This is what we have been saying for years. Inflammation, and eventual fibrosis are ultimately what causes hair loss in both MPB and FPB, not DHT per se. DHT simply initiates this process.
Reducing DHT and /or blocking its binding to receptors can be readily accomplished with either pharmaceuticals (Propecia, Dutasteride, or Spironolactone) or Natural compounds such as Black Tea(Theaflavin) Extract, a combination of either Mega Green Tea Extract and Super Absorbable Soy Isoflavones, or PalmettoGuard with Astaxanthin.
Many prefer to use natural compounds because of the numerous additional health benefits and the side effects associated with these particular drugs.
This research article points out that simply blocking or reducing androgen actions is often not enough to resolve hair loss. Inflammation and its eventual consequence, fibrosis must be dealt with as well.
Inflammatory Phenomena and Fibrosis in Androgenetic Alopecia
Ralph M. Treb
Department of Dermatology
University Hospital of Zurich
In androgenetic alopecia the genetically predisposed hair follicles are susceptible to androgen-stimulated hair follicle miniaturization, leading to replacement of large and pigmented hairs by barely visible depigmented hairs. The result is a progressive decline in visible scalp hair density that follows a defined, age- and sex-dependent pattern. Major advances have been achieved in understanding peculiarities of the androgen metabolism involved. Nevertheless, clinical practice has shown that simply blocking androgens has only limited success. On histologic examination, the miniaturization of terminal hairs is frequently associated with perifollicular inflammatory phenomena, and eventually fibrosis. Therefore, sustained microscopic follicular inflammation with connective tissue remodeling, eventually resulting in permanent hair loss, is considered a significant cofactor in the complex etiology of androgenetic alopecia.
Several of our long standing, and in some cases patented, hair loss treatment recommendations directly address the perifollicular inflammation alluded to in the above research:
Emu Oil: topically applied, immediately ameliorates inflammation , and it is this anti-inflammation effect that is thought to be behind its hair growth stimulation effects.
Optimized Resveratrol combined with Super BioCurcumin: a patented oral hair growth treatment combination from Italy that its research team found cured both perifollicular and neurogenic inflammation.
Super Absorbable Tocotrienols: a patented hair growth treatment that in addition to stimulating hair growth via its anti-oxidant/anti-inflammation effects, raises testosterone in men. For this reason it is often used by those coming off of Propecia.
Mega Green Tea Extract/Grape Seed Extract/ Taurine /Zinc combination: A patented combination by L’Oreal sold in Europe under the name Hair Mass. It counters hair loss by quelling peri-follicular inflammation and with the addition of Taurine, fibrosis.
Even though I use all of the above, these treatment compounds are also effective as standalone treatments. However if your treatment regime only involves lowering and/or blocking DHT at its receptor sites, your results as this research stated, may have limited success.
For optimal results you want to address not only DHT, but inflammation and fibrosis as well.