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This question comes from a member of our Hair Loss Social Community and Discussion Forums: 

After becoming concerned about my hair loss I started doing some research and found that dihydrotestosterone (DHT) is the hormone responsible for genetic baldness. Knowing this, I assume the best way to treat progressive hair loss is to “block” DHT? Is this true? Is DHT an important element of hair loss?

DHT (dihydrotestosterone) is the hormone (essentially) responsible for hair loss; in this sense, it is very important.

In my opinion, the best way to “block” DHT is to prevent it from forming in inappropriate amounts in the first place. Medications that block the activity of the 5-alpha-reductase enzyme (mainly type II 5-alpha-reductase), the compound responsible for converting testosterone to dihydrotestosterone, will greatly decrease the amount of DHT available to affect hair follicles and cease the progressive loss.

As of now, the two compounds known to block the 5-alpha-reductase activity are finasteride (the active ingredient in Propecia) and dutasteride (the active ingredient in Avodart). Of these two, finasteride is proven safe and effective for treating hair loss and, in my opinion, is the most effective compound to block DHT and prevent progressive baldness.
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Blake  – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

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This question comes from a member of our Hair Loss Social Community and Discussion Forums: 

Several months ago, I began taking Propecia (finasteride) for my progressive hair loss and experienced significant side effects. After stopping the medication, I switched to Avodart (dutasteride), another medication sometimes indicated in hair restoration, and did not experience any adverse side effects. Is there a reason for this? Should I continue taking the Avodart?

Finasteride (the active ingredient in Propecia) works by blocking the DHT (dihydrotestosterone – the hormone responsible for genetic baldness) converting activity of the type II 5-alpha-reductase enzyme. Dutasteride (the active ingredient in Avodart) works by inhibiting the activity of both the type I and type II 5-alpha-reductase enzymes. Although Propecia is shown to be just as effective, I’m not certain that utilizing one medication over the other would produce different side effects, as they are very, very similar drugs.

Regardless, there could be a variety of reasons why the Avodart is working without negative side effects, and if this will help prevent the progression of your hair loss, I think you should confirm and safety and efficacy of the pill with your hair restoration physician and keep utilizing it as a preventive measure. Additionally, keep in mind that Propecia is the only oral medication officially approved for treating progressive hair loss and usually causes side effects in a very small patient population (according to the official studies, less than 3%).

Can the hair loss treatments Propecia (finasteride) and Avodart (dutasteride) increase risks of cancer?

Last week, the U.S. Food and Drug Administration (FDA) released a statement claiming the drugs Avodart and Proscar, typically used to treat benign prostate hyperplasia (prostate enlargement) in men, may increase the risks of high-grade prostate cancer.

The news came suddenly after two large clinical trials revealed the increased risks (ironically enough, both drugs were tested as a method of preventing prostate cancer in late 2010), and now individuals at the FDA are pushing the makers of Avodart and Proscar to include prostate cancer warning labels on prescription bottles.

While this news is important for individuals taking these medications for prostate enlargement issues, the announcement also comes as a surprise to hair loss patients, as the active ingredient in both Avodart and Proscar is dutasteride and finasteride (respectively).  These two compounds are used to block the action of 5-alpha-reductase enzymes – proteins responsible for converting testosterone to the hair loss inducing, dihydrotestosterone (DHT) form.

Finasteride is also the key ingredient in the hair loss drug Propecia, which is proven safe and effective for treating male pattern baldness, and although the amount of finasteride in Propecia is greatly reduced (compared to Proscar), the FDA believes it should now carry a similar warning label (although it was not one of the drugs included in the initial clinical trial).

This question comes from a member of our Hair Loss Social Community and Discussion Forums:

I’ve started researching preventive hair loss medications and find myself confused about the difference between dutasteride (Avodart) and finasteride (Propecia) for male pattern baldness. What is the difference between these two medications?

In theory, the biggest difference between dutasteride and finasteride is that dutasteride blocks both forms (type 1 and type 2) of the alpha-reductase enzyme that is associated with the conversion of testosterone to dihydrotestosterone – the hormone responsible for hair loss, whereas finasteride only blocks type 2.

However, it was my understanding that only the type 2 enzyme is actually associated with the significant testosterone to dihydrotestosterone conversion as far as hair loss is concerned, and only blocking type 2 effectively prevents male baldness (though some studies argue that dutasteride/Avodart demonstrated a higher hair count while utilizing the medication).

Additionally, most people likely utilize finasteride (specifically in Propecia) above dutasteride because it has been tested and proven safe and effective for treating male hair loss. Furthermore, some hair loss sufferers report issues with the additional costs of dutasteride/Avodart and less available information regarding potential side effects.
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Blake – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

Follow our community on Twitter

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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
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.