RU58841 is a non-steroidal anti-androgen that has gained attention in hair loss communities as a potential alternative to topical finasteride. Does it work, is it safe and how does it compare with finasteride? Currently, there aren’t definitive answers to these questions, but we can help separate fact from fiction.
There are many online anecdotes where hair loss sufferers have described everything from positive treatment experiences with RU58841, to seeing no results at all. Importantly, there have also been some reports of unpleasant and potentially serious side effects. If you’re considering RU58841, we hope this guide will help get you closer to finding a solution that fits your needs.
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What is RU58841?
RU58841 is the name of a topical non-steroidal anti-androgen that first gained attention in the 1990s after several pre-clinical studies were published with positive results for hair growth. Pre-clinical studies are typically conducted on animals and data from these studies can give researchers and clinicians valuable information about whether a similar response or effect can be expected in humans. However, it’s important to understand that they aren’t a replacement for human studies.
Results from animal studies included observations like increased linear hair growth rate, number of active follicles and number of follicles that entered a second growth cycle, as well as increased hair density and thickness, with apparently no systemic effects (de Brouwer et al., 1997 and Pan et al., 1998).
In addition to these animal studies, there was one paper published in 2005 where a team of researchers performed a series of in vitro (laboratory) tests that examined how RU58841 moved through pork skin and whether their novel topical formula could be used to further target human hair follicles (Munster et al., 2005). The results confirmed that topical delivery was able to limit exposure to RU58841 in samples, but there was no further information about efficacy or safety.
There has been no published human clinical data on RU58841, but that hasn’t stopped some people from getting their hands on RU58841 and trying it themselves. Motivations range from trying finasteride previously without seeing results, concern over the possible side effects of finasteride and coming across before-and-after photos that seem (almost) too good to be true.
We aren’t here to shame anyone for wanting to find a solution for hair loss that works but it’s important for people to understand what they’re getting into. RU58841 is a wildcard treatment that hasn’t been extensively studied in humans, which means its safety profile and appropriate dosing aren’t clear. While it’s true that investigational or “experimental” drugs can change lives, it’s important to proceed with caution.
Dr. Christina Han: “I certainly advise my patients to take any data on an experimental drug with a grain of salt. Typically, the data that is presented reports small numbers of subjects so it’s difficult to draw any conclusions without a larger study looking at efficacy and safety, especially when we are talking about a completely new molecule and understanding the mechanism and safety is less understood.”
Is RU58841 actually for hair loss and how does it work?
The exact mechanism of RU58841 isn’t clear, but we can talk about how they’re theorized to work. RU58841 is an androgen receptor antagonist. Androgen receptor antagonists work by blocking access to androgen receptors. Androgen receptors are the binding sites or “landing docks” on the surface of cells that androgens (male hormones) such as testosterone and DHT need to attach onto to take effect.
Male pattern hair loss, or androgenetic alopecia, occurs when the hormone DHT attaches to androgen receptors in hair follicle cells, causing a process called follicular miniaturization to begin. Essentially, the hair follicle starts to shrink until it can no longer produce hairs healthy enough to break the scalp’s surface. This is what causes gradual thinning and eventually, the formation of bald spots.
By theoretically preventing DHT from binding to hair follicle cells, RU58841 may help slow down, or in some cases, prevent this process from happening. Also, RU58841 is used topically (i.e., applied directly to the scalp instead of a pill), this means that the DHT blocking effects are more likely to be localized to the scalp instead of affecting the whole body. This doesn’t mean however, that there is no chance that RU58841 could enter the bloodstream at levels significant enough to cause possible side effects. We just don’t have this information.
Again, we want to stress that the mechanism of RU58841 hasn’t been extensively studied and there is also next to no data on what a safe and effective dose would look like in humans.
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When to expect results with RU58841
Unfortunately, the lack of clinical data for RU58841 makes it difficult to provide definitive information on what patients can expect when it comes to results.
We can talk more generally about the results timeframe for a medication like finasteride. Even though these medications work in different ways, it’s not too much of a stretch to say that many hair loss medications (e.g., finasteride, dutasteride, or minoxidil) share similar result timelines.
Months 1-3: During months 1-3, this is when your body is adjusting to treatment and is also the period when shedding is the most likely. This is usually the result of these agents hitting “reset” on your hair follicles, causing them to enter new growth cycles and pushing out older hairs to make room for newer growth.
Months 3-6: This shedding typically resolves between months 3-6. At this point, patients sometimes report seeing baby hairs and early signs of previously thinning areas starting to fill in.
Months 6-12: At 6-12 months, this is when many people will really see the fruits of their consistency. In fact, many dermatologists and hair loss specialists recommend staying on hair loss treatment for at least 6 months before deciding whether something is working or not. Waiting can be hard, but hair regrowth is a long game. Any treatment or medication that claims to deliver results overnight should be approached with caution.
There can be variation between individuals in terms of how their bodies respond to medications or ingredients, as well as the degree to which androgens are driving their hair loss, that can lead to more dramatic results in some patients. While before and after photos can be extremely useful to help give you an idea of what to expect, they don’t guarantee results.
Dr. Christina Han: “I always remind my patients that treatment success doesn’t always equate to regrowth. I remind them that without any treatment, progressively the hair loss will continue, so going on treatment and having this slow or halt is considered treatment success. Regrowth of course, is the goal for all patients, but setting expectations when it comes to hair growth is important to stay aligned together.”
RU58841 before and after: what can you really expect?
It’s not hard to come across what people claim are real before-and-after photos after using RU58841. Again, because there isn’t any published human clinical data on efficacy or results, it’s difficult to verify the authenticity of these results. We feel that it’s important and valuable for patients to share their experiences with others, but here are some things to look out for when trying to decide whether to believe a set of photos:
- Are the photos taken with the same lighting, hair length, and angle? Are they all taken with wet hair or dry hair?
- Using tricks like changing the direction of combing or other styling techniques to create the illusion of more density?
- Using hair fibers and concealers to again, alter the appearance of hair density
- Timelines that seem too good to be true (example: dramatic change in weeks rather than months)
- Posts that are too pushy and sales focused (examples: using urgent language to try to get people to act quickly, or directing people to a website where they can buy the treatment)
Remember, RU58841 is not an approved hair loss treatment and it’s a good idea to be critical of what you see.
What side effects can RU58841 cause? What are the biggest unknowns?
Little is known about the safety profile of RU58841. Anecdotally, people have reported side effects ranging from chest pain to brain fog, to sexual dysfunction. Without clinical trials to support these findings, it’s not possible to know how serious or common these side effects are, or whether they leave patients with permanent effects. In addition to these systemic side effects, it’s also possible that RU58841 could result in skin-focused side effects such as irritation, dryness, or allergic reactions as a result of topical application.
If you think you may be experiencing side effects with any hair loss medication, it’s important to stop using it and seek medical attention as soon as possible.
Can RU58841 affect acne?
Pre-clinical studies on RU58841 did show some early signals of potential for treating acne, however like androgenetic alopecia, these effects haven’t been systematically explored in human trials. So, what’s the link between RU58841 and acne?
Acne is a common inflammatory skin condition that occurs when pores of the skin become clogged with sebum (oil) and dead skin cells. Bacteria can grow in these clogged pores, causing inflammation associated with redness, pain and swelling. It’s well known that androgen hormones such as testosterone and DHT can affect oil production.
When androgens bind to androgen receptors on sebaceous glands (oil producing cells), they produce more oil. This increased oil production can contribute to acne.
Since RU58841 is theorized to block androgen receptors, it’s possible that it could help reduce oil production and lower the risk of acne. However, there are many clinically validated options for treating acne that include prescription medications and over-the-counter treatments that are supported by evidence and safety information. It’s not necessary to resort to an experimental drug for this skin condition.
What's the difference between RU58841 powder vs premixed solutions?
RU58841 is intended to be used as a topical formulation. Powdered forms require an extra step of preparation, presumably mixing the powder with some quantity of solvent (usually a liquid that can dissolve it). Premixed solutions don’t require this step.
There is considerable risk in preparing these topical solutions at home. As before, there are no standardized methods or quantities and lots of room for user error and inconsistency. Remember, this is a drug with many unknowns. In addition to all of this, there’s no way to guarantee whether the RU58841 you’re using is legitimate and of a quality that is safe to use.
Our strong recommendation is to talk to a doctor or hair loss specialist about your options. If you’re worried about sexual side effects or efficacy, the best place to start is by consulting with a professional. That way, you’ll have an ally throughout your hair journey who can be there for you if you encounter issues.
How does RU58841 compare to finasteride (especially topical finasteride)?
One big reason people investigate using RU58841 is the belief that it could be a better option compared to finasteride (and specifically, topical finasteride). Let’s take some time to examine the differences between them.
First, RU58441 and finasteride work in different ways. Finasteride is a 5-alpha reductase inhibitor that works primarily by blocking the conversion of testosterone into DHT. This results in a decrease in DHT levels, which can help slow down or prevent the progression of pattern hair loss. Many men are worried about these DHT-lowering effects because they’ve been associated with side effects like erectile dysfunction and decreased libido.
These days, it’s possible to obtain a prescription for topical finasteride. It’s a compounded medication, which means that this topical format is not FDA or Health Canada approved. That said, physicians can prescribe it if they believe that the potential benefits outweigh the risks for a particular patient, or if someone is worried about systemic exposure. Choosing topical finasteride over oral finasteride may help reduce the risk of systemic side effects because these formulations are intended to focus treatment on the scalp and limit absorption of the drug into the body. However, not all topical formulations are created equal. It remains important to consult with a doctor about the potential risks and benefits of compounded topical finasteride.
Second, it’s important to remember that finasteride is supported by more than two decades of clinical research in humans and in its oral form at a dose of 1 mg, is FDA-approved to treat male pattern hair loss. This doesn’t mean that finasteride is completely risk-free—instead, it’s the fact that it’s been extensively studied that allows clinicians and patients to be understand dosing, the body’s response to it and what can go wrong. For topical finasteride, the format itself hasn’t been standardized, however, the active ingredient is well-researched. It’s the difference between an evidence-backed option and one that's theoretical.
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RU58841 for hair loss: the last word
RU58841’s potential as a treatment for male pattern hair loss is speculative. There is very limited data to support its efficacy, safety and appropriateness for human use. We understand that even approved medications like oral finasteride carry risks and patients are right to be concerned about potential side effects. However, it’s best to consult with a healthcare professional who can work with you on finding an option that fits your needs and goals. The other advantage to this is having access to a provider who you can go to with any questions or concerns about side effects and progress.
If you’re still interested in topical finasteride as a potential option, we may be able to help. Start a consultation with one of our hair loss specialists or learn more about our gel designed to target finasteride to the scalp and minimize body exposure.
Dr. Christina Han, MD FRCPC
Canadian and U.S. board-certified Dermatologist
XYON: Medical Director
Education
Dermatology (Postgraduate Residency) — University of British Columbia (UBC), Canada — 2012
Doctor of Medicine (MD) — University of British Columbia 58841(UBC), Canada — 2007
Bachelor of Science (BSc), Microbiology & Immunology — University of British Columbia (UBC), Canada — 2002
Additional Training
Additional dermatological training — Yonsei University, Seoul
Focus areas: dermatological and laser surgery; skin cancer treatment
Board Certification
Canadian board-certified dermatologist
U.S. board-certified dermatologist
References:
De Brouwer, B., Tételin, C., Leroy, T., Bonfils, A., & Van Neste, D. (1997). A controlled study of the effects of RU58841, a non-steroidal antiandrogen, on human hair production by balding scalp grafts maintained on testosterone-conditioned nude mice. The British Journal of Dermatology, 137(5), 699–702.
Pan, H. J., Wilding, G., Uno, H., Inui, S., Goldsmith, L., Messing, E., & Chang, C. (1998). Evaluation of RU58841 as an anti-androgen in prostate PC3 cells and a topical anti-alopecia agent in the bald scalp of stumptailed macaques. Endocrine, 9(1), 39–43. https://doi.org/10.1385/ENDO:9:1:39
Münster, U., Nakamura, C., Haberland, A., Jores, K., Mehnert, W., Rummel, S., Schaller, M., Korting, H. C., Zouboulis, C.hC., Blume-Peytavi, U., & Schäfer-Korting, M. (2005). RU58841-myristate prodrug development for topical treatment of acne and androgenetic alopecia. Die Pharmazie, 60(1), 8–12.
