TLDR Finasteride and dutasteride are effective in treating male hair loss but can cause sexual side effects and birth defects.
The document evaluates the effectiveness of 5 alpha reductase inhibitors (5ARIs), specifically finasteride and dutasteride, in treating male androgenic alopecia (AGA), a hair-loss disorder. Finasteride, approved by the FDA in 1997, reduces scalp and serum dihydrotestosterone (DHT) by 64% and 68% respectively, halting AGA in at least 90% of men and promoting hair regrowth in 48% at 12 months and 66% at 48 months. However, it can cause reduced libido and erectile dysfunction. Dutasteride, more potent than finasteride, decreases DHT more significantly but has a higher risk of sexual side effects. Both drugs can cause birth defects and are not recommended during pregnancy. The authors suggest 5ARIs for early and long-term use to prevent baldness, but discontinuation leads to loss of effect and return to baseline hair density at 6 months.
Cited in this study
9 / 9 results
1 citations
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August 2022 in “Journal of Dermatological Treatment” 11 citations
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October 2021 in “Journal of The European Academy of Dermatology and Venereology” 
6 citations
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December 2018 in “Australasian Journal of Dermatology” The Trichoscopy Derived Sinclair Scale offers a more accurate and reliable way to measure hair loss severity than the traditional visual method.
50 citations
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March 2017 in “PeerJ” Using finasteride or dutasteride may cause long-lasting erectile dysfunction.
17 citations
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February 2013 in “Australasian Journal of Dermatology” Finasteride and low-dose dutasteride combo improves hair growth and reduces hair loss with no major side effects.
40 citations
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August 2010 in “Australasian Journal of Dermatology” Chronic hair shedding may be caused by less variation in hair growth times and might stop on its own after several years.
116 citations
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179 citations
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1 citations
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June 2021 in “Singapore Medical Journal” 
19 citations
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8 citations
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May 2016 in “Indian Journal of Pharmacology” 47 citations
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January 2003 in “Current opinion in urology” A new drug, dutasteride, is at least as effective as the older drug, finasteride, for treating enlarged prostate and may have additional uses.
