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Regrow hair in as few as 3-6 months
If you’re not seeing the results you’d hoped for with hair loss medication, you might consider changing things up. But if you’re thinking of switching from finasteride to dutasteride, there are some critical things to know.
There are actually only two medications FDA-approved specifically for hair loss: finasteride (you may know it as Propecia®) and minoxidil, the active ingredient in Rogaine®.
There’s a ton of research backing their efficacy in slowing hair loss and even spurring regrowth, but these treatments may not yield results for everyone. If that’s you, your provider might prescribe an off-label medication, like dutasteride, to boost results.
We’ll answer all your questions about switching from finasteride to dutasteride and go over alternative hair loss treatment options (because, spoiler alert: There are other ways to increase your results without switching medications entirely).
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Before we dive into the differences between finasteride and dutasteride, we’ll start with some similarities.
Finasteride and dutasteride (Avodart®) are both FDA-approved for the treatment of benign prostate hyperplasia (BPH).
BPH happens when the prostate and surrounding tissue are enlarged. If left untreated, it can lead to bladder, urinary, or kidney problems. When used for BPH, the brand name of finasteride is Proscar®.
The medications are both 5-alpha reductase inhibitors (5ARIs). 5-alpha reductase (5AR) is an enzyme that converts testosterone into dihydrotestosterone (DHT), the hormone responsible for the development of male pattern baldness. You may have also heard these medications described as DHT blockers.
Essentially, high DHT levels cause hair to thin and shed in those who are genetically sensitive to it.
DHT-blocking medications are basically bouncers for your hair, keeping sketchy DHT out. They work by slowing or stopping the conversion of testosterone to DHT and reducing the number of androgen receptors in the hair follicles, thereby lowering DHT levels. That’s good news for your hair.
If you want to learn more (we think it’s pretty interesting), check out our guides to DHT and DHT blockers.
The two medications work very similarly (and therefore have similar side effects), but there are some key differences.
Type 1 vs. type 2 inhibitor. Finasteride is a type 2 5AR inhibitor, and dutasteride is both a type 1 and a type 2 inhibitor. Type 1 of the enzyme is produced primarily in the liver and skin but makes its way to the prostate via blood circulation. Type 2 is the major form found in the prostate.
FDA approval. As noted, finasteride is also FDA-approved for androgenetic alopecia (male-pattern hair loss) in men. Dutasteride isn’t specifically approved for hair loss.
Speed vs. effectiveness. Finasteride starts working more quickly (and is metabolized much faster). But dutasteride treatment generally shrinks the prostate more.
DHT reduction. Finasteride reduces serum DHT by about 70 percent and prostate DHT by 80 to 90 percent, and dutasteride reduces serum DHT by as much as 99 percent. The latter might also have better results when it comes to hair loss.
While both finasteride and dutasteride are well-studied for BPH, we have a lot more information on finasteride for hair loss specifically.
Finasteride is considered the gold standard for genetic hair loss. For most men, it works well, and there’s no need to switch.
One 10-year study on men using finasteride for androgenetic alopecia found that 99 percent experienced no worsening of hair loss during treatment. What’s more, 91 percent saw improvements in hair growth while using finasteride.
Having said that, not every single man will get results from this medication.
Maybe you’re among the nine percent of men who don’t see improvements in hair growth. In some cases, your healthcare provider or dermatologist may suggest switching to dutasteride.
Some studies suggest that dutasteride works better than finasteride. We’re missing long-term data on finasteride versus dutasteride for hair loss management. But short-term studies do seem to indicate that dutasteride is more effective at increasing hair count and thickness.
The research geeks among us (we see you) will enjoy this following deep dive into the research.
A 2017 study comparing the efficacy, safety, and tolerability of dutasteride and finasteride found that those who used dutasteride had a higher hair count and fewer thinning hairs than the finasteride group.
However, this study had a few flaws, so it shouldn’t be seen as the be-all and end-all. For instance, there was a small sample size of only 90 men, and the study period was only six months. Also, it was “open-label,” meaning the researchers and subjects knew what medication they were taking, which can cause confirmation bias.
A 2013 study also found that hair count and width increased dose-dependently with dutasteride (meaning the higher the dose, the greater the effects on hair) more than with finasteride or a placebo. This study had over 900 people but was still short at only 24 weeks.
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Any time you switch medications, it’s vital to let a healthcare provider know so they can guide you through the process.
But this is how it might go:
You’ll need to fully stop taking oral finasteride before switching to dutasteride.
Your provider will give you exact guidelines, but typically, finasteride leaves the body quickly (that’s why it’s important to take it every day to maintain results).
Finasteride has a much shorter half-life than dutasteride, so you might be able to start taking dutasteride as soon as a day or two after your last dose of finasteride.
Maybe your buddy has a buddy who swears by adding dutasteride to finasteride. But generally speaking, finasteride and dutasteride shouldn’t be used together.
It’s possible your healthcare provider will approve the use of topical finasteride and oral dutasteride together, but we just don’t have enough research to know how the two interact.
If your goal is to keep your hair — which we’ll go out on a limb and say it is — it’s understandable that any shake-up in your routine could make you worry about shedding and further hair loss.
Dutasteride shedding is possible but not super likely.
As you know, high levels of DHT miniaturize the hair follicle and mess with the hair growth cycle. When there’s less DHT, hair follicles begin to work again. But before the healthy new hair growth cycle starts back up, the hair follicles need to shed the thinning or damaged hair.
This can lead to shedding.
Switching from finasteride to dutasteride probably wouldn’t be enough of a change (you’re more likely to see initial dutasteride or finasteride shedding when starting one of these medications for the first time). But it’s possible.
The good news is that dutasteride shedding is temporary. But again, it’s unlikely that making the switch would actually cause this, especially if you start dutasteride within a few days of stopping finasteride.
The other thing that could potentially cause shedding when switching from finasteride to dutasteride is less about the dutasteride itself and more about any other hair loss medications you may be stopping.
For example, if you’ve been using a combination of minoxidil and finasteride (more on that duo soon) and go cold turkey on both, you may see some shedding once minoxidil is out of your system. Why? Minoxidil works differently from finasteride and dutasteride.
Since they’re so similar, it actually doesn’t make sense to switch from finasteride to dutasteride because you’re experiencing side effects.
The two medications appear to show similar rates of adverse reactions, including sexual dysfunction. If anything, the side effects of dutasteride may be even more pronounced because it’s more potent.
Potential side effects of finasteride and dutasteride are usually mild and improve over time. They include:
Low libido
Reduced ejaculatory volume or problems with ejaculation
Sexual or erectile dysfunction (ED)
Headache
Gastrointestinal side effects
Acne
Dizziness
The pills should also not be taken or handled by pregnant women due to their potential to cause birth defects in male fetuses.
If you’re experiencing side effects that make you want to stop using finasteride, other hair loss treatments might be a better option than dutasteride.
As mentioned, finasteride and minoxidil are the only two FDA-approved treatments for hair loss.
If you’re considering switching from finasteride to dutasteride because you want a boost in results, adding minoxidil can also help. But it’s not the only other option.
Minoxidil sends blood flow and nutrients to the scalp to support hair health. It alters the hair growth cycle by shortening the resting phase and prolonging the growth phase, resulting in increased hair length and thickness.
Topical minoxidil is over-the-counter, but oral minoxidil requires a prescription.
We offer topical minoxidil foam and minoxidil liquid solution, each containing 5% minoxidil. Some prefer the foam because it doesn’t contain propylene glycol (an alcohol), which might cause redness or irritation in rare cases.
Prefer oral minoxidil? Following an online consultation with a healthcare professional, we offer a minoxidil chew formulated with other hair-healthy ingredients like biotin and vitamins B5 and B6.
Minoxidil and finasteride are among the most effective combinations for fighting hair loss. A 2019 meta-analysis found that combining oral finasteride and topical minoxidil “has better therapeutic efficacy than and similar safety” to using just one or the other.
If you decide to double up on minoxidil and finasteride, we have two options:
Our topical finasteride & minoxidil spray is our best-selling treatment. It combines the two ingredients in an easy-to-use spray.
If hair growth products intimidate you or you’d just rather use an oral supplement, our minoxidil and finasteride chews combine the two with other hair health supplements.
You can’t use finasteride and dutasteride together, but you can amp up the effects of finasteride by adding saw palmetto to your routine. It’s not as well-researched as its FDA-approved counterparts, but saw palmetto (like dutasteride and finasteride) is a partial DHT blocker.
Our thickening shampoo with saw palmetto is a good place to start.
It’s unlikely that a dermatologist or healthcare provider would suggest an off-label hair loss treatment as a first line of defense, especially since there are many FDA-approved hair loss treatments available. However, certain situations may warrant transitioning from finasteride to dutasteride.
If you’re considering it, here are a few things to remember:
Finasteride and dutasteride are both FDA-approved for the treatment of BPH, but only finasteride has approval for hair loss. Some people who aren’t seeing results may wish to switch from finasteride to off-label dutasteride.
Most men see no further hair loss and some new hair regrowth on finasteride. But studies comparing finasteride and dutasteride show that dutasteride increases hair thickness and slows further deterioration even more than finasteride.
The two have similar side effects and aren’t meant to be used together.
Always speak to your provider before switching medications. They can make suggestions and guide you through the process.
We offer a range of hair loss medications, following a consultation with a licensed healthcare provider who can determine if a prescription is appropriate for your needs.
Our guide to preventing hair loss also outlines your options for stopping hair loss and promoting new hair growth.
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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.
Dr. Knox Beasley is a board certified dermatologist specializing in hair loss. He completed his undergraduate studies at the United States Military Academy at West Point, NY, and subsequently attended medical school at Tulane University School of Medicine in New Orleans, LA.
Dr. Beasley first began doing telemedicine during his dermatology residency in 2013 with the military, helping to diagnose dermatologic conditions in soldiers all over the world.
Dr. Beasley is board certified by the American Board of Dermatology, and is a Fellow of the American Academy of Dermatology.
Originally from Nashville, TN, Dr. Beasley currently lives in North Carolina and enjoys spending time outdoors (with sunscreen of course) with his wife and two children in his spare time.
Bachelor of Science, Life Sciences. United States Military Academy.
Doctor of Medicine. Tulane University School of Medicine
Dermatology Residency. San Antonio Uniformed Services Health Education Consortium
Board Certified. American Board of Dermatology
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