Dutasteride Rx
Oral Dutasteride is prescribed as an off-label treatment for for male pattern hair loss.
Dutasteride is a compound that reduces DHT (dihydrotestosterone) – a hormone that has been causally linked to androgenic alopecia.
Dutasteride can be used by those who experienced side effects with finasteride. It has been shown to reduce more DHT and stimulates more hair growth than finasteride. There are no increased risk or sexual side effects when compared to finasteride.
What is Dutasteride?
Dutasteride is primarily utilized to address various androgen-related issues in men. It is primarily prescribed under the brand name Avodart® and its primary medical use is in managing benign prostate hyperplasia (BPH). However, owing to its ability to reduce DHT, it's frequently prescribed off-label by many physicians to combat male pattern hair loss, also known as androgenic alopecia (AGA).
How does Dutasteride work?
Dutasteride functions as a dual 5-alpha-reductase inhibitor, targeting both type I and type II isoforms of the enzyme. This sets it apart from other DHT blockers like finasteride, which exclusively inhibits the type II 5-alpha reductase. The broader inhibition spectrum of dutasteride allows for a more comprehensive reduction in DHT levels compared to finasteride. Specifically, dutasteride demonstrates a substantial decrease in systemic DHT levels by 92-96% and scalp DHT levels by 51-79%, whereas finasteride reduces systemic DHT by 60-70% and scalp DHT by 50-60%.
Dutasteride vs Finasteride
Dutasteride and finasteride are both DHT blockers. It has been shown that dutasteride reduces more DHT than finasteride. Dutasteride inhibits both type I and type II 5-alpha reductase. Finasteride inhibits only the type II 5-alpha reductase enzyme.
Because dutasteride inhibits both isoforms of 5α-reductase, it might be more effective at treating hair loss than other inhibitors such as finasteride. This has been shown in clinical studies in which participants were treated with either finasteride or dutasteride. Dutasteride treatment significantly increased total hair and decreased the number of thin hairs compared to finasteride treatment.
Despite being more effective, dutasteride doesn't seem to come with an increased risk of side effects relative to finasteride. In some instances, dutasteride's risk of side effects is actually lower than that of finasteride's despite a more substantial decrease in systemic DHT.
Studies
American Academy of Dermatology, IncTitle: Efficacy, safety, and tolerability of dutasteride 0.5 mg once daily in male patients with male pattern hair loss: a randomized, double-blind, placebo-controlled, phase III study
Key Takeaways
Hair count increased by 61% from baseline.Relatively well tolerated for the treatment of male pattern hair loss.Reduces systemic dihydrotestosterone (DHT) levels by 92-96% and scalp DHT by 50-60%Indian J Dermatol Venereol LeprolTitle: Superiority of dutasteride over finasteride in hair regrowth and reversal of miniaturization in men with androgenetic alopecia: A randomized controlled open-label, evaluator-blinded study
Key Takeaways
Dutasteride group gained 9.8% and the finasteride group gained 1.7% in total hair count.Dutasteride group had a 9.8% decrease and the finasteride group had a 1.7% decrease in thin hair count.The dutasteride treatment significantly increased total hair count and decreased thin hair count when compared to finasteride.Additional Links & Studies
Marked Suppression of Dihydrotestosterone in Men with Benign Prostatic Hyperplasia by Dutasteride, a Dual 5α-Reductase Inhibitor
The importance of dual 5alpha-reductase inhibition in the treatment of male pattern hair loss: results of a randomized placebo-controlled study of dutasteride versus finasteride
The efficacy and safety of dutasteride compared with finasteride in treating men with androgenetic alopecia: a systematic review and meta-analysis
Superiority of dutasteride over finasteride in hair regrowth and reversal of miniaturization in men with androgenetic alopecia: A randomized controlled open-label, evaluator-blinded study
A randomized, active- and placebo-controlled study of the efficacy and safety of different doses of dutasteride versus placebo and finasteride in the treatment of male subjects with androgenetic alopecia
Changes in hair weight and hair count in men with androgenetic alopecia after treatment with finasteride, 1 mg, daily
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Hair Loss Medical Advisors
William Rassman
MD, Founder of the New Hair Institute (NHI)
Heidi Goodarzi, M.D.
Medical, Surgical, and Cosmetic Dermatologist
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