Sides And Back Thinning On Dutasteride (pics)

[MKP05]

I’ve been on duta for 6 weeks after 17 months of finasteride. My main problem areas are my temples and forelock with some diffuse thinning across the entire Norwood region. Approximately one week after starting duta I noticed thinning on the back of my head near the nape as well as the sides. It has gotten worse in the following 5 weeks but only slightly so. Additionally, the entire back of my head is now diffuse thinning when it wasn’t before starting duta. and I’m not talking about a shed either. It’s as if the hair shafts just miniaturized. This has me concerned obviously. Since I had a similar reaction to finasteride at the 4-6 month (diffuse across the Norwood area out of nowhere) I’m thinking that perhaps my body reacts poorly to hormonal changes and is triggering the thinning in the back. I never recovered from the initial thinning from finasteride even though it never got any worse either.

I just have a lot less density now all over than when I first started taking medication. And a lot less density on the back and sides than I did 6 weeks ago (strangely I haven’t noticed any change to the Norwood region and if anything it has slowed down my hair loss at the temples.) The other thing to mention is that I also suffer from alopecia areata but this thinning doesn’t look like what I’ve had in the past which is circular bald patches with zero hair. I’m wondering if the duta maybe triggered an immune response since I’m prone to areata. The back and sides certainly look and feel inflamed so I’ve been using clobetasol solution to try to calm things down.

I’m trying to decide whether to keep taking duta, switch back to finasteride, take finasteride with duta sprinkled in every few days, or just get off AAs and let my fate fall where it may. I was never really ok with losing the hair on the top of my head but I’m certainly not cool with losing the back and sides too. Appreciate any feedback especially if anyone else experienced this after switching from finasteride.

 

[EndlessPossibilities]

This is proof that dht isnt the only problem by its self. Do HormonE test.

 

[StevenGerrard]

if you saw the shed that I had after ~6 weeks on Duta you would legitimately jump off a bridge -- power through it and stick with the medication

 

[MKP05]

This is proof that dht isnt the only problem by its self. Do HormonE test.

Got one done yesterday. Results should be in this week.

So I went on finasteride and it shocked my Norwood area into diffuse but then maintained everywhere except the temples and forelock.

then I go on duta and it shocks my donor zone into diffuse but maintained everywhere (so far) including the temples and forelock.

Seriously, what the f***.

 

[MKP05]

if you saw the shed that I had after ~6 weeks on Duta you would legitimately jump off a bridge -- power through it and stick with the medication

did you shed/thin in the donor zone? Did you recover?

 

[MKP05]

This is proof that dht isnt the only problem by its self. Do HormonE test.

Again I’ve had alopecia areata for over 25 years and always on the back of my head. Always came back after corticosteroids injections. Could this be an immune response? Telogen Effluvium? Is this sh*t permanent?

 

[StevenGerrard]

did you shed/thin in the donor zone? Did you recover?

ALL OVER (srs), side and back has recovered nicely (getting thicker and healthier by the day) -- scalp and hairline = still recovering

 

[MKP05]

ALL OVER (srs), side and back has recovered nicely (getting thicker and healthier by the day) -- scalp and hairline = still recovering

Thanks. I see you are on a pretty aggressive regimen. How much of your recovery can be attributed to duta versus everything else? Were you on finasteride prior to duta? Was your shed diffuse like mine?

As you can imagine I’m pretty skeptical at this point. I stayed with finasteride for 17 months and got nothing out of it other than diffuse loss in places I was never balding to begin with. And it didn’t stop the progression of hair loss at my temples/hairline/forelock.

 

[StevenGerrard]

Thanks. I see you are on a pretty aggressive regimen. How much of your recovery can be attributed to duta versus everything else? Were you on finasteride prior to duta? Was your shed diffuse like mine?

As you can imagine I’m pretty skeptical at this point. I stayed with finasteride for 17 months and got nothing out of it other than diffuse loss in places I was never balding to begin with. And it didn’t stop the progression of hair loss at my temples/hairline/forelock.

yes I was on finasteride before (for like ~4 months) and it seemed to meek and useless (at least for me), I dropped my dosage down to 0.5mg/daily and added Avodart (Duta) about ~80 days ago. I have responded much better to Duta, for example; I now have hundreds of new vellus hair coming in nicely all along my hairline and temple (a few have turned terminal). I honestly regret not starting right away with Duta... oh well

 

[Slid]

Shock loss,had the same thing when I dropped fina.Hairs grew back in 4-5 months.

 

[pikemason]

I just switched to dutasteride and I went diffused all over.. I had a minor shed but not much, very scary. Im going to stick it out but dam it sucks. I was on finasteride for 12 months before I switched.

 

[Moosey]

happened to me too. even shedded on my crown where i have zero hairloss. it all grew back after 6-7 months or so

 

[Anatoly]

I’m wondering if the duta maybe triggered an immune response since I’m prone to areata. The back and sides certainly look and feel inflamed so I’ve been using clobetasol solution to try to calm things down.
I’m trying to decide whether to keep taking duta, switch back to finasteride, take finasteride with duta sprinkled in every few days, or just get off AAs and let my fate fall where it may. I was never really ok with losing the hair on the top of my head but I’m certainly not cool with losing the back and sides too.


Faced a similar problem. Some points for you to discuss with your doctor:
1) it's important you note very visible inflammation: unless you don't get rid go it, you're unlikely to succeed
2) it may be unreasonable to blame dutasteride
3) it is not a good idea to combine ketoconazole and clobetasol. You should get more info on the costs of steroid use. You may get more inflammation when you stop steroids. Consider with your doctor ways of its discontinuation asap.
4) you should consider your exact formulation of minoxidil as a cause (alcohol etc): I had very similar inflammation on some particularly sensitive parts of my scalp, which was caused by Rogaine foam. I used Rogaine on my beard and the skin there severely inflamed (I used Rogaine for a week on all sensitive parts and inflammation persisted). I discontinued it with some steroid cream help.
At the same time a 15% minoxidil solution with azelaic acid never caused any inflammation and helped to calm down the already inflamed skin
(azelaic acid cream etc may be better to address inflammation than clobetazol). Ask your doctor for more alternatives.
5) I use 2% Nizoral every day and leave it for 10-15min - very pleasant results in combating inflammation (I use a bit of it on my face as well) etc, this is far more impressive than my early low-intensity regimen (2 % Nizoral for 3-5min every 2-3 days) You may may not be using ketoconazole sufficiently

Hope, this may help)

 

[MKP05]

I’m wondering if the duta maybe triggered an immune response since I’m prone to areata. The back and sides certainly look and feel inflamed so I’ve been using clobetasol solution to try to calm things down.
I’m trying to decide whether to keep taking duta, switch back to finasteride, take finasteride with duta sprinkled in every few days, or just get off AAs and let my fate fall where it may. I was never really ok with losing the hair on the top of my head but I’m certainly not cool with losing the back and sides too.


Faced a similar problem. Some points for you to discuss with your doctor:
1) it's important you note very visible inflammation: unless you don't get rid go it, you're unlikely to succeed
2) it may be unreasonable to blame dutasteride
3) it is not a good idea to combine ketoconazole and clobetasol. You should get more info on the costs of steroid use. You may get more inflammation when you stop steroids. Consider with your doctor ways of its discontinuation asap.
4) you should consider your exact formulation of minoxidil as a cause (alcohol etc): I had very similar inflammation on some particularly sensitive parts of my scalp, which was caused by Rogaine foam. I used Rogaine on my beard and the skin there severely inflamed (I used Rogaine for a week on all sensitive parts and inflammation persisted). I discontinued it with some steroid cream help.
At the same time a 15% minoxidil solution with azelaic acid never caused any inflammation and helped to calm down the already inflamed skin
(azelaic acid cream etc may be better to address inflammation than clobetazol). Ask your doctor for more alternatives.
5) I use 2% Nizoral every day and leave it for 10-15min - very pleasant results in combating inflammation (I use a bit of it on my face as well) etc, this is far more impressive than my early low-intensity regimen (2 % Nizoral for 3-5min every 2-3 days) You may may not be using ketoconazole sufficiently

Hope, this may help)

It’s not minoxidil causing the problem since I only ever applied it to the hairline and discontinued it a few weeks ago before I even got on dutasteride. There is no doubt in my mind that the dutasteride has caused the back and sides to thin out considerably. It presented one week after starting and was the only thing that I had added to the mix. There’s no chance that this is a coincidence especially considering a had a similar reaction when I started finasteride. Ironically I haven’t noticed any drastic worsening of my hair anywhere else in the 7 weeks I’ve been taking it. The only areas which thinned out are in the safe zone. I used the clobetasol for about a week but I haven’t used it in about 5 days. I’ve recently been to a top dermatologist in NY and she’s completely stumped as my bloodwork is normal. Her recommendation was to stop taking the duta and go back on finasteride but at 1.25 mg rather than 1 mg. I have no idea what to do. I feel like I’ve been down this road already with finasteride and my situation did not improve over 17 months. Yet the alternatives are not appealing either as quitting all AAs could put me in an even worse predicament. Is azelaic acid available without a prescription? As for nizoral I only use 1% currently 3x per week and only leave it in for 4-5 min. I just can’t believe my donor area is now as screwed as the rest of my scalp.

 

[Anatoly]

I see your point.
1) I was mainly concerned about some visible skin inflammation shown in your photos. White on an intensive nizoral regimen, my scalp skin has never been in such a good condition: my skin now in very clean, well-peeled with no reddish oily skin. I first saw visible temples and sides regrowth only after my skin there started to look like my skin in the donor area. On some occasions I missed nizoral for a 2-3 days and my skin started to get reddish and oily again. I believe nizoral's peeling effect helps better minoxidil absorption as well. While washing my hair every morning I intensively massage my scalp (stretching it moderately) for 20min, trying to get out of my skin as many dead hairs as possible. However, nizoral itself is associated with making hairs thinner, so one needs a proper after-shampoo hair care.

Regarding thinning out, dutasteride produced the same effects in my case, it's true. I started with finasteride 5mg daily for about a month: experienced moderate shedding and some intolerable side effects (those not related to my hair). I switched to Avodart 0.5 mg daily. I tolerate it far better. Shedding was severe for the first 2-3 months. I probably lost 2/3 of my pre-avodart hair. My hair is 10-20 cm long, so has been easier for me to feel the difference. A lot of shedding occurred on my sides, tempes, as well as in my donor area. I knew it was a good sign and knew that I should stick to my regimen to get results. Nevertheless, it has been very psychologically uncomfortable. For instance, my hairline now looks funny: there is at most 10-15% of 'old' pre-Avodart hair (long hair) and a fantastic regrowth of new short hairs. These new hairs are about 3-5 cm now (4,5months on Avodart). In the most deceased segment my hairline lowered by about 2 cm (and these are not baby hairs, these are normal growing hairs).

Hair on my sides (the area between my temple and my ear): now I realise that to get results I had loose a lot of hair in this area. Have about 5-10% of pre-Avodart long (20+ cm) hair left and the rest is new healthy hair fully covering my scalp (3-5 cm long).
Also, my hairline on my neck (below my donor area) and around my ears lowered as well))

Intensive shedding stopped after 3-3,5 months on avodart in my case. Now I have almost no shedding at all (no more that 10 hairs lost with every morning wash).

I believe you should find a doctor who will better introduce you to data on Avodart, some alternative opinion. You may ask:
1) it it true that despite being more potent, dutasteride may be better tolerated as compared to finasteride?
2) it blocking both of the two types (dutasteride) more effective than blocking only one type (finasteride)?
3) it a percentage of DHT blocked a reliable predictor of hair regrowth? Some show regrowth while on 1 mg of finasteride, while others even need to use both oral dutasteride and topical dutasteride. There are some other mechanists at work when one compares finasteride and dutasteride.

 

[MKP05]

Getting more diffused on back and sides. 2 months on duta. Please tell me this is going to grow back. 19 months now on finasteride and duta and all I have to show for it is a completely diffused scalp.

 

[Slid]

It will probably last 3-4 months.

 

[Anatoly]

I'm confident about the data on dutasteride. It seems too early to judge. While in my second month on Avodart I still experienced substantial shedding. Most of the hair I lost was on my back in the donor area, which seems predictable: I had generally more hair in this area and therefore more dead (telogen) hair. It would have fallen out anyway to allow new growing (anagen) hair. You may get an assessment of your ratio of growing/dead hairs now and in several months, it should improve. The task in the long term, as I see it, is to keep more hair in the growing phase and smaller % in the telogen phase.
Avodart needs to accumulate in one's body. Concerning efficacy, It seems reasonable to assess it when you reach the plateau (1-2 years).

 

[MKP05]

I'm confident about the data on dutasteride. It seems too early to judge. While in my second month on Avodart I still experienced substantial shedding. Most of the hair I lost was on my back in the donor area, which seems predictable: I had generally more hair in this area and therefore more dead (telogen) hair. It would have fallen out anyway to allow new growing (anagen) hair. You may get an assessment of your ratio of growing/dead hairs now and in several months, it should improve. The task in the long term, as I see it, is to keep more hair in the growing phase and smaller % in the telogen phase.
Avodart needs to accumulate in one's body. Concerning efficacy, It seems reasonable to assess it when you reach the plateau (1-2 years).

I hear what you’re saying and it seems to make some sense especially considering my Norwood area has not really been impacted since i started duta. but I can’t wait a year to assess if it keeps thinning at this rate. I’m seriously considering dropping back to finasteride or maybe a combination of finasteride and duta. finasteride wasn’t stopping my hair loss but at least I had a donor area. I’m getting my hair cut tomorrow and usually do the back and sides with a 4 or 5. I’m very curious to see if that makes it at least appear better. I’ve been very patient with treatments over the past 20 months but I’m beginning to run out of it.

 

[Anatoly]

I believe it's a very bad idea to with back to less potent finasteride. Impressive shedding is a good sign that you're likely to experience regrowth. Maybe you want to consider a stronger minoxidil solution (10-15%) to accelerate regrowth.
In my case the first months on therapy were difficult, I lost a lot of dead hair. My scalp looked ridiculous and was incompatible with my social status and lifestyle. When some regrowth on my temples occurred I started to slick back my hair. Now regrowth is sufficient to fully cover my scalp, the rate of regrowth is different different areas (temples regrow at a slower rate).