dutasteride 2-3 times per week, alternating with finasteride

[nyhair19]

After a decade on finasteride, it seems to have been losing its kick this year, as I noticed some thinning around my hairline. Since April I have been using dutasteride once a week, but so far no regrowth. I am thinking to incorporate dutasteride 2 or 3 times a week and take finasteride the other days. I have about another half year's worth of finasteride, so I figure do this for the remainder of the finasteride and see where I am at and if still no progress, make the jump to dutasteride.

I was wondering if anyone has tried anything similar or if this is a dumb idea? I have read that others have had benefits of taking dutasteride once weekly or EOD.

Or perhaps I should give the weekly dutasteride another few months?

 

[Scott Ryan]

After 7 years on Propecia, it suddenly stopped having any effect and I was shedding, diffusing and tingling all over. It was very scary. I bit the bullet and bought Avodart.

First day I took it it had all the hallmarks of when I first took Propecia .... Ball ache being the main one. I gladly welcomed that as it was a sign something was happening. I stopped shedding. It worked.

I took Avodart once every two days and cut the Propecia out totally.

After about two weeks it's working. No tingling, no shedding.

I am into my 4th week and cut Propecia totally. If it doesn't work, I thought why put more junk in your system.

Now that the shedding has stopped and I am not as anxious about losing more ground, I am listening to my body more.

What I've decided to do is take an Avodart and wait two or even three days before taking another. As Avodart stays in your system for longer, I don't seem to be getting any shock shedding. I will start to feel it come on once the tingling and itching starts, so I am trying to listen to my body and see what it needs and when it's needs it.

I will be definitely adding an RU Minoxidil topical treatment. My hope is I can take less Avodart and keep it at bay topically.

If RU Minoxidil doesn't work, I will consider trying Finasteride Minoxidil solution.

Basically, if the Finasteride isn't working orally, ditch it for Dutasteride only. But sparingly use Dutasteride as it's the nuclear option. Find out what works for you.

Taking finasteride and dutasteride together to start off with ... You don't really know what's working and whats not working right?

I was scared to come of finasteride after so many years and did exactly what you proposed .. finasteride 4 days and dutasteride 2 days ... It completely made things worse as I didn't know what was working and what wasn't.

I couldn't believe my luck when I took Avodart .. it worked!

Problem is .. what do you do when that stops working? .. that's why I am taking it easy on the Avodart and taking it 3 times a week and get on the topicals!

I am 48. The crown is gone because I didn't save it early enough .. the front is solid.

You got to think long term and have the confidence to take the decisions. Go at your pace.

Avodart in my case pisses over Propecia.

For now.

 

[DoctorHouse]

After 7 years on Propecia, it suddenly stopped having any effect and I was shedding, diffusing and tingling all over. It was very scary. I bit the bullet and bought Avodart.

First day I took it it had all the hallmarks of when I first took Propecia .... Ball ache being the main one. I gladly welcomed that as it was a sign something was happening. I stopped shedding. It worked.

I took Avodart once every two days and cut the Propecia out totally.

After about two weeks it's working. No tingling, no shedding.

I am into my 4th week and cut Propecia totally. If it doesn't work, I thought why put more junk in your system.

Now that the shedding has stopped and I am not as anxious about losing more ground, I am listening to my body more.

What I've decided to do is take an Avodart and wait two or even three days before taking another. As Avodart stays in your system for longer, I don't seem to be getting any shock shedding. I will start to feel it come on once the tingling and itching starts, so I am trying to listen to my body and see what it needs and when it's needs it.

I will be definitely adding an RU Minoxidil topical treatment. My hope is I can take less Avodart and keep it at bay topically.

If RU Minoxidil doesn't work, I will consider trying Finasteride Minoxidil solution.

Basically, if the Finasteride isn't working orally, ditch it for Dutasteride only. But sparingly use Dutasteride as it's the nuclear option. Find out what works for you.

Taking finasteride and dutasteride together to start off with ... You don't really know what's working and whats not working right?

I was scared to come of finasteride after so many years and did exactly what you proposed .. finasteride 4 days and dutasteride 2 days ... It completely made things worse as I didn't know what was working and what wasn't.

I couldn't believe my luck when I took Avodart .. it worked!

Problem is .. what do you do when that stops working? .. that's why I am taking it easy on the Avodart and taking it 3 times a week and get on the topicals!

I am 48. The crown is gone because I didn't save it early enough .. the front is solid.

You got to think long term and have the confidence to take the decisions. Go at your pace.

Avodart in my case pisses over Propecia.

For now.

Your case will be a very interesting to follow as most will report that their hairline is thinning out after about 6 months or later. They also eventually complain of more sides than they had on finasteride and eventually some go back to finasteride and quit avodart. Hopefully you will keep us posted over the year and let us know how you are doing.

 

[nyhair19]

Dutasteride is more potent at inhibiting both 5ar type I and II than finasteride, and both also inhibit type III (with no reason to even suspect dutasteride isn't more effective here too...)

Prostate cancer researchers haven't even bothered to seriously develop a drug to inhibit type III, because it's so irrelevant in the sense that those 2 drugs already cover the need.

Everything known about dutasteride and finasteride suggests that if the goal is more complete DHT suppression, you'd be far better off increasing your dose of dutasteride than adding finasteride in any capacity

So then doing what I was doing doesn't sound wise? 3x a week dutasteride and 4x finasteride? Better to just stick with what I am doing or go all in on dutasteride?

 

[JaneyElizabeth]

So then doing what I was doing doesn't sound wise? 3x a week dutasteride and 4x finasteride? Better to just stick with what I am doing or go all in on dutasteride?

Is the issue shedding, rampant hair loss or no hair growth?

 

[nyhair19]

escalating from finasteride to dutasteride is exactly the right idea, in general

sorry if it seemed like my posts were directed at you, your original question is completely reasonable to ask - my comments were directed at the (now deleted?) posts from @JaneyElizabeth

...who was suggesting a strategy of taking both finasteride and dutasteride every single day. A suggestion that leads you down a path that isn't very helpful to your situation (or anyone's)

...and was also suggesting that finasteride commonly stops working in men due to some form of male "menopause", which leads you down a bad path in terms of actually identifying the problem and fixing it

---

re: your specific situation - no, I don't think it's helpful to take dutasteride some days of the week, and finasteride on others - because dutasteride has a 5 week elimination half-life and is far more powerful

ie instead of trying to customize your own dutasteride routine, maybe just use the recommended one of 0.5mg daily instead (or 3.5mg, once a week) and give it more time to see if it can stabilize

you're still within the window of time (6-12 months) where your hair might get worse before it gets better, and you might experience shedding from having moved from finasteride to dutasteride

and no idea what the rest of your routine is like, but this is probably the time to add other basics like dermarolling and ketoconazole shampoo, and consider whether you want to commit to adding minoxidil if all of that can't stop loss or you need regrowth - or simply don't want to risk further loss

Got it. I didn't realize the window was 6-12 months. I am only on about month 4-5! I should definitely give it until the end of the year and see what happens. I started doing this in April. If the window period is 6-12 months, I will just keep at it for now. I am also using nizoral 1%, and minoxidil foam 2x daily. I also take Saw Palmetto 2x/daily (for hair and prostate issues). Dermarolling might be a nice addition that I will look into. Seems a lot of upside with little risk and shouldn't break the bank.

 

[nyhair19]

Is the issue shedding, rampant hair loss or no hair growth?

It is hard to say. There is definitely no regrowth that I can tell. But it seems like the hairline is slightly worsening in the areas where it is already thinned out. This could be a 'shed', I suppose. Does this constitute one? It is also hard to say if this is due to the added dutasteride or something else.

 

[nyhair19]

BTW just want to say it's great to see someone else who wants to perform reasonable escalations and wait an appropriate amount of time to see their effects, takes a lot of discipline to not go from 0 to 100 and start applying estrogen to your head...

And I just want to sell you on dermarolling a bit more: it has high quality evidence that it pairs extremely well with minoxidil in terms of efficacy, with minimal risk as long as you're hygienic - so sterilize it before/after each use properly, do the needling after a shower where you cleaned your hair with shampoo.

"The mean increase in hair count in the targeted area of one square inch at the end of the treatment was significantly greater for the combination treatment group (12.52/inch2) compared to that for the minoxidil alone group (1.89/inch2). Four patients in the "microneedling plus topical minoxidil" group reported a 50% improvement versus none in the "minoxidil alone" group"

Plenty of routines to find in terms of needle depth + frequency, and although studies on it typically use 1mm-1.5mm that doesn't mean you have to, some decent reasons to believe that it can have very positive effects even at 0.5mm (but there's not actually much in the way of science to guide us on depth/frequency)

I do 1.25mm every 2 weeks with a Dr. Pen device

Thanks, I appreciate that! I will take a look. Is dermarolling and microneedling the same thing? Neither of these were really in the regimen of many people on here when I was active a decade ago. I am willing to try it. Any good resources to read up on how to do it properly and what it entails (sterilizing, using, maintaining, purchasing, etc)?

 

[Scott Ryan]

Your case will be a very interesting to follow as most will report that their hairline is thinning out after about 6 months or later. They also eventually complain of more sides than they had on finasteride and eventually some go back to finasteride and quit avodart. Hopefully you will keep us posted over the year and let us know how you are doing.

You could be right .. Dutasteride is a much stronger drug. Let's see where it goes.

 

[nyhair19]

Yes, formally they're both "collagen induction therapy". Anything that uses a bunch of tiny needles to punch through the skin to trigger a "wounding" response and growth factor release. Creating tiny holes in your skin also makes it more permeable to topicals like minoxidil

It's becoming more common part of the routine, as lots of new research showing it's effective has been published in the past 10 years

---

Don't have a good starter link to share, but I'll throw in some of my experiences so maybe you'll be able to find resources easier:

There's electronic ones (I use Dr. Pen) with cheap disposable cartridges (very hygienic, since you don't reuse them)

and rollers, where you simply rinse them with water and soak in isopropyl/rubbing alcohol for 10 minutes before/after every use

Other stuff:
-Most people do between 0.5mm and 1.5mm in terms of depth (I worked my way up over time)
-Most people avoid applying topicals like minoxidil for 12-24 hours after needling, since you'd have extra systemic absorption
-Never do it more frequently than every 4 days. The deeper you go, the longer you should wait between sessions ie 1-2 weeks if doing 1mm or more
-liberally apply moisturizer on the day before and of needling, right afterwards, and on the days after. This will reduce skin peeling

Okay great, thanks. This is a good place to start. I'll have to do some reading about it and look into it more. But as you said, it's relatively low risk and high reward, so when hitting a plateau it can't hurt. Will keep you guys updated if I decide to go for it.

 

[JaneyElizabeth]

Thanks, I appreciate that! I will take a look. Is dermarolling and microneedling the same thing? Neither of these were really in the regimen of many people on here when I was active a decade ago. I am willing to try it. Any good resources to read up on how to do it properly and what it entails (sterilizing, using, maintaining, purchasing, etc)?

Dump it in alcohol. Can you infect yourself with your own dried blood and secretions? Maybe but probably few people share their apparati.