DHT Types, Finasteride (Propecia, Proscar) and Dutasteride (Avodart) and male pattern balding
Good day to you sir. I read in a previous post dated over a year ago that type II DHT is linked to hair loss, but type I DHT has not been linked/proven to cause hair loss. Is there any news/updates on the two types of DHT with the relation to hair loss? Thank you for your time!
Nothing has changed in recent times.
For clarification, Propecia is a brand name of a generic drug named finasteride in 1mg strength. Proscar is also a brand name of a generic drug named finasteride but in 5mg strength. Avodart is a brand name of a generic drug named dutasteride in 0.5mg strength.
Propecia is the only FDA approved oral medication for the treatment of Androgenic Alopecia (AGA) which is a genetic cause of Male Pattern Balding (MPB)
Avodart and Proscar is FDA approved for prostate condition known as benign prostatic hyperplasia.
Propecia and Proscar works by blocking an enzyme called 5?-reductase type II which ultimately reduce the DHT level.
Avodart works by blocking the same enzyme 5 alpha-reductase type II but it also blocks 5 alpha-reductase type I which ultimately reduce the DHT level.
You would think that if DHT is responsible for men’s genetic hair loss, that if you block DHT entirely and most efficiently (with Avordart) you would stop the hair loss. This is not the case! It has been found that blocking only the 5 alpha-reductase type II is what you need to treat male pattern hair loss. Blocking that extra type I enzyme with Avodart does not necessarily equate to better result in terms of treating hair loss.
But people don’t really pay attention to science and research. People generally look for the most extreme treatment and non-scientifically based Internet anecdotal reports. So people are using Avodart thinking it has DHT blockade than Propecia (finasteride). For this reason, many who have tried Propecia (finasteride), with no significant or dwindling results switching to Avodart thinking it will work “better”. They don’t realize or factor in their genetic predisposition. They also do not realize the possible long term and increased sexual side effects with Avodart.
In the end Avodart is still used by many for treating hair loss in men. But its true efficacy and advantage over Propecia is not completely clear.
It is negligent to not mention that 5 alpha reductase type 2 also blocks 5 alpha DHP and DHDOC which are both critical hormones.
It doesn’t make sense that the author suggests dutasteride offers long term side effects when finasteride does not. Dutasteride inhibits the type 1 enzyme which does is found in non-gential skin and because the type 1 enzyme is active in the liver and non-genital, but the type 2 enzyme is the one active in sexual organs.
Many doctors would disagree with your view on avodart. Avodart decreases more dht so it is only logical that it would be more effective in treatin hair loss. Not only is it logical that it would be more effective but there are controlled studies showing that avodart is superior to finasteride in treating hair loss.