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‍ ‍ FactorNatural optionsFinasteride (prescription)DHT reductionModest and variable (saw palmetto near 32 percent prostatic DHT in one comparison)Roughly 70 percent serum DHT reductionEvidence strengthSmall trials, lab and animal data, often mixedLarge randomized trials, FDA approvedSpeed of resultsSlow and inconsistentOften visible within six monthsSide effect profileGenerally mild, but not risk freePossible sexual side effects in a minority of usersPrescription neededNoYes ‍ The pattern is consistent

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On the other hand, capsaicin, derived from chili peppers, can desensitize nerve endings in the skin when applied topically