Hi Dr. Rassman,
I have seen the results of the study that has shown significant increases in scalp testosterone with dutasteride (104% for 0.5 mg). Could this major increase in scalp testosterone contribute to further male pattern balding, since testosterone can also bind to the androgen receptors in hair follicles? Basically, is there any possibility that the decrease you get in DHT from dutasteride could be overwhelmed by this increase in testosterone? thanks very much.
What you are talking about is as much science as speculation. From what I have learned from doctors who use dutasteride in those patients who do not respond to finasteride (Propecia), the report is that it is stronger and more effective. I have addressed the scalp testosterone levels with dutasteride before here. More insights may be obtained by looking at pubmed.gov.
I only have a limited understanding of the pharmacology here, so I would rather just refer the readers to better authorities.