DHT and hair loss are intimately linked in patients with a genetic predisposition to alopecia. Indeed, DHT is the primary cause of male pattern baldness. Let’s unravel all there is to know about the topic and how to reverse lost hair.
What is Dihydrotestosterone (DHT)?
Dihydrotestosterone (DHT) is a potent androgen hormone directly derived from testosterone. It plays a crucial role in male sexual development and is responsible for many characteristics associated with male puberty, such as:
- Facial and body hair growth
- Deepening of the voice
- Development of the prostate and male genitalia
- Increased muscle mass
And this, even before you are born, in the fetus stage, inside your mother’s womb.
How is DHT Produced? The Connection with Testosterone
As an adult, your body converts about 10% of your testosterone into DHT every single day. Basically, DHT is formed when the enzyme 5-alpha reductase converts testosterone into DHT. DHT is about 5 times more potent than testosterone.
DHT Stages in Hair Development
Dihydrotestosterone (DHT) plays a crucial role in male hair development at different stages of life:
1. Puberty (11-18 years)
During puberty, DHT levels increase significantly, leading to:
- Facial and body hair growth (beard, chest, underarms, pubic hair).
- Increase in sebum production, which may cause acne & dermatitis.
2. Adulthood (19-40 years)
- DHT helps maintain facial and body hair growth.
- Can contribute to male pattern baldness (androgenetic alopecia) if a person is genetically predisposed.
What Happens to Hair When DHT Levels Are Too Low?
During Adulthood (19-40 years), low DHT levels can lead to thin or absent facial/body hair. For example, men with low DHT may struggle to grow a beard or chest hair.
What Happens to Hair When DHT Levels Are Too High?
During Adulthood (19-40 years), excess DHT can lead to Male pattern baldness (MPB), as high DHT accelerates hair miniaturization, leading to receding hairlines and thinning.
Moreover, excess DHT can lead to hyperandrogenism, which results in excessive body hair growth (hirsutism) and increased sweat and odor production.
Premature Balding: The Effect of DHT on Hair Loss (Androgenic Alopecia)
Dihydrotestosterone (DHT) is the primary cause of male pattern baldness (androgenetic alopecia). It binds to hair follicles, causing them to shrink over time, leading to thinner, weaker hair and eventually hair loss.
DHT affects hair loss through a process called hair follicle miniaturization. This happens in 3 stages:
- Stage 1: DHT Binds to Hair Follicle Receptors
- Stage 2: Hair Follicles Begin to Shrink (Miniaturization)
- Stage 3: Hair Stops Growing (Follicular Dormancy & Death)
Areas Affected by DHT-Induced Hair Loss
DHT does not affect all hair on the body equally. That means, some areas of the body are more and less sensitive to the hormone, leading to more or less hair shedding:
More Affected Areas (Sensitive to DHT)
- Scalp (Frontal Hairline & Crown)
- Temple and Crown (Vertex Balding)
- Top of the Head (Mid-Scalp Thinning)
Less Affected Areas (DHT-Resistant)
- Back & Sides of the Head
- Beard & Body Hair
How to Know if DHT is Causing Your Hair Loss?
To determine if DHT is responsible for your hair loss, you need to analyze symptoms, genetics, hair loss patterns, and confirm with medical tests.
1. Analyze Key Symptoms
A. Hair Loss Pattern (Androgenetic Alopecia)
- Receding Hairline
- Thinning Crown
- Miniaturization of Hair
- Sparing of the Sides and Back
B. Oily Scalp and Increased Sebum Production
- DHT stimulates sebaceous (oil) glands, causing an oily scalp.
- Anoily scalp can clog hair follicles, making hair loss worse.
2. Medical Tests to Confirm DHT-Related Hair Loss
If you suspect DHT is causing your hair loss, you can confirm it with medical tests:
A. Scalp Analysis (Hair Miniaturization Test)
Both a dermatologist or a trichologist can examine your scalp under a dermatoscope to check for:
- Miniaturized hair (thin, weak strands).
- Patterned thinning (temples, crown, mid-scalp).
- Reduced hair density.
B. Blood Tests for Hormone Levels
Measuring hormone levels can reveal if DHT is excessive too. Key tests include:
- DHT Test– Directly measures dihydrotestosterone levels in the blood.
- Total Testosterone Test– Since DHT is derived from testosterone, high testosterone may mean more DHT production.
- Free Testosterone Test– Measures unbound (active) testosterone, which can convert to DHT.
- 5-Alpha Reductase Test– Checks the activity of the enzyme that converts testosterone to DHT.
- Thyroid Panel– Rules out thyroid issues (which can also cause hair loss).
- Iron & Vitamin D Levels– Nutrient deficiencies can worsen hair loss but are not related to DHT.
Differentiating DHT Hair Loss from Other Types of Hair Loss
Not all hair loss is due to DHT. Here’s how to differentiate DHT-related hair loss from other conditions:
Hair Loss Type | DHT-Related Hair Loss | Other Hair Loss Conditions |
Pattern | Starts at temples & crown, progresses slowly | Diffuse or patchy shedding |
Progression | Gradual over months/years | Sudden or rapid loss |
Scalp Condition | Normal or oily | Dry, flaky, itchy, or inflamed |
Reversible? | Partially reversible (if caught early) | Varies (some are temporary) |
Affected Areas | Only top of scalp, not sides or back | Can be all over the scalp |
Family History | Common | Not always hereditary |
How to Combat DHT-Related Hair Loss
We currently know of 2 treatments that effectively reverse DHT hair loss with long-lasting results. Both should be carefully considered through medical consultation. Depending on the specific patient, one might be more effective than the other:
1. DHT Blockers to Manage Hair Loss
The first known way to combat DHT-related hair loss is medication. This hair regrowth therapy can be subdivided into 2 categories:
A. Counter Medication
- Finasteride (Propecia): Blocks 5-alpha reductase, reducing DHT by 70%.
- Minoxidil (Rogaine): Increasesblood flow to hair follicles, helping regrowth.
- PRP Therapy (Platelet-Rich Plasma): Injecting growth factors to stimulate hair growth.
- Low-Level Laser Therapy (LLLT): Helps boost hair regrowth through controlled red laser
- Microneedling (Dermaroller): Helps boostcollagen and follicle regeneration.
- Mesotherapy: uses natural plant extracts and amino acid cocktails to promote hair growth.
B. Natural Remedies
- Saw Palmetto– Blocks 5-alpha reductase, reducing DHT production.
- Pumpkin Seed Oil– Contains phytosterols that may inhibit DHT.
- Green Tea (EGCG)– Helps reduce testosterone conversion into DHT.
- Zinc & Biotin– Supports hair health and hormone balance.
Note: Natural blockers work best for mild hair loss and may not be strong enough for advanced baldness.
⚠️ Beware of the Side Effects of DHT Blockers
DHT blockers can lead to serious consequences. Make sure you consult an expert and go through all necessary medical tests before making a decision.
A. Sexual Side Effects (Most Reported)
DHT is crucial for male sexual function. Reducing it can cause:
- Lower Libido
- Erectile Dysfunction (ED)
- Delayed or Weak Orgasms
B. Mental Health Side Effects
DHT affects brain function and mood regulation, so blocking it may lead to:
- Depression & Anxiety(even leading to PFS & suicidal thoughts)
- Fatigue & Lack of Motivation
- Brain Fog & Memory Issues
Are Natural DHT Blockers Safer?
Some people prefer natural hair treatments & hair regrowth products like saw palmetto, pumpkin seed oil, and green tea. They are less potent than finasteride but may still cause mild side effects, such as:
- Reduced Libido– Some users report a drop in sex drive.
- Digestive Issues– Bloating, nausea, or upset stomach.
- Mild Fatigue or Brain Fog– Less common but still possible.
2. Hair Transplants to reverse Severe DHT Hair Loss
When DHT hair loss reaches an advanced stage, treatment options become limited. If you have surpassed stage 3 or 4 on the Norwood-Hamilton scale, a hair transplant may be the only effective solution to restore hair density.
When to Consider a Hair Transplant?
🔹 If your baldness has progressed beyond stage 3 or 4 on the Norwood-Hamilton scale.
🔹 If DHT blockers and other treatments are no longer effective.
🔹 If you still have enough donor hair in DHT-resistant areas (the back and sides of the head).
Compare Hair Transplant Costs
Before proceeding, it is advisable to compare hair transplant costs and determine whether they fit your budget. Prices can vary based on:
✅ The technique used (Sapphire FUE, DHI, Long DHI, FUT, Stem Cell).
✅ The number of grafts required.
✅ The clinic and surgeon chosen.
✅ Geographic location (some countries offer more competitive prices).
💡 Conclusion: If you have advanced hair loss due to DHT, a hair transplant can be an effective and permanent solution. However, before making a decision, consult an expert to assess feasibility and determine the best treatment plan.
Who is More Likely to Experience DHT-Related Hair Loss?
Hair loss due to DHT is primarily genetic, but some factors increase the risk:
- Family History (Genetics)
- High DHT Levels
- Sensitivity to DHT– Some people have more androgen receptors in their scalp, making their follicles more vulnerable.
- Age
- Hormonal Imbalance
Common Hair Loss Types That Are NOT Due to DHT
- Telogen Effluvium: Sudden hair shedding from stress, illness, or diet deficiencies.
- Alopecia Areata: Autoimmune hair loss that causes patchy bald spots.
- Scalp Infections: Fungal infections can cause localized bald spots.
- Traction Alopecia: Hair loss from excessive pulling (tight hairstyles).
FAQs
Does hair loss from DHT grow back?
Only in early stages. If follicles are dormant, treatments like Finasteride, Minoxidil, PRP, or transplants help. If follicles are dead, regrowth is impossible.
How do you fix DHT hair loss?
With DHT blockers (Finasteride, Dutasteride), Minoxidil, PRP therapy, microneedling, hair transplants, and natural DHT inhibitors like saw palmetto.
What causes high levels of DHT?
Genetics, high testosterone, overactive 5-alpha reductase enzyme, anabolic steroids, or hormonal imbalances.
How do I know if DHT is causing hair loss?
Receding hairline, crown thinning, hair miniaturization, oily scalp, family history, and high DHT in blood tests all confirm it.
Is blocking DHT bad?
It prevents hair loss but may cause low libido, erectile dysfunction, depression, brain fog, and muscle loss.
How can I increase DHT naturally?
Strength training, a high-protein diet, healthy fats, zinc, sunlight (Vitamin D), reducing stress, and avoiding DHT blockers can all boost DHT.
