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Dr. Justin Rome: Is Dutasteride Stronger Than Finasteride For Hair Loss?

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Dr. Justin Rome

I use both Dutasteride and Finasteride in my practice for male pattern hair loss, because there are little differences between them which may make one or the other more suitable for each patient’s particular presentation.

Basically, I prescribe either Finasteride or Dutasteride on a case-by-case basis in a treatment regimen tailored to the individual. Both Dutasteride and Finasteride are used for prostate enlargement, hair loss treatment, and they are even in the same class of medications -- 5-Alpha Reductase Inhibitors.

Clearly, these medications have a lot in common, and they seem to have similar effects when it comes to prostate treatment and hair preservation and regrowth. However, there are some key differences in these medications which we will go over, including just how strong they are at blocking certain enzymes. What we currently know about these medications is that they both work by blocking the enzyme, 5-alpha reductase, in order to help prevent the conversion of Testosterone into Dihydrotestosterone (DHT), which is a known cause of hair loss.

In this way, both medications help limit the exposure of the hair follicles to DHT, in order to help prevent the shrinkage of the follicles and eventually the potential loss of hair. But, this is where a distinct difference appears between the two medications. Studies have shown that Dutasteride blocks both type 1 and type 2 of the 5-alpha reductase enzyme, while Finasteride only inhibits type 2.

And, when the serum DHT levels were measured in patients taking a 0.5mg Dutasteride tablet vs those taking a 5mg Finasteride tablet daily, significantly different levels of DHT inhibition were discovered. Dutasteride 0.5mg tablets were found to reduce serum DHT up to 93%, while the 5mg Finasteride tablets only decreased serum DHT by about 70%.

This suggests that even at a much lower mg to mg dose, oral Dutasteride is significantly stronger than oral Finasteride when it comes to reducing serum DHT levels. A recent meta-analysis reviewed three studies that compared oral Dutasteride and Finasteride for hair loss, and they concluded that Dutasteride seems to be more beneficial for androgenic alopecia hair loss while having about the same rates of adverse reactions as Finasteride.

While these results seem promising, more studies need to be done in order to determine whether the stronger Dutasteride is much more effective than Finasteride when it comes to hair loss treatment, without adding additional risks of side effects. Also, Finasteride is currently FDA approved as a treatment for androgenic alopecia, while Dutasteride is currently only approved for prostate enlargement, and must be prescribed for hair loss off-label at the discretion of your doctor.

If you are interested in a prescription for your androgenic alopecia and would like to help figure out which 5-alpha reductase inhibitor may be the best choice for you, I suggest that you have a consultation with your doctor in-person or online at Strut Health to help find the best fit for you and your hair.

Topical formulations may help reduce the systemic exposure to the medication and may result in less risk of whole-body side effects.

Strut Health offers both Dutasteride and Finasteride in oral and topical formulations, so you can have the best medication regimen for your hair loss goals.

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