Hello dr Panagotacos. Whats your opinion on dutasteride on long term use? Can you say that it completly stops mpb ? Do you have patients on it that had further hairloss ? Thanks in advance.
At what age should someone consider a ht ? How long time does hairloss have to stop to say that the hairloss has stabilized in a patient?
Dutasteride can lower DHT levels 90% if taken daily whereas 1mg Finasteride, Propecia, lowers the DHT 66%. Large studies have been done to show Propecia can stop baldness in 85% of men. There has not been a large study showing what percentage of men continue to lose hair if they take dutasteide daily however when I have a young man with an inherited pattern of extensive baldness ( Norwood classification Type V to VII ) and they fail to either gain hair in the first six months or state they have lost hair after a year of Propecia they are then placed on Dutasteride. In the past ten years that I have had perhaps 100 men on Dutasteride in this category I have had only one man with continued thinning. Men who have inherited Male Pattern Baldness Norwood Type VII can not be expected to ever stabilize their hair loss. In those cases even a very little DHT will continue to tell the hairs to die and the baldness to progress. If you look at rare 80 year old women who have inherited the same genes for extensive baldness you will find she continues to go bald as she ages even with very low DHT. Most young men who have inherited extensive baldness would prefer to go thin gradually as a woman might with the same inherited genetic baldness pattern rather than be shiny bald all over.
A hair transplant can be considered when the patient and doctor are fairly certain to what degree the loss will continue and how much hair can be move safely without it looking as if a transplant was done. That is an individual decision with no definite time period however one year of therapy on Propecia or Avodart should give a very good clue.