Category Archives: Dutasteride

Dutasteride Works when Finasteride Fails

In 2021, the single most important drug in the fight against hair loss remains Dutasteride (brand name Avodart). However, it is not approved for that use by the US FDA. I have written numerous past posts on Dutasteride to treat male pattern hair loss.

The most useful one remains my Avodart reviews for hair loss post due to the vast number of reader comments. Also see my posts on Dutasteride injections (also knows as mesotherapy).

Dutasteride v/s Finasteride Dosage and DHT Reduction
Dutasteride reduces more Dihydrotestosterone (DHT) than Finasteride.

Dutasteride more Potent than Finasteride

Every week I search PubMed for the latest papers on Dutasteride and hair loss. This week, I discovered an important new June 2021 study that was just published. It is titled:

“Change in hair growth-related gene expression profile in human
isolated hair follicles induced by 5-alpha reductase inhibitors: dutasteride and finasteride.”

The findings of this study are quite interesting and related to something similar that I published in 2014 (see old post at bottom). Note that this latest work was led by Japanese researchers and funded by GlaxoSmithKline (GSK), the manufacturer of Avodart.

It is encouraging to see GSK still interested in Avodart for hair loss. They will almost certainly not try to get the drug approved to treat hair loss in the US or EU. To date, Japan and South Korea remain the only countries where you can officially use Dutasteride to treat hair loss.

In the rest of the world, the drug is prescribed to treat enlarged prostates (BPH) in older men. For hair loss, you need off-label prescriptions. Also note that on average, side effects from Dutasteride are worse than from Finasteride.

Although GSK is headquartered in the UK, this particular research was affiliated with the company’s Singapore subsidiary. Professor Manabu Ohyama (who I have covered in the past) gave advice on the study protocol and methodology.

Key Findings

The key findings of this latest paper on Dutasteride (and Finasteride) include:

  • Dutasteride and Finasteride both suppressed the negative effects of testosterone on hair-related gene expression.
  • In particular, the gene expression for growth factors FGF7, IGF1 and WNT5a.
  • Dutasteride may have a stronger inhibitory potency to increase growth factor expression than Finasteride.
  • Dutasteride’s greater efficacy on hair growth in comparison to Finasteride is possibly due to the inhibition of 5α-reductase Type 1; or due to greater inhibition of 5α-reductase Type 2 by Dutasteride when compared to Finasteride. My note: most likely both issues are at play per next conclusion.
  • The authors claim that there results suggest that: “Type I 5 alpha reductase may play an important role in hair growth along with Type II 5 alpha reductase.

I forgot that this issue of the significance of Type 1 5α-reductase in relation to hair loss is still unresolved. My guess is that Type 1 is significant, but not quite as significant as Type 2. Dutasteride attacks both Type 1 and Type 2, while Finasteride only attacks the latter.

Make sure to also read my post on destroying androgen receptors on the scalp.

June 8, 2014

Dutasteride Works when Finasteride Fails

An interesting study by South Korean scientists was recently published in “The International Journal of Dermatology”.  It measured the effect of Dutasteride on men with androgenetic alopecia unresponsive to treatment with Finasteride.

They took 35 balding people who did not see any improvement while on Finasteride 1 mg/day for 6 months. They then put those same people on Dutasteride 0.5 mg/day for 6 months.  31 of those patients completed the 6 months of treatment.  Hopefully, the 4 who stopped treatment did not stop due to experiencing significant side effects.

Over three-quarters of these 31 patients saw at least some increase in hair count. Only 1 patient had a marked improvement, while 6 patients had a moderate improvement and 17 patients had a slight improvement. The remaining 7 patients did not see any improvement or worsening.

Side effects included transient sexual dysfunction in 6 patients (17.1%).

Dutasteride and Minoxidil Before and After Photos

When I originally wrote this post, I focused on topical Minoxidil and oral Dutasteride combination hair loss treatments. Nowadays, it seems like oral Minoxidil plus oral Dutasteride has become the gold standard combination treatment among some doctors. Some also add injection Dutasteride into the mix.

Oral Dutasteride plus Oral Minoxidil

In March 2021, Dr. Sergio Vano (Spain) and Dr. Bevin Bhoyrul (Australia) posted interesting before and after success story photos on Twitter. Both doctors made use of oral Minoxidil and oral Dutasteride (aka Avodart).

Dr. Vano tends to offer both oral and injection Dutasteride in the beginning, with the patient deciding on one or both after a year.

Oral Dutasteride and Oral Minoxidil Hair Growth
Oral Dutasteride and Oral Minoxidil Hair Growth Results. Dr. Bhoyrul and Dr. Vano.

Jan 3, 2019

In my previous post on Dutasteride injections for hair loss, I showed an incredible before and after photo. That male patient was taking taking Dutasteride (oral and injection) in combination with oral Minoxidil. This person was treated by Dr. Sergio Vañó-Galván from Spain. The doctor later sent me a number of other before and after photos of his hair loss patients. All of them saw significant hair growth while on some variation of this Dutasteride (oral and/or injection) and Minoxidil (topical or oral) combination treatment.

I was debating on whether these new photos were worthy of a new post, and concluded in the affirmative. Sometimes people forget about the excellent existing hair loss treatment medications out there that have been proven to work really well for many patients.

Of course one must be willing to risk potential side effects of these medications. Most published studies suggest very few people get major permanent side effects from Dutasteride, but it is up to you to do your own research and reach your own conclusions. Note that Dutasteride is only approved in several countries to treat hair loss as of 2019. However, it is approved as an enlarged prostate treatment all across the world.

Dr. Sergio Vañó-Galván was on the organizing committee of the 11th World Congress for Hair Research that took place in Barcelona in 2019. He is also on the Board of Directors of the EHRS.

Oral Dutasteride plus Topical Minoxidil Hair Growth

For those getting side effects from oral Minoxidil or fearful of taking it, topical Minoxidil is always a good alternative. Below are some great hair regrowth results of men who took topical Minoxidil 5% and Dutasteride.

Patient 1: Dutasteride injections plus oral Dutasteride plus 5%  topical Minoxidil at 12-months.

Dutasteride and Topical Minoxidil – 12 Month Hair Growth

Patient 2: Dutasteride injections plus oral Dutasteride plus 5% topical Minoxidil at 12-months.

Dutasteride plus Topical Minoxidil Hair Growth at 12 Months

Patient 3: Dutasteride injections plus oral Dutasteride plus 5% topical Minoxidil at 12-months.

Dutasteride and Topical Minoxidil Hair Growth Before After

Oral and Injection Dutasteride

One can also ignore Minoxidil entirely and just focus on Dutasteride (oral and injection combination treatment) if desired. Note that Dutasteride injections are sometimes termed as mesotherapy.

Patient 4: Oral Dutasteride plus mesotherapy with Dutasteride 0.05% once every three months.

Dutasteride Mesotherapy Before and After

Female Hair Loss Treated with Oral Minoxidil

Women are not given Dutasteride if trying to get pregnant. However, females are allowed to take oral Minoxidil at any time if healthy. However, women should note that oral Minoxidil can cause excessive body hair (hirsutism) as a side effect.

Patient 5: Oral Minoxidil 1 mg/day at 12-Months in a female.

Oral Minoxidil Hair Growth in a Female: Before and After