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Hair Loss/Switching Medications


QUESTION: I am a 25 year old male around a NW 3. My brother is a NW 3 and is 28, but my father is a NW 6 and lost his hair relatively later on in his early 30's.  My maternal grandfather however is a NW2 at 90 years old. I have been on finasteride for nearly two years with decent results.  My crown filled in after 8 months of the medication, but my concern is my hairline area.  I believe finasteride has slowed things down and has somewhat kept things at bay, but my hairline seems to be slowly eroding away and getting thinner.  I was prescribed avodart by my family doctor to try for hair loss.  I started last week taking .5mg of avodart two times a week and continuing taking 1mg. finasteride the other 5 days of the week.  

After reading many reviews on dutasteride the majority of people reported that it destroyed their hairlines and was worse for their hairline than what finasteride showed.  This has me somewhat worried about taking the medication.  Also, my plan was to slowly work up to taking dutasteride .5mg daily by 6 months.  I am afraid that since finasteride is slowing my hair loss down and I switch to dutasteride and don't respond to the drug then I will lose all of my gains or stabilization that I had with finasteride.  Because of this I am wondering if it would be a better idea just to take finasteride 1mg 5 days a week and adding .5mg of dutasteride the other two days of the week and staying with this approach instead of building up to more avodart.  This way I am staying with finasteride, but also having the chance of protecting or regrowing more hair at the hairline by adding .5mg twice a week of dutasteride.  I am just having a hard time figuring out the best approach and my doctor doesn't seem to be knowledgeable with hair loss.  Thank you for your time.  It is greatly appreciated.

ANSWER: Tyler,
 I would have recommended exactly what your doctor prescribed. The problem with reading reviews on the internet blogs is that you do not get a truly scientific view but primarily the views of disgruntled patients who are at the fringe. Perhaps the ones who lost hair were going to lose even more hair without dutasteride or perhaps they expected to see regrowth instead of stabilization of the hairline. The facts are that dutasteride lowers your DHT up to 90% if taken daily and the more you lower your DHT the greater the chance of stopping the progression of hair loss. I have my patients who are experiencing hair loss even while on 1mg Finasteride gradually switch to Avodart by taking one Avodart a week instead of a finasteride that week and each month add one more Avodart and one less finasteride so that at the end of 7 months they are taking Avodart daily. Taking 2 Avodart a week and 5 finasteride will lower your DHT an additional 10% and if you continue to do this you can gradually transition to 90% suppression of DHT with little chance of feeling any side effectss.

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QUESTION: Thank you for your response.Do you have any patients that respond to finasteride but do not respond to dutasteride? My hairline is starting to take a big hit and am worried if I wait too long in essence only taking dutasteride a couple of times a week it will be too late to bring those miniaturized hairs at the hairline back. If I'm not too worried about the side effects of dutasteride would it be beneficial in stopping my hair loss to just start taking .5 mg of dutasteride daily going forward? It's odd that these drugs seem to not do very much to the hairline even though the disease process is the same throughout the whole top of the head meaning the front and back.

No, I do not have any patients who do better with finasteride than dutasteride.  I suggest you gradually add the Avodart as suggested. Perhaps Avoadart on Saturday and Sunday the first month and then Mon- Wed - Fri the second month and then every other day the third month. Taking it daily the next month is up to you.

Hair Loss

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


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


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

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