Hair Restoration Blog

Q:

Hi Dr. Mohebi,

I am a male to female transgender patient of yours.  I was doing some research and I wondered if I should use Dutasteride in the form of Avodart instead of Finisteride in the form of Proscar. Here is the link I found: http://en.wikipedia.org/wiki/Dutasteride
This wikipedia artical inidicates that Dutasteride inhibits both isoforms of 5-alpha reductase, Type I and Type II, while finasteride only inhibits Type II.  Some early studies showed that Dutasteride is more effective.
I’m curious to know your opinion of taking this drug, and if it will have any effect of regenerating any of my lost hair?  While Finisteride seems to have mostly abated hair loss, I haven’t seen any kind of re-growth.

Thank you so much

A:

Dutasteride has been studied for its effect on hair loss prevention and prevention of miniaturization process.  The studies show that Dutasteride is more potent for hair loss treatment in comparison to finasteride.  Having said that, dutasteride (Avodart) has never been approved by FDA for hair loss treatment partially due to its side effects that are more commonly seen.

Dutasteride is FDA approved for Benign Prostate Hypertrophy (BPH) treatment.  It might become approved for hair loss in the future, but until then I do not prescribe it for my patients on a regular basis.
Since you are a transsexual person and you are going through medical treatments and sex reassignment surgeries and until you have your testosterone, you can use dutasteride instead of finasteride for a more complete male hormone blockage as long as you understand that you may have a higher risk of experiencing the sexual side effects.

Dr. Mohebi,

You performed a hair transplant on me to make a female hair line as part of my male to female transgender process.  I recently decided to do a scalp surgery that may require a scalp advancing procedure.  My Dr. Will transplant hairs along the scar in hairline.  I am not convinced this will be enough, and we may need to do one final pass after all is done to be sure, possibly the middle of next year.  I’ll have to wait and see, money is also an issue.

A:

Good luck with your scalp advancement surgery. Please do your research and make sure your plastic surgeon does perform hair transplant on a regular basis before letting him place hair on your hairline.  It is especially important that he has experience with creating hairline for transgenders.

If he is not doing hair transplant on a regular basis as is the case for many cosmetic surgeons, it might still be OK to have him put the hair removed during the scalp advancement surgery on the top areas, where you still need more reinforcement.

Hairline is very meticulous specially for male to female trans gender patients.  We can easily repair the hairline in front of the scar of your scalp advancement surgery.  It will be more difficult if there is less than perfect transplanted hair on the hairline area.  that requires removing the hair grafts that are transplanted out of their normal locations and reuse them in the other areas.