DHT Inhibitors

Dihydrotestosterone (DHT) inhibitors are a class of medications and natural compounds that help prevent hair loss by reducing the levels or activity of DHT, a hormone linked to androgenetic alopecia. DHT binds to hair follicle receptors, causing them to shrink over time, leading to thinning and eventual hair loss. By blocking the conversion of testosterone into DHT or preventing its interaction with hair follicles, DHT inhibitors help slow hair thinning and, in some cases, promote regrowth. Common pharmaceutical DHT inhibitors include finasteride and dutasteride, while natural alternatives like saw palmetto are also used. These treatments are widely recognized for their effectiveness in preserving hair, particularly when started early in the hair loss process.

Finasteride (Propecia)

An oral or topical (liquid or foam) medication that inhibits the enzyme 5-alpha-reductase, thereby reducing DHT levels.

Effectiveness

Used for male pattern baldness, it stops hair loss and stimulates growth. Results take 3–6 months and requires continuous use to maintain benefits.

Usage

Taken once daily.

Dutasteride (Avodart)

Similar to finasteride, it is an oral or topical (liquid or foam) medication but, unlike finasteride, it inhibits both types of 5-alpha-reductase enzymes, making it potentially more effective in reducing DHT levels.

Effectiveness

Used off-label for hair loss, particularly in men with androgenetic alopecia. Like finasteride, results take 3-6 months and requires continuous use to maintain benefits.

Usage

Taken once daily.

Cost

Oral Tablets:

Finasteride (Generic): $2-$10 per month.

Dutasteride (Generic): $15–$40 per month.

Propecia (Brand Name): $120-$160 per month.

Avodart (Brand Name): $150–$200 per month.

Topical Solutions:

Finasteride: $40-$100 per month.

Dutasteride: $70-$150 per month.

***The cost of any medication often depends on the pharmacy, location, discounts, or insurance coverage.

Potential Side Effects

Common Side Effects:

Finasteride pill users may experience (1) Reduced libido (low sex drive); (2) Erectile dysfunction (ED); (3) Decreased semen volume; (4) Breast tenderness or enlargement (gynecomastia); (5) Dizziness or weakness.

Dutasteride pill users may experience (1) More pronounced erectile dysfunction; (2) Greater reduction in libido; (3) Stronger decrease in semen volume; (4) Gynecomastia (breast tissue growth/tenderness); (5) Longer-lasting side effects due to a longer half-life (it stays in the system for weeks to months).

Rare, but Serious, Side Effects:

Finasteride pill users may experience (1) Depression, anxiety, or mood changes; (2) Testicular pain; (3) Allergic reactions (rash, itching, swelling); (4) Brain fog or cognitive impairment; (5) Possible increased risk of high-grade prostate cancer (though the evidence is mixed).

Dutasteride pill users may experience the same serious side effects as finasteride users but since dutasteride is more potent, it has stronger and longer-lasting effects compared to finasteride.

A subset of finasteride and dutasteride users report persistent sexual, hormonal, neurological, and psychological symptoms even after stopping use.

***Topical formulations target the scalp directly, leading to less absorption into the bloodstream. As a result, systemic side effects are much less common but still possible.

Finasteride (Propecia)

An oral or topical (liquid or foam) medication that inhibits the enzyme 5-alpha-reductase, thereby reducing DHT levels.

Effectiveness

Used for male pattern baldness, it stops hair loss and stimulates growth. Results take 3–6 months and requires continuous use to maintain benefits.

Usage

Taken once daily.

Dutasteride (Avodart)

Similar to finasteride, it is an oral or topical (liquid or foam) medication but, unlike finasteride, it inhibits both types of 5-alpha-reductase enzymes, making it potentially more effective in reducing DHT levels.

Effectiveness

Used off-label for hair loss, particularly in men with androgenetic alopecia. Like finasteride, results take 3-6 months and requires continuous use to maintain benefits.

Usage

Taken once daily.

Cost

Oral Tablets:

Finasteride (Generic): $2-$10 per month.

Dutasteride (Generic): $15–$40 per month.

Propecia (Brand Name): $120-$160 per month.

Avodart (Brand Name): $150–$200 per month.

Topical Solutions:

Finasteride: $40-$100 per month.

Dutasteride: $70-$150 per month.

***The cost of any medication often depends on the pharmacy, location, discounts, or insurance coverage.

Potential Side Effects

Common Side Effects:

Finasteride pill users may experience (1) Reduced libido (low sex drive); (2) Erectile dysfunction (ED); (3) Decreased semen volume; (4) Breast tenderness or enlargement (gynecomastia); (5) Dizziness or weakness.

Dutasteride pill users may experience (1) More pronounced erectile dysfunction; (2) Greater reduction in libido; (3) Stronger decrease in semen volume; (4) Gynecomastia (breast tissue growth/tenderness); (5) Longer-lasting side effects due to a longer half-life (it stays in the system for weeks to months).

Rare, but Serious, Side Effects:

Finasteride pill users may experience (1) Depression, anxiety, or mood changes; (2) Testicular pain; (3) Allergic reactions (rash, itching, swelling); (4) Brain fog or cognitive impairment; (5) Possible increased risk of high-grade prostate cancer (though the evidence is mixed).

Dutasteride pill users may experience the same serious side effects as finasteride users but since dutasteride is more potent, it has stronger and longer-lasting effects compared to finasteride.

A subset of finasteride and dutasteride users report persistent sexual, hormonal, neurological, and psychological symptoms even after stopping use.

***Topical formulations target the scalp directly, leading to less absorption into the bloodstream. As a result, systemic side effects are much less common but still possible.