Efficacy and safety of oral finasteride versus dutasteride in moderate-to-severe androgenetic alopecia in males based on trichoscopic and laboratory findings: a clinical comparison in Iran
In brief
Dutasteride lowers PSA more than finasteride while both boost hair density equally
In a 24-week trial of 46 Iranian men with moderate-to-severe androgenetic alopecia, daily dutasteride (0.5 mg) and finasteride (1 mg) each increased hair density, with no significant difference between them. Dutasteride produced a larger drop in serum PSA, but safety and satisfaction were comparable, and erectile dysfunction was reported slightly more often with finasteride.
- Journal
- The Journal of dermatological treatment (Q1)
- Published
- 17 July 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Nazila Poostiyan, Zahra Nikyar, Reza Makhmali, Mohsen Hosseini, Zabihollah Shahmoradi
- PMID
- 42466626
- DOI
- 10.1080/09546634.2025.2583849
Why clinicians should know about it
- Picked for Dermatology (paper of the day, 18 July 2026): Androgenetic alopecia trial, hair loss not primary dermatology focus
Abstract
BACKGROUND: Androgenetic alopecia (AGA) is the most common type of hair loss in men. Finasteride and dutasteride are oral 5-alpha-reductase inhibitors. This study compared their efficacy and safety in Iranian men with moderate to severe AGA. METHODS: This randomized single-blind clinical trial included 46 men aged 20-50 years. Patients received finasteride 1 mg daily or dutasteride 0.5 mg daily for 24 weeks. Hair density and thickness were measured by trichoscopy and photographs. Satisfaction was recorded with a visual analog scale (VAS). Adverse effects were documented. RESULTS: Both groups improved in hair growth after 24 weeks with no significant difference. Serum PSA fell in the dutasteride group from 0.63 ± 0.18 to 0.42 ± 0.22 (p < 0.001). No significant change appeared in the finasteride group. Dutasteride produced greater PSA reduction than finasteride (B = 0.17, p < 0.01). Age had no effect on PSA (p = 0.58). VAS scores showed no difference. Safety profiles were similar. Sexual side effects were most common, with erectile dysfunction more frequent in the finasteride group. No serious events occurred. CONCLUSION: Finasteride and dutasteride improved hair density with similar safety. Dutasteride caused stronger PSA reduction, suggesting more potent 5-alpha-reductase inhibition.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.