Can dutasteride help with genetic hair loss?

Question

Hi Doctors. Sorry to bother again. I know dihydrotestosterone is the primary cause of male pattern hair loss. Can testosterone by itself cause hair loss as well? Dutasteride causes an increase in testosterone in the scalp and blood. Can that increase in testosterone lead to more hair loss? Or is dihydrotestosterone the main culprit? Thank you

Jeff Donovan, MD, PhD · Answer

Sure, testosterone can cause hair loss because some will be converted to DHT. However, if there is something around that blocks the DHT then that DHT will be less available to cause hair loss. For example, patients who use testosterone supplementation or use anabolic steroids often have androgenetic hair loss. Some patients who are on finasteride or dutasteride before using these supplements note lower chances of significant hair loss. Furthermore, many patients are able to improve their hair again with use of topical or oral 5 alpha reductase inhibitors. The testosterone (or DHT) may still be around but it is less able to influence the hair follicle machinery. In the case of patients who use topical finasteride or dutasteride, both testosterone and DHT may be high in the blood but levels of DHT in the scalp are potentially lowered and therefor the effects are blocked to some degree at least. In the case of patients who use oral finasteride or dutasteride, testosterone may be high in the blood but levels of DHT in the blood are reduced. Levels of DHT in the scalp are potentially lowered and therefore the effects of DHT are also blocked to some degree at least. Be sure to speak with your doctors about this physiology.

Can dutasteride help with genetic hair loss?

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