Why is dutasteride better than finasteride

The protocol was approved by the Institutional Ethics Committee. Efficacy assessments Global photography assessments Clinical assessment was performed by blinded and non-blinded dermatologists using standardized photographs of the vertex scalp taken by placing the head on a stereotactic positioning device. Subjective evaluation Subjects were asked to rate changes in the size of the vertex spot, hair loss on top of the scalp, bitemporal recession, the amount of hair shedding, hair quality and overall satisfaction with hair growth on a 3-point rating scale increased, no change, or decreased.

Safety assessment Safety assessment was performed through enquiry, physical examination and laboratory evaluation. Results A total of 72 patients completed the study. Hair growth The mean change in total hair count after 24 weeks of treatment was significantly greater in the dutasteride group Figure 2a: Pre treatment modified phototrichogram of patient on dutasteride Figure 2b: Post treatment modified phototrichogram of the same patient on dutasteride Figure 2c: Pre treatment modified phototrichogram of patient on finasteride Figure 2d: Post treatment modified phototrichogram of the same patient on finasteride.

Table 1: The baseline characteristics of patients in two groups. Table 2: Blinded investigator's assessment of hair growth on global photograph between dutasteride and finasteride cases. Sato A, Takeda A. Evaluation of efficacy and safety of finasteride 1 mg in Japanese men with androgenetic alopecia.

J Dermatol ; Finasteride in the treatment of Japanese men with male pattern hair loss. Eur J Dermatol ; Finasteride in the treatment of Taiwanese men with androgenetic alopecia: A month open-label study. Kaohsiung J Med Sci ; Long-term 5-year multinational experience with finasteride 1 mg in the treatment of men with androgenetic alopecia.

Effect of dutasteride 0. Int J Dermatol ; Finasteride in the treatment of men with androgenetic alopecia. Finasteride male pattern hair loss study group. J Am Acad Dermatol ;39 4 Pt 1 Finasteride: A review of its use in male pattern hair loss.

Drugs ; Finasteride increases anagen hair in men with androgenetic alopecia. Br J Dermatol ; Changes in hair weight in men with androgenetic alopecia after treatment with finasteride 1 mg daily : Three- and 4-year results. J Am Acad Dermatol ; Clinical dose ranging studies with finasteride, a type 2 5alpha-reductase inhibitor, in men with male pattern hair loss. Efficacy and tolerability of finasteride 1 mg in men aged 41 to 60 years with male pattern hair loss. The 5 alpha-reductase system and its inhibitors.

Recent development and its perspective in treating androgen-dependent skin disorders. Dermatology ; Messenger A. Male androgenetic alopecia. Hair Growth and Disorders. Berlin: Springer; Kaufman KD.

Androgen metabolism as it affects hair growth in androgenetic alopecia. Dermatol Clin ; Olsen EA, editor. Disorders of Hair Growth: Diagnosis and Treatment.

New York: McGraw-Hill; Prostate ; Predominance of type I 5alpha-reductase in apocrine sweat glands of patients with excessive or abnormal odour derived from apocrine sweat osmidrosis. Activity of the type 1 5 alpha-reductase exhibits regional differences in isolated sebaceous glands and whole skin. J Invest Dermatol ; Marked suppression of dihydrotestosterone in men with benign prostatic hyperplasia by dutasteride, a dual 5alpha-reductase inhibitor. J Clin Endocrinol Metab ; There are two types, called isoenzymes, of 5-alpha reductase: type 1 and type 2.

Finasteride specifically blocks type 2. Dutasteride blocks both type 1 and type 2 5-alpha reductase, which means it prevents more testosterone from being converted into DHT. Researchers have even compared the treatments, no pun intended, head-to-head.

Total hair counts were higher in the group treated with dutasteride, as was subject assessment of the results of 24 weeks of treatment Zhou, Both, however, are generally well tolerated. Common sexual side effects include decreased sex drive, trouble getting or keeping an erection erectile dysfunction , and a decrease in semen.

More adverse effects have been reported, however. These include breast tenderness and enlargement, depression, allergic reactions, and problems with ejaculation.

These medications can affect a blood test called PSA prostate-specific antigen , which is used as a screening test for prostate cancer. Studies have found that dutasteride is more effective at treating male pattern baldness.

This medication is not only shown to be potentially more effective at treating hair loss but also shows the same rate and types of side effects as finasteride. There are other considerations your healthcare provider may take into account. Since dutasteride is more effective at lowering DHT and is FDA-approved to treat benign prostatic hyperplasia which is believed to be driven by DHT levels , it may be prescribed to treat both hair loss and BPH simultaneously Nickel, Is one better than the other?

Hair loss. Last updated June 26, Written by Linnea Zielinski. Disclaimer If you have any medical questions or concerns, please talk to your healthcare provider.

AGA, a multifactorial skin disease with a complex genetic inheritance, is characterized by a progressive shedding of visible terminal hair. Clinically, both dutasteride and finasteride, as two kinds of 5ARI, have performed certain curative effects.

One study discovered that dutasteride was approximately three times more potent than finasteride in inhibiting type 2 5AR and times more potent in inhibiting type 1 5AR. The result showed that dutasteride was more effective than finasteride in all respects for the treatment of AGA. However, two RCTs 16 , 17 showed that there was no statistical significance in self-assessment of size of vertex spot, hair shedding, and hair quality between the two groups with the exception of hair loss on top of scalp.

A related clinical study stated that 0. The present study showed that dutasteride and finasteride were relatively well-tolerated. Considering possible sexual dysfunction, mainly including altered libido, ED, and ejaculation disorders, the dutasteride group showed no statistical differences compared with the finasteride group. However, Debruyne et al 27 found that dutasteride would have a better tolerance and fewer adverse events after a 4-year course of treatment.

Andriole et al 28 reported that long-term use of dutasteride might increase the risk of the progression of prostate cancer. As our study is a meta-analysis of short-term treatment, the above-mentioned views could not be supported.

According to the current analysis of the safety of the two drugs, the application of two drugs should be carefully considered for young middle-aged men, especially for patients who are sexually active. Clinical reports found that 5ARI could independently improve the occurrence rate of ED, but many clinicians believed that the side effects of 5ARI would gradually disappear with ongoing treatment.

Kaufman et al 31 found that adverse reactions related to sexual functions most commonly occurred in year 1 of treatment with finasteride and placebo 4. Therefore, this may indicate that there was no increase in the incidence of adverse reactions related to sexual functions during the course of long-term finasteride treatment. A Phase III trial followed for 4 years demonstrated that dutasteride therapy was well-tolerated over 4 years, with a general trend toward a reduction in incidence of the most common sexual adverse reactions over time 6.

Due to the limitation of follow-up period, more studies are needed to explain this concept. Above all, dutasteride seems to provide a better efficacy compared with finasteride, and two drugs appear to show similar rates of adverse reactions, especially with respect to sexual dysfunction. In terms of dosage, there is no uniform fixation for both drugs at present.

Clinically, dutasteride 0. Further clinical studies are needed to explain the effect of different dosage of drugs in treating AGA. We could not infer the long-term efficacy and tolerance of dutasteride and finasteride, and selection bias and publication bias may affect the final results of our study. So, it still needs a lot of substitution of head-to-head comparison to confirm our findings. More high-quality RCTs with suitable study cohorts are needed to ascertain the efficacy and tolerance of dutasteride and finasteride for the treatment of AGA.

The two drugs appear to show similar rates of adverse reactions, especially with respect to sexual dysfunction. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author contributions. All authors contributed to data analysis, drafting or revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work. National Center for Biotechnology Information , U. Journal List Clin Interv Aging v. Clin Interv Aging. Published online Feb Author information Copyright and License information Disclaimer. This work is published and licensed by Dove Medical Press Limited. By accessing the work you hereby accept the Terms.

Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. This article has been cited by other articles in PMC. Abstract Aim We performed a meta-analysis to evaluate the efficacy and safety of dutasteride and finasteride in treating men with androgenetic alopecia AGA during a week treatment cycle.

Results Three articles including participants which compared dutasteride with finasteride were selected for our analysis. Conclusion Dutasteride seems to provide a better efficacy compared with finasteride in treating AGA. Keywords: androgenetic alopecia, meta-analysis, randomized controlled trials, dutasteride, finasteride. Inclusion criteria and trial selection RCTs that met the following criteria were included: 1 dutasteride vs finasteride in treating men with AGA; 2 the full-text of study was gettable; and 3 the study provided accurate data that could be analyzed, mainly including the total number of subjects and the valuable results of each indicator.

Open in a separate window. Figure 1. Flowchart of the study selection process. Abbreviation: RCT, randomized controlled trial. Quality assessment The Jadad scale was used to evaluate the quality of each study. Statistical analyses and meta-analysis The data were calculated by using Rev Man v5. Results Characteristics of individual studies Our search strategy found 76 articles. Table 1 Study and patient characteristics. Harcha et al 15 Dutasteride Finasteride Oral 24 0. Shanshanwal and Dhurat 17 Dutasteride Finasteride 35 37 Oral 24 0.

Quality of the individual studies All RCTs showed the randomization and double-blinded processes. Figure 2. Funnel plot of the studies included in our meta-analysis. Abbreviation: SE, standard error. Table 2 Quality assessment of individual study.

Efficacy The mean change in total hair count Three RCTs enrolling patients in the dutasteride group and in the finasteride group contained data on the mean change in total hair count Figure 3. Figure 3. Abbreviation: IV, inverse variance. Panel global photographic assessment for the vertex and frontal views Two RCTs enrolling patients in the dutasteride group and in the finasteride group Figure 3 contained data on the panel global photographic assessment.

Safety Altered libido Three RCTs involving participants in the dutasteride group and in the finasteride group Figure 4 contained data on altered libido.