Updated: Apr 22
People have been losing their hair since before we can remember. There are many reasons behind why you may be losing your hair, though the most common is androgen alopecia, or pattern hair loss.
There are also many different ways to combat hair loss. Research and scientific studies have found that blocking the hormone DHT is probably the most effective approach towards stopping hair loss.
Even if you have only dipped your toes into hair loss research, you have probably heard of the drug finasteride. In 2017, finasteride was the 86th most prescribed drug in the United States with 9.1 million prescriptions (per data collected at clincalc.com) and continues to be one of the most popular hair loss treatments to date.
What many people do not know is that there is a more effective alternative called dutasteride. If you have never heard of, or never considered dutasteride, you will definitely want to keep reading.
What is dutasteride?
Commonly sold under the brand name “Avodart", dutasteride is a 5-alpha reductase (5-AR) inhibitor, just like its counterpart finasteride.
Also just like finasteride, dutasteride was originally used to treat Benign Prostatic Hyperplasia (BPH), or an enlarged prostate. It was quickly discovered however, that the link between an enlarged prostate and pattern hair loss resulted in dutasteride inadvertently benefiting both conditions.
Since dutasteride is classified as a 5-AR inhibitor, it works to suppress DHT, the hormone responsible for both prostate enlargement and hair loss. 5-alpha reductase is the enzyme that is responsible for converting testosterone into the byproduct DHT, and anything that inhibits 5-AR is lowering the amount of DHT being made, therefore benefitting the scalp by preventing damage to hair follicles.
Dutasteride was patented in 1993, and received its FDA approval in 2001 for the treatment of BPH. Unfortunately, despite all of the data supporting it, dutasteride still does not have the FDA’s approval for the treatment of hair loss, and therefore cannot be prescribed for such. The only way to get it is to have it prescribed as an off-label treatment.
Dutasteride is more effective than finasteride
Even though both drugs work similarly to block DHT, finasteride is the vastly more popular option due to its FDA approval status. But, if you are looking for the most effective option it may be time to reconsider.
Multiple studies have been able to show that while finasteride can block up to 70% of DHT in the scalp, dutasteride can block 90% or more (one study even showed a 98% decrease in DHT!). Not only that, one study (amongst several others) showed that dutasteride also was superior to finasteride in increasing total hair count. These are both very profound findings in showing that not only does dutasteride almost completely stop hair loss at its source, but can also help regrow hair too.
There are two main reasons that can help explain this.
The first is due to dutasterides ability to block type 1 and type 2 5-alpha reductase, both of which contribute to hair loss. Finasteride is only able to block type 2, in fact one study was able to reveal that dutasteride is not only 3 times more effective at blocking type 2, but 100 times more effective at blocking type 1. This multi-targeted effect is likely the explanation behind dutasteride being able to block about 20% more DHT than finasteride.
The second reason is that dutasteride has a much… much longer half-life than finasteride. The half-life of a drug is essentially how long it remains active in your body. Dutasterides half-life is anywhere from 4-5 weeks, while finasterides is a mere 5-6 hours.
With such a long half-life, dutasteride is much more forgiving if you miss a dose. Often, if a dose of your hair loss supplement is missed DHT can “rebound”, but studies have shown that missing a dose of dutasteride has much less of an effect on rising DHT levels in the blood than missing a dose of finasteride does.
There is essentially an overwhelming abundance of evidence that suggests that dutasteride should be the new standard when it comes to 5-AR inhibitors. It has consistently shown to be more effective than finasteride and could vastly increase the standards of modern-day hair loss treatments. Finasteride is simply outdated.
The side effects…
are no more worrisome than those of finasteride.
There is a common misconception that because dutasteride is more effective than finasteride, the side effects will be amplified, but this is not true.
Although there hasn’t been any studies done specifically on the side effects, multiple studies (1,2) have inadvertently concluded that the side effect profiles are the same. The chances of experiencing adverse side effects are no higher with dutasteride than they are with finasteride.
The side effects for dutasteride are extremely uncommon, and have even been shown to be generally reversible and tolarable, but they are still important to be aware of:
-decreased libido (sex drive)
-impotence (trouble getting or keeping an erection)
Always talk to your doctor about which medication is right for you, matter of fact only they can prescribe you dutasteride, so I guess you have to! If you experience any of these side effects make sure you let your doctor know so that you can both determine what the best thing to do is.
Of the available hair loss treatments, though finasteride is more popular, dutasteride is likely more effective… like a lot more effective.
If you have not started any 5-AR treatments, you may want to start finasteride first. Not only is it currently easier to get a prescription for, but results vary from person to person and you might have great success with it. It is a great starting point to see if you respond well and to gauge if you should upgrade to dutasteride.
Personally, I tried finasteride for a year before I made the switch. It was ultimately because although the hair loss had slowed down, I was still not getting the results I wanted. If you are on the same boat as I was and have given finasteride a fair chance, I highly recommend asking your doctor about switching to dutasteride. Just like it has for me, it can give you much better results if you do not respond well to finasteride and is one of the most effective hair loss treatments available right now.