Hair loss is an incredibly common issue for many men worldwide. According to the American Hair Loss Association, by the age of 35, over one-third of men will experience Androgenic Alopecia, also known as male pattern baldness.
Thankfully, there are many safe and reliable options on the market to combat a hairless future, with some being more invasive than others.
Though surgical methods like hair transplant procedures, provide long lasting and sometimes impressive results, experts typically recommend starting off with a non-invasive approach, especially if the thinning is mild to moderate.
The most well-known and successful non-invasive treatments available come in the form of hormone-blocking pills called finasteride and dutasteride. Currently finasteride 1mg is the only FDA approved drug to treat male pattern baldness. However, both have been proven effective with minimal side effects but there are some notable differences between the two.
Let’s go through exactly what those differences are, what these pills do, and why you may choose to take one over the other for beating baldness.
What Is Finasteride & Dutasteride?
Finasteride, commonly known on the market as Propecia or Proscar, and dutasteride, also known as Avodart, both work in the same general way.
Most genetic baldness is the result of a hormone call dihydrotestostrone, or DHT. Both medications act to block DHT production and are in a category of drugs known as 5-alpha reductase inhibitors. Basically, they reduce the effectiveness of the enzyme 5-alpha reductase (5RA) which facilitates the creation of DHT from its precursor testosterone.
By chemically fighting the hormones responsible for baldness, both finasteride and dutasteride have shown significant successes in increasing hair growth. Patients also report very few side effects for both medications.
However, there are some significant differences between the two medications. So why might you choose dutasteride vs. finasteride for hair loss? Is one really better than the other?
How Effective Are They?
Since their initial launch, both pills have been proven to be incredibly successful based on medical studies, and patient experiences. But that doesn’t mean results, or side effects, have been identical. How do they differ?
Finasteride (Propecia, Proscar)
The first of the two medications to hit the market, finasteride made a near immediate mark by providing fast, unmistakable results.
In a study published by the Journal of American Academy of Dermatology (JAAD), over 2,000 men were given either finasteride or a placebo for two years. A specific patch of hair was monitored regularly for hair loss or hair growth.
At the end of the study, results definitively showed that subjects taking finasteride grew significantly more hairs than those taking the placebo. After two years, men taking finasteride saw a growth of, on average, 138 hairs in the scalp area studied. Those taking placebo reported excessive hair loss.
Dutasteride (Avodart)
Though on a smaller scale, studies on dutasteride have demonstrated the drug to be significantly more effective than finasteride at male pattern hair loss. With dutasteride, patients can expect even better results in less time.
According to a 24-week joint study, participants receiving dutasteride saw a growth of 109.6 hairs vs the 75.6 hairs on finasteride users.
The reason for the more powerful results comes from the fact that dutasteride is a more potent inhibitor of the enzyme. Whereas finasteride only blocks Type 2 of the 5 alpha reductase enzyme, dutasteride blocks Type 1 and Type 2.
It is important to note that the makers of dutasteride never pursued studies in hair loss, explaining why hair loss studies of dutasteride were done on much smaller populations than finasteride.
Risks & Side Effects
With substantially better results, this means dutasteride must be the clear winner, right?
Not so fast. With increased potency can come increased risks and side effects.
Though overall side effects for both medications are mild and minimal, dutasteride does report higher levels of impotence or decreased libido, though numbers are low. This 2016 study found that 1.21% of patients using the medication for Androgenic Alopecia reported increased sexual dysfunction. In clinical trials, the side effects reversed once the drug was stopped.
It also has several significant drug interactions with certain medications that treat:
- HIV
- Blood pressure
- Angina
- Infections
Though similar drug interactions as those seen in dutasteride may be possible, studies have shown no significant interactions with finasteride. Still, always tell your doctor about all medications you are currently taking.
Also, only finasteride has technically been approved by the FDA to treat hair loss. Dutasteride was developed to treat benign prostatic hypertrophy (BPH), also known as an enlarged prostate, though it is sometimes prescribed “off-label” for hair loss.
In addition, both drugs can significantly harm a developing fetus. Women who are pregnant or trying to get pregnant should completely avoid both pills as the medication can be absorbed through the skin.
Below is a chart breaking down the basic differences of dutasteride vs finasteride.
| Dutasteride | Finasteride | |
| Brand Names | Avodart | Propecia, Proscar |
| Half Life | 4 Weeks | 6–8 Hours |
| Average Hair Growth* | 109.6 | 75.6 |
| Drug Interactions | Certain HIV, blood pressure, angina & antibiotics | None specifically reported |
| Dosage | 2.5 mg | 5 mg |
| Side Effects | Impotence, Low libido | Impotence, Low libido |
| Generic Available | Yes | Yes |
Based on the study: The importance of dual 5a-reductase inhibition in the treatment of male pattern hair loss: Results of a randomized placebo-controlled study of dutasteride versus finasteride
Which Medication is Right for Me?
Overall, both dutasteride and finasteride can be safe and effective hair loss treatments. So how do you know the correct choice for you?
If you are in the early stages of balding and this is your first attempt at combatting hair loss, it’s often best to start off slow rather than bring out the big guns right away. Why raise the risk of side effects if a “milder” medication does the trick? Plus, it’s always better to start with what is FDA approved.
It’s suggested that first-time users with minimal to moderate balding choose finasteride.
However, if you’ve been struggling with hair loss for years, have significant hair loss, or have already tried finasteride with little success, it might be the time for dutasteride.
Either way, we always suggest consulting your doctor or a hair loss expert in your area to help you choose the best treatment plan to regain the full head of hair you deserve.
Ready to see if these medications are right for you, or want to look into other fantastic hair restoration solutions? Trust the experts at Limmer Hair Transplant Center. We are dedicated to putting patients first, and to providing you incredible results. For any questions, or to set up a consultation, call us at (210) 496-9992 or request an appointment online today.
