Is Dutasteride equally effective? I have read reports of it causing thinning along hairline due to increase in testosterone.

Question

I have recently switched from Finasteride 1mg to Dutasteride .5mg. I made the switch because I felt like the Finasteride was losing effectiveness. Is Dutasteride equally effective? I have read reports of Dutasteride causing thinning along hairline due to increase in testosterone. Is this true? Will my results improve or diminish with the switch from Finasteride to Dutasteride? A solid answer would be greatly appreciated!

Jonathan Kulbersh, MD · Answer

This will need an evaluation to answer effectively. I suggest a consultation with a cosmetic dermatologist with experience in hair restoration and maintenance. There are some great options for hair restoration and maintenance like prp injections which can stimulate hair growth. Hope this helps.

Jason Emer, MD · Answer

This needs an in-person evaluation. I suggest seeing a hair loss expert now to evaluate and go over your condition and provide you information about your best treatment options. There are great non-invasive options like prp/progesterone and/or hair transplantation. 
See an expert. Best, Dr. Emer

Anil R. Shah, MD · Answer

Dutasteride theoretically has more potency for hair preservation than Finasteride but a higher side effect profile as well.  The use of dutasteride for hair loss is an off-label use according to the FDA.  Typically regrowth of both agents occurs in areas where the hair is miniaturized and not where slick baldness occurs.  Consider the use of regenerative techniques such as PRP and others and the use of nutraceuticals such as Nutrafol which have a much better side effect profile.Best, Dr. Anil Shah

Jeff Rapaport, MD · Answer

Dutasteride is more effective than finasteride at suppressing DHT. Dutasteride 
is not FDA approved for hair loss. Dutasteride is dose dependent and higher doses such as 2.5 mg are more effective than standard dosing at .5 mg. Dutasteride blocks more parts of the enzyme Alpha reductase then finasteride.. The half-life of dutasteride is significantly longer than the half-life of finasteride. The increase in serum testosterone should not affect the hairline when using dutasteride. It is the scalp levels that are important.. Find a hair loss expert.

Jeff Donovan, MD, PhD · Answer

Dutasteride is not equally effective. No. It’s better. There is no well conducted medical study published in a medical journal that shows it worsens hairline like you have described. It improves it in many users.

Ryan Welter, MD · Answer

There have been good studies showing the efficacy of dutasteride in Male Pattern Baldness.    Prescribing for this purpose is outside FDA approval but it is very common for physicians to prescribe drugs that are FDA approved for other reasons when clinical evidence exists for alternate indications.  I think if you had some difficulty with finasteride, then switching is a good decision.  Please follow closely with your doctor.  Remember that cell therapies are also a GREAT way to help stimulate your hair without drug side effects or daily regimens.
See this citation for reference: 
The importance of dual 5α-reductase inhibition in the treatment of male pattern hair loss: Results of a randomized placebo-controlled study of dutasteride versus finasteride

Richard E. Moore, MD · Answer

Thank you for your question. Both Finasteride and Dutasteride decrease the conversion of testosterone to DHT. DHT is the principal cause of androgenetic hair loss. The 1 mg dose of Propecia (Finasteride) is the only FDA approved medication for this indication. Some physicians elect to use Dutasteride since it blocks a higher percentage of the conversion than Finasteride. It is also available in generic form which is less expensive than Propecia. I recommend you speak with a hair restoration specialist to get on a hair preservation program that works best for you. In addition to DHT blockers there are additional treatments that may benefit you including low level laser therapy, PRP injections, oral supplements, and topical products such as minoxidil.I hope this was helpful - Dr. Moore.

Karl Hekimian, MD · Answer

This is your third question about dutasteride vs. finasteride.  Dutasteride is not approved for use in hair loss; finasteride is.  Neither will completely stop hair loss permanently stop hair loss, though the rate of hair loss is decreased (you lose less while taking finasteride).  Concomitant use of laser, minoxidil and PRP can also help.As suggested previously, you'd be best served having a discussion about dutasteride vs. finasteride with a qualified hair replacement physician who can go over your history and hair loss pattern in detail, and also review other options to preserve and maintain your hair.

William Rassman, MD (retired) · Answer

A comparison between two test to ride and Finasteride are about equivalent excepting dutasteride is not effectively proven safe by the FDA not cleared by the FDA.

Is Dutasteride equally effective? I have read reports of it causing thinning along hairline due to increase in testosterone.

Answers (9)

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