Propecia is high on the results list when searching for hair loss treatments and rightfully so. It is one of a number of brand names for the drug finasteride 1mg – one of two scientifically proven and medically approved treatments for hair loss. Another one that’s slowly climbing the ladder is dutasteride but caution is still advised because it is not yet scientifically recognized to prevent hair loss and not yet medically approved for safety. There may be a day when we can welcome a third clinically proven and effective hair loss treatment but unfortunately that day is not here yet.
Finasteride and dutasteride are essentially quite similar drugs. Both are inhibitors of the 5-alpha-reductase enzyme that would normally convert testosterone to dihydroteststerone, or DHT. Both are prescribed for benign prostatic hyperplasia (BHP), or prostate enlargement, and as for the treatment of hair loss, both prevent DHT from binding to those hair follicles that are genetically predisposed to baldness and as a result reduce and stabilise hairloss. In this way, both finasteride and dutasteride can be said to be effective in combating baldness.
“Theoretically, dutasteride should be better than Propecia in treating male pattern hair loss,” says Leonora Doclis, senior hair loss specialist at the Belgravia Centre’s flagship clinic in Central London. While finasteride 1mg inhibits one type of the 5-alpha-reductase enzyme, the more recently developed dutasteride inhibits both types. “It may prove to be a second generation form of Propecia.”
The problem at this stage lies in its safety. PROSCAR and Propecia are FDA approved medications containing 5mg and 1mg of finasteride respectively. PROSCAR is licensed for the treatment of BHP and Propecia for the treatment of male hair loss. Dutasteride is currently approved by the FDA only for use in the medical treatment of BPH (at a dose of 0.5mg/day) under the brand name Avodart. And while dutasteride has been used in other countries as a hair loss product, it has not yet received FDA approval for that use in the U.S or the UK.
“I had had high hopes for dutasteride but we will not advise the use of medication which is not licensed – I have heard negative reports about side effects, which may not leave the system for weeks or even months,” Leonora said.
Clinical trials for dutasteride as a hair loss drug were undertaken but called off in late 2002 for unknown reasons. Some medical professionals believe the study was dropped because the results were inconclusive, others believe the side effects of dutasteride were lingering in patients after ceasing use. Reports state that dutasteride (whose side effects include impotence, decreased libido, ejacultaion disorders and gynecomastia, or enlargement of the breast gland) has a half-life of over 240 hours which means 2.5mg of dustasteride will still be in your system 240 hours after consuming a 5mg dose. After one month, 0.625mg will still be present in the body. Finasteride’s side effects, experienced by 1.8 percent or roughly two in 100 patients, include erectile dysfunction and less often gynecomastia but always cease once dosage is discontinued. Propecia is metabolised in the liver and has a half-life of just a few hours, meaning it leaves the body very quickly. Further clinical trials for dutasteride are currently underway in the U.S. and investigators have reported successful outcomes when using a dose several times higher than in Avodart.
“Some clients tell me their GP had prescribed dutasteride for their hair loss but I can’t imagine why any GP in the UK in their right mind would do that,” Leonora says. “They could be ordering from Timbuktu and – of course – if it’s more potent than Propecia, then the side effects will be too.”
The reason organisations such as the FDA exist is to protect the public health by assuring the safety, efficacy, and security of drugs. You can find almost any miracle drug on the internet that will promote the results that you want from them but ultimately if it’s a safe and effective treatment you’re after it’s best to stick to what’s proven and licensed. There are always going to be improvements as science make new discoveries and maybe one day dutasteride will prove to be the next generation in hair loss treatment. But for the time being finasteride 1mg and other proven hair loss treatments are still getting results.