Dutasteride and Hair Loss

Dutasteride is a medication that can be prescribed to men suffering from male pattern hair loss (androgenic alopecia). It helps to prevent hair loss by reducing the level of dihydrotestosterone (DHT) a hormone that is pivotal in causing androgenic alopecia.

What is Dutasteride?

Dutasteride is a medication that works to prevent conversion of the male sex hormone, testosterone, to dihydrotestosterone (DHT). It is similar to Finasteride except it blocks both type 1 and type 2 5 alpha reductase enzymes that convert testosterone to DHT. As a result of lowering the level of DHT Dutasteride can also be used to treat male pattern hair loss.

Hair loss conditions

To understand how Dutasteride can work for hair loss, it is important to know about the main hair loss conditions it can help with.

There are numerous types of hair loss, but the most common one Dutasteride is prescribed for is androgenic alopecia.

• Androgenic alopecia

Also known as male-pattern baldness, androgenic alopecia, is the most common form of hair loss in men. It also occurs in women, commonly called female pattern baldness. It affects up to 50% of males and females. Although hair loss follows a unique distribution in both sexes. In males, hair loss is mostly seen in the hairline, temples and crown regions, while in females, hair loss is seen at the crown and top of head.

• Alopecia areata

In this form of hair loss, it is the body’s own immune system that attacks hair follicles and causes hair loss. It is considered an autoimmune condition. Although hair loss can affect any part of the body, it is most prominent on the head and face. Alopecia areata can affect both men and women equally. And it affects mostly people that are in their twenties and thirties. Dutasteride is not commonly prescribed in cases of alopecia areata.

• Telogen effluvium

This form of hair loss is one of the common causes of temporary hair loss. It occurs due to excessive shedding of hair follicles that are at the telogen or resting phase. It is usually caused by several factors like severe emotional or physiological stress and use of certain medications. It is commonly seen in women post-pregnancy. Dutasteride is not commonly prescribed in this hair loss condition.

Can Dutasteride prevent hair loss?

As a stronger 5-alpha reductase enzyme inhibitor than Finasteride, Dutasteride ultimately works by preventing the conversion of testosterone into DHT, which is the key hormone that drives hair loss in androgenic alopecia. It is currently not licensed for use by the FDA or MHRA. But in other countries like Japan and South Korea, Dutasteride has been approved for the treatment of male androgenetic alopecia.

When Dutasteride blocks type 1 and 2 5-alpha reductase enzymes, it prevents the formation of DHT. DHT affects the hair growth cycle, miniaturising the hair, causing it to shorten and shrink, and eventually fall out. By preventing this process, Dutasteride can effectively prevent further hair loss. This process is summarised in the diagram below.

Dutasteride and Hair Loss Research

• In a study published in Clinical Interventions in Aging Journal, Dutasteride was found to be more effective than FDA-approved finasteride in the treatment of hair loss in men with androgenetic alopecia.
• Another study, published in the Indian Journal of Dermatology, Venereology and Leprology, further proved the efficacy of dutasteride over finasteride in the treatment of androgenic alopecia. Men who consumed dutasteride showed a higher total hair count per cm² than those who took finasteride.
• Another study published as far back as 2010 in Journal of the American Academy of Dermatology, intake of 0.5 mg of dutasteride daily for 6 months in male patients suffering from androgenic alopecia was able to increase hair count by up to 12.2/cm² — an amount that was more than double the change seen in the placebo group. The study further concluded that intake of 0.5 mg of dutasteride daily can improve hair growth. Such intake was also found to be well tolerated by patients of male androgenic alopecia.

Dutasteride Dose For Hair Loss

Dutasteride is commonly prescribed at a dose of 0.5mg once a day. Before starting Dutasteride it is important to have a consultation with a hair loss specialist who can advise on the benefits and risks of Dutasteride. Patients may wish to start on Finasteride and assess their response before starting on Dutasteride.

Does Dutasteride Have Side Effects?

Some of the most common side effects associated with Dutasteride include:

• Ejaculation disorder that’s characterised by decrease in the amount of semen released during sexual activity
• Testicular pain and swellings
• Increased breast size and tenderness
• Reduced sex drive or libido
• Dizziness

These are similar to Finasteride’s side effects which you can read about here: Finasteride side effects.

Is Dutasteride the best option for hair loss treatment?

Dutasteride is an effective medication that is used to prevent hair loss and improve its growth. However, a balanced decision needs to be made between the side effects Dutasteride can give over the potential side effects of other drugs like finasteride. Patients ought to discuss with their healthcare professional to decide on the most suitable treatment option.

Dutasteride use in women

Dutasteride is not recommended for routine use in women. Much like Finasteride, Dutasteride can cause complications for any developing baby, (please read Finasteride use in women). If Dutasteride is being used in women, it requires specialist supervision and guidance to ensure the patient understands the risks around pregnancy and family planning.

How do you know if Dutasteride is working?

Regular follow-up appointments and pictures every 3-6 months can help to monitor the effectiveness of Dutasteride. We commonly advise patients to take photos in the same lighting from the front, sides and the top to monitor the effectiveness of Dutasteride. You may also want to review your progress with Dutasteride with your prescribing Doctor to ensure you are not suffering from any side effects.

If you feel Dutasteride is not working, please consult with your doctor to explore other options for your hair loss.

When to have a hair transplant if you are on Finasteride

If you have been taking Dutasteride and you have stabilised your hair loss you may want to restore hair in your hairline, temples and crown with a hair transplant.

At The Treatment Rooms London all patients are seen by their dedicated hair transplant surgeon, Dr Roshan Vara, Dr Dilan Fernando or Dr Puroshini Pather who are able to guide them through the decisions required.

Other treatments for hair loss

Depending on the cause and extent of the hair loss, treatments can range from behavioural and lifestyle changes, to medications, and advanced procedures like hair transplant surgery.

• Lifestyle changes

Upon examination, if lifestyle behaviours are the source of your hair loss, the doctor would recommend making immediate changes to address them. These kind of changes might include adopting a balanced diet, avoiding harmful habits like smoking and alcohol, and managing stress.

• Platelet-rich plasma (PRP)

This is a form of advanced treatment that involves drawing out some quantity of your blood, concentrating the plasma, and then injecting this platelet-rich plasma into the scalp to accelerate hair growth and prevent hair loss. The evidence supporting PRP in hair loss treatment is variable so it is important you speak with a specialist before starting this therapy.

• Hair transplant

Hair transplants are effective in treating permanent hair loss conditions. They involve extracting hair follicles from the back or sides of the scalp, and transplanting them into areas affected by hair loss. There are 2 methods of hair transplant surgery:

1. FUE hair transplant surgery
2. FUT hair transplant surgery

• Medications

Medications are the most common form of hair loss treatment. There are numerous medications that can improve hair growth and prevent hair loss. Some of these drugs include minoxidil or Regaine, and Finasteride (Propecia). Another commonly used drug is the Dutasteride. However, it is yet to get approval from the FDA. As such, Doctors prescribe it as an off-label medication.

Summary

Hair loss affects a significant number of people. One of the most common methods of treating hair loss is the use of medications. These medications include Finasteride and Dutasteride — both have been shown by research to prevent hair loss.

References

1. https://www.rxlist.com/consumer_dutasteride_avodart/drugs-condition.htm
2. https://www.ncbi.nlm.nih.gov/books/NBK430924/
3. https://www.niams.nih.gov/health-topics/alopecia-areata
4. https://www.ncbi.nlm.nih.gov/books/NBK482293
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8922312/
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388756/
7. https://pubmed.ncbi.nlm.nih.gov/25382509/
8. https://pubmed.ncbi.nlm.nih.gov/20605255/