From the Research
Dutasteride is generally considered more effective than finasteride for treating frontal fibrosing alopecia (FFA) due to its ability to inhibit both type I and type II 5α-reductase enzymes, making it more potent at reducing dihydrotestosterone (DHT) levels throughout the body, including the scalp. The most recent and highest quality study, a systematic review and meta-analysis published in 2024 1, found that oral dutasteride was effective in stabilizing FFA in 62.8% of patients, with a significant proportion of patients showing improvement. Another study published in 2021 2 also found that dutasteride was effective in stabilizing FFA, with a dose-dependent response. Key points to consider when treating FFA with dutasteride include:
- The typical dosage for dutasteride in FFA treatment is 0.5 mg daily
- Treatment duration is typically long-term, often continuing for years, as FFA is a chronic inflammatory condition
- Patients should be aware that dutasteride can take 6-12 months to show noticeable improvement, and it should be used alongside topical anti-inflammatory treatments like corticosteroids
- Women of childbearing potential must use effective contraception during treatment as dutasteride can cause birth defects if taken during pregnancy
- Regular follow-up appointments every 3-6 months are recommended to monitor progress and potential side effects, which may include sexual dysfunction, breast tenderness, and rarely, mood changes. Other studies, such as those published in 2019 3, 4, also support the use of dutasteride as a treatment option for FFA, although they may not provide as strong or direct evidence as the 2024 systematic review and meta-analysis 1.