Finasteride and Dutasteride for Male Pattern Hair Loss

Summary

In this episode of the Hair Loss Show, Dr. Russell and Dr. Vicam discuss medical treatments for hair loss, focusing on finasteride and dutasteride. They explain the role of the hormone DHT in hair loss and how these medications inhibit its production. Finasteride, an FDA-approved drug, is commonly used but only partially blocks DHT, while dutasteride, not FDA-approved for hair loss but used off-label, offers more significant blocking. The doctors emphasize the importance of a tailored approach, considering the severity of hair loss and potential side effects, and advise consulting a qualified professional for the best treatment plan.

Takeaways

• 🧬 Male pattern hair loss is caused by a genetic predisposition combined with hormonal changes, specifically the conversion of testosterone to dihydrotestosterone (DHT) by the enzyme 5-alpha reductase.
• 💊 Finasteride is an FDA-approved medication that blocks the 5-alpha reductase enzyme, reducing DHT levels and slowing hair loss progression.
• 🔍 Finasteride was initially developed for treating prostate enlargement but is now also used in a 1 milligram dose for male pattern hair loss.
• 📉 Clinical trials show that finasteride can prevent deterioration in a significant percentage of men, with 86% showing no deterioration after one year, and 64% after five years.
• 🌟 Dutasteride is another medication that blocks both type one and type two of the 5-alpha reductase enzymes, potentially providing a more significant reduction in DHT levels.
• ⚠️ Dutasteride is used off-label for hair loss, as it was developed as a prostate drug and has not undergone specific trials for hair loss treatment.
• 👨‍⚕️ Doctors may recommend a combination of finasteride and dutasteride for patients whose hair loss is not adequately controlled by finasteride alone.
• 💡 The decision to use dutasteride should be made on a case-by-case basis, considering the patient's specific condition and the potential for side effects.
• 🔄 It's important to have a comprehensive discussion with a qualified professional about the medical and surgical options available for hair loss treatment.
• ⏳ Long-term management of hair loss should consider both medical treatments to prevent further hair loss and potential surgical options for restoration.

Q & A

What is the primary focus of the 'Hair Loss Show'?

The 'Hair Loss Show' primarily discusses issues related to hair loss and explores medical and surgical treatments for hair loss in both men and women.

What is the role of hormones in male pattern hair loss?

In male pattern hair loss, hormones play a significant role. Testosterone is converted into dihydrotestosterone (DHT) by the enzyme 5-alpha reductase, and an overactivity of this enzyme in genetically predisposed individuals leads to increased DHT levels, causing hair to thin and eventually fall out.

How does finasteride work in treating hair loss?

Finasteride works by blocking the 5-alpha reductase enzyme, which converts testosterone into DHT. By inhibiting this enzyme, finasteride reduces DHT levels, which can help halt the progression of hair loss.

What is the FDA-approved use of finasteride?

Finasteride is FDA-approved for the treatment of male pattern hair loss. It was initially introduced for treating prostate enlargement but is now licensed in a 1 milligram dose specifically for hair loss.

How effective is finasteride in preventing hair loss progression?

Clinical trials have shown that finasteride is highly effective, with 86% of men not experiencing deterioration after one year, 83% after two years, and 64% after five years.

What is dutasteride and how does it differ from finasteride?

Dutasteride is another medication that has been developed for prostate drugs. It differs from finasteride in that it blocks both type one and type two of the 5-alpha reductase enzymes, resulting in a more significant reduction of DHT (about 93%) compared to finasteride's 63%.

Is it common to use dutasteride as a standalone treatment for hair loss?

No, dutasteride is not commonly used as a standalone treatment for hair loss. It is often considered when finasteride alone is not sufficient to control hair loss progression, and its use is typically off-label for hair loss treatment.

What is the significance of the difference between finasteride and dutasteride in terms of DHT blockage?

The difference in DHT blockage between finasteride (63%) and dutasteride (93%) indicates that dutasteride is a more potent drug. However, it does not necessarily mean it is always better due to the potential for increased side effects with higher dosages.

Why might a doctor consider combining finasteride and dutasteride?

A doctor might consider combining finasteride and dutasteride for patients whose hair loss is progressing despite treatment with finasteride alone. The combination aims to achieve better control over hair loss by using the lowest effective doses to minimize side effects.

What advice do the doctors give to patients considering hair loss treatments?

The doctors advise patients to seek qualified advice, understand the causes of hair loss, and consider both medical and surgical options. They emphasize the importance of a long-term approach to managing hair loss and the potential risks and benefits of treatments.

Why is it crucial for patients to discuss medical treatments before considering hair transplant surgery?

Discussing medical treatments before hair transplant surgery is crucial because it allows patients to understand the potential for reducing future hair loss and how medical treatments can be combined with surgery for the best long-term results. Skipping this step may lead to dissatisfaction with the transplant results over time.