Although dutasteride (also known as Avodart) is considered more effective in terms of hair loss, many start with finasteride as it does great and its safety profile looks better. Finasteride is the only oral medication to treat male baldness that is FDA approved.
Also known as Proscar and Propecia, it blocks a 5-alpha reductase enzyme that decreases serum DHT levels by 70% and testosterone levels by 10%.
Just like finasteride, dutasteride inhibits the same enzyme to convert testosterone to DHT. Finasteride, however, blocks only the Type 2 form of the enzyme, while dutasteride also inhibits the Type 1.
It makes the drug more potent but increases the chances of adverse reactions.
Compared Effects On Hair Growth
Years of studies have shown that after 5 years of finasteride, 90% of men experienced either a halt to their hair loss or growth of new hair. After 5 years, 50% of men experienced an increase in current hair growth, 42% demonstrated no further recession or thinning and only 10% kept loosing hair.
The “Hair Count Clinical Study” showed a gain of 277 hairs per an inch at the end of 5 years. New hair was healthier and larger than miniaturized hair patients had.
Dutasteride (also known as Avodart) decreases DHT by 91% which looks more impressive compared to finasteride. However, Type 1 from the enzyme isn’t present in significant quantities in the follicle, meaning the effect is not as dramatic as one might expect.
However, a placebo-controlled study published in the American Academy of Dermatology proved that there are benefits of dutasteride that finasteride doesn’t have.
Results Of The Hair Loss Treatment Study
During the study, 416 men were divided into groups to receive dutasteride or finasteride every day during 24 weeks. The results proved that dutasteride was superior to finasteride in terms of hair loss in men with MPHL as judged by expert panel assessment at 24 weeks.
Results showed that men who had finasteride got 75.6 new hairs while men who were on dutasteride got 78.5 new hairs. For adverse effects, both drugs were well tolerated and no new safety concerns have appeared. There was also no big difference in adverse effects in any of the treated groups.
“Dutasteride increased target area hair count versus placebo in a dose-dependent fashion and dutasteride 2.5 mg was superior to finasteride at 12 and 24 weeks” (Source)
All in all, 8 men withdrew because of side effects: all 8 were in the dutasteride group and withdrew due to malaise and fatigue, skin disorders, decreased libido and neurology-related complains.
Side Effects Of Dutasteride And Finasteride
Side effects from both dutasteride and finasteride are uncommon and revisable. Researchers report that 3.8% of men on finasteride experienced sexual dysfunction.
The side effects reversed in those who didn’t continue taking finasteride and in 58% of those who continued the treatment. Finasteride is not recommend in any way for men going bald at 19-26.
After the end of treatment, side effects disappeared in a couple of weeks. There are no reports about side effects that persisted after the end of the therapy.
Besides, those who discontinued taking finasteride only lost hair that had been preserved or gained by the drug. Patients had their balding where they would have it without medication.
*This article was reviewed by Dr. Anil Simhadri.