Hair loss is common but can be distressing especially when traditional treatments haven’t worked. There are so many different treatments available which makes it easier to find an effective solution that addresses each person’s individual needs. However, what happens when the best known treatments including Finasteride have failed? Dutasteride is a medication available in oral or topical form that is increasingly getting attention for its powerful ability to combat hair loss. In this article we’ll take a deep dive into how Dutasteride can help with hair regrowth and how it compares vs Finasteride. we’ll also discuss who Dutasteride is suitable for, what results you can expect and side effects of this treatment.
A Quick Guide to Hair Loss
Hair loss, or alopecia, affects millions of people worldwide. It can manifest in various forms including androgenetic alopecia (male or female pattern baldness), alopecia areata (full or patchy baldness) and telogen effluvium (hair shedding). It can be permenent and progressive or temporary depending on the underlying cause.
The most common type of hair loss is androgenetic alopecia which is due to genetic and hormonal factors. The hormone dihydrotestosterone plays a crucial role in this process as it binds to hair follicles and causes them to shrink, weaken and eventually stop producing hair.
What is Dutasteride & How Does it Treat Hair Loss?
Dutasteride is a prescription only medication that inhibits the conversion of testosterone to dihydrotestosterone (DHT). It does so by blocking the action of the enzyme 5-alpha-reductase. It was initially developed and approved for the treatment of benign prostatic hyperplasia (enlarged prostate). Although it does not have FDA approval for treating hair loss, doctors use it off-label in some cases to treat androgenetic alopecia.
The main way Dutasteride works is by inhibiting both type 1 and type 2 forms of the 5-alpha-reductase enzyme. This leads to a significant reduction in DHT levels. This lowering of DHT helps to reduce the miniaturisation of hair follicles which stops adrogenetic hair loss and promotes the growth of thicker and healthier hair. Compared vs Finasteride, another 5-alpha-reductase inhibitor that only inhibits the type 2 for of the enzyme, Dutasteride fares better for hair regrowth. Studies have shown that Dutasteride is more effective at reducing DHT levels, making it a potentially more potent treatment for hair loss. However, for the time being only Finasteride is licensed for hair loss.
How Effective is it?
Numerous clinical studies have demonstrated the effectiveness of both oral and topical Dutasteride in promoting hair regrowth. Additional, several studies have also found that Dutasteride 0.5 mg daily was significantly more effective vs Finasteride 1 mg daily in increasing hair count and improving scalp coverage. Patients typically begin to notice improvements in hair density and thickness within six months, with continued progress over the course of a year or more. Long-term studies indicate that Dutasteride maintains its effectiveness over several years if used consistently. Users reported experiencing sustained hair regrowth and minimal progression of hair loss with ongoing use. This potentially makes it a viable long-term solution for those struggling with androgenetic alopecia.
What Results to Expect from Dutasteride Treatment
Dutasteride like any hair loss treatment requires patience. In fact, during the first three months, many users may not notice significant changes. This is because it takes time for the medication to begin reducing DHT levels, halting further hair loss and promoting regrowth. These are the main phases of hair regrowth with Dutasteride treatment:
- Early Improvement (3-6 Months): Initial signs of improvement often become visible during this period. Users may observe a reduction in hair shedding and the early stages of new hair growth. Thin areas might start showing slight increases in hair density. Additionally, existing hair may feel thicker and healthier.
- Noticeable Growth (6-12 Months): Around the six month mark is when more substantial results typically start to appear. This is when many users see a marked increase in hair density and improved scalp coverage. Areas that were thinning or balding may begin to experience noticeable regrowth. The overall appearance of the hair improves, becoming fuller and stronger.
- Peak Results (12 Months and Beyond): Long-term, consistent use of Dutasteride—usually around a year or more—yields the most pronounced results. By this stage, the medication has effectively maintained low DHT levels, leading to significant hair regrowth. Users often report thicker, healthier hair with sustained improvements in density and coverage. The effects are additive, meaning that continued use helps maintain and even enhance the gains.
It’s important to note that individual responses to Dutasteride (as with any medication) can vary. While some may experience dramatic changes, others might see more gradual progress. Factors such as age, the extent of hair loss, and overall health can influence the outcome. Adhering to the prescribed treatment protocol and keeping your medical provider updated of your progress is the best way to maximise your chances of success.
Potential Side Effects and Risks
Dutasteride is a highly effective medication for treating hair loss, but like any medication, it comes with potential side effects. When used correctly and for the right patient, serious side effects are rare. However, it’s crucial to fully understand these risks if you’re considering treatment. The general side effects of Dutasteride include:
- Allergic Reactions: Although very rare, some individuals may experience allergic reactions to Dutasteride. Symptoms can include rash, itching, swelling, severe dizziness, or difficulty breathing. Immediate medical attention is necessary if any of these symptoms occur.
- Sexual Dysfunction: Sexual side effects are more likely to occur in men. Some users may experience decreased libido, erectile dysfunction, or reduced ejaculate volume. These side effects are generally uncommon and often resolve after discontinuing the medication. Studies indicate that the incidence of sexual side effects is around 2-4%, and they usually diminish over time even while continuing the medication.
- Depression and Anxiety: There have been reports of mood changes, including depression and anxiety, although these are less common. The exact mechanism but Dutasteride is usually not suitable for individuals with a history of depression.
- Cognitive Effects: There have been anecdotal reports suggesting possible cognitive side effects such as memory problems or foggy thinking. However, these claims still require further research.
- Gynecomastia & Breast Changes: In rare cases, men may develop breast tenderness or enlargement due to hormonal changes caused by Dutasteride. Women might also experience similar side effects. This side effect is relatively rare but requires close monitoring.
- Local Irritation: Users may experience scalp irritation, itching, redness, or dryness with topical Dutasteride at the application site. These side effects are typically mild and manageable.
In addition to the above there are also some specific risks for men which include:
- Male Breast Cancer: There have been extremely rare reports of male breast cancer in patients using Dutasteride. Whilst there isn’t yet a direct causal relationship, it is important to monitor for any unusual changes.
- Prostate-Specific Antigen (PSA) Levels: Dutasteride can affect PSA levels, which is the main biomarker for screening prostate cancer. It can lower PSA levels, potentially masking the detection of prostate cancer. You need to inform your healthcare providers of this effect so they can ensure accurate interpretation of PSA test results.
- Fertility Concerns: Some studies suggest that Dutasteride may impact male fertility by affecting sperm count and quality. While these effects are generally reversible upon discontinuation, men planning to conceive should discuss this potential risk with their doctor.
As well as the general side effects stated earlier, there are also some specific risks for women:
- Teratogenic Effects: Dutasteride can cause severe birth defects in a developing male foetus if taken by a pregnant woman. For this reason, women of childbearing potential should not use Dutasteride. Even handling crushed or broken tablets or contact with topical formulas can be risky if absorbed through the skin.
- Menstrual Irregularities: There have been rare reports of menstrual cycle disruptions in women taking Dutasteride. However these require further studies.
The only way to reduce the risk and manage side effects, is to consult with a healthcare provider before starting Dutasteride so they can see if it is appropriate for you. Regular monitoring and open communication with your clinician can help address any concerns or side effects early on.
Who is Dutasteride Hair Loss Treatment Best For?
Despite its promising potential for treating androgenetic alopecia, who Dutasteride is suitable for depends on several factors. These include the type and extent of hair loss, overall health and individual circumstances. In general, here are the more likely suitable candidates for Dutasteride:
- Men with Androgenetic Alopecia: Men experiencing male pattern baldness are the primary candidates for Dutasteride treatment though this usually not a first-line treatment due to side effects.
- Men Who Have Not Responded to Other Treatments: Those who have tried other hair loss treatments, such as Finasteride or Minoxidil, without satisfactory results might find Dutasteride to be a more effective alternative. Dutasteride’s dual inhibition offers a more comprehensive approach to reducing DHT levels, potentially leading to improved outcomes.
- Postmenopausal Women with Androgenetic Alopecia: Although Dutasteride is primarily used in men, some studies suggest it may be effective for women suffering from female pattern hair loss who have not responded to other treatments. However, it is generally prescribed with caution and mainly only for postmenopausal women or those who cannot become pregnant. The medication is not recommended for women of childbearing potential because of the severe birth defects it can cause if used during pregnancy.
Oral vs Topical Dutasteride
The most common form of Dutasteride hair loss treatment is oral and the typical dosage is 0.5 mg per day. That being said, some clinicians are increasingly able to offer topical compounded formulations. These topical treatments aim to deliver the medication directly to the scalp. As such, topical Dutasteride hair loss treatments can reduce the risk of systemic side effects. However, more research is needed to confirm the efficacy of topical Dutasteride as this is a relatively new treatment.
Dutsteride vs Other Non Surgical Hair Loss Treatments
Although Dutasteride is a potentially powerful treatment for hair loss, there are many other well established treatments. These are often used as first line or in combination with Dutasteride which is not usually used alone for hair regrowth (especially the topical form).
Minoxidil stimulates hair follicles by increasing blood flow to the scalp and prolonging the anagen (growth) phase. Unlike Dutasteride, which reduces DHT levels, minoxidil’s non-hormonal approach makes it suitable for both adult men and women of all ages. Using minoxidil alongside Dutasteride can enhance results by employing a two pronged approach to targeting hair loss. Minoxidil is widely accessible and available over-the-counter in lower strength topical treatment (Regaine®) or by prescription for higher strengths. It’s safe for women of all ages and does not carry hormonal side effects like Dutasteride.
Finasteride which we discussed earlier is less potent vs Dutasteride as it inhibits only type II 5-alpha-reductase enzyme. This however makes it less likely to cause side effects and it has been more extensively studied for hair loss both in oral and topical form. For this reason, Dutasteride is usually a second-line treatment for those unresponsive to Finasteride.
Spironolactone is actually a diuretic with anti-androgen properties. However it can also effectively treat hormone-related hair loss in women by blocking androgen receptors and reducing androgen production. Spironolactone is often more preferable vs Finasteride and Dutasteride for premenopausal women due to its safer reproductive health profile. However, it’s generally not suitable for male pattern baldness.
As a general rule, Dutasteride and in particular topical form is not usually used by itself for hair regrowth. It is often used alongside treatments like Minoxidil to enhance its results. Topical Dutasteride is often used with microneedling to enhance its delivery to the scalp and boost hair regrowth.
Where to Get Dutasteride Hair Loss Treatments
Dutasteride is a prescription only medicine regardless of the dose or form it comes in. It is not licensed for use for hair loss but can be used off label by healthcare practitioners where they feel it is appropriate. You would need an assessment with a medical provider (e.g. a doctor) either in a physical or online hair loss clinic to diagnose the cause of your hair loss and potential suitable treatments. They will then decide what is the best treatment for you. Your provider will either give you a prescription to take to a pharmacy or send your prescription to a specialist compounding pharmacy who will formulate your treatment depending on their setup.
Dutasteride offers a promising solution for those struggling with androgenetic alopecia as it can help prevent hair loss and promote regrowth even compared vs Finasteride. Due to its risks and unlicensed status, it is best to use in a very specific subset of patients who tried other treatments unsuccessfully. Despite its promise, consistency and patience as it can take months before you might even start to see outcomes. Like most hair loss treatments, results require continual use to maintain. Understanding the potential and limitations of Dutasteride can help you make informed decisions and find a treatment plan that works for you.
We strongly believe that hair regrowth is a personal and individual journey. This is why we provide personalised hair loss and regrowth treatments through our virtual clinic. Our doctors create bespoke hair loss treatments using actives like Minoxidil, Spironolactone, Finasteride, Dutasteride and Tretinoin. We also treat skin concerns like acne, hyperpigmentation, melasma and signs of skin ageing. Book your virtual consultation and start your journey to great hair today.