Alfatradiol

I don't really think alfatradiol (17α-estradiol) actually does much of anything. It's purported to help with androgenic alopecia (primarily in women) by inhibiting 5α-reductase, but mechanistically I struggle to see how this is possible. Chemically, it does not look like 5α-reductase inhibitors; and estrogens, to my knowledge, aren't known to inhibit 5α-reductase. It doesn't bind to androgen receptors, so its action can't be explained through direct anti-androgenism. And it barely even binds to estrogen receptors, so it can't suppress androgenic effects the indirect way that sufficient levels of 17β-estradiol can; and, being such a weak estrogen, it's hard to fathom alfatradiol providing enough of an estrogenic effect to be meaningful in women, who are typically full of potent estrogens (and who are the main target of this drug). Making matters even worse, I've seen it claimed that the doses administered through products like Ell-Cranell are considerably lower than those that have been found in some studies to be efficacious; and while I have not looked into this claim to verify it, my understanding is indeed that the quality and amount of research into alfatradiol's effects on androgenic alopecia are rather wanting.

All of this taken together, I suspect that the causative agent in alfatradiol's purported effects on hairloss is actually its solvent (alcohol (isopropyl (rubbing) alcohol, specifically, judging by its smell)), with alfatradiol itself being a mostly-biologically-inactive substance used simply as an excuse to sell rubbing alcohol at exhorbitant prices. Unlike with alfatradiol, there actually are obvious mechanistic explanations for why alcohol might help with hairloss, if for no other reason than the fact that it causes vasodilation, which means it directly counteracts some of the effects of DHT (the causative agent in androgenic alopecia). Minoxidil sulfate does this too (with much greater efficacy), and its topical formulations also contain alcohol, so alfatradiol + minoxidil (a combination sometimes suggested to people who can't tolerate 5α-reductase inhibitors) is really no better than minoxidil on its own.

I think the applicator used in alfatradiol products (a two-pronged slow-dripper in the case of Ell-Cranell) may be of notable help as well: it is notoriously tricky to dropper liquid minoxidil evenly; using this prongèd style of applicator gets a fairly-consistent dosage fairly-evenly applied across the scalp with no difficulty. So this superior application method may be enhancing the effects of the alcohol in solution with alfatradiol, further-leading people to misattribute the effects of other things to 17α-estradiol.

All of this considered, I think the best use of Ell-Cranell is to dump the contents of its bottles into some empty rubbing alcohol bottles (for use in household cleaning) and fill the emptied Ell-Cranell bottles with liquid minoxidil instead. Considering the fact that hairloss treatments continue for the remainder of one's life, the exhorbitant costs of Ell-Cranell ($130 for three bottles (three months) on eBay) can be justified as a one-off purchase for the acquisition of their superior pronged applicators.

If anyone ever wants to put all this to rest for good, they'd need to fund a double-blind study with a large number of male and female participants of varying ages, all with androgenic alopecia, and divided into four groups, each using Ell-Cranell bottles and applicators, though with differing substances: water (control), Ell-Cranell without its alfatradiol (basically just alcohol), normal Ell-Cranell, Ell-Cranell with a higher percentage of alfatradiol; and to publish the study regardless of results. Given how many people are paying out the ass for Ell-Cranell/Pantostin/etc in drug stores and online, this is a study that is worth doing, as it could expose this whole scam (or prove alfatradiol's efficacy for real), and publicly position alcohol as a poor-man's mediocre hair-loss treatment.