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DR. AYSHA BUTT

MEDICAL DIRECTOR

Dr. Aysha Butt is the Medical Director of FROM MARS, and is a GP Partner at Woodcote NHS Medical Practice.

GMC NUMBER: 6164178

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Dutasteride vs finasteride for hair loss

Dutasteride and finasteride are two medications that work in a similar way to combat hair loss. They both reduce how much testosterone your body converts into dihydrotestosterone (DHT). This is the hormone that causes male pattern baldness (MPB).

But there are important differences between the meds, including what they’re actually used for. Here we’ll explain what dutasteride and finasteride are, how they work, and how they compare for hair loss.

How does finasteride work?

Finasteride is a prescription medication taken to treat MPB – the most common cause of hair loss in men.

MPB is caused by a mix of genetics, ageing, and hormones - mainly one hormone called DHT. Your body makes DHT from testosterone, and in some men, it causes hair follicles in the scalp to shrink. As the follicles get smaller, hairs have less time to grow, meaning they become finer and shorter. Eventually, the follicles close up and can’t produce any hair at all.

Finasteride helps to stop this. It blocks the enzyme, called 5α-reductase, that converts testosterone into DHT. This is why finasteride is called a 5α-reductase inhibitor – it reduces the amount of DHT in your scalp and stops your follicles from shrinking. If you take finasteride daily, it can stop you losing any more hair, and can even help you regrow lost hair.

Finasteride is taken as a daily pill. You should also know that finasteride is the generic name of the medication; you can also buy a branded version called Propecia.

Is finasteride only used to treat male pattern baldness?

Finasteride was actually patented first in the USA as a treatment for benign prostatic hyperplasia (BPH) in 1992. It received FDA approval to also be used as a treatment for MPB in 1997.

What is dutasteride?

Like finasteride, dutasteride is also a 5α-reductase inhibitor. And just like finasteride, it reduces how much testosterone your body converts into DHT. But unlike finasteride, dutasteride hasn’t been approved by the FDA to treat MPB.

Is dutasteride approved for hair loss?

Dutasteride was approved in the US in 2001 to treat BPH. And although it has been approved to treat MPB in other countries, like South Korea and Japan, it hasn’t yet been authorized for this use by the FDA.

Dutasteride vs finasteride – which is better for hair loss?

Remember, dutasteride isn’t approved to treat MPB in the US. Finasteride is a proven and effective treatment for MPB. Studies have shown that up to 90% of men who take it see a halt in hair loss and even re-grow hair within four to six months.

Research has shown that dutasteride binds more completely to the enzyme 5α-reductase than finasteride. There are three forms of 5α-reductase. Dutasteride binds to and blocks all three of them, whereas finasteride only blocks two of the three.

It’s for this reason why dutasteride is an effective drug to treat BPH and why many believe it should also be used to treat MPB. However, the fact it is not FDA approved means that its safety as a treatment for MPB hasn’t been established yet through appropriate clinical trials. It may be in the future, but currently, the best choice to treat hair loss is finasteride.

Dutasteride vs finasteride - are there any side effects?

Dutasteride and finasteride are safe for most men when they’re taken as prescribed, but like all medications, they can cause side effects.

Both are generally well-tolerated drugs, and side effects are rare, with usually less than 5% of men experiencing any. As finasteride and dutasteride work in similar ways, they cause similar side effects with comparable severity.

The most common side effects of both drugs are sexual. They include a decreased desire for sex (reduced libido), problems getting and keeping an erection (erectile dysfunction), and difficulty ejaculating. Remember this really isn’t the norm when you take either of the meds, as less than 1 in 20 men will experience these sexual side effects. It is something to be aware of though.

There have been reports too that some men experience these sexual side effects after they’ve stopped taking dutasteride or finasteride, sometimes for months and even years. This is extremely rare!

If you do experience any sexual side effects, in the vast majority of cases these will disappear quickly when you stop taking either medication.

Dutasteride vs finasteride – which should you choose to fight hair loss?

In the US, you really only have one option to make sure you are treating MPB safely and with the best possible medication. Finasteride is the only one of the two that has FDA approval to be used as a hair loss treatment.

Whilst dutasteride shows promise for treating MPB, it’s only been put through clinical trials as a treatment for BPH in the US. Its safety as a treatment for MPB hasn’t been established, meaning you shouldn’t use it as a treatment for MPB and it won’t be prescribed for this purpose.

Are there any other effective treatments for male pattern baldness?

Another option for treating MPB is a drug called minoxidil. Minoxidil works differently to finasteride and dutasteride. Rather than limiting the conversion of testosterone into DHT, it improves the flow of blood through your scalp. This increases the supply of oxygen and nutrients to your hair follicles, stimulating them to shed older hairs and grow longer, thicker ones in their place.

You use minoxidil by applying it directly to your scalp, usually as a liquid or a foam. Minoxidil is the generic version of the medication, the branded version is called Rogaine.

As minoxidil and finasteride contain different active ingredients and work in different ways, you can take them together. There’s evidence that using both on a daily basis is the most effective way to fight male pattern baldness.

Try finasteride and minoxidil

If you’d like to try finasteride or minoxidil, you can order them both directly FROM MARS.