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Hair Loss/Testosterone and hair

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Dr. Panagotacos,

We know that testosterone also has a negative effect on human head hair follicles albeit less of an affect than DHT. Dutasteride raises scalp testosterone by 104% at .5 mg dosed every day. Blood serum testosterone levels also rise (likely because there is less testosterone being converted to DHT since 5 alpha reductase is being inhibited by dutasteride). Are dutasteride users potentially setting themselves up for a slower failure? What I mean by that is we are inhibiting DHT but slowly allowing testosterone to shrink away follices long term?

Answer
There are no long term studies for dutasteride, which would mimic a Type I and Type II 5 alpha reductase enzyme deficiency. What we do know is that a Type II enzyme deficiency does exist and the men in those families never go bald and never get prostate cancer. So, for a long term study already done by nature it would seem lowering DHT by 66% with finasteride right after puberty onwards or the Type II inherited deficiency both should show beneficial effects the longer you take them.  I have not seen any long term thinning in my patients on dutasteride. If it exists after four decades of use someone will write a paper on it. Personally I do not think it will happen.

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Peter J. Panagotacos, <B>M.D.</B>

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I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery.

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I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery. More information can be found at my website www.hairdoc.com

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