Finasteride / Hydrocortisone / Latanoprost / Minoxidil / Tretinoin / Vit E (FHLMT-VIT E – Women)

Available Dosage Strengths

0.3% / 1% / 0.05% / 6% / 0.01%

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Product Overview

Description

This topical formulation for women combines finasteride, hydrocortisone, latanoprost, minoxidil, tretinoin and vitamin E together to target multiple pathways of hair loss by promoting follicle stimulation, reducing inflammation, and enhancing absorption. Each drug has a unique mechanism of action to support development and growth of hair. Designed for alopecia, it may support hair regrowth, scalp health, and improved hair density with consistent use.

Finasteride Description^1-3

Finasteride, a 5-alpha reductase inhibitor, has been shown to benefit patients with female pattern hair loss. Finasteride topically has shown to improve hair density and hair growth in pre-menopausal and post-menopausal women.

Hydrocortisone^4,5

Hydrocortisone, a steroid hormone that systematically has both glucocorticoid and mineralocorticoid activity, is the synthetic form of cortisol. Cortisol is a hormone produced by the adrenal glands. Hydrocortisone topically has anti-inflammatory, antipruritic, anti-mitotic, and immunosuppressive properties. There are many topical steroids available on the market. Hydrocortisone is a low potency steroid.

Latanoprost^6-10

Latanoprost works by mimicking prostaglandin F2α (PGF2α) to minimize glaucoma and to stimulate hair growth. There is evidence that the drug promotes hair growth, particularly in androgenetic alopecia (AGA) and eyelash/eyebrow hypotrichosis.^6-8 Its role in hair regrowth was first noted due to its adverse effect of increased eyelash growth in glaucoma patients.

Minoxidil^11-13

Topical minoxidil is a vasodilatory compound originally developed as an oral antihypertensive agent. It was found to stimulate hair growth (from the observation of hypertrichosis (excessive, abnormal hair growth) in patients taking oral minoxidil) and was subsequently FDA approved for androgenetic alopecia (male and female pattern hair loss).

Tretinoin^14-17

Tretinoin, a naturally occurring derivative of vitamin A, is also called all-trans-retinoic acid. Retinoids may facilitate regulation of cell reproduction, cell proliferation and differentiation. Combing tretinoin and minoxidil may provide a synergistic increase in the expression of hair growth markers(e.g., Erk, Akt, Bcl-2, and Bax).

Vitamin E¹⁸

Vitamin E (or tocopherol), a fat-soluble vitamin, that functions as an antioxidant, protecting the cell membrane. The body does not form vitamin E and needs to be provided it exogenously. Vitamin E may prevent reactive oxygen species from forming and protect the biosynthesis of collagen and glycosaminoglycans in skin. Vitamin E may benefit the following dermatological conditions: atopic dermatitis, epidermolysis bullosa, psoriasis, wound healing, melasma, scleroderma, acne vulgaris and melasma.

Mechanism of Action

Finasteride^1-3

Finasteride is an analog of testosterone that acts as a competitive, specific inhibitor of type II 5-alpha-reductase, an intracellular enzyme that converts testosterone to the potent androgen 5-alpha-dihydrotestosterone. The type II 5-alpha-reductase isozyme is found in the scalp hair follicles. Finasteride may decrease dihydrotestosterone levels through its effect on increasing insulin growth factor-1 production in the dermal papillae.

Hydrocortisone^4,5

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.

Latanoprost^6-10

Latanoprost binds to the prostaglandin F2α receptor on hair follicle dermal papilla cells, influencing the hair growth cycle as follows:

Prolongation of Anagen Phase (Growth Phase):

Increases the duration of anagen, which may result in longer and thicker hair shafts.

Stimulation of Melanogenesis:

May enhance pigmentation in vellus hairs, which may make them appear darker and more terminal-like.

Increased Follicular Density:

Some studies suggest latanoprost may increase the number of follicles actively producing hair, particularly in the eyelash and eyebrow regions, and potentially the scalp.

Minoxidil^11-13

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.

Tretinoin^14-17

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.

Vitamin E¹⁸

Gamma (γ) tocopherol is the most abundant vitamin E in the diet and alpha (α) tocopherol is the most abundant form of vitamin E in the skin. These forms of vitamin E are thought to inhibit the production of prostaglandin and nitric oxide, protect skin cells from sunburn and generally prevent oxidative stress in the skin.

Adverse Reactions

Finasteride^1-3,19

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

Latanoprost^9,10

Common

Local irritation (itching, burning, erythema)
Hyperpigmentation of skin (especially around eyelids or eyebrows)
Increased pigmentation of treated hair
Eyelid darkening (rare with scalp use)
Unwanted hair growth if medication spreads to unintended areas
Eye irritation (if it migrates to eye area)

Minoxidil^11-13

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)

Tretinoin¹⁴

Common

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

Contraindications & Precautions

Contraindications ^{1-4,9,10-14,18}

Known hypersensitivity or intolerance to finasteride, hydrocortisone, latanoprost, minoxidil, and tretinoin or excipients
Contraindicated in women who are or may become pregnant if absorbed systemically due to risk of teratogenicity (can cause abnormalities in the external genitalia of male fetuses)

Precautions ^{1-4,9,10-14,18}

Do not apply to open wounds
Finasteride lowers serum PSA levels by ~50% after 6 months, which can mask early detection of prostate cancer.
Use cautiously in patients with hepatic dysfunction. The drug is metabolized extensively in the liver.

Storage

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.

References

Iamsumang W, Leerunyakul K, Suchonwanit P. Finasteride and Its Potential for the Treatment of Female Pattern Hair Loss: Evidence to Date. Drug Des Devel Ther. 2020 Mar 2;14:951-959.
Finasteride (Propecia) www.accessdata.fda.gov/drugsatfda_docs/label/2012/020788s020s021s023lbl.pdf
Clinical Pharmacology finasteride clinical monograph 2025 https://www.clinicalkey.com/pharmacology/ Accessed August 15, 2025
Clinical Pharmacology hydrocortisone clinical monograph 2025 https://www.clinicalkey.com/pharmacology/ Accessed August 15, 2025
Gabros S, Nessel TA. Topical Corticosteroids. April 26, 2025. Accessed July 27, 2025.
Johnstone, M. A. (1997). Hypertrichosis and increased pigmentation of eyelashes and adjacent hair in latanoprost therapy. American Journal of Ophthalmology, 120(7), 999–1001.
Blume-Peytavi, U., et al. (2012). Latanoprost stimulates human scalp hair growth in vivo. Journal of the American Academy of Dermatology, 66(5), 807–814.
Kwon, O. S., et al. (2007). Prostaglandin analogs as a potential treatment for hair loss: Latanoprost and bimatoprost in the management of alopecia. International Journal of Dermatology, 46(9), 1044–1048.
Clinical Pharmacology. Elsevier. Latanoprost Monograph. Accessed August 15, 2025
FDA Drug Label: Xalatan (latanoprost ophthalmic solution) https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=a98595b3-9f47- 48e0-b18d-550a2095f264&type=display Revised May 2023. Accessed June 15, 2025
Clinical Pharmacology [Internet].: Elsevier; accessed May 2025; Minoxidil topical monograph. Available from: ClinicalKey; https://www.clinicalkey.com/pharmacology/monograph/408?n=Minoxidil
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
Goren A, Naccarato T. Minoxidil in the treatment of androgenetic alopecia. Dermatol Ther. 2018 Sep;31(5):e12686.
Clinical Pharmacology tretinoin clinical monograph 2025 https://www.clinicalkey.com/pharmacology/
Yoham AL, Casadesus D. Tretinoin. March 27, 2023. Accessed July 27, 2025.
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.
Can Tretinoin Help with Hair Growth? https://cityskinclinic.com/tretinoin-hair-growth/ June 12, 2025. Accessed August 15, 2025
Keen MA, Hassan I. Vitamin E in dermatology. Indian Dermatol Online J. 2016 Jul-Aug;7(4):311-5.
Gupta AK, Talukder M. Topical finasteride for male and female pattern hair loss: Is it a safe and effective alternative? J Cosmet Dermatol. 2022 May;21(5):1841-1848.

Disclaimer

This information is for educational purposes only. This compounded product has not been reviewed, approved, or evaluated by the Food and Drug Administration for safety and effectiveness. This product is not intended to diagnose, treat, cure, or prevent any disease. No claims are made regarding treatment, cure, or prevention of any disease or condition.

This information may not cover all possible drug information about this product. Call your doctor for medical advice and/or about side effects. You may report side effects to the FDA at 1-800-FDA-1088. A Wells Pharmacy Network pharmacist will be happy to answer any questions. For consultation, please call 1-800-622-4510.