What can Propecia do?
In two-year clinical studies in men between the ages of 18-41 with mild
to moderate hair loss at the top of their heads, Propecia was shown to:
- Maintain the amount of hair in 86% of men (vs. 42% taking placebo).
- Promote visible hair regrowth in 48% of men, as determined by an independent panel of dermatologists. (vs. 7% taking placebo)
How does Propecia work?
Propecia lowers the levels of a hormone called dihydrotestosterone (DHT)
in the scalp and blood by blocking the enzyme that metabolises DHT.
Researchers in this area believe male pattern hair loss is due to
heredity and is dependent on the levels of DHT. DHT contributes to a
shortening of the growth phase and a thinning of the hair. Men with male
pattern baldness have increased levels of DHT in their scalps.
How long does it take for Propecia to work?
You may need to take Propecia daily for three months or more before you
can see a benefit. Hair grows very slowly, about half an inch a month.
Most men begin to see the first benefit of Propecia, slowing of hair
loss, after 3 months, and after 6 months begin to experience regrowth.
Generally, you will not grow back all the hair you have lost. If the
treatment has not worked for you in 12 months, further treatment is
unlikely to be of benefit. If you stop taking Propecia, it is likely
that you will lose the hair you have gained within 12 months of stopping
treatment. There is a small but significant incidence of side effects;
click on the following link for information about Propecia side effects.
Warning
Propecia is not indicated for use in females, and females should not handle crushed or broken Propecia tablets.
Propecia Side Effects
Along with its needed effects, a medicine may cause some unwanted
effects. Although not all of these side effects may occur, if they do
occur they may need medical attention. Check with your doctor to learn
more about side effects of Propecia. Contact your doctor as soon as
possible if you experience side effects after taking Propecia and to
learn more about side effects.
Hair Loss
We all lose a little hair every day, and 40 to 100 hair follicles is
considered normal. That may sound like a lot but a normal scalp would
have as many as 100,000 hairs. Each hair shaft grows 0.5 to 1 inch per
month for between two and six years then it is shed after a resting
period, and a new hair grows. The process is regular and cyclical on a
normal scalp and 85% to 90% of hair is growing at any one time.
Scientists who have researched the process of hair loss are confident
that hair loss experienced by men and women is a condition called
"androgenetic alopecia". In men it is known as male pattern baldness and
in many cases progresses to a horseshoe-shaped fringe of hair (a
receding hairline) and/or balding on the top of the head. In women it
usually results in a general thinning of hair.
A combination of factors causes hair loss. Heredity, hormones and age
causes a progressive shrinking of the hair follicles that contain the
hair shaft. As the hair follicle shrinks the growth cycle shortens, and
the rest phase lengthens. The follicles tend to produce hair shafts that
are short, thin and barely visible.
Hair loss affects a significant proportion of the population and is more
prevalent as we age. By the age of 35 almost 40% of men and women show
some degree of hair loss. It can start as early as teenage years.
What is Dutasteride ?
Dutasteride is the active compound in a new oral medicine made by
GlaxoSmithKline, which has proved very effective in treating genetic
male pattern hair loss on the vertex (top of the head) and the mid-scalp
area.
The medicine has been approved for prescription by the US Food
& Drug Administration, and in Europe.
Why was Dutasteride developed?
Dutasteride was developed for treating symptomatic benign
prostatic hyperplasia (BPH) in men. Dutasteride is chemically similar
to Finasteride, the active compound in Propecia, but has proven more
effective in clinical trials. Like Propecia, Dutasteride has proved to
be effective in treating male pattern hair loss as well as BPH.
How does Dutasteride work?
Researchers have discovered that men who suffer from either male
pattern hair loss or benign prostatic hyperplasia (BPH), have increased
levels of the hormone dihydrotestosterone (DHT).
DHT is produced from testosterone by an enzyme called
5-alpha-reductase. Biochemical analysis reveals higher levels of
5-alpha-reductase in the bloodstream of men with BPH, and in the scalps
of men with hair loss; and less of this enzyme in men with no BPH or no
hair loss.
Dutasteride inhibits 5-alpha-reductase, blocking the formation of
DHT. This interrupts a key trigger element in development of male
pattern hair loss and in development of BPH.
How is Dutasteride different from Propecia?
Both medicines work in a similar way. However, Dutasteride inhibits the activities of
two types of 5-alpha-reductase enzymes. In contrast, Propecia (Finasteride) only inhibits
one
type. Dutasteride has been shown to decrease levels of DHT by 90%
after only two weeks, making it a more powerful and faster-acting weapon
against hair loss and BPH than Finasteride.
What is dihydrotesterone (DHT)?
DHT is one of several male hormones in the body. DHT is
responsible for the development of the external genitals in the male
foetus. However, in adult males DHT appears to cause:
- male pattern hair loss
- prostate enlargement
- shortening of the growing phase of hair
- progressive miniaturisation of hair follicles
- decreasing number of visible hairs
- acne
What studies and trials have been done concerning Dutasteride?
GlaxoSmithKline completed Phase II trials for FDA approval of
Dutasteride for treating hair loss. After six month of treatment, the
hair counts measured in a 1 inch diameter circle increased by an average
96 hairs with 0.5mg Dutasteride, compared to an average 72 hairs with
5mg Propecia (Finasteride). The drug was shown to be well tolerated.
Also, a total of 2951 men with moderate to severe BPH were treated
with 0.5 mg Dutasteride daily. The study found that acute urinary
retention was reduced by 57%, and the risk of benign prostatic
hyperplasia-related surgical intervention was cut by 48% compared with
placebo. The drug was shown to be well tolerated.
So these initial trials show that Dutasteride is around 30% more effective than Propecia in promoting hair regrowth.
However,
please note that Dutasteride has only been specifically approved for
treating BPH. It has not yet been approved specifically for treating
hair loss.
When will Dutasteride be approved for treating hair loss?
In November 2002 GlaxoSmithKline cancelled its planned Phase 3
trials for Dutasteride for treating hair loss. The company has not
publicly given a reason for this.
However, industry sources speculate that the reason is commercial
rather than medical: the suggestion is that trials were stopped because
the maker thinks Dutasteride will be perceived as too similar to
Propecia in consumers’ minds, and may not generate sufficient return on
investment to justify the cost of approvals as a treatment for hair
loss.
However, Dutasteride is approved by the US FDA and by European
bodies for the treatment of BPH, and so has passed all relevant safety
standards.
Will Dutasteride help hair re-growth for all men?
As with Propecia, Dutasteride increases the number of scalp hairs,
helping to fill-in thin areas of the scalp. Although results will
vary, generally men will not re-grow
all of the hair they have
lost. Male pattern hair loss occurs gradually over time, but Dutasteride
can significantly reduce or delay hair loss.
How should I take Dutasteride?
Dutasteride is supplied as gel-filled capsules with 0.5mg dosage
(GSK’s Avodart). Take dutasteride exactly as directed by your doctor.
If you do not understand these instructions, ask your pharmacist, nurse,
or doctor to explain them to you.
Take each dose with a full glass of water, swallow the capsules
whole. Do not chew, crush or break the capsules. Dutasteride can be
taken with or without food.
What dosage should I take?
You should only take the dose as recommended by your doctor. Do not change the dose without consulting your doctor.
Effectiveness of Dutasteride has been evaluated at different daily
dosages, ranging from 0.01mg, 0.05mg, 0.5mg, 2.5mg, and 5.0mg per day.
It was found that the highest suppression of DHT was achieved with
2.5mg or 5.0mg per day. At a daily dosage of 2.5mg or 5.0mg,
Dutasteride suppresses close to 100% of DHT. This compares favourably
with 5.0mg daily dosage of Propecia (Finasteride) which suppresses only
70% of DHT.
You should note, however, that Dutasteride is very effective at
small doses. At a daily dose of 0.5mg, DHT inhibition is close to 90%.
Also, the level of DHT suppression is not significantly greater between
2.5mg and 5.0 mg.
Is Dutasteride safe?
Clinical trials showed that it was generally well tolerated. Most
side effects were mild, and generally went away while on treatment in
both the Dutasteride and placebo groups.
Drug-related side effects during the first six months were as follows:
- impotence (4.7% vs. 1.7% for placebo)
- decreased libido (3% vs. 1.4%)
- breast tenderness and breast enlargement (gynecomastia; 0.5% vs. 0.2%)
- ejaculation disorders (1.4% vs. 0.5%).
Dutasteride should
not be used in women and children. Women who are pregnant or may become pregnant should
not handle this medicine because of possibility of absorption and subsequent potential risk to a male foetus.
Men treated with Dutasteride should not donate blood until at
least six months after their final dose to prevent the medicine going to
a pregnant woman through a blood transfusion.
Men with liver disease should talk to their doctor before taking Dutasteride.
How do Minoxidil work?
It works in part by partially enlarging miniaturised follicles and reversing the miniaturisation process.
This prolongs the growth phase of the hair cycle, allowing the hair to
become longer and thicker. And with more follicles in the growth phase
at the same time, it is possible to see improved coverage of the scalp.
Although the growth phase may be prolonged, the follicle will continue
to cycle. Several cycles may be necessary before maximum potential hair
regrowth can be achieved.
While clinical trials have proven Rogaine can assist in hair regrowth
for both men and women, thicken existing hair, reduce hair loss, and
stimulate new hair growth, individual results can be affected by several
factors.
- The younger the age of patients, the greater chance of good results.
- If hair is thinning as opposed to having a bald spot, response will be better.
- If the bald area is less than 10cm and has been that way for less than 10 years, response will be better.
- Response is better on the crown (back) rather than on the front of the scalp.
I may be applied twice daily every day. It will need to be used
for four to six months before seeing hair regrowth. If treatment
is stopped after regrowing hair, the new hair will fall out within four
months.
It may cause scalp itchness. Minoxidil do not stop DHT.
