By 2026, the management of androgenetic alopecia will undergo a profound transformation. The focus will no longer be solely on efficacy, but also on selectivity. Increasingly informed patients will reject systemic (oral) treatments for prioritize local approaches, without impacting overall hormonal balance.
Two major developments dominate the news: Clascoterone and Dutexome.
Clascoterone (Breezula): a promising prospect at +539 %
This is the molecule that's causing a stir in the scientific and general press. Clascoterone is a topical androgen receptor antagonist.
Unlike finasteride, which reduces DHT production throughout the body, it acts locally: it prevents DHT from attaching to the hair follicle, without ever passing through the bloodstream.
The striking figure According to recent phase III data reported by Midi Libre, this molecule could generate up to 539 % more hairs compared to the placebo group.
Availability Clascoterone is not yet available in pharmacies. Marketing authorization applications are being finalized with the FDA and EMA, with availability expected in 2027.
It is a molecule of the future, but for now it remains a clinical hope.
For who ? Men and women with early to moderate androgenetic alopecia, especially those who refuse or cannot tolerate oral treatments.
Also a possible complement to a hair transplant to stabilize native hair.
The Dutexome (C.PROF 231): the solution available now
For patients wishing to act immediately without waiting for marketing authorizations for new molecules, Mesoestetic's Dutexome has established itself as the reference protocol in practice.
This formula combines Dutasteride (0.05 %), aloe vera plant exosomes, copper tripeptide, biotin and B vitamins.
This cocktail targets hair miniaturization while improving the quality of the follicular environment.
Application by microneedling
Dutexome is administered by microneedling: an electric pen equipped with microneedles makes thousands of controlled micro-perforations on the scalp.
This technique offers a dual action: mechanical regeneration (stimulation of growth factors by the natural healing process) and transdermal passage (homogeneous penetration of active ingredients via the micro-channels created).
Micro-needling combined with the C.PROF 231 solution allows a large area to be treated uniformly, with an excellent tolerance profile.
For who ? Men and women with androgenetic alopecia, patients who have stopped or refuse oral finasteride/dutasteride, preparation of the donor area before FUE transplantation, protection of native hair after transplantation.
In summary
- Clascoterone (Breezula): currently being validated (2027+), blocks receptors (anti-DHT shield)
- Dutexome (C.PROF 231): Available in-office, blocks the 5-alpha reductase enzyme + regeneration
Why these local approaches?
For patients concerned about side effects on their libido or hormonal balance, these local solutions offer a credible alternative to oral treatments.
The product works where it is applied: on the scalp.
The serum concentration remains almost zero, which allows alopecia to be treated safely, whether as a preventative measure or in conjunction with a hair transplant.
Key takeaway: the earlier treatment is started, the higher the chances of stabilization.
Clascoterone represents the near future.
Dutexome via micro-needling allows action to be taken today.
Scientific studies
Clascoterone
These studies constitute the current scientific basis (2025-2026) for the use of clascoterone in androgenetic alopecia (AGA).
1. The pivotal phase III studies (SCALP-1 and SCALP-2)
The most recent and largest studies (1,465 patients) have validated the effectiveness of the 5% solution.
- Reference: Cosmo Pharmaceuticals, “Cosmo Announces Breakthrough Phase III Topline Results from SCALP-1 and SCALP-2” (December 2025).
- Link to the scientific press release: Cosmo Pharmaceuticals – Phase III Results
- Details on ClinicalTrials.gov: NCT05914805 (SCALP-2) and NCT05910450 (SCALP-1).
2. Phase IIb Study (Dose-Ranging Study)
This study determined that the concentration at 5% twice daily was the most effective compared to placebo and lower dosages.
- Reference: Mazzarella F, et al. “A Phase 2b randomized, double-blind, vehicle-controlled, dose-ranging study of clascoterone solution in males with androgenetic alopecia.”
- PubMed link: Journal of the American Academy of Dermatology (JAAD) (Note: This initial study from 2019/2020 laid the foundations for the 5% solution).
3. Safety data and FDA approval (Winlevi)
Although for acne, these data confirm the systemic safety profile and the absence of impact on the hormonal axis (HPA axis).
- Reference: FDA, “Winlevi (clascoterone) Cream 1% Label and Approval Data” (2020).
- Link to the FDA: FDA Access Data – Winlevi
4. Comparative analysis and pharmacology
An article detailing why clascoterone does not cause sexual side effects unlike finasteride.
- Reference: Rosette C, et al. “Cortexolone 17α-Propionate (Clascoterone) is a Novel Androgen Receptor Antagonist that Inhibits Follicular Miniaturization.”
- Link : ResearchGate – Clascoterone Mechanism
Dutexome / Dutasteride
1. Studies on Dutasteride (efficacy and safety)
Dutasteride is widely documented, although its use for alopecia is often “off-label”.
- Meta-analysis (2025) – Efficacy of Dutasteride: A recent systematic review confirms the superiority of dutasteride over finasteride in increasing hair density.
- Long-term comparative study: Analysis of the safety and efficacy of dutasteride versus finasteride in a large cohort.
- Topical Dutasteride and Nanocarriers (2025): Review of new targeted delivery methods to reduce systemic absorption.
2. Studies on exosomes in hair regeneration
Exosomes are the new frontier of “cell-free” therapy.
- Systematic Review (2025): Analysis of clinical evidence concerning exosomes (mesenchymal and plant sources) in the treatment of alopecia.
- Mechanism of action of Exosomes: How these nanovesicles influence the follicular cycle and the dermal papilla.
3. Specific documentation: c.prof 231 Dutexome
The data for this specific product comes primarily from the manufacturer (Mesoestetic Pharma Group).
- Official Tricology / Dutexome page: Presentation of the complex and mention of internal studies (Study on 60 patients, 2024).
- Technical and Medical Protocol (PDF): Details on microneedling depth (0.25mm – 0.5mm) and recommended doses.
- Informed Consent Form: A useful document for practices, listing risks and limitations.