Dutasteride vs finasteride: How much more hair does dutasteride grow?

Summary

The presenter compares dutasteride and finasteride for male-pattern hair loss, focusing on randomized studies that tested the drugs directly against each other. Overall, dutasteride generally produced greater hair-count gains and thicker hair, though the size of the difference varied across studies. The trials lasted about 24 weeks, so they provide a six-month comparison rather than a long-term one.

Main findings

• 2006 trial: Dutasteride 0.5 mg/day increased hair counts by 94.6 hairs in the measured target area, compared with 75.6 for finasteride 5 mg/day. The difference was not statistically significant. Dutasteride 2.5 mg/day did show a significant advantage over finasteride, but this is a much higher dose than the standard dutasteride dose.
• Larger trial: Dutasteride 0.5 mg/day increased counts by 89.6 hairs, versus 56.5 with finasteride 1 mg/day. This statistically significant difference of 33.1 hairs in the target area was estimated by the presenter as about 6.5 more hairs per cm². Dutasteride also improved hair width, though the difference in terminal-hair counts was not statistically significant.
• Smaller Indian study: Dutasteride increased hair counts by 23 hairs per cm², compared with 4 for finasteride, and reduced miniaturized hairs more. The presenter cautions that this study was small and not double-blinded.
• Intermittent-dose comparison: In a small study, dutasteride taken twice weekly performed worse than daily finasteride, while dutasteride taken three times weekly performed better on terminal-hair counts. The study did not test the standard daily dutasteride dose.

Across the studies, the presenter estimates dutasteride’s advantage at roughly 6 to 18 more hairs per cm², depending on the study and how results are measured. He also says the evidence suggests greater hair thickness and visible improvement with dutasteride.

Caveats and decision factors

The presenter argues that head-to-head trials are more useful than comparing results from separate studies, since participants and hair-loss severity can differ between studies. He says dutasteride is more dose-dependent than finasteride and notes limitations in a meta-analysis discussed in the video: it combines different measurement areas and, for one study, uses a high dutasteride dose rather than the standard dose.

Potential drawbacks of dutasteride include higher cost, limited availability in some countries, and a long half-life, meaning side effects may take months to fully resolve after stopping. The presenter also raises a personal concern about its non-vegan formulation.

His takeaway is not that everyone taking finasteride should switch. He encourages viewers to weigh dutasteride’s greater average efficacy against its drawbacks and make a considered decision. The video is informational, not individualized medical advice.

Presenters and sources

• Presenter: Haircafe narrator; not named in the subtitles.
• Olsen et al. (2006), dutasteride-versus-finasteride randomized trial.
• Gubelin Harcha et al. (2014), randomized trial comparing dutasteride, finasteride, and placebo.
• Shanshanwal and Dhurat (2017), randomized open-label study.
• Zhou et al. (2019), meta-analysis.
• A small intermittent-dose comparison is also discussed, but its authors are not identified in the subtitles.