). This is 0.1 mg/ml applied topically. We can also use 0.005% (0.05 mg/ml), as this was the dosage used in the original topical finasteride study:

"The first study on topical finasteride in humans was completed in 1997 by Mazarella et al.as a single-blind, placebo-controlled study, including 28 males and 24 females patients with Androgenetic Alopecia. Subjects were randomized to receive either 1.0 mL topical FNS 0.005% solution or placebo twice daily to the affected scalp for 16 months. Pharmacodynamic data revealed no significant change in plasma levels of total testosterone, free testosterone, and DHT between the groups.

A Systematic Review of Topical Finasteride in the Treatment of Androgenetic Alopecia in Men and Women

3) We can include topical melatonin. I've seen formulations that use 0.0033% that don't seem to have significant systemic effects:
"Treatment with the cosmetic melatonin solution was shown to be well tolerated because no significant changes were detected in the various laboratory tests and circulatory system parameters nor were any effects on the central nervous system identified in comparison with placebo." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3681103/

4) We can include tretinoin 0.01%. Any downsides to doing so?

5) Anything else?

I believe Triple Hair will be using 0.1% melatonin in their upcoming topical.

Source:

WO2017004692A1 - Composition comprising resveratrol and melatonin for reducing hair loss and/or increasing hair regrowth - Google Patents

The invention relates to a composition comprising 0.01% to 15% resveratrol and 0.01% to 15% of melatonin. In a preferred embodiment, the composition comprises 5% resveratrol and 0.1 % melatonin. The invention also relates to the use of the said composition to reduce hair loss and/or increase...

patents.google.com

 

[jamesbooker1975]

1) We're formulating a daily topical, so if duasteride can't be used daily due to it's long half-life and elimination, then we should probably not include it.

2) Can you share any anecdotes about topical finasteride causing side effects even at microdoses like 0.01% (NOT 0.1%). This is 0.1 mg/ml applied topically. We can also use 0.005% (0.05 mg/ml), as this was the dosage used in the original topical finasteride study:

"The first study on topical finasteride in humans was completed in 1997 by Mazarella et al.as a single-blind, placebo-controlled study, including 28 males and 24 females patients with Androgenetic Alopecia. Subjects were randomized to receive either 1.0 mL topical FNS 0.005% solution or placebo twice daily to the affected scalp for 16 months. Pharmacodynamic data revealed no significant change in plasma levels of total testosterone, free testosterone, and DHT between the groups.

A Systematic Review of Topical Finasteride in the Treatment of Androgenetic Alopecia in Men and Women

3) We can include topical melatonin. I've seen formulations that use 0.0033% that don't seem to have significant systemic effects:
"Treatment with the cosmetic melatonin solution was shown to be well tolerated because no significant changes were detected in the various laboratory tests and circulatory system parameters nor were any effects on the central nervous system identified in comparison with placebo." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3681103/

4) We can include tretinoin 0.01%. Any downsides to doing so?

5) Anything else?

5) Anything else?
Cetirizine at 1 % is all another good thing to add.

 

[nick123]

1) We're formulating a daily topical, so if duasteride can't be used daily due to it's long half-life and elimination, then we should probably not include it.

2) Can you share any anecdotes about topical finasteride causing side effects even at microdoses like 0.01% (NOT 0.1%). This is 0.1 mg/ml applied topically. We can also use 0.005% (0.05 mg/ml), as this was the dosage used in the original topical finasteride study:

"The first study on topical finasteride in humans was completed in 1997 by Mazarella et al.as a single-blind, placebo-controlled study, including 28 males and 24 females patients with Androgenetic Alopecia. Subjects were randomized to receive either 1.0 mL topical FNS 0.005% solution or placebo twice daily to the affected scalp for 16 months. Pharmacodynamic data revealed no significant change in plasma levels of total testosterone, free testosterone, and DHT between the groups.

A Systematic Review of Topical Finasteride in the Treatment of Androgenetic Alopecia in Men and Women

3) We can include topical melatonin. I've seen formulations that use 0.0033% that don't seem to have significant systemic effects:
"Treatment with the cosmetic melatonin solution was shown to be well tolerated because no significant changes were detected in the various laboratory tests and circulatory system parameters nor were any effects on the central nervous system identified in comparison with placebo." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3681103/

4) We can include tretinoin 0.01%. Any downsides to doing so?

5) Anything else?

4) I don't see any downsides to including tretinoin, more companies are catching onto the Minoxidil + Tretinoin combination and including it in their products: e.g https://www.strutyours.com/p/43/finasteride-hair-loss-gel uses 7% Minoxidil and 0.05% Tretinoin.

5) I'm not entirely sure about this one but potentially 1% Sandalore? Sandalore was widely discussed on this forum on a big thread here: https://www.gourmetstylewellness.com/intera...s-to-mimic-sandalwood-triggers-growth.117273/ . You'll find in the thread a number of people tried Sandalore but I'm not convinced all of these people properly formulated it. Sandalore is water insoluble and many users were just throwing it into their Minoxidil solution which is mostly comprised of water, meaning most of the sandalore would have precipated and become ineffective.

Sandalore Sources:

Topical odorant application of the specific olfactory receptor OR2AT4 agonist, Sandalore® , improves telogen effluvium-associated parameters - PubMed

This clinical trial supports previous findings of anagen-prolonging effects of Sandalore^® ex vivo with similar results now reproduced in clinical practice. It also provides proof-of-principle that a topically applied cosmetic odorant acting through HF olfactory receptors can be a...

pubmed.ncbi.nlm.nih.gov

Olfactory receptor OR2AT4 regulates human hair growth

Olfactory receptors are expressed by different cell types throughout the body and regulate physiological cell functions beyond olfaction. In particular, the olfactory receptor OR2AT4 has been shown to stimulate keratinocyte proliferation in the skin. ...

www.ncbi.nlm.nih.gov

 

[jazz1]

I use this in my prescription formula from a compound pharmacy in America:

15% Minoxidil
0.1% Finasteride
5% Azelaic Acid
0.25% Progesterone
0.025% Tretinoin
0.1% Hydocortisone

You can order here and compare the price might work out cheaper for you....

https://www.gourmetstylewellness.com/interact/threads/topical-minoxidil-finasteride-mixture-check-here.126633/

 

[Dr.]

Wanted to provide an update and get feedback on the latest formula:

- Decided to forgo the finasteride (even at 0.01%) because if it scares consumers away from using it, then that's no good.
- I've seen azalaic acid concentrations from 0.025-12.5% used (mostly between 1.5-5%), so it's hard to tell what dose is optimal.
- Any strong feelings/anecdotes about Cetirizine 1%, Diclofenac, or Resveratrol, which were previously mentioned?
- Reluctant about adding coritcosteroids (Betamethasone 0.01%) long-term, or Ketozonazole at 2% due to possible systemic absorption

• Rx Ingredients:
  • Latanoprost 0.1%
  • Minoxidil 8%
  • Tretinoin 0.01%
• OTC Ingredients:
  • Melatonin 0.0033%
  • Sandalore 0.1%
  • Azelaic Acid 5%
  • Zinc Sulfate 0.25%
  • Vitamin B6 (P5P) 0.25%

 

[Isneezedsohard]

Wanted to provide an update and get feedback on the latest formula:

- Decided to forgo the finasteride (even at 0.01%) because if it scares consumers away from using it, then that's no good.
- I've seen azalaic acid concentrations from 0.025-12.5% used (mostly between 1.55-5%), so it's hard to tell what dose is optimal.
- Any strong feelings/anecdotes about Cetirizine 1%, Diclofenac, or Resveratrol, which were previously mentioned? I
- Reluctant about adding coritcosteroids (Betamethasone 0.01%) long-term, or Ketozonazole at 2% due to possible systemic absorption

• Rx Ingredients:
  • Latanoprost 0.1%
  • Minoxidil 8%
  • Tretinoin 0.01%
• OTC Ingredients:
  • Melatonin 0.0033%
  • Sandalore 0.1%
  • Azelaic Acid 5%
  • Zinc Sulfate 0.25%
  • Vitamin B6 (P5P) 0.25%

when/where/how can this be purchased