Dutasteride Hair Loss Study and Its Implications

The current treatment options for men suffering from hereditary hair loss, typical for its horseshoe balding pattern, are relatively limited in their effectiveness. The two medicinal drugs that were approved by the FDA for treating hair loss in men (Propecia - finasteride 1mg and Rogaine - minoxidil 5%) cannot help preserve, let alone regrow, hair in the frontal area of the scalp. The only method of reversing hair loss permanently in the frontal scalp area is hair transplantation which is, though, not suitable to all patients. There are a few prospective hair loss drugs currently being tested but, apart from bimatoprost and RK-023, they are only in the initial stages of clinical trials and unlikely to hit the market in the near future. The greatest current promise for reversing hair loss in the frontal scalp is the drug that is already available for treating benign prostatic enlargement called dutasteride. Dutasteride (Avodart 0.5mg) is an antiandrogen medication similar to Propecia's finasteride and it has been subjected to all three phases of clinical testing for exploring its suitability for treating male pattern baldness but the study results have not been yet released to the public. According to the latest rumors the originator of dutasteride, GlaxoSmithKline, suddenly decided not to seek an FDA approval for its application in the treatment of hair loss.

Dutasteride vs Finasteride

Dutasteride is a dual 5-alpha-reductase inhibitor and thus it is stronger antiandrogen than finasteride, capable of inhibiting both isoforms of this enzyme which converts the male hormone testosterone into biologically more active dihydrotestosterone (DHT). DHT was found to be the main cause of genetically determined hair loss by attacking and damaging susceptible hair follicles and causing their miniaturization and decay. Due to its ability to inhibit both isoforms of 5-alpha-reductase, dutasteride is not only stronger DHT inhibitor but it also possesses significantly longer half-life and so it stays in human body much longer than finasteride. Dutasteride's long half-live and strong antiandrogenic properties led to general belief that it also possesses much more severe secondary effects than finasteride. However, clinical study has not been able to confirm assumption of its harsher side effects. The fact is, however, that dutasteride stays in the body for several months after discontinuing the treatment so that negative side effects, though no more severe, can be experienced for much longer than with finasteride. Although preliminary study data from clinical testing of dutasteride's effects on preserving and regrowing hair indicated that it is more effective in the frontal scalp, this assumption remains unconfirmed as no final study data is available.

Is Dutasteride Suitable for Treating Hair Loss after All?

It is hard to believe that GlaxoSmithKline would not have proceeded with the approval of dutasteride for treating male pattern baldness if it was proven to be more effective than finasteride while its side effects were no more severe. The most logical conclusion is that dutasteride is not significantly more effective in fighting hair loss than the currently available Propecia pill so that it would compensate the patient for the risk of longer-lasting negative side effects. Or in other words, the risk of the longer-lasting side effects would pose too big obstacle to make this new hair loss drug commercially successful for its originator. Nevertheless, there are patients who have been prescribed dutasteride (Avodart 0.5mg) for treating their hair loss problem by their doctor off-label so that they can buy dutasteride online, reporting improved results over Propecia. Despite that dutasteride will in all likelihood remain to be an alternative hair loss treatment to patients who do not satisfactorily respond to Propecia or to those who are ready to accept the risk of its longer-lasting side effects for the chance of the added benefit of preserving their hair in the frontal scalp area.