What is DHT & Its Role in Hair Loss?

Hair loss is a common concern that millions, if not billions, of people experience at some point in their lives. Although there are numerous forms of hair loss, the most commonly diagnosed type in men is ‘androgenetic alopecia’ or ‘male pattern balding’.

According to studies, this condition affects up to 50% of men by the age of 50 and is caused by dihydrotestosterone (DHT), a sex hormone present in both men and women. 

This potent hormone can influence the health of hair follicles, especially in individuals who are genetically predisposed to male pattern hair loss.

In this article, we will dig deeper into the actions of DHT on hair and what you can do to prevent hair loss caused by this hormone.

Everything You Need to Know about DHT

DHT (dihydrotestosterone) is a sex hormone derived from testosterone. Testosterone gets converted into DHT by the enzyme 5-alpha reductase. In reality, only about 10% of circulating testosterone is converted to DHT. However, the effect of DHT remains potent, as it affects specific body parts, such as hair follicles, and plays a key role in development before birth and during puberty. 

 DHT has a range of physiological effects:

• Pubertal Development: DHT is indispensable for the formation of male genitalia and for deepening the voice during adolescence.
• Body Hair Growth: DHT encourages body and facial hair growth. Interestingly, despite encouraging growth elsewhere, it causes hair loss in the scalps of men with a genetic predisposition to male pattern baldness.

This table summarises some key statistics about hair loss in the UK:

Category	Statistics
Men with pattern hair loss	Approximately 6.5 million men in the UK are affected by male pattern hair loss at some point in their lives.
Women with pattern hair loss	8 million women in the UK experience female pattern hair loss.
Men with noticeable hair loss	Over 50% of men with hair loss have visible thinning or baldness by their early 50s5.
Women post-menopause with thinning hair.	After menopause, up to 50% of women may experience noticeable thinning after menopause6.

DHT’s Relationship to Hair Follicles

Individuals with male pattern hair loss have fair follicles that are oversensitive to DHT and become damaged by the hormone. In these cases, DHT triggers a process called “miniaturisation,” where follicles gradually shrink over consecutive hair cycles until eventually they stop growing back. 

Here’s what happens to the hair growth cycle:

1. Shortened Anagen Phase: This phase typically lasts 2-6 years on average and can be shortened when exposed to DHT, which prevents the hair shaft from achieving its healthy length. 
2. Thinner Hair Shafts: Over time, these shortened growth phases produce progressively thinner strands that aren’t achieving full thickness. 
3. Increased Shedding: Eventually, miniaturised follicles thin until negligible hair is produced, which gives the appearance of thinned hair and eventual baldness.

Not every follicle on the scalp reacts this way. As a general rule of thumb, the hair follicles on the back and sides of the scalp are more resistant to damage by DHT and tend to stay thick and full. This explains why hair transplants use donor hair from these resilient regions.

This table lets us see how DHT relates to testosterone and hair loss:

Measure	Effects of DHT
Conversion of testosterone to DHT	10% of total testosterone.
Affinity compared to testosterone	DHT is up to 2- 10x more potent when bound to androgen receptors that activate male characteristics.
Linked to prostate enlargement	A significant number of men over the age of 50 may experience benign prostate hypertrophy (BPH) associated with DHT.
Role in scalp hair miniaturisation	A significant factor in androgenetic alopecia (pattern hair loss).

Positive Effects of DHT

Many people view DHT as a villain when it comes to hair loss. However, this hormone still has some positive effects, including:

• Supports male genital development during foetal and pubertal stages⁴.
• Aids sexual health and libido as it binds to androgen receptors in specific tissues⁴.
• Regulates certain metabolic pathways in the body.
• It is thought to aid in maintaining healthy body composition and promoting muscle growth.

Adverse Effects of Elevated DHT

Now, let’s look at the adverse effects of elevated DHT levels:

• Scalp hair miniaturisation (due to androgenetic alopecia), which we already covered above.
• Increases the risk of Benign prostatic hyperplasia (BPH), or prostate enlargement.
• Excess DHT in females can lead to excessive body or facial hair growth.
• DHT can contribute to acne as it increases sebaceous gland activity¹¹.

Medications That Lower DHT

Certain medications can help lower DHT levels in the body, which effectively helps slow and stabilise hair loss caused by androgenetic alopecia. 

Finasteride

This drug can be found as a tablet or topical solution, and works to inhibit the conversion of testosterone to DHT by blocking the 5-alpha-reductase enzyme. Finasteride can slow hair loss in men, with the potential for partial regrowth in some individuals.

To maintain its benefits and prevent hair loss from resuming, Finasteride must be taken regularly to continue its effects and slow hair loss. 

Dutasteride

Dutasteride works similarly to finasteride; however, it is more potent due to its ability to block two types of 5-alpha reductase enzymes (Type I and Type II). This drug is mainly used in individuals resistant to finasteride or no longer experiencing lasting benefits from it. 

Minoxidil

Minoxidil is available as a tablet or topical solution and works to prolong the anagen phase, thereby improving blood flow and follicle health. This drug can be used safely in both men and women, with the topical form more commonly applied. 

Lifestyle and DHT

Although medications and topical solutions are considered first-line treatments, lifestyle measures can still influence DHT levels and hair health:

Diet

A balanced intake of proteins, omega-3 fatty acids, vitamins, and minerals all helps support the function of hair follicles. Some data suggests that a high-sugar diet may worsen androgen imbalances¹⁵.

Exercise

Frequent physical activity modulates hormonal health. But remember, moderation is key! There is growing evidence that highly intense exercise may elevate certain hormones in ways that could impact hair growth.

Stress Management

Chronic stress elevates cortisol, a hormone produced by the adrenal glands. High cortisol levels can disrupt the body’s processing of DHT, potentially exacerbating hair loss as a result.

To tackle hair loss most effectively, we recommend combining healthy lifestyle measures with evidence-based treatments for optimal results. 

DHT & Its Role in Hair Loss FAQs

1. Does high testosterone automatically mean elevated DHT?

Not necessarily. High testosterone does not always mean high DHT. The conversion rate of testosterone to DHT depends on 5-alpha reductase activity and genetic factors. Therefore, two individuals with similar testosterone levels can have significantly different DHT levels.

2. Why does DHT stimulate beard growth but reduce scalp hair?

The difference lies in how sensitive hair follicles are to DHT damage in some areas of the body. Facial hair follicles thrive under high DHT levels. On the other hand, scalp follicles in the frontal hairline, midscalp, and crown do not miniaturise when exposed to high DHT levels. 

3. Are there natural ways to lower DHT levels?

Some organic substances, such as saw palmetto, green tea extract, and rosemary oil, are believed to block DHT mildly. However, the results are still inconclusive. Additional natural ways to reduce hair loss include maintaining a healthy weight, limiting sugar intake, and managing stress to support balanced hormone levels.

4. How long does it take to see improvements with DHT-blocking medications?

In general, 3–6 months of consistent use with Finasteride or Dutasteride is required to notice a slowdown in hair loss. Regrowth may appear after 6–12 months.

5. Could DHT blockers affect libido or sexual function?

A small percentage of individuals who take finasteride/dutasteride report diminished libido or erectile difficulty. These side effects can be managed by reducing the medication dose, decreasing the frequency of administration (e.g., from daily to 2-3 times per week), or stopping the medication entirely. 

Conclusion

DHT is a potent sex hormone that significantly contributes to male and female pattern hair loss in individuals with a genetic predisposition. This hormone shrinks scalp follicles and abnormally accelerates the hair cycle, leading to weaker, smaller hair follicles and eventual hair loss.

However, the good news is that modern medicine provides multiple avenues for treatment. Some of these options include 5-alpha reductase inhibitors (e.g., finasteride/dutasteride), topical agents (e.g., minoxidil), and more permanent solutions, such as hair restoration surgery.

If you suspect that DHT-related hair loss is affecting you, the first step is to consult with a qualified healthcare professional to determine the exact cause of your thinning tresses. 

They will be able to conduct the necessary evaluations, recommend tailored treatments, and advise on supportive measures, ranging from lifestyle changes to medication use to surgical solutions. Embracing a well-rounded approach often yields the best outcomes in preserving, or even restoring, your luscious locks. 

Get in touch

Ready to elevate your hair restoration journey? Book a free consultation call with our London-based FUE hair transplant clinic. If you are based in Brighton, you can reach out to our FUE hair transplant clinic in Brighton; we also offer consultations for Oxford and Bristol.

References

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