Males have reported serious side effects from using topical finasteride, a popular hair loss treatment available through telehealth platforms. The FDA recently issued a warning after documenting 32 adverse events between 2019 and 2024.

While finasteride is FDA-approved in oral form, no topical versions have received approval. Despite this, telehealth companies like Hims & Hers and Ro commonly market these compounded formulations.

Reported side effects mirror those of oral finasteride, including:

• Depression
• Fatigue
• Insomnia
• Decreased libido
• Erectile dysfunction
• Dizziness
• Anxiety

Many users claim they weren't properly informed about these risks, with some being told that topical application carried no side effects. Dr. Anthony Oro of Stanford Medicine explains that people mistakenly assume topical application is safer, but the drug can still enter the bloodstream.

Additional risks specific to topical finasteride include:

• Skin irritation
• Erythema
• Dryness
• Stinging or burning
• Potential transfer to others through skin contact
• Serious risks during pregnancy

The FDA warning highlights broader concerns about compounded medications, which aren't subject to FDA review or approval. As telehealth makes these products more accessible, patients may be unaware of potential dangers.

The agency emphasizes the importance of healthcare providers educating patients about these risks. Dr. Oro stresses that proper medical oversight and an established doctor-patient relationship are crucial for safe treatment with finasteride, whether oral or topical.

Experts advise patients considering topical finasteride to:

1. Consult with a qualified healthcare provider
2. Discuss all potential risks and side effects
3. Report any adverse effects to the FDA
4. Be particularly cautious with compounded formulations
5. Understand that topical application doesn't eliminate systemic risks

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