Dutasteride works best for men with androgenetic alopecia (male pattern baldness) at Norwood stages 2 through 5 who have not responded adequately to finasteride. Only about 40% of men with pattern baldness are good candidates for medication alone, so knowing your stage first is critical.
Who Is a Good Candidate for Dutasteride?
The ideal dutasteride candidate meets these criteria:
- Diagnosed with androgenetic alopecia (not alopecia areata, telogen effluvium, or other types)
- Norwood stage 2 to 5 with active miniaturization still in progress
- Did not respond sufficiently to finasteride after 12 months of consistent use
- Male and over age 18 (dutasteride is contraindicated in women of childbearing age)
- No history of liver disease since dutasteride is metabolized by the liver
- Willing to commit to long-term daily use because benefits reverse upon discontinuation
Who Should Avoid Dutasteride?
Dutasteride is not appropriate for everyone:
- Women who are or may become pregnant due to risk of birth defects in male fetuses
- Men under 18 as safety data for this age group is limited
- Patients with liver impairment since the drug undergoes extensive hepatic metabolism
- Men with Norwood 6 or 7 where medication alone is unlikely to produce meaningful results and transplant surgery (4,000-7,500 grafts) becomes the primary intervention
- Patients who experienced significant side effects on finasteride as dutasteride side effects tend to be similar but at higher rates
How Dutasteride Response Varies by Norwood Stage
| Norwood Stage | Expected Medication Response | Better Option? |
|---|---|---|
| Norwood 2 (800-1,500 grafts if surgical) | Strong. May avoid surgery entirely | Dutasteride or finasteride as first line |
| Norwood 3 (1,500-2,200 grafts) | Moderate to strong. Can delay surgery | Medication first, reassess at 12 months |
| Norwood 3V (2,000-2,800 grafts) | Moderate. Vertex may respond well | Combination of medication and monitoring |
| Norwood 4 (2,500-3,500 grafts) | Mild to moderate. Stabilization more likely than regrowth | Medication plus transplant planning |
| Norwood 5+ (3,000-4,500+ grafts) | Minimal regrowth expected | Transplant with medication as adjunct |
Not sure what stage you are? Get a free AI assessment at myhairline.ai/analyze.
How Dutasteride Compares to Finasteride for Candidacy
Both drugs are 5-alpha reductase inhibitors, but they work differently:
- Finasteride blocks Type II 5-alpha reductase only (about 70% DHT reduction)
- Dutasteride blocks both Type I and Type II (about 90% DHT reduction)
Finasteride is typically the first-line treatment because it is FDA-approved for hair loss (1mg daily), has a shorter half-life (6-8 hours vs. 5 weeks), and has a lower side effect rate (2-4% sexual side effects). Read our full dutasteride vs finasteride breakdown for detailed comparisons.
Dutasteride enters the conversation when finasteride proves insufficient after 12 months of compliant use.
What Happens If You Stop Dutasteride?
Hair loss resumes within 3 to 6 months of discontinuation. Because dutasteride has such a long half-life (approximately 5 weeks), the decline is more gradual than stopping finasteride. However, within 12 months of stopping, most patients return to where they would have been without treatment.
This is why candidacy is not just about whether the drug works for your stage. It also depends on your willingness to take it indefinitely.
Next Steps to Determine Your Candidacy
- Check your Norwood stage at myhairline.ai/analyze
- Consult a dermatologist who specializes in hair loss
- If you have not tried finasteride yet, that is usually the recommended first step
- If finasteride was insufficient, ask your doctor about finasteride vs hair transplant options or switching to dutasteride
Knowing your exact Norwood stage is the foundation of every treatment decision, whether you end up on medication, in the surgical chair, or both.
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Dutasteride is not FDA-approved for hair loss treatment. Always consult a qualified healthcare provider before starting any medication.