THE IMPACT OF PERIOPERATIVE DUTASTERIDE USE (ORAL AND MESOTHERAPY) ON THE AESTHETIC OUTCOMES OF HAIR TRANSPLANTATION: A LITERATURE REVIEW

Abstract

This article aimed to review the medical literature on the impact of perioperative dutasteride use — through oral and intradermal routes (mesotherapy/microneedling) — in preventing shock loss and optimizing aesthetic outcomes of hair transplantation in patients with androgenetic alopecia (AGA). A narrative literature review was conducted in PubMed/MEDLINE, SciELO, and LILACS databases, covering publications from 2018 to 2025. Clinical trials, systematic reviews, cohort studies, and case reports evaluating perioperative dutasteride use in patients undergoing hair transplantation or AGA treatment were included. Results showed that dutasteride, a dual inhibitor of type I and II 5-alpha-reductase isoenzymes, demonstrates superior efficacy over finasteride in  suppressing dihydrotestosterone (DHT), favoring preoperative and postoperative follicular stabilization. Mesotherapy with dutasteride showed comparable efficacy to the oral route with a lower risk of systemic adverse effects. The combination of both modalities yielded superior results compared to isolated use. It was concluded that perioperative dutasteride protocols represent a promising strategy to minimize shock loss and maximize graft survival, although specific randomized controlled trials on this topic remain scarce.