Post Hair Loss Questions and Get Answers

For over a decade, balding men have had two clinically proven options for treating their hair loss medically. !n 1988, Rogaine (minoxidil) 2% Topical Solution for Men launched as a prescription medication. Men’s Rogaine 5% Extra Strength Solution was approved for over-the-counter use in 1997. That same year, the FDA also approved finasteride to treat male pattern baldness (MPB) under the brand name Propecia. When used in combination, minoxidil and finasteride are still considered by many experts to be the best drug treatment for hair loss currently available.

However, over the past few years, some patients have begun to explore Avodart (dutasteride) as an alternative to finasteride. The reasons for this switch are varied. Some men hope that dutasteride will offer fewer side effects while others have simply not had success with Propecia and are looking for something more effective. Whatever the reason, it is important to note that Avodart is currently not FDA approved for the treatment of male pattern balding. So how does Avodart work? What are its side effects? How do you know if it’s time to make the switch?

Dutasteride, the active ingredient in Avodart is a 5-alpha-reductase inhibitor that inhibits the conversion of testosterone into dihydrotestosterone (DHT). As most balding men can tell you, DHT is the hormone responsible for androgenic alopecia or male pattern baldness. While Propecia (finasteride) only inhibits the Type II isoform of 5-alpha reductase, Avodart (dutasteride) blocks both Type I and Type II, potentially making it a more effective treatment for hair loss.

I am considering using Avodart (dutasteride) as a hair loss treatment because it is supposedly stronger than Propecia (finasteride).  Does this sound like a good plan to regrow hair?

It appears that many more hair loss sufferers are turning to Avodart (dutasteride) for hair loss before first trying Propecia (finasteride).

Though Avodart (dutasteride) is said to potentially be a more potent hair loss drug, it is not FDA approved for hair loss.  Avodart (dutasteride) inhibits both type I and type II 5-alpha-reductase enzymes minimizing the production of DHT more than Propecia.  But with a more potentially potent drug comes more potentially potent side effects.

In my opinion, it would be better to try Propecia first, which has been FDA approved as a hair loss medication. Many balding patients have great success with Propecia especially when combined with Rogaine 5%. (minoxidil).  Many hair restoration physicians will recommend trying Avodart as an alternate hair loss treatment in the event that Propecia isn’t working after 1 year of use.

Be sure however, to discuss these hair restoration treatments with a physician beforehand to learn fully about the benefits, limitations, and potential side effects.

Bill Seemiller – aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

Technorati Tags: Avodart, dutasteride, hair loss treatment, Propecia, finasteride, regrow hair, hair loss, 5-alpha-reductase, Propecia, hair loss medication, balding, minoxidil, hair restoration physician, hair restoration treatments

Having attended the annual International Society of Hair Restoration Surgery (ISHRS) meetings over the past ten years, while publishing the Hair Transplant Network, I now seem to know or be known by almost all of the prominent hair transplant physicians.

Those who have become famous online for doing outstanding work typically greet me warmly, while others who I have chosen not to recommend often stiffen up and scowl when they encounter me.  One hair restoration physician last week even took me aside in the hallway and threatened to sue me for having his recommendation discontinued.

But, like it or not, most physicians have come to realize that our patient based community and our open forum are here to stay and that we will continue to say when the “emperor has no clothing” even if it may be awkward or embarrassing. As the publisher of this community, I will continue to critique various techniques, treatments and those who perform them, while keeping an eye out for top-notch hair transplant physicians and clinics. I know the active members of this community will also continue to do the same.

In this report I’d like to share highlights from the 15th annual ISHRS scientific meeting that was held in Las Vegas from September 26th to the 30th.

I will focus on what may be of most interest to hair loss sufferers and patients such as presentations on the potential dangers of Dutasteride (Avodart), new advances such as hair multiplication (follicular cell implantation), the effectiveness of low light laser therapy (LLLT) in treating hair loss, the pros and cons of FUE (follicular unit extraction) and other topics.

I have been taking Avodart .5mg for about 6 weeks and am experiencing some pain in my testicles.  Do you know why this is?  What should I do?

Avodart is a medication that is prescribed by medical doctors for those who suffer from a large prostate.  Avodart works by decreasing the amount of Dihydrotestosterone (DHT) in the body which results in a smaller prostate. 0.5 mg of this medication is typically the recommended amount for this process to work.

As you may or may not be aware, Avodart (dutasteride) is not an FDA approved medication for hair loss.  Though it has been speculated to be a stronger and more efficient medication than Propecia (finasteride), it has not been fully tested.   Avodart, like Propecia is a DHT (the hormone responsible for the loss of genetically predisposed hairs) inhibitor.

Reported potential side effects  of the medication according to the official Avodart website include: sexual side effects (such as impotence, decreased sex drive, decreased amount of semen, and impotence) and swelling of the breasts.  Other less reported side effects include allergic reactions such as itching, swelling of the face or lips, hives, and rash.  According to their website, most side effects will stop after continued use of the medication.

If you are experiencing any of the above side effects or any side effects you think are related to Avodart, the best move would be to consult with the doctor who prescribed it to you and explain your symptoms.

I do not want or have decided that I’m not a good candidate for a hair transplant.  How can I manage my hair loss?

It should be noted first hand that hair transplantation does NOT manage hair loss.  Learn more about hair transplantation here.

There are only two hair loss medications approved by the FDA for hair loss.  These are are finasteride (marketed as Propecia) and Minoxodil (marketed as Rogaine).  Both hair loss medications can be effective means to help you maitain your existing hair.   Less common, however possible, people have re-grown some hair.

There is another medication that can be considered in the event that Propecia doesn’t work or loses it’s efficacy called Avodart which contains dutasteride.  Please understand that this medication has not been approved for Male Pattern Baldness at least not at this point.  I recall at one point, for some unknown reason, testing as a treatment for hair loss was discontinued.  If testing has resumed, I am unaware of it.

Please understand that these hair loss medications are NOT miracle cures.    For those who are trying to do something about their hair loss in the early stages, medication may be an effective treatment alone.   However, most people with extensive hair loss find that these treatments are simply not enough.  This is why many consider hair transplantation.

Finasteride (Propecia Vs Proscar)

Meeting Report by Pat Hennessey – Publisher of the Hair Transplant Network and the Coalition Hair Loss Learning Center

Each year the International Society of Hair Restoration Surgery (ISHRS) hosts a four day meeting that is attended by ISHRS members from around the world. I have attended several of these international meeting as both a guest and as a member of the press. The highlights that I thought would be of interest to hair loss sufferers are presented in this report.

This years annual ISHRS meeting was held in San Diego, California from October 18th to the 22nd. Over four hundred hair restoration physicians from around the world attended this international meeting along with over 100 medical technicians and staff members. It was impressive to see so many hair transplant physicians sharing and debating the fine points of hair restoration. I found it interesting that many of the issues that have been discussed on our forum over the past couple of years were the hot topics at the meeting. These topics included – optimal session and graft sizes, ultra dense “super” mega sessions vs traditional density mega sessions, sub follicular unit grafting vs follicular unit grafting, growth rates, hair multiplication, FUE, and trichophytic closure techniques.

The internet has been a great ally to the hair loss sufferer in the past several years. Caught off guard with a widespread genetically-determined condition with a nearly socially-crippling stigma, guys with thinning hair have been able to go onlline to exchange information, ask advice, and voice their opinions in totally anonymity. The Hair Restoration Research Forums have provided a safe harbor for hair loss sufferers for years.

However, the internet is not without its dangers. Thousands of online prescription drug distributors dot the web with flashy sites that tout low prices for generic Propecia, Proscar, Avodart, and Rogaine. With prices of prescription drugs escalating in the U.S., the U.K. and everywhere else, it’s very tempting to buy from these merchants. But how is the consumer supposed to know that the drugs he is getting legitimate?

Many generic forms of finasteride and dutasteride (medicinal names for Propecia and Avodart, respectively) are manufactured in India by pharmaceutical drug companies Cipla and Dr. Reddy’s. Both are reputable medication giants that are approved in one form or another by the FDA for the manufacture of prescription grade and over-the-counter medication. There is no question that the products generated by these two companies are of superior quality.

There are thousands of products available to treat hair loss and every single one of them claim to be the best. It can be a daunting task for anyone suffering from male-pattern baldness to research what will work best for them to keep the hair they have and regrow hair they have lost. With this list, I’m going to cut through the hype and lies to present the 5 proven methods that regrow hair.

1. Block DHT -

DHT (Dihydrotestosterone) is the root cause of male-pattern baldness. This potent derivative of testosterone binds to the receptor sites in hair follicles. Over time the DHT binding with these vulnerable receptors in the follicle slowly choke the follicle’s ability to produces healthy hairs.

To effectively combat hair loss you have to attack it at its source. There is currently only one DHT-inhibitor that is FDA-approved for the treatment of male-pattern baldness: Propecia. Avodart is another, more potent, DHT inhibitor that is available, however it is not approved for the treatment of MPB.

To find out which DHT inhibitor is right for you see the article, “Propecia vs. Avodart: Which Internal DHT Inhibitor Should You Choose?”

View charts that illustrate the efficacy of Propecia.

View charts that illustrate the efficacy of Avodart.

2. Stimulate Hair Growth -

The only other medication FDA-approved for the treatment of male-pattern baldness other than Propecia is minoxidil (Rogaine).

For anyone considering using Avodart (Dutasteride) to combat their male-pattern baldness, these charts should come in handy. The first one shows the amount of DHT inhibited by Avodart in concentrations of .1mg per day, .5 mg per day, and 2.5 mg per day. .5 mg per day is the dose prescribed to BPH (benign prostatic hyperplasia) sufferers and is often the dose taken by hair loss sufferers. View larger chart.

The next chart shows the amount of DHT inhibited by Avodart on different dosing schedules. The lines are kind of hard to see so I’ll list them here:

• Purple line: 1.5 mg per day (3 Avodart pills) for 10 days and then .5 mg per day thereafter
• Blue line: .5 mg per day
• Green line: .5 mg per day for 2 days, then take one day off, then repeat
• Red line: .5 mg every other day
• Black line: Finasteride (Propecia/Proscar 1 mg per day) equivalent.

View larger chart.

As you can see, loading with 1.5 mg per day and then taking .5 mg per day thereafter inhibits the largest amount of DHT the fastest. You can achieve the same rate of inhibition with taking .5 mg per day from the start but it will take time to build in your system to its maximum levels of inhibition.When I started Avodart (and discontinued Propecia) I went ahead and took the loading method. I have been lucky enough to not have any side effects with Avodart thus far other than a brief shedding period that lasted about a month-and-a-half starting at around the two month mark. I have been using Avodart for about a year-and-a-half now with great results.

This is Part 2 in a two part series. Before reading on you will want to read Part 1.

Avodart – an even stronger DHT inhibiting drug

Since the FDA approval of Propecia another DHT-inhibiting drug with great potential for inhibiting hair loss has come on the scene. This drug is called Dutasteride.
Dutasteride was developed by Glaxo-Smith Kline (GSK) and is marketed under the brand name Avodart. Like Finasteride, Dutasteride is a 5AR-inhibitor. However, unlike Finasteride, Dutasteride inhibits both Type I AR and Type II AR. Dutasteride also has a much longer half-life than Finasteride (Propecia) so any side effects that occur from use of the medication will be sustained for a much longer period of time.

Also like Propecia or Proscar, Avodart is available for prescription for treatment of BPH and has FDA approval for that application. However, testing of Dutasteride for the treatment of male-pattern baldness was discontinued by GSK for unknown reasons, though it is not thought to have been a safety issue since the drug is still available for BPH. This means that Avodart has not yet been FDA approved for the treatment of male pattern baldness.

Since Avodart is a dual 5AR inhibitor and is much stronger than Propecia, it is generally accepted that it is possible that it can be a more effective treatment for male pattern baldness. However, without sufficient testing this is speculative.