Do Hair Growth Tablets Work? A UK Guide to Oral Treatments

Introduction: Exploring Oral Treatments for Hair Loss

While a significant number of hair loss treatments are topical – applied directly to the scalp in forms such as liquids, foams, shampoos, and creams – there are also oral medications, taken as tablets, that are licensed for use in the UK to combat male pattern baldness. These systemic treatments work from within the body to address the underlying hormonal causes of this common type of hair loss. But how effective are these tablets, and what do men considering this route need to know? This article will take a closer look at the two primary oral treatments licensed in the UK for male pattern hair loss, examining how they work, their efficacy, and important considerations.

Licensed Hair Loss Tablets in the UK: Finasteride and Dutasteride

In the United Kingdom, there are two main prescription medications in tablet form licensed for the treatment of male pattern baldness (androgenetic alopecia):

Finasteride (often known by the brand name Propecia)

Finasteride is perhaps the most widely known and commonly prescribed oral tablet for hair loss in men. Propecia is the original branded version, while Finasteride is the generic name for the same active drug, generally available at a lower cost. The standard dosage for treating hair loss is one 1mg tablet taken daily, with or without food.

Dutasteride (often known by the brand name Avodart)

Dutasteride is another oral medication used to treat male pattern baldness, although its primary licensed indication in the UK was initially for benign prostatic hyperplasia (BPH), similar to Finasteride's origins. Avodart is the branded version, and Dutasteride is its generic counterpart. While sometimes used 'off-label' for hair loss in the UK at a typical dose of 0.5mg daily, its official licensing specifically for hair loss may vary or be more recent compared to Finasteride. The recommended dosage is often one 0.5mg capsule taken daily, approximately half an hour after food.

It is crucial to note that because these treatments significantly affect the male hormonal system (specifically DHT levels), they are not suitable for use by women or children. For women, particularly those of childbearing potential, exposure can have adverse effects, including risks to a male foetus if pregnant.

How Do These Hair Loss Tablets Work?

Both Finasteride and Dutasteride belong to a class of drugs known as 5-alpha-reductase inhibitors. Their mechanism of action in treating male pattern baldness is to target the hormonal pathway that leads to hair follicle miniaturisation:

1. The Role of DHT: Male pattern baldness is primarily caused by the effects of dihydrotestosterone (DHT) on genetically susceptible hair follicles. DHT is a potent androgen (male hormone) derived from testosterone through the action of an enzyme called 5-alpha-reductase.
2. DHT's Impact: DHT binds to androgen receptors in hair follicles, causing them to shrink over time. This process, known as follicular miniaturisation, results in progressively shorter, finer hairs until the follicle eventually stops producing visible hair.
3. Inhibition of 5-alpha-reductase: Finasteride and Dutasteride work by blocking the activity of the 5-alpha-reductase enzyme. By inhibiting this enzyme, they significantly reduce the conversion of testosterone into DHT.
4. Reduced DHT Levels: With lower levels of DHT circulating in the body and specifically in the scalp, the miniaturisation process of the hair follicles is slowed down, halted, or in some cases, partially reversed. This can lead to a cessation of further hair loss and, for some men, an increase in hair density and thickness as miniaturised follicles recover.

Comparing Effectiveness: Finasteride vs. Dutasteride

While both Finasteride and Dutasteride work through a similar mechanism by inhibiting 5-alpha-reductase, there are differences in their potency and the extent of DHT reduction they achieve:

• Types of 5-alpha-reductase: There are different types (isoenzymes) of 5-alpha-reductase. Finasteride primarily inhibits Type II and Type III 5-alpha-reductase. Dutasteride is a more potent inhibitor as it blocks all three known types: Type I, Type II, and Type III 5-alpha-reductase.
• DHT Reduction: Because Dutasteride inhibits more types of the enzyme, it leads to a more significant reduction in circulating DHT levels. Studies suggest Dutasteride can reduce serum DHT levels by up to 90-98 percent. Finasteride typically reduces serum DHT levels by around 65-70 percent.

Due to its more comprehensive inhibition of 5-alpha-reductase and greater DHT suppression, Dutasteride is generally considered to be more effective than Finasteride in promoting hair growth and increasing hair count in some studies. However, this increased potency may also come with a slightly different side effect profile for some individuals. The choice between them should be made in consultation with a doctor.

Potential Side Effects of Hair Loss Tablets

While generally well-tolerated by many men, both Finasteride and Dutasteride can cause side effects in a small percentage of users. It's important to be aware of these potential effects, which can include:

• Sexual Side Effects: These are among the most commonly discussed and can include decreased libido (low sex drive), erectile dysfunction (difficulty achieving or maintaining an erection), and problems with ejaculation (e.g., decreased volume). For most men who experience these, they are reversible upon stopping the medication.
• Breast Changes: Tenderness or enlargement of breast tissue (gynecomastia) can occur, though this is uncommon.
• Mood Changes: There have been reports of mood alterations, including depression, although a direct causal link is still debated and researched.
• Other Less Common Effects: These may include testicular pain or allergic reactions.

It's crucial to discuss any side effects experienced with your doctor. Many men take these medications without experiencing significant issues, but awareness and open communication with a healthcare provider are key.

The Big Question: Do Hair Loss Tablets Really Work?

There is no simple 'yes' or 'no' answer that applies to everyone, as individual responses to medication can vary. However, extensive clinical trials and real-world use have provided considerable evidence that hair loss tablets like Finasteride and Dutasteride do work for a majority of men with male pattern baldness. Most men who take these tablets consistently can expect to see a slowing or cessation of further hair loss, and a significant proportion will also experience some degree of hair regrowth, often noticeable as increased thickness or density. Visible results typically take time, often around six months to a year, with continued improvement possible beyond that. Some men may see a considerable difference, while for others, the primary benefit might be the prevention of further loss, which is still a positive outcome. These tablets are often most effective when treatment is started in the earlier stages of hair loss. Their efficacy can also be enhanced when combined with other treatments, such as topical Minoxidil or adjunctive therapies like Platelet-Rich Plasma (PRP) treatments.

Important Considerations and Warnings

Beyond the potential side effects, there are other crucial considerations when using Finasteride or Dutasteride:

• Use in Women: These medications are not approved for use by women and are contraindicated in women who are or may become pregnant due to the risk of causing birth defects in a male foetus. Women of childbearing age should avoid handling crushed or broken tablets.
• Condom Use: Because these drugs can be present in semen, it is often recommended that men taking them use a condom during sexual intercourse if their partner is or may become pregnant.
• Impact on Mental Health: While rare, reports of sexual function impairment and mood changes like depression highlight the importance of monitoring mental well-being during treatment and discussing any concerns with a doctor.
• Persistence of Side Effects: In a very small number of cases, some side effects (particularly sexual ones) have been reported to persist even after discontinuing the medication, a condition sometimes referred to as Post-Finasteride Syndrome (PFS). This is an area of ongoing research and debate.
• Prostate Cancer Screening: Finasteride and Dutasteride can lower levels of prostate-specific antigen (PSA), which is used in screening for prostate cancer. It's important to inform any doctor testing your PSA levels that you are taking one of these medications.

Alternative and Complementary Treatments

Given the potential for side effects with oral tablets, some individuals may prefer to explore alternative or complementary treatments. These can include:

• Topical Minoxidil: A widely used over-the-counter foam or solution that stimulates hair growth.
• Platelet-Rich Plasma (PRP) Therapy: Injections of the patient's own concentrated platelets into the scalp to stimulate hair follicles.
• Low-Level Laser Therapy (LLLT): Devices that use red light to stimulate cellular activity in follicles.
• Hair Transplant Surgery: A surgical option for more advanced hair loss.

Often, a combination approach, potentially including lower-risk topical solutions or treatments like PRP, alongside or instead of oral medications, can be effective and may have fewer systemic side effects.

Conclusion: Weighing Up the Pros and Cons of Hair Loss Tablets

There is considerable scientific evidence to support the claim that hair loss tablets like Finasteride and Dutasteride do work for many men experiencing male pattern baldness. They can effectively slow down hair loss and, in many cases, promote some regrowth. However, there is no absolute guarantee that they will work effectively for every individual. Furthermore, the potential side effects, particularly those related to sexual function and mood, alongside the important precautions concerning women of childbearing age, are significant factors that must be carefully considered and discussed with a healthcare professional. For some, the benefits will outweigh the risks, while others may find treatments with fewer systemic side effects, such as topical solutions or procedures like PRP therapy, to be a more suitable and safer option for their circumstances. Ultimately, the decision to use hair loss tablets should be an informed one, made in consultation with a doctor who can assess your individual situation and help you weigh the potential benefits against the risks.