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Many brands are now offering oral and topical dutasteride (a medication approved to treat BPH) off-label directly to consumers to help prevent hair loss. Kelvin Murray/Getty Images
  • Many brands are offering dutasteride directly to consumers.
  • The medication is used to treat benign prostatic hyperplasia (BPH) in men with an enlarged prostate but is also used as an off-label treatment for hair loss.
  • Clinical studies have shown oral and topical dutasteride to be an effective hair loss treatment.
  • The treatment works by inhibiting the conversion of a hormone that kills hair follicles

No matter your age, hair loss can be an unwelcome change and it’s not always easy to know how to treat it.

Direct-to-consumer brands are now marketing both oral and topical dutasteride formulas for hair loss, in a move that could offer fresh hope to those with the condition.

The treatment which is primarily used to treat benign prostatic hyperplasia (BPH) in men with an enlarged prostate, is sometimes prescribed off-label as a treatment for hair loss as well.

In fact, some brands are now making dutasteride capsules, shampoos, and topical solutions available directly to customers.

But when it comes to treating hair loss, how effective and safe are these dutasteride formulas?

“Dutasteride is a medication that blocks an enzyme known as 5-alpha reductase (5-AR),” explains Dr. Simon Pimstone, founder, and director, at XYON Health Inc. “This enzyme is responsible for the production of dihydrotestosterone (or DHT), which is the androgen hormone that plays a key role in prostate development and male pattern hair loss.”

Dutasteride is often used in situations where hair loss is extensive or not responsive to another treatment known as finasteride.

Both of these treatments block 5-AR, however, Pimstone points out that dutasteride inhibits two forms of the enzyme known as isoforms I and II, whereas finasteride only acts on isoform II.

Finasteride also only blocks about 70% of the conversion of testosterone into DHT. Dutasteride can block more than 90%.

Taking dutasteride orally works by stopping the conversion of testosterone to DHT in the body so that the DHT doesn’t have the chance to reach the hair follicles.

When applied topically, it works by stopping DHT conversion in the hair follicles.

So, just how effective is dutasteride when used as an off-label treatment for hair loss?

When compared to finasteride, Pimstone says dutasteride is a far more active inhibitor of the 5-AR enzyme and hence has a more potent effect in lowering DHT levels.

In particular, he says when used topically, dutasteride can have a strong clinical effect as it delivers a higher amount of the medication to the target hair follicle.

“A number of well-controlled and observational clinical studies have now shown clear clinical benefit of dutasteride over finasteride,” Pimstone surmises. “The clinical benefit of dutasteride appears as a result of its potent effect on the 5-AR enzyme and DHT.”

In one meta-analysis conducted in 2019, dutasteride showed a significant increase in the total hair count compared with finasteride.

Meanwhile, the results of an older randomized placebo-controlled study of dutasteride versus finasteride, found that the former was more effective in increasing target area hair count.

While there is some research supporting the effectiveness of dutasteride for hair loss, it may be best to manage your expectations.

Using dutasteride can be an effective tool for stopping hair loss, but experts say to keep in mind that it isn’t going to grow hair.

However, there are combinations of finasteride and minoxidil that have been shown to be effective treatments to stop hair loss and promote hair growth at the same time.

As with all medications, particularly off-label treatments, there are risks and side effects to consider.

It’s also important to note that dutasteride is not FDA-approved as a hair loss treatment so you’ll need to exercise extra caution if using it for this purpose.

Some potential side effects include skin and scalp irritation, cold sweats, and dizziness.

“In some cases, you might experience depression, chest pains, swelling, sexual dysfunction, and suicidal thoughts,” says Abdullah.

Generally though, Pimstone believes that topical formulations — provided the ingredients are used at concentrations where they are known to be safe — should be safe to use, “as these topical forms generally deliver less dutasteride into the systemic circulation than oral forms.”

He also notes that oral and topical dutasteride for male pattern hair loss has been studied clinically for years.

“With this extensive clinical experience, we are not aware of any serious adverse reactions that have highlighted significant risks with oral formulations,” he concludes.

Whether you decide to use dutasteride or not, Pimstone says one of the most important things when it comes to preventing hair loss is treating it early.

“Typically men want to get ahead of their hair loss as early intervention and early treatment will allow for best results,” he explains.

“If the risk for hair loss is high, or if you are noticing thinning (including areas where you often can’t see such as the crown or top of your head), it is worth speaking to a doctor about the options,” he adds.

Dr. Michele Green, a board-certified cosmetic dermatologist, says she recommends a treatment called HydraFacial Keravive as a great option for maintaining scalp health.

“Keravive treatment utilizes a three-step process using patented vortex technology to deeply cleanse and exfoliate, reduce flakiness, itchiness, and irritation, and nourish and moisturize the scalp,” she says. It can be done on a monthly basis.

Green says that the two primary medications that are currently FDA-approved for treating hair loss are finasteride and minoxidil. Finasteride, as mentioned previously, is similar to dutasteride. Minoxidil, on the other hand, works by restoring inactive hair follicles and elongating the growth phase of the hair growth cycle.

“Low-dose minoxidil is a safe and effective hair loss treatment that strengthens hair follicles and promotes hair retention and growth,” says Green.

In some cases, a drug called spironolactone is also appropriate. “Spironolactone is an anti-androgen oral medication that regulates hormones and is particularly useful for female patients with PCOS,” she notes. It aids in hair growth because it can reduce the production of male hormones.

“Hormone replacement therapy can also be an option for those experiencing hair loss due to menopause, PCOS, or hormonal irregularities,” she adds.

Finally, Green points to platelet-rich plasma (PRP) as a non-surgical approach for both male and female-pattern hair loss.

Platelet-rich plasma contains growth factors that can stimulate the dermal papilla cells in hair follicles, she explains. The platelets also contain proteins that encourage tissue healing and regeneration in inactive hair follicles.

“In short,” she says, “PRP maintains the health of the hair follicle, improving the blood supply to the area and stimulating reparative cells.”

There are also other natural methods that studies indicate may prevent hair loss and, in some cases, stimulate hair growth.

However, these tend to be much slower.

Hair products that contain essential oils of peppermint, rosemary, and lavender may also help to rejuvenate the hair follicles.

For some people though, these solutions simply won’t be enough.

The good news is, when it comes to hair loss, dutasteride has shown promising clinical effectiveness, is generally safe for use, and is now more accessible than ever.