Clascoterone (Breezula) --
What It Can and Cannot Do
Clascoterone (Breezula) for androgenetic alopecia - mechanism, evidence, comparison with Finasteride and who should use it.
Reviewed by Dr. Arslan Musbeh · Last updated 2026-04-17
Clascoterone (Breezula) for androgenetic alopecia - mechanism, evidence, comparison with Finasteride and who should use it. Dr. Arslan Musbeh.
How it works
Clascoterone is a topical competitive antagonist of androgen receptors at the hair follicle. Unlike Finasteride which reduces systemic DHT production, Clascoterone blocks DHT from binding to follicle receptors locally - without affecting systemic hormone levels. This makes it relevant for men concerned about Finasteride side effects and for women.
Clinical evidence
Phase III trials showed statistically significant reduction in hair loss progression vs placebo at 24 weeks. The effect is stabilising - slows progression rather than reversing established baldness. It is not a surgical alternative and does not restore significant density in established bald areas.
Clascoterone vs Finasteride
| Factor | Finasteride 1mg | Clascoterone |
|---|---|---|
| Mechanism | Reduces systemic DHT (oral) | Blocks follicle receptors (topical) |
| Efficacy | Higher (85% stabilisation) | Moderate |
| Systemic side effects | Possible 1-2% | Minimal to none |
| Use in women | Contraindicated | Potentially appropriate |
Hair Transplant Turkey | Dr. Arslan Musbeh
Common questions
Can Clascoterone regrow hair in a bald area?
No. Phase III trials show it slows progression of hair loss rather than reversing established baldness. It is not a surgical alternative and does not restore significant density where follicles are already dormant.
Is Clascoterone a safe option for women with hair loss?
It is potentially appropriate for women because it acts locally at the follicle rather than lowering systemic DHT, unlike oral Finasteride, which is contraindicated in women of childbearing potential. A dermatologist should confirm suitability based on the pattern of loss.
Can Clascoterone be combined with a hair transplant?
Yes. It can be used alongside or after a transplant to slow miniaturisation of the native hair surrounding the grafts. Transplanted follicles are DHT-resistant and unaffected by it either way.
References & sources
- Onda M et al. Follicular unit extraction: A systematic review of the literature. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2020. https://doi.org/10.1016/j.bjps.2019.11.006
- Bernstein RM, Rassman WR. Follicular unit transplantation: 2005. Dermatologic Clinics. 2005. https://doi.org/10.1016/j.det.2005.01.007
- Avram MR, Rogers NE. Contemporary hair transplantation. Dermatologic Surgery. 2009. https://doi.org/10.1111/j.1524-4725.2009.01338.x
- American Academy of Dermatology Association. Hair loss: diagnosis, treatment and outcome. AAD Guidelines. 2023. https://www.aad.org/public/diseases/hair-loss/treatment
- International Society of Hair Restoration Surgery. Practice census survey โ global hair restoration statistics. 2022. https://www.fue-europe.com/professionals/resources/practice-census/
- NHS. Hair loss โ overview and treatment options. National Health Service (UK). 2023. https://www.nhs.uk/conditions/hair-loss/
All references are peer-reviewed medical literature or official health authority publications. No commercial sources included.
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