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Oral Dutasteride for Hair Loss

Hair loss is an area that cause enormous stress for both male and female patients. There are many new treatments on the market and it can be very confusing to know which ones are effective. Dustasteride is one of the newer medications for male and female alopecia which has been getting increasingly more notice. Dr. Michele Green has been treating men and women at her Upper East Side NYC dermatology office for hair loss for over 25 years. As an expert in hair loss and Platelet Rich Plasma (PRP) for alopecia, Dr. Green is always looking for ways to improve the treatment of her patients who are suffering from hair loss.

Oral dutasteride is a prescription drug commonly known by its brand name Avodart. It blocks the action of an enzyme called 5-alpha-reductase and is part of a class of medications known as 5-alpha-reductase inhibitors. This class of drugs prevents your body from converting testosterone into an androgen hormone called dihydrotestosterone (DHT) which has been linked to male pattern hair loss. DHT plays a major role in the development of male sex characteristics such as facial and body hair. However, as an adult that is genetically predisposed to baldness, DHT can bind to androgen receptors in your scalp and cause the hair follicles to stop producing new hair. This ultimately results in loss of hair around your crown (top of head), thin hair, and a receding hairline. Recent studies indicate the promising effects dutasteride may have in male androgenetic alopecia, the most common type of baldness.

Traditionally, over the past two decades, oral dutasteride has been used to treat the symptoms of men with enlarged prostates, or benign prostatic hyperplasia (BPH). Men with BPH have enlarged prostates that compress their bladder, leading to urinary retention and an inability to empty the bladder completely. Dutasteride helps by preventing the conversion of testosterone into dihydrotestosterone, which causes prostate enlargement, ultimately reducing prostate gland size. New studies have shown that dutasteride is effective in treating male pattern baldness and may even be more effective than finasteride (brand name Propecia) and minoxidil (brand name Rogaine), two medications currently uses to treat patients with male pattern baldness. Dutasteride is currently pending FDA approval to treat male pattern baldness.

JS 26 6 Months Before and After PRP Hair MGWatermark

6 months before and after PRP

What are the side effects of dutasteride?

The side effects of dutasteride are comparable to the side effects of finasteride. Side effects to both medications are rare. However, the most common side effects that may require medical attention include chills, cold sweats, and faintness or dizziness when getting up from a lying or sitting position. Other less common adverse effects may include bloating, swelling, and unusual weight gain or loss. Dutasteride may cause a severe allergic reaction in some individuals, resulting in a rash and swelling of the face, tongue, or throat. It may also be associated with an increase risk of high-grade prostate cancer. Other side effects have been reported such as a decreased sex drive, erectile dysfunction, and ejaculation disorder. Rare side effects include unusual drowsiness, back pain, headache, and stomach ache.

Young women who may be pregnant should not be exposed to dutasteride. Dutasteride has serious side effects on pregnant women and can lead to severe defects in the fetus.  As such, women should not handle dutasteride as it can also be absorbed into their skin and may harm an unborn baby. Dutasteride should never be used in breastfeeding women or in children as the effects are unknown. In addition, men who have been taking this medicine should not donate blood until 6 months have passed since the last dose as the blood may be used on a pregnant woman.

Dutasteride may also have adverse supplement and drug interactions and may not be suitable for all people, such as those with severe bladder problems or liver disease. Those who take cimetidine, diltiazem, ritonavir, verapamil, and ketoconazole, among other medications with dutasteride may have increased risk of side effects. Dutasteride may also affect results of the prostate-specific antigen (PSA) test used to detect prostate cancer. Please consult with an expert healthcare provider such as Dr. Michele Green in New York to get the proper medical advice to know if dutasteride is right for you.

YR 1 year before and after 6 PRP treatments MGWatermark

PRP 6 treatments before and after

Is topical finasteride better than oral or topical dutasteride?

Finasteride was developed in the 1970s and was FDA approved in 1992 to treat BPH and later male pattern hair loss in 1998. Dutasteride is a much newer drug and was approved to treat BPH in 2001 and is yet to be FDA approved for hair loss. Both drugs belong to a class of medications called 5-alpha-reductase inhibitors, or 5-ARIs. 5-ARIs inhibit the conversion of testosterone to the androgen dihydrotestosterone (DHT), which is the primary cause of male pattern baldness.

The main difference between finasteride and dutasteride is that finasteride is selective for 5AR type II while dutasteride inhibits both type I and type II. Dutasteride also has a longer half-life of 5 weeks compared to the half-life of 5-6 hours for finasteride. Dutasteride was found to be 3 times more potent than finasteride at inhibiting 5AR type II and 100 times better at inhibiting 5AR type I. One reason may be because dutasteride blocks 90% of DHT compared to 70% by finasteride, indicating that oral dutasteride may be more efficacious than topical and oral finasteride. However, topical finasteride may be beneficial if you have taken oral finasteride and experienced adverse side effects. Topical finasteride is applied directly to the scalp, which may lower systemic side effects like sexual dysfunction.

Dutasteride is only available in one dosage form: liquid-filled capsules to treat BPH. There has been interest in the idea of topical dutasteride, but there are currently no studies published regarding its effectiveness.

How can I get dutasteride for hair loss?

Although studies with dutasteride have shown promising results in reducing hair loss in male pattern baldness, it is currently not FDA approved to treat hair loss. The only medications currently on the market for male pattern baldness are finasteride (Propecia) and minoxidil (Rogaine). However, physicians like Dr. Michele Green in NYC, may prescribe dutasteride for “off label” use when they determine it is medically appropriate for their patient.

How long does it take for dutasteride to work?

Dutasteride usually takes at least 3 months to see results but can take up to 6 months or more depending on the person. Most current studies are limited to 6 months but have shown dutasteride increases hair growth and restoration in men with androgenetic alopecia. The effects of dutasteride lasts only for as long as the patient takes the medication. Once stopped, hair shedding and prostate enlargement resume.

How much does dutasteride cost?

Dutasteride-tamsulosin capsules are currently used to treat men with symptoms of BPH. Dutasteride is not authorized to treat hair loss but can be prescribed for off-label use by a medical provider. Based on WebMD, the average cost for 30 0.5mg capsules of the generic dutasteride is $181.59 but can cost as little as $12. This cost may vary drastically depending on healthcare coverage, the pharmacy you go to, your geographic location, and whether you buy the generic or the brand name.

Meanwhile, the average cost for 30 capsules of the generic finasteride is around $20-$60 per month but can cost as little as $11. Since dutasteride is not currently on the market for hair loss, pricing is unknown. The price of dutasteride once it hits the market will likely be comparable to finasteride since it will be a strong competitor.

Does dutasteride increase estrogen?

Dutasteride increases both estrogen and testosterone levels, but these increases are still within normal physiologic range. An increase in estrogen levels after taking dutasteride should not be of major concern as adverse reactions are highly unlikely.

In rare instances, certain male individuals may show symptoms of de-masculinization and feminization. An example of feminization is gynecomastia or the enlargement of breast tissues.  Less than 1 percent of men experience breast tissue enlargement and less than 1 in 5 men experience any adverse reaction. If you have any concerns on how dutasteride may affect your body, always consult with a healthcare professional.

A.H 34 6 months Before and After PRP Hair MGWatermark

Male patient treated for hair loss with PRP – 6 months

How does Oral Dutasteride compare to Oral Minoxidil?

Oral dutasteride outperforms every other male hair loss treatment and is much better at treating androgenetic alopecia than oral minoxidil. A study by JAMA Dermatology did a meta-analysis of 23 trials analyzing the efficacy of orally and topically administered minoxidil, dutasteride, and finasteride. The conclusion was that dutasteride had the highest probability of being the most efficacious treatment. 0.5mg/d of oral dutasteride was the best performer to treat male pattern baldness. Dutastride was followed by 5mg per day of oral finasteride , followed by 5mg per day of oral minoxidil (Rogaine). The next best performing medication was a 1mg dosage of oral finasteride, followed by 5% topical minoxidil, 2% topical minoxidil, and lastly 0.25mg per day of oral minoxidil.

Using Oral Dutasteride for hair growth

Oral dutasteride capsules has been successful in reducing hair loss and increasing hair growth in many clinical trials. Research found that oral dutasteride was more efficacious than both oral and topical finasteride, the current leading hair loss treatment. Ninety men with androgenetic alopecia were randomly assigned to either a finasteride or a dutasteride group. Men between 18 and 40 years of age either received 0.5mg dutasteride or 1mg finasteride daily for 24 weeks. Hair counts at the start of the study and at the 24 week follow-up were measured in total hair counts per cm². The baseline for the dutasteride group was 223 and was 246 after 24 weeks, while the baseline for the finasteride group was 227 and 231 after 24 weeks. There was significantly more hair growth with the use of dutasteride as compared to finasteride.

Another study by the American Academy of Dermatology found that finasteride resulted in significant hair growth and restoration in men. In this study, 917 men aged 20 to 50 with androgenetic alopecia were randomized to receive either dutasteride (0.02, 0.1, or 0.5mg/d), finasteride (1mg/d), or a placebo for 24 weeks. These results are corroborated by recent data released by JAMA Dermatology, which concluded that oral dutasteride outperforms every other male hair loss treatment. Current research indicates the potential for oral dutasteride to be the next big medication to treat male pattern baldness. It is not currently FDA approved but may soon be as more studies are underway.

What time of day should you take dutasteride? 

There is no best time of day to take dutasteride. Choose a time of day that works best for you whether it be in the morning, evening, or night time, and make sure to consistently take it at that time in order to maximize the effectiveness of the medication. Dutasteride should be taken as a whole capsule daily on a regular basis for at least 3-6 months before seeing any benefits. In the case of a missed dose, do not double dose. Instead, resume your regular routine on the following day. The capsule should not be chewed or crushed because it can get into your semen and harm an unborn baby. The capsule is normally covered in a protective coating to prevent this from happening. Be sure to store dutasteride at room temperature, away from heat, moisture, and light.

Can dutasteride cause dry mouth?  

As with any medication, there are potential side effects. Dry mouth or xerostomia is a common side effect for many different medications, including dutasteride. Other risk factors for dry mouth include mouth breathing, older age, and certain medical conditions like diabetes. A combination of medications can contribute to dry mouth, from antihistamines to anti-depressants to opioids.

In order to prevent dry mouth, proper dental and oral hygiene is necessary. Be sure to frequently rinse your mouth and use an alcohol-free mouthwash. Staying hydrated and chewing sugarless gum may help increase salivation and provide some relief. Other ways to alleviate dry mouth include using a room humidifier, stopping tobacco use if you smoke, and limiting your caffeine intake. You may also try an over-the-counter saliva substitute like the Biotene Oral Balance. If your dry mouth persists or worsens, you may consult a medical professional.

JT alopecia before after 1 MGwatermark

Male treated for Alopecia

How do I get started with Dutasteride today for hair loss?

If you are suffering from androgenetic alopecia, there are many treatments which work. The first step is a consultation with Dr. Michele Green to examine and diagnosis the nature of your hair loss. Based on your examination, Dr. Green will help design a treatment regimen for you to re-grow your hair. If you’re ready to learn more about your treatment options, please contact us online today or call 212-535-3088. With over 25 years of experience in cosmetic dermatology, Dr. Green has is consistently voted as on of the best dermatologists in New York. Dr. Michele S. Green is at the forefront of hair loss treatments and will help to diagnose, treat, and re-grow your hair.

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