Millions of people worldwide are searching for an effective solution to regain their confidence and feel good about themselves. It can be overwhelming to navigate through the countless hair loss treatments available. What if we told you a powerful combination therapy could give you the results you’ve been dreaming of? Oral minoxidil and dutasteride are two medications that work together to address the root causes of hair loss. In this article, we’ll explore this dynamic duo, how they work, their effectiveness, and how they compare to other hair loss treatments. We hope to provide you with the information you need to make an informed decision for your hair regrowth journey.
Understanding Hair Loss
Hair loss can be caused by various factors, including genetics, hormonal imbalances, stress, medications, and more.
Androgenetic alopecia (AGA), also known as pattern hair loss, is the most common type of hair loss and affects both men and women. Dihydrotestosterone (DHT), a derivative of the hormone testosterone, plays a significant role in AGA in men, causing hair follicles to shrink and eventually stop producing hair. While DHT plays a role in female pattern hair loss, other hormonal imbalances, such as polycystic ovarian syndrome (PCOS) and metabolic syndrome, are more common. In both men and women, the end result is the same, which is the miniaturization of the hair follicle, which makes hairs fragile, break and shed.
Oral Minoxidil and Dutasteride: An Overview
Oral minoxidil is a vasodilator that was initially developed to treat high blood pressure. However, it was discovered to have the unexpected side effect of promoting hair growth. Minoxidil works by increasing blood flow to the hair follicles, providing them with the necessary nutrients and oxygen to thrive. This enhanced blood flow prolongs the growth phase of the hair cycle, leading to thicker and more robust hair growth. Oral minoxidil is typically more potent than its topical counterpart.1
Dutasteride is a 5-alpha reductase inhibitor that works by reducing DHT levels in the body, preventing hair follicle shrinkage and promoting hair growth. It comes from the same family of drugs as Finasteride (Propecia/Proscar). Dutasteride is a potent inhibitor of both types of 5-alpha reductase (finasteride only inhibits one type) and in some studies has been shown to be more effective at regrowing hair whilst maintaining a similar side effect profile to finasteride.2
By blocking the conversion of testosterone, the levels of DHT in the scalp are reduced which preserves the growth cycle of the hair follicles. Dutasteride has been found to reduce DHT levels in the blood by over 90%.3
How a combination of oral minoxidil and dutasteride work together
By combining oral minoxidil and dutasteride, this treatment addresses both hormonal and blood flow-related hair loss factors. The result is a comprehensive approach to treating androgenetic alopecia, potentially leading to improved hair growth and maintenance. In the next section, we will take a look at the studies on oral minoxidil and dutasteride.
Effectiveness of Oral Minoxidil and Dutasteride for Hair Loss
Oral minoxidil and oral dutasteride are not yet approved by the FDA for hair loss treatment. Despite this, medical professionals have been increasingly prescribing these medications off-label for hair loss management. Japan and South Korea have recently approved oral dutasteride (0.5 mg/day) for the treatment of male pattern hair loss. At the moment, there are no large-scale studies examining the use of these drugs but several studies have demonstrated the effectiveness of oral minoxidil and or dutasteride as a hair loss treatment.
Oral Dutasteride for hair loss
Research has shown that dutasteride can effectively treat hair loss when used orally.4 One study examined the effectiveness of dutasteride, a medication used to treat hair loss, in 416 men with male pattern baldness. Over 6 months, participants received 0.5mg of dutasteride or a placebo. Those who took dutasteride experienced significant improvements in hair growth and density compared to the placebo group. Furthermore, participants in the dutasteride group reported higher satisfaction levels regarding their hair’s appearance.4
In a comparison between various studies, 0.5mg of oral dutasteride was found to have the greatest impact on increasing the total and terminal hair count at 24 and 48 weeks when compared to high-dose oral finasteride and oral minoxidil.1
Oral Minoxidil for hair loss
Oral minoxidil has also been shown to be an effective hair loss alternative for healthy patients having difficulty with topical formulations. In a study of 148 women, 1mg/day was shown to be an effective dose for treating female pattern hair loss, including advanced-stage loss.5 For male patients, higher doses are needed, but effective results have still been demonstrated with doses of 2.5-5mg.5
Research on combined oral minoxidil and dutasteride for hair loss
In a case report published in 2022, a 28-year-old male with Grade 5 pattern hair loss was started on oral minoxidil 2.5mg once a day and dutasteride 0.5 mg on alternate days orally. Previously he had been unsuccessfully treated with topical minoxidil 5%. The patient experienced some regrowth in a month, with increased hair volume and new growth seen in all the areas of the scalp by 4 months.6
In another study, 105 male patients with hair loss were treated with oral minoxidil alone or combined with dutasteride injections directly into the scalp. The dutasteride solution was injected over three months. The combination of oral minoxidil and dutasteride injections showed significant improvements in hair growth versus oral minoxidil alone. Side effects observed were equal in both groups, and no sexual dysfunction was reported by any participants. This suggests that the combination of the two medications could be a useful treatment option for certain patients7.
Why choose a combination of oral Minoxidil and Dutasteride?
You prefer oral treatments to topical ones.
Oral treatments like oral minoxidil and dutasteride are advantageous versus topical treatments for certain people. For example, people who prefer not to wash or wet their hair daily. Some patients struggle with topical treatments because of the necessity to apply the medication daily or even twice daily which can lead to poor compliance. Others may find that topical treatments can cause an undesirable hair texture or cause scalp irritation.
You use other products in your hair.
Many patients use other products to enhance their hair. These can include products such as keratin fibres that visually enhance the hair and give a fuller appearance. Using products such as these is simpler without the use of competing topical scalp treatments.
You want to save money.
Oral treatments such as oral minoxidil and finasteride are often more economical than topical versions. In one study, a 3-month supply of oral minoxidil offered cost‐savings relative to the topical over‐the‐counter product.8
You haven’t had results with topical preparations.
A major advantage of oral minoxidil and dutasteride is that it bypasses the skin barrier which significantly increases drug absorption.9 Oral preparations can offer more effective hair regrowth when compared to their topical counterparts, as evidenced by this study which found that 5 mg/d of minoxidil was more effective than a 5% topical concentration for improving terminal hair count.1
Comparing Oral Minoxidil and Dutasteride to Other Hair Loss Treatments
Topical minoxidil, also known as Rogaine, is a popular over-the-counter hair loss treatment. While it can be effective for some people, it may not provide the same level of hair growth stimulation as oral minoxidil and dutasteride. Studies have shown that oral minoxidil is more effective and potent than topical versions.
Finasteride, commonly known as Propecia, is another 5-alpha reductase inhibitor like dutasteride. It’s less potent than dutasteride and may not be as effective in reducing DHT levels. One study found that 0.5mg of dutasteride was more effective at 24 and 48 weeks versus high-dose oral finasteride.1 However, some people may prefer finasteride due to its potentially lower risk of side effects.
Topical dutasteride may have fewer side effects than oral, but a limited amount of research has been done on its effectiveness. Some studies looking at topical dutasteride in combination with therapies such as mesotherapy or micro-needling have shown that it is an effective treatment, however, these are in-office procedures that cannot be performed at home.10-12
Hair transplant surgery
Hair transplant surgery involves transplanting hair follicles from one part of the body to another. This method can provide long-lasting results, but it’s invasive, expensive, and may not be suitable for everyone.
Oral minoxidil and dutasteride: side effects and precautions
It’s crucial to discuss your medical history and any current medications with your healthcare provider before starting the combination treatment. Pregnant women and individuals with certain medical conditions, such as liver or kidney disease, may not be suitable candidates for this treatment.
Some common side effects of oral minoxidil include dizziness, light-headedness, and increased body hair growth. In rare cases, it can cause more serious side effects, such as allergic reactions or changes in blood pressure.
If you have a heart condition, such as arrhythmia, angina, a history of heart attack or stroke, or blood vessel disorders, minoxidil could worsen these conditions. Patients with a rare endocrine tumour called phaeochromocytoma or kidney disease should also avoid minoxidil, as it could cause complications or a dangerous build-up of the medication. Lastly, those prone to low blood pressure should exercise caution when considering minoxidil.
Dutasteride can cause side effects like decreased libido, erectile dysfunction, and gynecomastia. In some cases, these side effects may persist even after discontinuing the medication.
Dutasteride is not a suitable medication for female patients. Pregnant women or women of childbearing age should not handle or touch this medicine as it can be absorbed through the skin and can cause birth defects in male foetuses.
Frequently Asked Questions
How long does it take to see results?
While individual results may vary, most people can expect to see improvement in hair growth within three to six months of starting the combination treatment.
Can I use other hair loss treatments simultaneously?
In some cases, it is possible to use other treatments alongside oral minoxidil and dutasteride however it’s essential to discuss any additional treatments with your healthcare provider.
Is the combination of oral minoxidil and dutasteride safe for women?
Oral minoxidil and dutasteride are primarily studied and prescribed for men with AGA. Dutasteride is not a suitable medication for women and female patients should consult their healthcare provider to discuss potential hair loss treatments tailored to their specific needs.
The combination of oral minoxidil and dutasteride presents a promising treatment option for those struggling with hair loss. By targeting both hormonal and blood flow-related factors, this treatment can potentially provide better results than using either medication alone. This product could be best suited for male patients who prefer a tablet-based treatment or have had little success with other topical treatments. In certain cases, topical treatments can cause scalp irritation or come with cosmetic concerns about hair texture, which oral treatments can bypass.
As with any medication, it’s important to consider potential side effects and consult with a healthcare provider before beginning treatment. By exploring various treatment options and being patient with the process, you can find the best solution for your hair loss journey and regain your confidence.
- Gupta AK, Venkataraman M, Talukder M, Bamimore MA. Relative Efficacy of Minoxidil and the 5-α Reductase Inhibitors in Androgenetic Alopecia Treatment of Male Patients: A Network Meta-analysis. JAMA Dermatology. 2022;158(3):266-74.
- Pohlman GD, Pohlman EA, Crawford ED. Dutasteride: A Review of its Use in the Management of Prostate Disorders. Clinical Medicine Insights: Therapeutics. 2011;3:CMT.S1956.
- Yamana K, Labrie F, Luu-The V. Human type 3 5α-reductase is expressed in peripheral tissues at higher levels than types 1 and 2 and its activity is potently inhibited by finasteride and dutasteride. Hormone Molecular Biology and Clinical Investigation. 2010;2(3):293-9.
- Eun HC, Kwon OS, Yeon JH, Shin HS, Kim BY, Ro BI, et al. Efficacy, safety, and tolerability of dutasteride 0.5 mg once daily in male patients with male pattern hair loss: a randomized, double-blind, placebo-controlled, phase III study. J Am Acad Dermatol. 2010;63(2):252-8.
- Rodrigues-Barata R, Moreno-Arrones OM, Saceda-Corralo D, Jiménez-Cauhé J, Ortega-Quijano D, Fernández-Nieto D, et al. Low-Dose Oral Minoxidil for Female Pattern Hair Loss: A Unicenter Descriptive Study of 148 Women. Skin Appendage Disord. 2020;6(3):175-6.
- Bansod S. Combination therapy with oral minoxidil and dutasteride in the treatment of male patterned baldness: A case report. Cosmoderma. 2022;2:4.
- Villarreal-Villarreal CD, Boland-Rodriguez E, Rodríguez-León S, Le Voti F, Vano-Galvan S, Sinclair RD. Dutasteride intralesional microinjections in combination with oral minoxidil vs. oral minoxidil monotherapy in men with androgenetic alopecia: a retrospective analysis of 105 patients. J Eur Acad Dermatol Venereol. 2022;36(7):e570-e2.
- Beach RA. Case series of oral minoxidil for androgenetic and traction alopecia: Tolerability & the five C’s of oral therapy. Dermatol Ther. 2018;31(6):e12707.
- Randolph M, Tosti A. Oral minoxidil treatment for hair loss: A review of efficacy and safety. J Am Acad Dermatol. 2021;84(3):737-46.
- Moftah N, Moftah N, Abd-Elaziz G, Ahmed N, Hamed Y, Ghannam B, et al. Mesotherapy using dutasteride-containing preparation in treatment of female pattern hair loss: photographic, morphometric and ultrustructural evaluation. J Eur Acad Dermatol Venereol. 2013;27(6):686-93.
- Abdallah M, el-zawahry K, Besar H. Mesotherapy using Dutasteride-Containing Solution in Male Pattern Hair Loss: a Controlled Pilot Study. Journal of Pan-Arab League of Dermatologists. 2009;20.
- Nada E, Sharkawy R, Abd Elmaged W, Elmagd M. Topical dutasteride with microneedling in treatment of male androgenetic alopecia. Sohag Medical Journal. 2018;22:387-400.