Medical treatments
Dutasteride and spironolactone
Two prescriptions people hear about in clinics. Neither is the NHS first-line tablet for scalp hair loss.
Written in the UK, for women and men.
Dutasteride is licensed in the UK for prostate enlargement, not for hair loss. Any use for pattern hair loss is off-label. Spironolactone is mentioned by the NHS for excess facial and body hair in PCOS, not as a routine treatment for scalp hair loss, and it is not for men or for pregnancy. This page gives no dose and no success rate.
See a GP if hair loss is sudden, patchy, or comes with illness, a rash, or other symptoms. The NHS asks for that conversation before a private clinic.
Clinics mention dutasteride for men and spironolactone for women as the “next step” after finasteride and minoxidil. The UK public sources are more cautious than the clinic menu.
Dutasteride
Dutasteride (often the brand Avodart in prostate care) is a 5-alpha-reductase inhibitor, in the same family as finasteride, used for benign prostate enlargement. It is not licensed for male pattern hair loss. NICE CKS discusses finasteride 1 mg, privately, not dutasteride. There isn’t a UK decision that says it works better than finasteride by a set percentage.
The MHRA warnings on mood and sexual function are written for finasteride. They are a reason to be at least as careful with a related drug, not a worksheet for switching yourself. Do not buy either tablet from an overseas site to avoid a prescriber.
Spironolactone
Spironolactone is a blood-pressure and hormone-related medicine. On the NHS PCOS page it is listed, with eflornithine, to help reduce excess hair on the face and body. That is hirsutism. Scalp hair loss is also a PCOS symptom, but the page does not present spironolactone as the routine fix for a widening parting.
Specialists do sometimes discuss it off-label for female pattern hair loss. That practice is not a dose or a success rate. It is not a medicine for men with pattern baldness, and it is not a medicine to take in pregnancy. Women should not use finasteride either. The NHS option to read next is minoxidil.
A GP or dermatologist is the right person. A trichologist who is not a doctor cannot prescribe these.
Common questions
Is dutasteride better than finasteride for hair?
There isn’t a UK decision that says dutasteride works better than finasteride by a set percentage. Dutasteride is not licensed for hair loss in the UK. Finasteride 1 mg is the hair-loss tablet, via a private prescription, with the side effects on the finasteride page.
Can women take spironolactone for thinning hair?
Some specialists discuss it off-label. The NHS PCOS page lists spironolactone for excess hair on the face and body, which is a different problem. It is not a medicine to start in pregnancy, and it is not for men.
What should women use instead?
The NHS names minoxidil for female pattern baldness. A GP should check iron, thyroid and the pattern before anyone adds a hormone drug.
Sources
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