DHT and Hair Loss
This article was medically reviewed by Dr. Kuddusi Onay
Dihydrotestosterone (DHT) is an androgen hormone, a derivative of testosterone, that plays a pivotal role in the development of male characteristics. However, it also has a less favorable effect on hair follicles. DHT binds to receptors in the scalp and shrinks hair follicles, which eventually leads to hair thinning and loss.
How Is It Produced?
Dihydrotestosterone (DHT) is a hormone derived from testosterone through the action of an enzyme called 5-alpha-reductase. While testosterone is responsible for developing male characteristics such as muscle mass, a deeper voice, and facial hair, a portion of it is naturally converted into DHT in tissues like the prostate, skin, and hair follicles.
DHT plays a key role during puberty in:
Male sexual development
Growth of facial and body hair
Enlargement of the prostate
However, in adulthood, elevated sensitivity to DHT can negatively impact certain tissues — particularly hair follicles on the scalp.
How DHT Contributes to Hair Loss
The process starts when testosterone is converted into DHT by the enzyme 5-alpha-reductase. DHT then attaches to specific receptors in the hair follicles, particularly those located on the scalp. Over time, this leads to a phenomenon known as follicular miniaturization, where hair follicles progressively become smaller and the anagen phase of hair growth is shortened.
The Role of DHT in Baldness
Both male pattern baldness (androgenetic alopecia) and female pattern hair loss share a common biological mechanism: the miniaturisation of hair follicles under the influence of DHT.
In men, this typically begins with a receding hairline and thinning at the crown, sometimes progressing to near-complete baldness.
In women, hair loss is usually more diffuse, with a general reduction in density rather than distinct bald spots.
When DHT binds to receptors in scalp hair follicles:
Growth cycles shorten, producing progressively thinner and weaker hairs.
Anagen phase (growth stage) becomes shorter, while the resting phase lengthens.
Over time, follicles stop producing visible hairs altogether.
Why Some People Are More Sensitive to DHT
Not everyone with the same DHT levels experiences hair loss. This difference arises from genetic factors, particularly variations in the androgen receptor (AR) gene.
Certain gene variants increase the number or sensitivity of DHT receptors in the scalp.
A strong family history of baldness often predicts higher susceptibility.
Environmental factors such as stress or poor nutrition may accelerate the process but do not directly affect DHT sensitivity.
This explains why two people with similar hormone levels can have very different hair loss experiences.
DHT and Other Hormonal Interactions
While DHT is central, other hormonal factors can contribute to hair loss:
Cortisol, the stress hormone, may exacerbate shedding through inflammatory pathways.
Thyroid hormones influence metabolism and hair growth cycles; imbalances can worsen thinning.
In women, oestrogen provides some protection against follicle miniaturisation, explaining why hair loss often increases after menopause when oestrogen declines.
Measuring DHT Levels
Routine DHT testing is not always required because:
Hair loss severity does not always correlate with blood DHT levels.
Follicle sensitivity, rather than absolute hormone concentration, drives most cases of androgenetic alopecia.
However, testing may be recommended when:
Hair loss appears suddenly or severely.
Accompanied by other hormonal symptoms, such as infertility or metabolic changes.
Treatments That Target DHT and Hair Loss
Several treatments aim to reduce DHT levels or block its action on hair follicles:
Oral Medications
Finasteride: Inhibits 5-alpha-reductase, lowering DHT levels in the scalp and bloodstream.
Dutasteride: More potent, blocks both type I and type II forms of the enzyme.
Topical Treatments
Topical Finasteride offers localised DHT reduction with potentially fewer systemic side effects.
Minoxidil, while not affecting DHT directly, prolongs the growth phase and improves blood flow to follicles.
Advanced Treatments
Hair Transplant Surgery: DHT-resistant follicles from the back or sides of the scalp are transplanted to thinning areas.
Platelet-Rich Plasma (PRP) Therapy: Growth factors stimulate dormant follicles, improving thickness and density.
Myths About DHT
“High testosterone always causes baldness.”
Baldness depends on follicle sensitivity to DHT, not total testosterone levels.
“Lowering DHT stops all hair loss.”
Other factors like stress, nutrition, and ageing also contribute.
“Women are not affected by DHT.”
Women can experience DHT-related hair thinning, particularly after menopause.
FAQs
DHT, or Dihydrotestosterone, is a hormone derived from testosterone and is known to contribute to hair loss. It binds to receptors in hair follicles, especially in the scalp, leading to the shrinkage of these follicles which eventually causes the hair to thin and fall out.
While DHT-induced hair loss can be challenging to reverse, treatments like minoxidil and finasteride have been effective for many individuals. These treatments either increase blood flow to the follicles or decrease the production of DHT, helping to prevent further hair loss and potentially regrow some hair.
Yes, some natural remedies and lifestyle changes can help reduce DHT levels. These include foods rich in zinc, such as pumpkin seeds and spinach, which can inhibit the enzyme that converts testosterone to DHT. Herbal supplements like saw palmetto also show potential in reducing DHT levels.
DHT-related hair loss typically follows a pattern, which is often referred to as male pattern baldness or androgenetic alopecia. This includes receding hairline and thinning around the crown and temples. A dermatologist can perform tests and examine your hair loss pattern to confirm if it’s related to DHT.
No. Most men retain normal hormone balance and reproductive function after DHT-blocking treatments.
Typically 3–6 months for noticeable improvement, with continued use for sustained results.
Some herbal supplements claim DHT-blocking effects, but scientific evidence remains limited compared to medical treatments.