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Oral Dutasteride

Evidence
59%
Regrowth
Viability

Topical Dutasteride

Evidence
55%
Regrowth
Viability

Mesotherapy Dutasteride

Evidence
60%
Regrowth
Viability
  • Oral
  • Topical
  • Mesotherapy
  • Dutasteride
    Evidence Quality

    59%

    Regrowth Potential
    Long-Term Viability
    Written by Perfect Hair Health Team
    Medically Reviewed by Rob English
    First Published Oct 2, 2024
    Last Updated Oct 23, 2024

    Key Information

    Free Resources

    KEY INFORMATION

    What Is Dutasteride?

    Dutasteride is a drug that lowers dihydrotestosterone (DHT) – a hormone causally linked to androgenic alopecia. Dutasteride is FDA-approved to treat benign prostatic hyperplasia, but is also prescribed off-label for hair loss in oral, topical, and mesotherapy formulations.

    How Does Dutasteride Work?

    Dutasteride lowers DHT by inhibiting type I and II 5-alpha reductase. At daily doses of 0.5 mg and higher, dutasteride can reduce DHT by 90% and more.

    What You Should Know

    Clinical studies show that dutasteride reduces more DHT and grows more hair than finasteride. Despite this, dutasteride has no increased risk versus finasteride for sexual side effects. Interestingly, topical dutasteride is well-tolerated by members here who experienced side effects on topical finasteride – with some members showing no changes to serum DHT at applications up to 6 mg weekly of topical dutasteride.

  • Dutasteride
    Evidence Quality

    55%

    Regrowth Potential
    Long-Term Viability
    Written by Perfect Hair Health Team
    Medically Reviewed by Rob English
    First Published Oct 2, 2024
    Last Updated Oct 23, 2024

    Key Information

    Free Resources

    KEY INFORMATION

    What Is Dutasteride?

    Dutasteride is a drug that lowers dihydrotestosterone (DHT) – a hormone causally linked to androgenic alopecia. Dutasteride is FDA-approved to treat benign prostatic hyperplasia, but is also prescribed off-label for hair loss in oral, topical, and mesotherapy formulations.

    How Does Dutasteride Work?

    Dutasteride lowers DHT by inhibiting type I and II 5-alpha reductase. At daily doses of 0.5 mg and higher, dutasteride can reduce DHT by 90% and more.

    What You Should Know

    Clinical studies show that dutasteride reduces more DHT and grows more hair than finasteride. Despite this, dutasteride has no increased risk versus finasteride for sexual side effects. Interestingly, topical dutasteride is well-tolerated by members here who experienced side effects on topical finasteride – with some members showing no changes to serum DHT at applications up to 6 mg weekly of topical dutasteride.

  • Dutasteride
    Evidence Quality

    60%

    Regrowth Potential
    Long-Term Viability
    Written by Perfect Hair Health Team
    Medically Reviewed by Rob English
    First Published Oct 2, 2024
    Last Updated Oct 23, 2024

    Key Information

    Free Resources

    KEY INFORMATION

    What Is Dutasteride?

    Dutasteride is a drug that lowers dihydrotestosterone (DHT) – a hormone causally linked to androgenic alopecia. Dutasteride is FDA-approved to treat benign prostatic hyperplasia, but is also prescribed off-label for hair loss in oral, topical, and mesotherapy formulations.

    How Does Dutasteride Work?

    Dutasteride lowers DHT by inhibiting type I and II 5-alpha reductase. At daily doses of 0.5 mg and higher, dutasteride can reduce DHT by 90% and more.

    What You Should Know

    Clinical studies show that dutasteride reduces more DHT and grows more hair than finasteride. Despite this, dutasteride has no increased risk versus finasteride or sexual side effects. Interestingly, topical dutasteride is well-tolerated by members here who experienced side effects on topical finasteride – with some members showing no changes to serum DHT at applications up to 6 mg weekly of topical dutasteride.

FREE RESOURCES

Articles

Explore the science behind hair loss and hair growth. Our in-depth articles cover topics ranging from natural remedies to pharmaceuticals to breakthroughs in hair loss science. Want to request an article topic? Contact us.

SRD5A1 & 2: Can These Genes Predict Regrowth From 5-Alpha-Reductase Inhibitors?
By Ben Fletcher, PhD
Aug 6, 2024

SRD5A1 & 2: Can These Genes Predict Regrowth From 5-Alpha-Reductase Inhibitors?

Can your genes predict the effectiveness of 5α-reductase inhibitors for hair loss? The SRD5A1 and SRD5A2 genes, encoding type I and type II 5α-reductase respectively, are central to DHT production, a key factor in the pathogenesis of androgenic alopecia. Genetic testing companies suggest certain SR5...
Can a Blood Test for Finasteride Determine the Risk of Side Effects?
By Perfect Hair Health Team
Jan 15, 2023

Can a Blood Test for Finasteride Determine the Risk of Side Effects?

Can blood tests reliably determine the risk of sexual side effects from hair loss drugs? Low-quality evidence (i.e., anecdotes and observational studies) suggest, in men, that low levels of free testosterone and/or high levels of sex hormone binding globulin are correlated with higher rates of sexua...
The 6 Best DHT Blockers For Men
By Perfect Hair Health Team
Apr 6, 2022

The 6 Best DHT Blockers For Men

Which DHT blockers work? Which ones put hair loss sufferers at a greater risk of side effects? What does the actual evidence say versus marketing hype for the latest DHT-reducing supplements, topicals, and drugs? The answers may surprise you. In this article, the Perfect Health Team evaluates 6 DHT ...
FREE RESOURCES

Articles

Explore the science behind hair loss and hair growth. Our in-depth articles cover topics ranging from natural remedies to pharmaceuticals to breakthroughs in hair loss science. Want to request an article topic? Contact us.

SRD5A1 & 2: Can These Genes Predict Regrowth From 5-Alpha-Reductase Inhibitors?
By Ben Fletcher, PhD
Aug 6, 2024

SRD5A1 & 2: Can These Genes Predict Regrowth From 5-Alpha-Reductase Inhibitors?

Can your genes predict the effectiveness of 5α-reductase inhibitors for hair loss? The SRD5A1 and SRD5A2 genes, encoding type I and type II 5α-reductase respectively, are central to DHT production, a key factor in the pathogenesis of androgenic alopecia. Genetic testing companies suggest certain SR5...
Can a Blood Test for Finasteride Determine the Risk of Side Effects?
By Perfect Hair Health Team
Jan 15, 2023

Can a Blood Test for Finasteride Determine the Risk of Side Effects?

Can blood tests reliably determine the risk of sexual side effects from hair loss drugs? Low-quality evidence (i.e., anecdotes and observational studies) suggest, in men, that low levels of free testosterone and/or high levels of sex hormone binding globulin are correlated with higher rates of sexua...
The 6 Best DHT Blockers For Men
By Perfect Hair Health Team
Apr 6, 2022

The 6 Best DHT Blockers For Men

Which DHT blockers work? Which ones put hair loss sufferers at a greater risk of side effects? What does the actual evidence say versus marketing hype for the latest DHT-reducing supplements, topicals, and drugs? The answers may surprise you. In this article, the Perfect Health Team evaluates 6 DHT ...
FREE RESOURCES

Articles

Explore the science behind hair loss and hair growth. Our in-depth articles cover topics ranging from natural remedies to pharmaceuticals to breakthroughs in hair loss science. Want to request an article topic? Contact us.

SRD5A1 & 2: Can These Genes Predict Regrowth From 5-Alpha-Reductase Inhibitors?
By Ben Fletcher, PhD
Aug 6, 2024

SRD5A1 & 2: Can These Genes Predict Regrowth From 5-Alpha-Reductase Inhibitors?

Can your genes predict the effectiveness of 5α-reductase inhibitors for hair loss? The SRD5A1 and SRD5A2 genes, encoding type I and type II 5α-reductase respectively, are central to DHT production, a key factor in the pathogenesis of androgenic alopecia. Genetic testing companies suggest certain SR5...
Can a Blood Test for Finasteride Determine the Risk of Side Effects?
By Perfect Hair Health Team
Jan 15, 2023

Can a Blood Test for Finasteride Determine the Risk of Side Effects?

Can blood tests reliably determine the risk of sexual side effects from hair loss drugs? Low-quality evidence (i.e., anecdotes and observational studies) suggest, in men, that low levels of free testosterone and/or high levels of sex hormone binding globulin are correlated with higher rates of sexua...
  • FREE RESOURCES

    Research Tables

    Want the latest research on Oral Dutasteride? Every quarter, our research team conducts a literature search on Oral Dutasteride to keep you up-to-date on new studies. See our search criteria & research tables below – including a summary of key findings from every single study.

    Last updated: October 2024

    Results

    Search Criteria

    Parameter
    Inclusion Criteria
    Exclusion Criteria
    PatientsPatients of any age with hair loss.Patients with no hair loss disorder.
    InterventionOral dutasteride as a standalone or adjunct therapy.A study that doesn’t contain oral dutasteride either as a standalone or adjunct therapy.
    ComparatorPlacebo and/or other therapies or baseline.No comparator.
    OutcomesPrimary Endpoints of phototrichogram, investigator, and/or patient assessments.Any study not designed to adequately test for the standalone or additive effect of oral dutasteride.
    Study DesignProspective, observational, retrospective, and case series studies.Literature reviews, non-human subjects, or ongoing clinical trials.

    Search Terms

    Search Terms:
    oral hair loss alopecia dutasteride
    • Abbreviations:
    • FFA
      Frontal Fibrosing Alopecia
    • AGA
      Androgenetic Alopecia
    • DST
      Dutasteride
    • DHT
      Dihydrotestosterone

    Summarized Studies

    StudyParticipantsDesignTreatmentResultsKey TakeawayAdverse EffectsEvidence Quality
    Authors (year)SexHair Loss TypeDesignDoseUsageDurationEndpointsHair Growth Assessments and Changes in Serum/Scalp DHTSummaryLimitationsAdverse EffectsJadad Score
    Vano-Galvan et al (2020)n=42 (m)
    Group 1: 12
    Group 2: 15
    Group 3: 15    		iconAGARetrospective, monocentric, descriptive studyGroup 1: less than 3 0.5 mg DST capsules/week
    Group 2: 5 0.5 mg DST capsules/week
    Group 3: 7 0/5 mg DST capsules/week.    		Weekly.52 weeks minimum.Comparison of pre-and post-treatment with clinical images by 3 independent dermatologists using a 4-point scale.Group 1: 4/12 patients were stable, and 8/12 patients showed mild improvement.
    Group 2: 11/15 patients showed mild improvement, 4/15 patients showed marked improvement.
    Group 3: 9/15 patients showed mild improvement, 6/15 patients showed marked improvement.    		7 capsules of 0.5 mg DST appeared to lead to the highest number of patients who showed marked improvement.Retrospective study.Group 2: Erectile dysfunction (1), Decreased libido (1).
    Group 3: Decreased libido (1).
    None of these side effects caused withdrawal from the study.
    1
    Tsunemi et al (2016)n=110 (M)iconAGAMulticenter, open-label, prospective, outpatient study.All patients took 1 capsule of 0.5 mg DST.Once daily.52 weeks.Hair growth, hair restoration, global improvement in hair and change in AGA stage, safety assessments.Mean target hair count:
    Baseline: 87.3±81.14
    Week 26: 72±102.6
    Week 52: 68.1±82.14
    Hair Width: Week 26: 6.7 μm±4.8
    Week 52: 6.5 μm±5.29

    Terminal Hair Count:
    Week 26: 60.8±70.22
    Week 52: 76.9±86.19

    Investigator Assessment:
    Week 52: Improvement was observed in 40% of patients who were at stage III vertex at baseline, 43% of patients who were at stage IV, and 84% of patients who were at stage V.

    Serum DHT:
    Week 26: -84.9% compared to baseline
    Week 52: -85.4% compared to baseline.    		0.5 mg of DHT appears to exhibit good efficacy, safety, and tolerability.High variation in results, open-label design.Drug-related adverse events:
    Erectile dysfunction (11%), libido decrease (8%), Ejaculation disorder (4%), sexual dysfunction (3%), retrograde ejaculation (<1), depressed mood (<1), suicidal ideation (<1), headache (<1), sensory disturbance (<1), fatigue (<1), rash (<1), hypertension (<1).
    1
    Stough (2007)n=34 (17 pairs of twins)
    Group 1: 17
    Group 2: 17    		iconAGAA randomized, placebo-controlled, double-blind study.Group 1: 0.5 mg
    Group 2: placebo    		Once daily52 weeks.Standardized clinical photographs, Hair counts, and Patient self-assessment questionnaires.Change from Baseline - Hair Counts at 52 weeks:
    Week 52:
    Group 1: +16.5
    Group 2: -3.8

    Hair Growth Scores:
    Week 52:
    Group 1: 5 (slightly improved)
    Group 2: 4.07 (no change)    		0.5 mg DST daily appears to improve hair counts and scores over a year of treatment.Small sample size.Group 1: decreased libido of mild to moderate severity (2).
    3
  • FREE RESOURCES

    Research Tables

    Want the latest research on Topical Dutasteride? Every quarter, our research team conducts a literature search on Topical Dutasteride to keep you up-to-date on new studies. See our search criteria & research tables below – including a summary of key findings from every single study.

    Last updated: October 2024

    Results

    Search Criteria

    Parameter
    Inclusion Criteria
    Exclusion Criteria
    PatientsPatients of any age with hair loss.Patients with no hair loss disorder.
    InterventionTopical dutasteride as a standalone or adjunct therapy.A study that doesn’t contain topical dutasteride either as a standalone or adjunct therapy.
    ComparatorPlacebo and/or other therapies or baseline.No comparator.
    OutcomesPrimary Endpoints of phototrichogram, investigator, and/or patient or physician assessments.None.
    Study DesignProspective, observational, retrospective, and case series studies.Literature reviews, non-human subjects, or ongoing clinical trials.

    Search Terms

    Search Terms:
    topical alopecia hair loss dutasteride
    • Abbreviations:
    • MN
      Microneedling
    • MX
      Minoxidil
    • DST
      Dutasteride
    • GPA
      Global Photographic Assessment
    • VAS
      Visual Analog Scale
    • CIA
      Chemotherapy-induced alopecia
    • FPHL
      Female pattern hair loss
    • AGA
      Androgenic alopecia

    Summarized Studies

    StudyParticipantsDesignTreatmentResultsKey TakeawayAdverse EffectsEvidence Quality
    Authors (year)SexHair Loss TypeDesignDoseUsageDurationEndpointsHair Growth Assessments and Changes in Serum/Scalp DHTSummaryLimitationsAdverse EffectsJadad Score
    Nada et al (2018)n=30 (M)
    Group 1: 15
    Group 2: 15    		iconAGAProspective, randomized, clinical studyGroup 1: MN + topical DST (0.02%)
    Group 2: MN only    		13 sessions (once every week for 8 weeks, then once every two weeks for one month, then once every month for three months)24 weeksHair loss grading, phototrichoscopy (hair density, hair width, terminal/vellus hair ratio), patient self-assessment, investigator assessment, adverse effects, and hormone levels.Change in hair density:
    Group 1: 27.6±62.49
    Group 2: -9±30.30 (p=0.02)
    Change in hair width:
    Group 1: 0.023±0.024
    Group 2: 0.0003±0.015 (p=0.003)
    Change in terminal/vellus ratio:
    Group 1: 3.10±6.17
    Group 2: 0.17±1.40 (p=0.02)
    Patient self-assessment: Higher ‘improvement’ and ‘satisfaction’ scores in Group 1 than in Group 2.
    Change in serum DHT:
    Group 1: -22±40.60    		A combination of MN and 0.02% DST was able to significantly increase hair density and width, as well as improve the terminal/vellus ratio. Serum DHT was also reduced. Patient-self-assessment was improved however, according to the investigator assessment, there was no change in the Norwood/Hamilton scale.Small sample size, short follow-up period.Group 1:
    Pain = 86.67% (13)
    Headache = 13.33% (2)
    Itching = 33.33% (5)

    Group 2:
    Pain = 66.67% (10)
    2
    Sanchez-Meta et al (2022)n=34 (M)
    Group 1: 17
    Group 2: 17    		iconAGAComparative, double-blind, randomized prospective study.Group 1: MN + topical DST (0.01%)
    Group 2: MN only    		12 treatments (3 every 4 weeks), then follow-up at 16 weeks.16 weeksGPA using a 4-point rating scale, photo-trichoscopy, pain assessment using VASGPA:
    Group 1: 11.8% mild, 35.3% moderate, and 52.9% marked improvement. Group 2: 47.1%, 35.3%, and 17.6%, respectively (p = 0.037).
    Hair diameter from baseline: dutasteride (frontal) 6µm vs 16µm, (occipital) 5µm vs 12µm (p = 0.049).
    Hair density from baseline: dutasteride (frontal) 5.5 vs. 26.6 hairs per cm2, (occipital) 5 vs. 12 hairs per cm2 (p = 0.045).
    Vellus terminal ratio: (frontal) -0.09 vs -0.38, (occipital) no data. (p = 0.045).    		MN + DST produces a superior overall change in hair thickness and density compared to MN alone.Small sample size and short treatment durationErythema and sensitive scalp lasting up to 36 hours affected 88.2% and 84.2% of saline and dutasteride groups, respectively.
    2
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    Research Tables

    Want the latest research on Mesotherapy Dutasteride? Every quarter, our research team conducts a literature search on Mesotherapy Dutasteride to keep you up-to-date on new studies. See our search criteria & research tables below – including a summary of key findings from every single study.

    Last updated: October 2024

    Results

    Search Criteria

    Parameter
    Inclusion Criteria
    Exclusion Criteria
    PatientsPatients of any age with hair loss.Patients with no hair loss disorder.
    InterventionMesotherapy dutasteride as a standalone or adjunct therapy.A study that doesn’t contain mesotherapy dutasteride either as a standalone or adjunct therapy.
    ComparatorPlacebo and/or other therapies or baseline.No comparator.
    OutcomesPrimary Endpoints of phototrichogram, investigator, and/or patient or physician assessments.None.
    Study DesignProspective, observational, retrospective, and case series studies.Literature reviews, non-human subjects, or ongoing clinical trials.

    Search Terms

    Search Terms:
    dutasteride mesotherapy intradermal intralesional alopecia hair loss
    • Abbreviations:
    • FPHL
      Female pattern hair loss
    • GPA
      Global Photographic Assessment
    • DST
      Dutasteride
    • MetS
      Metabolic syndrome
    • OM
      Oral minoxidil
    • MX
      Minoxidil

    Summarized Studies

    StudyParticipantsDesignTreatmentResultsKey TakeawayAdverse EffectsEvidence Quality
    Authors (year)SexHair Loss TypeDesignTreatment TypesTreatment RegimenProcedureNo. of SessionsDurationEndpointsHair Growth AssessmentsSummaryLimitationsAdverse EffectsJadad Score
    Moftah et al (2021)n=51 (F)
    Group 1: 26 (with FPHL + MetS)
    Group 2: 25 (without FPHL + MetS)

    iconFPHL
    with MetS
    		Prospective cohort study0.02% DST injectionsWeekly for 12 weeks, then every 8 weeks for 32 weeks.Intradermal injection in a defined area of the vertex by 0.05 ml at 2 cm interval using a 30-gauge needle with 30° angle.1647 weeksTrichoscopy, Investigator assessment, patient self-assessment, evaluation of side effects3 months post - treatment:
    % of Terminal hair =
    Group 1: 70.86%±11.95
    Group 2: 86.04%±6.17

    % Vellus hair = Group 1: 29.29%±12.02
    Group 2: 14.45%±5.98

    Mean Hair Thickness:
    Group 1: 0.024 mm±0.009
    Group 2: 0.033 mm±0.007

    Investigator Assessment: Group 1: 0.9±0.91 (stabilization)
    Group 2: 1.9±0.91 (slight improvement).    		MetS negatively impacted response to intradermal injection of DST for patients with FPHL.Small sample size, short follow-up period.None were reported in either group.
    2
    Saceda-Corralo et al (2017)n=6
    (M = 5)
    (F =1)    		iconAGAProspective clinical study0.01% DSTEvery 3 monthsNot reported324 weeks with assessments taking place 36 weeks after the last sessionSerum hormone tests and trichoscopuySerum Hormone: No differences were observed before and after treatment.
    Trichoscopy: Increase in hair density and diameter observed.    		DST intradermal injection may be an effective therapy for patient with AGA, even with less intensive treatment schedules.Small sample size, No raw data given for hair counts.No adverse effects recorded.
    1
    Moftah et al (2013)n= 126 (F).
    Group 1: 86
    Group 2: 40    		iconFPHLPlacebo controlled, open, randomized, prospective study.Group 1: 2 mL of 0.05% DST solution.
    Group 2: 2 mL of saline.    		Weekly for 8 weeks, then weeks 10, 12, and 16.Intradermal injection of vertex by 0.05 ml solution at a 1 cm interval at a 2-4 mm depth at an angle of 30-60° using a 4 mm long 30 gauge needle.1116 weeksGPA using a 6-point rating scale, week, hair pull (with epilated hair count), hair strand diameter, and patient self-assessment. Five patients were also given ultrastructural examinations.GPA: improvement in 62.8% of the treatment group (30.2% mild, 15.1% excellent) (p <0.05). For the control group 17.5% of users showed mild improvement.
    Hair number in the hair pull test at baseline: 5.2 ± 1.2 vs 3.8 ± 1.7 at week 18 in the treatment group and 4.7 ± 1.5 in the control group (p < 0.05).
    Hair Diameter: 25.8 ± 7.6 µm, vs 34.6 ± 11.8 µm in the treatment group compared to 26.8 ± 3.8 µm in the control group (P < 0.05).
    Patient self-assessment: Improvement more significant in group 1 than group 2 (p < 0.05).
    Ultrastructural examination: revealed return of cuticle or repair.    		DST intradermal injection was effective, tolerable, and minimally invasive treatment modality in FPHL.Did not count the number of terminal hairs per follicular unit.Tolerable pain in both groups (82.6% and 80% respectively). Headaches reported in 22.1% and 12% respectively (up to 1 per day). Itching in 3.5% and 0% respectively.
    3
    Sobhy et al (2013)n=90 (M)
    Group 1: 30
    Group 2: 30
    Group 3: 30    		iconAGARandomized clinical trialGroup 1: DST 0.05%
    Group 2: DST 0.05%, dexpanthenol 500 mg, biotin 20 mg, pyridoxine200 mg
    Group 3: 0.9% saline.    		Once weekly for four weeks then once every two weeks for four weeks, then once every four weeks for 12 weeks.Not reported919 weeksTrichogram analysis, investigator assessment, patient self-assessment, semenogram, and serum DHT.Trichogram:
    Results favored Group B, showing statistically significant increases in anagen hair %, hair shaft diameter and anagen/telogen ratio.

    Patient satisfaction:
    Patients in Group 1 and 2 reported high levels of satisfaction.

    Semenogram: Group 1: Decline in semen volume + sperm motility
    Group 2: Decline in sperm concentration + sperm motility. No change in sperm morphology between any of the groups.    		The DST-containing mixture (Group 2) appears to exhibit the highest efficacy for hair growth, however, further studies should be completed to investigate systemic absorption.Needs further research to examine potential systemic effects.Semen parameter changes.
    3