Dutasteride is an oral medication used to treat male pattern baldness (also known as androgenetic alopecia). Here are the key points about dutasteride:
Mechanism of Action:
Dutasteride inhibits the conversion of testosterone to dihydrotestosterone (DHT).
DHT is a hormone largely responsible for male pattern baldness.
By blocking the action of the type II 5-alpha reductase enzyme (more concentrated around hair follicles in balding men), dutasteride reduces DHT levels more effectively than finasteride.
Effectiveness:
Research shows that dutasteride is more effective than finasteride.
About half of users are expected to improve hair density, while the other half will maintain their current density over an extended period.
Frontal Scalp Treatment:
Dutasteride is effective in treating hair loss in the front part of the scalp as well as the crown.
Long-Term Benefits and Risks:
Dutasteride’s effects are mainly confined to thinning areas of the scalp with existing hair.
It does not significantly promote hair growth in completely bald areas.
The major benefit lies in slowing down or halting hair loss and regrowing hair in thinning areas.
Dutasteride’s peak effectiveness occurs at one to two years.
It continues to be effective for at least 5 years in preventing additional hair loss.
Discontinuing dutasteride leads to a gradual return to the pre-medication hair loss pattern.
Dutasteride and Hair Transplantation:
Dutasteride can be a useful adjunct to surgical hair restoration for several reasons:
It maintains or increases hair growth in 90% of patients.
Works well for younger patients who may not yet be candidates for hair transplantation.
Less effective in the front part of the scalp, where surgical restoration provides the greatest cosmetic improvement.
Can re-grow or stabilize hair loss in the back part of the scalp (crown) where transplantation may not always be indicated.
In the long term, dutasteride may allow hair restoration surgeons to create more density in cosmetically critical areas while keeping reserves for future hair loss in other regions.
Remember to consult with a healthcare provider for personalised advice on hair loss treatment options.
Usage and Assessment:
Dutasteride should be taken once daily, with or without meals.
Patients need to take it for one year or longer before accurately assessing its effects in preventing hair loss and promoting hair regrowth.
During the initial six months, you may notice thinning of existing hair. This could be due to either the progression of hair loss before dutasteride takes full effect or shedding of miniaturized hair to make way for healthier growth.
Patience is essential during this period.
Sexual Side Effects:
Side effects from dutasteride at the 0.5-mg dose may occur in 5-17% of users.
Studies have varied in their findings, some suggesting side effects like placebo and others slightly higher than finasteride.
Most sexual dysfunction cases occur soon after starting the medication, but some may appear later.
Side effects generally reverse upon discontinuation, with 58% improvement even in those continuing treatment.
Anecdotal reports mention changes in penile sensation and shrinkage, like finasteride.
Discontinuation and Hair Loss:
When dutasteride is stopped, only the hair preserved by the medication is lost, returning the patient to their pre-drug balding level.
No clinically significant drug interactions have been identified.
Persistent Erectile Dysfunction (PED):
A study examined patients using finasteride and reported erectile dysfunction.
Approximately 1% of men using finasteride 1 mg experience persistent erectile dysfunction (PED).
About 1 in 3 young men with initial erectile dysfunction using finasteride may experience persistent issues, lasting several years.
The longer the medication is used, the greater the risk of PED.
Remember to consult with a healthcare provider for personalized advice on hair loss treatment options
Effects on Breast Tissue:
Adverse reactions related to the breast, including breast tenderness or enlargement (gynecomastia), occurred in men taking dutasteride.
The risk of gynecomastia is slightly greater with dutasteride than finasteride.
Although some data suggests an association between 5-alpha reductase inhibitor use and breast cancer, a recent study did not find such a link.
Self-breast examinations are recommended for those taking dutasteride to check for lumps, tenderness, or nipple discharge.
Other Adverse Reactions:
Uncommon side effects include hypersensitivity reactions, such as rash, pruritus, urticaria, and swelling of the lips and face.
Testicular pain and mood changes, including depression, are also possible.
Dutasteride and Prostate Disease:
An 18-year study on prostate cancer prevention showed that taking finasteride 5mg a day does not increase the likelihood of death from prostate cancer.
Although early results suggested an increased risk of higher-grade tumors, follow-up data did not confirm this.
Taking 5-alpha reductase inhibitors decreases the likelihood of prostate cancer diagnosis by 30% and low-grade cancer diagnosis by 43%.
By shrinking healthy prostate tissue, dutasteride reduces false positive results in PSA screening tests and avoids unnecessary surgery.
The FDA continues to assess dutasteride’s risk/benefit profile for treating prostate issues.
Off-Label Use in Women:
Dutasteride is prescribed for female pattern hair loss and frontal fibrosing alopecia in post-menopausal women.
However, it is not FDA approved for use in women.
A personal or family history of breast cancer is a contraindication for off-label use.
Women should only use dutasteride under the guidance of a physician experienced in diagnosing and managing complex hair disorders.
Remember to consult with a healthcare provider for personalized advice on hair loss treatment options. If you have further questions, feel free to ask!
Caution during Pregnancy:
Dutasteride use is contraindicated in pregnant women due to the risk of developmental abnormalities in a male foetus.
Pregnant women should not handle crushed or broken dutasteride tablets to avoid potential absorption and risk to the foetus.
Dutasteride tablets are coated, preventing direct contact with the active ingredient if they remain intact.
Exposure of pregnant women to semen from men treated with dutasteride has not been shown to pose a risk to the foetus.
Blood Donation:
Patients taking dutasteride should not donate blood, as it may potentially be given to pregnant women.
Effects on PSA:
Dutasteride reduces serum PSA (prostate-specific antigen) levels by approximately 50% in normal men.
Physicians interpreting PSA results should be aware of dutasteride use.
Patient Monitoring:
Men aged 50 or over should inform their physicians or urologists about dutasteride use.
Routine annual evaluations for prostate disease are recommended regardless of dutasteride use.
Specific recommendations may vary based on individual judgment.
Prescriptions:
Our clinic can provide 6-monthly prescriptions of dutasteride if our doctors recommend it for you.
For repeat prescriptions, patients are required to either attend an in-person or virtual paid consultation or fill out an online evaluation form if there are no changes to your prescription or health.
If you experience any issues or adverse reactions while taking dutasteride, please contact us via email, phone or the chat facility.
