Dutasteride / Hydrocortisone / Minoxidil / Tretinoin

(DHMT for Men) Solution

0.3% / 1% / 6.5% / 0.01%

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Product Overview

This topical solution for men combines dutasteride, hydrocortisone, minoxidil, and tretinoin in a formulation intended to address hair thinning and hair loss. Each ingredient has a distinct mechanism of action related to hair follicle biology, inflammation, and scalp processes. The formulation is designed to support follicle activity and overall scalp condition.

Dutasteride1-3

Dutasteride is a 5-alpha reductase inhibitor and a 4-aza analog of testosterone. It has been studied in relation to androgenetic alopecia, commonly referred to as male pattern hair loss.

Hydrocortisone4,5

Hydrocortisone is the synthetic form of cortisol, a hormone naturally produced by the adrenal glands, and exhibits both glucocorticoid and mineralocorticoid activity. When applied topically, hydrocortisone demonstrates anti-inflammatory, antipruritic, anti-mitotic, and immunosuppressive effects. Among topical corticosteroids, hydrocortisone is considered a low-potency option.

Minoxidil6-8

Topical minoxidil is a vasodilator that was originally developed as an oral antihypertensive medication. Its association with hair growth was identified following reports of hypertrichosis in patients receiving oral minoxidil. Subsequently, topical minoxidil received FDA approval for the treatment of androgenetic alopecia in both men and women.

Tretinoin9-12

Tretinoin is a naturally occurring derivative of vitamin A, also known as all-trans-retinoic acid. Retinoids may participate in the regulation of cell reproduction, proliferation, and differentiation. When used in combination with minoxidil, tretinoin has been associated with increased expression of certain markers related to hair growth, including Erk, Akt, Bcl-2, and Bax.

Dutasteride1-3

Dutasteride is a 4-azo analog of testosterone. It competitively and selectively inhibits both reproductive tissues (type 2) and skin and hepatic (type 1) 5α-reductase. This activity of dutasteride prevents the conversion of testosterone to dihydrotestosterone and significantly suppresses serum dihydrotestosterone levels. The type II 5-alpha-reductase isozyme is primarily found in prostate, seminal vesicles, epididymides, and hair follicles, as well as liver. Dihydrotestosterone has been shown to increase prostate growth and can lead to hair thinning.

Hydrocortisone4,5

The anti-inflammatory effects of topical hydrocortisone may occur through vasoconstriction. The vasoconstriction minimizes inflammatory mediators delivered to the inflamed area. Topical hydrocortisone may also inhibit the release of phospholipase A2, which reduces prostaglandins and leukotriene. Lastly, topical hydrocortisone inhibits DNA and transcription factors related to inflammation. It does this by increasing the expression of anti-inflammatory genes and indirectly inhibit inflammatory transcription factors, such as NF-kB, to decrease the expression of pro-inflammatory genes.

Topical hydrocortisone also has an anti-mitotic effect by decreasing epidermal mitosis mediated through an increase in lipocortin, an endogenous glucocorticoid-regulated protein.

Topical hydrocortisone also inhibits humoral factors in the inflammatory response by suppressing immune cells from maturing, differentiating and proliferating.

Minoxidil6-8

The drug has many mechanisms in supporting hair growth:

  • Potassium channel opening: Minoxidil is a K⁺-ATP channel opener, which may result in vasodilation and enhanced blood flow to hair follicles.
  • Prolongation of the hair cycle: It may extend the growth phase of the hair cycle, leading to increased follicle size and more robust hair shafts.
  • Activation of prostaglandins: May indirectly affect prostaglandin-mediated signaling to stimulate hair follicle activity.
  • Upregulation of vascular endothelial growth factor (VEGF): Promotes angiogenesis in dermal papillae, which may improve follicular nourishment.

Tretinoin9-12

Tretinoin may have several mechanisms to facilitate hair growth including the following:

  • Cell turnover-Tretinoin facilitates skin cell turnover which may open up hair follicles for hair growth
  • Enhanced absorption-Tretinoin may help absorption of minoxidil. This may be from the increased absorption of minoxidil which may be the result of increased sulfonation.
  • Prolong anagen phase-Tretinoin may help lengthen the growth phase of hair follicles.

Dutasteride1-3

Common

  • Scalp pruritus, burning sensation, irritation, contact dermatitis, and erythema

With systematic absorption (rare)

  • Decreased libido
  • Erectile dysfunction
  • Ejaculatory disorders (e.g., reduced volume)
  • Breast tenderness or enlargement
  • Gynecomastia

Hydrocortisone4

Common

  • Skin irritation, pruritus, dry skin, folliculitis, hair growth, acne

 

Minoxidil6-8

Common

Topical minoxidil is generally well tolerated but may cause local effects:

  • Scalp irritation, dryness, flaking
  • Erythema or contact dermatitis (more common with propylene glycol-containing formulations)
  • Pruritus or burning sensation
  • Unwanted facial hair growth (esp. in women or if solution drips onto other areas)

 

Tretinoin9

Common

  • Skin irritation, such as peeling, xerosis (dry skin), burning, stinging, erythema, and pruritus

Contraindications1-12

  • Known hypersensitivity or intolerance to dutasteride, hydrocortisone, latanoprost, minoxidil, and tretinoin or excipients
  • Contraindicated in women who are or may become pregnant if absorbed systemically due to risk of teratogenicity

Precautions1-12

  • Do not apply to open wounds
  • Use cautiously in patients with hepatic dysfunction. The drug is metabolized extensively in the liver.

Store at room temperatures between (59-86°F). Protect from light and keep the container tightly closed. Women should not handle crushed or broken finasteride tablets when they are pregnant or may potentially be pregnant because of the possibility of absorption of finasteride and the subsequent potential risk to a male fetus. Keep out of reach of children and pets.

  1. Dustasterife package insert. January 2020. Accessed August 24, 2025 https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/021319s032lbl.pdf
  2. Clinical Pharmacology dutasteride clinical monograph 2025 https://www.clinicalkey.com/pharmacology/  Accessed August, 24, 2025
  3. Al-Horani RA, Patel P. Dutasteride. StatPearls. March 20, 2024. Accessed August 24, 2025. https://www.ncbi.nlm.nih.gov/books/NBK603726/
  4. Clinical Pharmacology hydrocortisone clinical monograph 2025 https://www.clinicalkey.com/pharmacology/     Accessed August 15, 2025
  5. Gabros S, Nessel TA. Topical Corticosteroids. Statpearls. April 26, 2025. Accessed July 27, 2025.
  6. Clinical Pharmacology [Internet].: Elsevier; accessed May 2025; Minoxidil topical monograph. Available from: ClinicalKey; https://www.clinicalkey.com/pharmacology/monograph/408?n=Minoxidil
  7. Rogaine® (minoxidil topical solution) package insert. Johnson & Johnson Consumer Inc. https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=12fd18f0-859c-7b9a-e063-6394a90addbf&type=display Revised March 2024. Accessed June 16, 2025
  8. Goren A, Naccarato T. Minoxidil in the treatment of androgenetic alopecia. Dermatol Ther. 2018 Sep;31(5):e12686.
  9. Clinical Pharmacology tretinoin clinical monograph 2025 https://www.clinicalkey.com/pharmacology/
  10. Yoham AL, Casadesus D. Tretinoin. Statpearls. March 27, 2023. Accessed July 27, 2025.
  11. Sharma A, Goren A, Dhurat R, Agrawal S, Sinclair R, Trüeb RM, Vañó-Galván S, Chen G, Tan Y, Kovacevic M, Situm M, McCoy J. Tretinoin enhances minoxidil response in androgenetic alopecia patients by upregulating follicular sulfotransferase enzymes. Dermatol Ther. 2019 May;32(3):e12915.
  12. Can Tretinoin Help with Hair Growth? https://cityskinclinic.com/tretinoin-hair-growth/ June 12, 2025. Accessed August 15, 2025

WPPL operates as a 503A compounding pharmacy and prepares individualized prescription medications pursuant to provider direction. Compounded preparations are not reviewed, tested, or approved by the FDA.

This listing also includes commercially manufactured products for convenience; these items are not compounded by our pharmacy and are sold as provided by their manufacturers. Any statements regarding non-compounded products are manufacturer-supplied, have not been evaluated by the FDA, and are not intended to diagnose, treat, cure, or prevent any disease. WPPL does not verify or endorse any therapeutic claims made by manufacturers. Please refer to original labeling for complete product information.

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