The importance of dual 5alpha-reductase inhibition in the treatment of male pattern hair loss: results of a randomized placebo-controlled study of dutasteride versus finasteride

J Am Acad Dermatol. 2006 Dec;55(6):1014-23. doi: 10.1016/j.jaad.2006.05.007.

Abstract

Background: Male pattern hair loss (MPHL) is a potentially reversible condition in which dihydrotestosterone is an important etiologic factor.

Objective: Our aim was to evaluate the efficacy of the type 1 and 2 5alpha-reductase inhibitor dutasteride in men with MPHL.

Methods: Four hundred sixteen men, 21 to 45 years old, were randomized to receive dutasteride 0.05, 0.1, 0.5 or 2.5 mg, finasteride 5 mg, or placebo daily for 24 weeks.

Results: Dutasteride increased target area hair count versus placebo in a dose-dependent fashion and dutasteride 2.5 mg was superior to finasteride at 12 and 24 weeks. Expert panel photographic review and investigator assessment of hair growth confirmed these results. Scalp and serum dihydrotestosterone levels decreased, and testosterone levels increased, in a dose-dependent fashion with dutasteride.

Limitations: The study was limited to 24 weeks.

Conclusion: Dutasteride increases scalp hair growth in men with MPHL. Type 1 and type 2 5alpha-reductase may be important in the pathogenesis and treatment of MPHL.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • 5-alpha Reductase Inhibitors*
  • Adult
  • Alopecia / drug therapy*
  • Alopecia / enzymology
  • Androgen Antagonists / administration & dosage
  • Androgen Antagonists / adverse effects
  • Androgen Antagonists / pharmacology
  • Androgen Antagonists / therapeutic use*
  • Azasteroids / administration & dosage
  • Azasteroids / adverse effects
  • Azasteroids / pharmacology
  • Azasteroids / therapeutic use*
  • Dihydrotestosterone / analysis
  • Dihydrotestosterone / blood
  • Dose-Response Relationship, Drug
  • Dutasteride
  • Finasteride / administration & dosage
  • Finasteride / adverse effects
  • Finasteride / pharmacology
  • Finasteride / therapeutic use*
  • Hair / drug effects
  • Hair / growth & development
  • Humans
  • Isoenzymes / antagonists & inhibitors
  • Libido / drug effects
  • Male
  • Middle Aged
  • Scalp / chemistry
  • Scalp / drug effects
  • Testosterone / analysis
  • Testosterone / blood
  • Treatment Outcome

Substances

  • 5-alpha Reductase Inhibitors
  • Androgen Antagonists
  • Azasteroids
  • Isoenzymes
  • Dihydrotestosterone
  • Testosterone
  • Finasteride
  • Dutasteride