Dutasteride is one of the most effective non-surgical hair loss treatments for male pattern baldness [1]. As a 5-alpha reductase inhibitor, it blocks the production of the hormone responsible for male pattern hair loss, dihydrotestosterone, or DHT.
Topical Dutasteride is currently undergoing clinical trials as an alternative to the traditional oral drug for treating androgenetic alopecia in men [1]. So what do we know about topical Dutasteride as a hair loss treatment so far?
Here, we’ll explore:
Dutasteride is a medication used to treat benign prostatic hyperplasia (BPH) as well as hair loss. Oral Dutasteride works by preventing the 5-alpha reductase (5-AR) enzyme in your body from converting testosterone to DHT. This leads to lower levels of DHT throughout the body, so the hormone is less likely to bind to androgen receptors in your hair follicles and cause them to shrink.
This is the same process behind oral Finasteride, though Dutasteride is generally said to be more effective as it inhibits all three types of 5-AR, while Finasteride only reduces the impact of two [1]. Multiple studies have shown that topical Finasteride also works, by reducing DHT levels in the area it’s applied (namely, the scalp) while also creating fewer systemic side effects [2-3]. So can topical Dutasteride have a similar effect?
Early research on the effectiveness of topical Dutasteride is limited but promising. Topical Dutasteride is currently undergoing phase 2 clinical trials in the US to establish its safety and effectiveness for men with male pattern baldness [4]. The study is planned for completion in April 2024.
In the meantime, a handful of smaller studies have found some encouraging data to suggest that topical Dutasteride does work for androgenetic alopecia (pattern hair loss).
One study explored the effectiveness of using topical Dutasteride alongside micro-needling to promote hair growth [5]. 53% of participants using topical Dutasteride had a marked improvement in hair growth after 4-5 months, compared with just 18% of those using a saline solution (both groups also used micro-needling). Marked improvement was defined as improving by one full level on the Norwood Scale.
In addition, patients using topical Dutasteride had slight improvements in hair thickness and density. This suggests that topical Dutasteride is more effective for hair loss than micro-needling alone.
Another study found that combining topical Dutasteride with topical Finasteride and Minoxidil significantly improved hair growth in 90 days [6]. This could be reduced more quickly by supplementing treatment with Propecia and ketoconazole shampoo. In fact, aggressive treatment with all these medications could result in significant hair growth in just 30 days.
Due to the combination of active ingredients, it’s difficult to establish the exact contribution of topical Dutasteride for these patients. But it suggests it can at least play a supplementary role in hair regrowth.
Microneedling, also known as derma rolling, is a treatment that uses tiny sterilised needles to prick the skin, stimulating collagen production and promoting hair growth.
Dutasteride is a large molecule, so it’s more difficult to penetrate the skin without intervention. Micro-needling is often used in conjunction with topical Dutasteride to help the active ingredient penetrate the skin more easily.
These patients show the impact of using topical Dutasteride for treating hair loss:
The side effects noted from the limited studies into topical Dutasteride include:
These side effects were reported in a study that also used microneedling [7]. So it’s unclear which aspect of treatment has caused these side effects.
Other side effects you may experience include:
Even if you experience any of these, Dutasteride side effects aren’t permanent in most cases. They tend to subside within the first year of use.
One of the main arguments for using topical Dutasteride is to avoid the systemic side effects of 5-alpha reductase inhibitors, such as erectile dysfunction and low libido.
However, some people worry that Dutasteride administered in its topical form can eventually lead to systemic side effects. There’s no research yet to establish whether this is the case.
We can make a few educated guesses, though, based on the features of Dutasteride and the more extensive research for topical Finasteride. This suggests that topical Finasteride is a good way to get hair regrowth benefits without the systemic side effects [2].
In addition, because Dutasteride is a large molecule, it doesn’t penetrate the skin easily. Researchers have attempted to improve absorption by creating different delivery methods of Dutasteride, such as nanoparticles and liposomes [8]. The need for these studies suggests it’s unlikely that topical Dutasteride will reach high enough systemic levels to cause side effects.
It’s also important to note that serious side effects are extremely rare with both Finasteride and Dutasteride [9-10]. So using a topical formulation may help lower the risk even further.
Topical Dutasteride usually comes in a dropper bottle, so it’s easy to apply. Here’s what you need to do:
As current studies show topical Dutasteride to be effective alongside micro-needling treatment, this can also form part of your application process. Micro-needling can increase the ability of the Dutasteride solution to penetrate the skin [9].
Anecdotal evidence suggests micro-needling and topical Dutasteride application frequency needs to happen more than once every ten days to create visible results.
Topical Dutasteride is still in clinical trials, so it’s not yet widely available. However, a trichologist may be able to prescribe it to you as an off-label male hair loss treatment.
To find out if topical Dutasteride is a suitable hair loss treatment for you, book a free consultation at the Wimpole Clinic. We can find and prescribe the right treatment to help you manage your hair loss.
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