Is Dutasteride Better Than Finasteride?

If you're dealing with hair loss, you've probably come across two medications that keep coming up in your research: finasteride and dutasteride. Both belong to a class of drugs called 5-alpha reductase inhibitors, and both work by blocking DHT (dihydrotestosterone) – the hormone responsible for androgenetic alopecia, or male pattern baldness.

But here's where it gets interesting: while these medications work similarly, they're not exactly the same. Dutasteride is often described as the "more powerful" option, but finasteride has FDA approval specifically for hair loss treatment. So which one should you choose? Is dutasteride better than finasteride?

Let's break down the science, the effectiveness, and what you need to know about both options.

Understanding the Mechanism: How DHT Blockers Work

Androgenetic alopecia (male patterned hair loss) happens when hair follicles are sensitive to DHT, a hormone created when testosterone interacts with an enzyme called 5-alpha reductase.

Both finasteride and dutasteride work by blocking this enzyme, but they do it differently:

Finasteride blocks only type 2 5-alpha reductase, reducing DHT serum levels by approximately 70%.

Dutasteride takes a dual-action approach, blocking both type 1 and type 2 5-alpha reductase enzymes. This more comprehensive blockade reduces DHT levels by up to 95%.

Think of it this way: if DHT production is like water flowing through two pipes, finasteride blocks one pipe while dutasteride blocks both. 

The result? Dutasteride achieves more significant DHT suppression.

Effectiveness: Does More DHT Blocking Mean Better Results?

The short answer appears to be yes – at least according to the research we have so far.

Let’s consult research to determine if dutasteride is better than finasteride. Multiple studies have shown dutasteride to be more effective than finasteride for hair loss treatment. 

• In a randomized controlled study of 90 men found that dutasteride produced significantly greater hair count increases over 24 weeks. The dutasteride group showed an increase from 223 to 246 hairs/cm², while the finasteride group increased from 227 to 231 hairs/cm². Hair count increased by ~10.3% with dutasteride and ~1.8% with finasteride.
• In a phase III randomized controlled trial demonstrated that dutasteride 0.5mg was statistically superior to finasteride 1mg at increasing hair count and width after 24 weeks of treatment. Dutasteride increased hair counts in a dose-dependent fashion. Dutasteride was more effective than finasteride even at half the dose
• Among 576 participants, this real-world study found that dutasteride showed significantly better efficacy than finasteride, as measured by total hair count and investigators' assessment of both vertex and frontal views.
• In a comprehensive meta-analysis using data from multiple randomized controlled trials identified dutasteride as more efficacious than finasteride for treating androgenetic alopecia.

The numbers are compelling: studies consistently show dutasteride producing greater hair count improvements.

However, it's important to note that both medications are effective. Finasteride has decades of research behind it and has helped millions of men maintain and regrow their hair. For many people, finasteride provides excellent results.

The FDA Approval Factor

Here's where things get a bit complex from a regulatory standpoint. 

Finasteride (brand name Propecia) is FDA-approved specifically for treating male pattern baldness at a 1mg daily dose. This approval came after extensive clinical trials demonstrating both safety and effectiveness for hair loss.

Dutasteride, on the other hand, is FDA-approved for treating enlarged prostate (benign prostatic hyperplasia) at a 0.5mg daily dose. When prescribed for hair loss, dutasteride is used "off-label" – meaning doctors can legally prescribe it for hair loss, but it doesn't have specific FDA approval for this indication.

What does this mean for you? It doesn't necessarily mean one is safer than the other. 

Off-label prescribing is common and perfectly legal in medicine. Many effective treatments started as off-label uses before eventually receiving specific approval. However, it does mean that finasteride has more extensive long-term data specifically for hair loss treatment.

The Topical Alternative: Possibly Reducing Systemic Side Effects

For those concerned about potential sexual side effects from either oral medications, topical formulations of both finasteride and dutasteride are emerging as promising alternatives.

Topical dutasteride works by blocking DHT conversion directly in the hair follicles rather than systemically throughout the body. This localized approach may help maintain effectiveness while potentially reducing the risk of sexual side effects that can occur with oral medications.

Early research on topical dutasteride suggests it can be effective for hair loss while having fewer systemic effects. However, it's worth noting that some absorption into the bloodstream still occurs, so while it’s not completely without the potential for side effects, it may reduce the risk.

Topical formulations are often combined with other hair loss treatments like minoxidil or used with techniques like microneedling to enhance absorption. While more research is needed on long-term effectiveness, topical dutasteride represents an exciting option for those who want the benefits of DHT blocking with potentially fewer side effects.

Bottom Line: Is Dutasteride Better Than Finasteride?

Both finasteride and dutasteride are effective treatments for hair loss, with dutasteride showing superior DHT blocking and potentially better results in clinical studies. However, finasteride remains an excellent first-line treatment with decades of safety data and FDA approval for hair loss.

The choice between them often comes down to individual factors: your response to treatment, tolerance of side effects, cost considerations, and personal preferences about FDA-approved versus off-label treatments.

Whether you choose finasteride, dutasteride, or explore topical alternatives, the most important step is getting started with treatment early. Hair loss is progressive, and both medications work best when there are still active hair follicles to preserve and potentially reactivate

Take control today with a treatment that delivers results right where you need them most.

Take Strut’s medical questionnaire to see if you’re a good fit for treatment with our 5-in-1 prescription formula containing Dutasteride, Minoxidil, Tretinoin, Fluocinolone, & Biotin in a safe high-penetration delivery vehicle.