Efficacy and safety of oral finasteride <i>versus</i> dutasteride in moderate-to-severe androgenetic alopecia in males based on trichoscopic and laboratory findings: a clinical comparison in Iran

July 2026 in “ Journal of Dermatological Treatment ”

Nazila Poostiyan, Zahra Nikyar, reza makhmali, Maede Hosseini, Zabihollah Shahmoradi

TLDR Finasteride and dutasteride both improve hair growth effectively, but dutasteride has stronger anti-androgen effects and finasteride may cause more sexual side effects.

This study evaluated the efficacy and safety of oral finasteride and dutasteride in 46 Iranian men with moderate to severe androgenetic alopecia over 24 weeks. Both medications effectively improved hair density and thickness, with no significant difference in overall effectiveness or patient satisfaction. Dutasteride showed a more potent systemic anti-androgenic effect, as indicated by a greater reduction in serum PSA levels. Both treatments were well tolerated, though sexual side effects like erectile dysfunction were more common with finasteride. No serious adverse events occurred, and the study suggests considering genetic factors like SRD5A2 gene polymorphisms in treatment outcomes.

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