- What is DHT?
- DHT and hair loss
- Testosterone vs DHT
- Treatment options to reduce DHT levels
- Side effects of DHT blockers
- Other hair loss casues
DHT is an androgen, a type of sex hormone that plays a significant role in the development of the most common type of hair loss.
Androgenic alopecia, otherwise known as male or female pattern baldness affects around half of men over 50 and women over 65.
But how does DHT trigger hair loss, and what treatments can slow (or stop) its effects?
We’ll answer these, and many other, important questions below.
DHT (short for dihydrotestosterone) begins as testosterone, a hormone found in male and female bodies. Around 10% of an adult’s testosterone is converted into DHT, due to the 5-alpha reductase (5-AR) enzyme.
Both DHT and testosterone are androgens: sex hormones responsible for the development of specific traits traditionally considered male. These include:
- Extra body hair
- Increased muscle mass
- Growth of the genitals (coinciding with sperm production)
- Deep voice
- Changes in fat distribution
DHT and testosterone perform various other functions as the body ages, such as managing fertility and muscle mass.
However, DHT can also attach to hair follicle receptors in the scalp as it courses through your blood. And, over time, those follicles will shrink and be unable to follow the usual hair growth cycle. That can lead to hair loss and eventual baldness.
But excessive DHT levels are also believed to cause other issues, such as prostate enlargement. Seeking treatment may offer greater benefits besides healthy hair growth.
While high DHT levels can raise the risk of an enlarged prostate, having too little DHT in your bloodstream can also trigger issues.
For example, it could delay the start of puberty in males and females, while the former may experience a wider range of problems with sexual development.
These include unusual changes in the way fat is distributed throughout the body, the potential development of gynecomastia (bigger male breasts), and delayed growth of the penis or testicles.
You may be more likely to experience hair loss if other members of your family do, as it’s a genetic condition.
DHT’s ability to shrink the follicles tends to be stronger in people with a family history of pattern baldness. If your mother or father has been affected by male pattern baldness, you might shed your hair in a similar way as you get older.
But your head’s shape and size could also affect how quickly DHT changes your follicles.
The follicles on your scalp and other areas of your body produce hair according to a four-stage hair growth cycle. This lasts between 2 and 6 years, on average.
Hairs continue to grow from the roots inside follicles again and again, no matter how short you cut it. The hair enters the resting (telogen) phase when the growth cycle reaches its end, but will fall out after a few months. The cycle begins again when the follicle forms a new strand.
As excessive DHT levels shrink hair follicles, the cycle shortens. New strands become consistently thinner, weaker, and more likely to shed faster than before. You’ll also notice that your scalp takes longer to produce new hairs.
Some people are more likely to experience hair loss from high DHT levels due to differences in the androgen receptor (AR) gene. These receptors enable testosterone and DHT to bind to them, which usually leads to natural hormonal processes (such as growing body hair).
However, AR gene variations can also make androgen receptivity in follicles on the scalp stronger. And that increases your likelihood of developing male pattern baldness.
In a man’s body, testosterone is the prominent androgen. It facilitates a range of natural developments, such as:
- Managing sperm production
- Ensuring balanced fat distribution
- Managing androgen hormone levels
- Balancing emotions and mood
- Maintaining muscle mass and bone strength
As DHT is derived from testosterone, it’s crucial to some of the same processes — but it’s far more powerful. That’s why DHT is capable of binding to androgen receptors for longer, enhancing the effect of the body’s testosterone production.
Various medications treat DHT-related hair loss by targeting both the production of DHT and its binding to androgen receptors.
Medications come in 2 forms:
DHT blockers are designed to stop DHT from adhering to receptors and prevent follicles from shrinking.
This type encourages your body to produce less DHT.
Here are some of the most common treatments for DHT-related hair loss:
This is a peripheral vasodilator: it promotes better circulation by increasing the width of blood vessels, facilitating clearer flow throughout the body.
While minoxidil is usually prescribed as a medication for blood pressure, it can aid hair growth when applied to the scalp. But the results will fade if you stop applying minoxidil, so it’s a long-term commitment.
As an oral treatment available by prescription only, finasteride prevents DHT from binding with androgen receptors by essentially shielding them. As a result, your hair follicles may be less likely to shrink and your hair growth cycle should remain normal.
Research found that finasteride achieved a success rate of more than 80%. However, as with minoxidil, you would need to keep taking the medication to maintain any hair growth.
This natural B vitamin converts a portion of the food and drink you consume into energy to fuel your body. It also increases keratin (an essential protein in the hair and skin) levels and keeps them stable.
While it’s not confirmed exactly what makes biotin so important to keratin levels, one study showed that it can encourage hair growth and reduce shedding rates. You can get biotin from various foods (e.g. nuts) or as an oral supplement.
Again, though, you would have to stay on top of your biotin intake to reduce your risk of hair loss.
Pumpkin seed oil
Research has also shown that pumpkin seed oil can be an effective DHT blocker, driving 40% growth in the number of hairs on test subjects’ heads during the two-month study.
You can take pygeum bark as an oral supplement.
This herb, derived from a cherry tree native to Africa, can block DHT. At present, though, there’s little research to confirm that pygeum bark could encourage hair growth and reduce shedding by itself.
B vitamins are crucial for the production of red blood cells, which transport oxygen to the scalp and stimulate hair growth. That’s why people with a B vitamin deficiency may experience hair loss.
Taking vitamins B-12 and B-6 can help to improve circulation, and may lead to hair becoming thicker over time (even if it might not enable hair to regrow after falling out).
Caffeine is believed to aid hair growth, though credible research is still hard to find.
However, one study revealed that caffeine shampoo may help to fight hair loss by increasing the length of strands, stimulating keratin production, and boosting the duration of the growth phase in the hair growth cycle.
You may experience some of the following side effects if you try DHT blockers:
- Development of extra chest/breast fat
- Erectile dysfunction (ED)
- Premature or delayed ejaculation
- Hair on the face and upper body may become darker and denser
- Rash formation
- Possible heart problems due to retaining water or salt (a possibility with minoxidil)
- Nausea and vomiting
With these possible effects in mind, think carefully and seek medical advice before trying DHT blockers.
You may start to shed hair for other reasons beyond DHT. Common triggers include:
A number of thyroid gland conditions can contribute to shedding. Glands may produce too much or too little of specific thyroid hormones involved in metabolism regulation. And that can contribute to hair loss.
Alopecia areata is an autoimmune condition causes the body to attack hair follicles on the scalp and other areas. It initially manifests as hair loss in isolated patches, before progressing to full baldness (possibly across the entire body).
Another autoimmune condition, celiac disease triggers digestive problems connected to gluten (a common protein in bread and grains). Hair loss is just one possible symptom.
This oddly named genetic disorder causes individual hairs to appear segmented and thinner than usual, instead of smooth and healthy. Hair growth may become irregular, and affected people typically shed far more skin than others.
This autoimmune condition causes the body to target skin cells across the body, including on the scalp, which can trigger follicle damage and hair loss.
Fungal infections, such as tinea capitis, can make the scalp irritated and scaly. Infected follicles will be unable to produce hair as they should, and thinning or baldness may occur.
DHT is a common cause of hair loss, specifically male pattern baldness, though treatments are available.
A hair transplant may be able to restore your hair with natural, lasting results. A hair restoration specialist will discuss your hair loss, examine your scalp, and help you find the ideal treatment.
You may be advised to take medication to regulate your DHT production and reduce the risk of further hair loss after a procedure. But always speak to your doctor before you try any new form of treatment.
DHT blockers can cause a number of side effects, such as erectile dysfunction and ejaculating earlier or later than usual. Patients may also develop excess fat or tenderness in or around the breasts.
Yes, DHT blockers are an effective way to treat hair loss. The American Academy of Dermatology (AAD) discovered that finasteride can block DHT effectively, helping to prevent future hair loss and encourage new growth.
Can blocking DHT lead hair to grow back? The main advantage of using DHT blockers is slowing or actually stopping hair loss. It’s often regarded as the most effective hair loss solution as it fights one of the biggest causes of baldness. But DHT blockers don’t encourage new hair to grow directly.
Finasteride, an oral medication, is the most powerful way to stop DHT. This cuts the amount of DHT produced by the body without eliminating it completely. In some shampoos formulated to block DHT, an antifungal agent — ketoconazole — is the active ingredient.