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Higher doses of dutasteride reduce scalp DHT more effectively than finasteride, but have diminishing returns after 3mg daily and may cause more side effects. Combining dutasteride with topical minoxidil can enhance results, but using both finasteride and dutasteride together is unnecessary.

Dutasteride 0.5 mg significantly reduces both scalp and hair follicle DHT, with a greater reduction in hair follicle DHT. The discussion questions which reduction is more important for androgenetic alopecia and diffuse thinning.

The reduction in scalp oiliness is likely due to finasteride reducing DHT levels and the use of ketoconazole shampoo. The combination of these treatments may have decreased sebum production.

The user experienced severe scalp issues and hair loss after using ketoconazole shampoo, which worsened despite various treatments. They seek advice on restoring scalp health, suspecting an allergic reaction or imbalance caused by the shampoo.

Finasteride helps with hair loss by lowering DHT levels in the scalp, which is more important than blood DHT levels. If finasteride is not effective, consulting a doctor or considering switching to dutasteride may be advisable.