April 6th 2026

Breezula (clascoterone): The new topical treatment for alopecia

Doctor Amaro de Hospital Capilar Pontevedra

Dr. Raquel Amaro Silva
SURGEON PONTEVEDRA
Collegiate No. 362607457

Graduated in Medicine and Surgery from the University of Santiago de Compostela with a Master's Degree in Aesthetic Medicine and Trichology and Hair Micrograft. She currently works as a doctor and hair surgeon in Hospital Capilar as head of the headquarters Hospital Capilar Pontevedra.

research in treatments for alopecia has been a hot topic in recent months thanks to Breezulaa topical drug based on clascoterone which could become a new alternative for treating androgenetic alopecia.

Although it's presented as a promising option, it's important to understand what this treatment can and cannot actually do. Like other drugs such as dutasteride and finasterideIts main objective is to slow the progression of alopecianot to recover hair that has already been lost.

Furthermore, there are already existing infiltrated treatments that act directly on the hair follicle and offer comparable efficacy with a similar or even lower side effect profileTherefore, they remain a widely used option in clinical practice.

What is Breezula?

Breezula is the trade name for clascoterone, a compound being investigated as a topical treatment for androgenetic alopecia.
This is a 5% hair lotion that is applied directly to the scalp. Its purpose is to act locally on the hair follicle to block the action of the hormones responsible for hair miniaturization.
Currently, the drug is in phase 3 of clinical trials, the last step before its possible approval for commercial use.

How clascoterone works in androgenetic alopecia

Androgenetic alopecia is caused by a combination of hormonal and genetic factors. The hormone DHT (dihydrotestosterone) plays a role in this process, causing the progressive miniaturization of the hair follicle.
Over time, the following occurs:

  • The hair becomes thinner and weaker 
  • The hair cycle shortens
  • The follicle atrophies
  • Finally, the follicle dies

 

When this happens, hair loss is irreversible. Therefore, all treatments for alopecia share a common goal: to halt or slow down this process. Clascoterone acts as an androgen receptor blocker. In other words, it prevents DHT from binding to the hair follicle and continuing the miniaturization process. When applied topically, its action is primarily local to the scalp.

The differential mechanism of clascoterone

Currently, there are various treatments for androgenetic alopecia, each with different mechanisms of action and methods of administration. One of the most interesting aspects of Breezula, and the reason it has generated so much interest, is that it is a topical solution that acts locally and directly on the androgen receptor of the hair follicle. In contrast, there are classic medications, such as Finasteride or Dutasteride, which act in the same way, but because they are absorbed into the bloodstream, they can cause side effects, although in a small percentage of patients.

FeatureFinasteride / DutasterideMesotherapy with drugsBreezula (Clascoterona)
Route of administrationOralTopical, through direct microinjections into the follicleTopical, through a lotion applied to the scalp
Type of treatmentSystemic drug for daily useInfiltrated medical treatmentTopical drug for daily application
FrequencyOnce a daySpaced sessions (every 3–4 months)1 or 2 times a day (according to protocol)
Mechanism of actionThey inhibit the enzyme 5 alpha reductasereducing the conversion of testosterone into DHT, hormone responsible for follicular miniaturizationThey inhibit the enzyme 5 alpha reductasereducing the conversion of testosterone into DHT, hormone responsible for follicular miniaturizationIt inhibits the action of the androgens in the hair folliclereducing the effect of the DHT in a localized manner
AdvantagesHighly effective in slowing hair loss and stabilizing alopeciaDirect action on the hair follicleLocalized action on the scalp
LimitationsIt may cause side effects in a small percentage of patients; it requires continued use.It requires several sessions and periodic maintenance.Currently in phase 3 clinical trials and not yet commercially available

Clinical trial results

The phase 3 SCALP-1 and SCALP-2 studies have evaluated the efficacy of Breezula in more than 1.400 patients with androgenetic alopecia. 

During the study: 

  •  Participants received either clascoterone 5% or a placebo. 
  • Twice a day for 6 months
  • With subsequent security monitoring

 

The results showed improvements in hair density compared to placebo and a favorable safety profile. 

However, it is important to emphasize that these figures reflect relative improvements compared to the placebo group, which in alopecia refers to progressive hair loss. Therefore, it does not mean that patients have increased the number of hairs by 500%, but rather that the treatment showed better results compared to the group that did not receive treatment for alopecia.

Who can Breezula be useful to?

Breezula could be an interesting option for different types of patients. Among them:

  • Patients with androgenic alopecia in early or moderate stages who want to slow its progression.
  • People who are afraid of the side effects of oral treatments or who do not tolerate these drugs and are looking for a safer alternative.
  • People who want to complement other hair treatments to enhance the results.
  • Patients who have undergone a hair transplant, but need medical maintenance to care for the native hair that is still affected by alopecia.

What Breezula cannot do: recover lost hair

One of the most important points that patients should know is that no current medical treatment can recover a follicle that has already died.

When the miniaturization process has progressed too far:

  • The follicle stops producing hair
  • The loss becomes irreversible

 

In these cases, the only way to recover lost hair is through a FUE hair transplant.

Medical treatments—including Breezula, finasteride, dutasteride, or infiltrated treatments—have a different goal: to slow hair loss, stabilize alopecia, and protect existing hair.

When will it be available in Spain?

After completing phase 3 clinical trials, the treatment is currently in a 12-month safety follow-up phase.

If the regulatory process continues as planned, Breezula could reach the market between the end of 2026 and 2027.

The future of hair loss treatments

Breezula represents an interesting line of research within the treatments for alopecia, especially due to its topical approach.

However, it is important to remember that:

  • It is not yet commercially available
  • It does not necessarily replace finasteride or dutasteride.
  • And it doesn't recover lost hair.

 

Meanwhile in Hospital Capilar We offer infiltrated treatments and effective medical therapies that can stop alopecia and improve hair density. 

Platelet-Rich Plasma treatment at the Madrid clinic

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