What is Dutasteride?

Dutasteride is a synthetic steroid compound that is approved for the treatment of benign prostatic hyperplasia.^{1, 2} It is considered an improved version of its predecessor, finasteride, and is used off-label to treat hair loss.

Dutasteride works by blocking production of the enzyme 5α-reductase, which is responsible for converting testosterone into dihydrotestosterone (DHT).³ In the context of hair loss, DHT compromises the growth phase of the hair cycle, leading to follicular miniaturisation. The end result is the progressive formation of shorter, finer hairs leading to hair loss.

5α-reductase exists as different subtypes (Types 1-3) that all perform the same function but differ in terms of their distribution in human tissue and levels of expression at various stages of development.⁴Dutasteride inhibits the Type 1 and Type 2 forms of 5α-reductase whereas finasteride inhibits only the Type 2 form.

Several studies evaluating the efficacy of oral dutasteride⁵ to treat androgenetic alopecia (male pattern hair loss), with comparison^{6, 7, 8}to oral finasteride suggest that dutasteride provides superior results to finasteride, although patient response can vary between individuals.

Despite dutasteride not being approved for the treatment of hair loss, it is commonly used off-label for this purpose. Not surprisingly, there are also no approved versions of topical dutasteride, although several online entities appear to offer it, usually in conjunction with a prescription.

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