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Finasteride and dutasteride are the most evidence-supported pharmacological treatments for androgenetic alopecia (AGA) in both men and women. Finasteride 1 mg/day reduces serum DHT by about 70%, while dutasteride 0.5 mg/day achieves approximately 90% suppression, with dutasteride showing slightly greater hair count gains. A pivotal trial found dutasteride 2.5 mg superior to finasteride 5 mg/day, but the 0.5 mg dose is standard due to its efficacy and lower systemic exposure. Genetic factors, particularly androgen receptor variations, significantly influence treatment response. In women, higher doses of finasteride and variable doses of dutasteride are effective, especially in postmenopausal and some premenopausal groups. The choice between these drugs involves balancing DHT suppression, drug half-life, and tolerability, with genetic modifiers being an important area for future research.

Finasteride and dutasteride are the most evidence-supported pharmacological treatments for androgenetic alopecia (AGA) in both men and women. Finasteride 1 mg/day reduces serum DHT by about 70%, while dutasteride 0.5 mg/day achieves approximately 90% suppression, with dutasteride showing slightly greater hair count gains. A pivotal trial found dutasteride 2.5 mg superior to finasteride 5 mg/day, but the 0.5 mg dose is standard due to its efficacy and lower systemic exposure. Genetic factors, particularly androgen receptor variations, significantly influence treatment response. In women, higher doses of finasteride and variable doses of dutasteride are effective, especially in postmenopausal and some premenopausal groups. The choice between these drugs involves balancing DHT suppression, drug half-life, and tolerability, with genetic modifiers being an important area for future research.