What is DHT & Its Role in Hair Loss?

Key Takeaways 

• DHT (dihydrotestosterone) is a hormone derived from testosterone and plays a central role in patterned hair loss.
• Hair loss occurs due to the genetic sensitivity of hair follicles, not simply high DHT levels.
• DHT causes follicular miniaturisation, leading to progressively thinner, shorter hairs over time.
• Both men and women can be affected by DHT-related hair loss, though hair loss patterns can differ.
• DHT-blocking treatments can slow or stabilise hair loss, but they work best when started early.

Hair transplant surgery restores lost density but does not stop ongoing DHT-driven thinning. 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 baldness’. 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. 

DHT is a hormone that influences hair follicle health, 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.

What is DHT? 

DHT (dihydrotestosterone) is an androgen (male sex hormone) that contributes to the development of male characteristics, including deepening of the voice, growth of body and facial hair, and muscle growth.

DHT is produced when testosterone is converted by the enzyme called 5-alpha reductase. This process occurs in several tissues, such as the prostate, skin, and hair follicles.¹

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 foetal development before birth and during puberty. 

Women also produce DHT, but in smaller amounts.² In a healthy hormonal balance, oestrogen can prevent the influence of androgens on women’s hair follicles. However, during hormonal changes such as menopause or PCOS, the protective effect of oestrogen is diminished, exposing follicles to DHT-induced hair thinning.²

DHT is responsible for hair growth in the beard, but conversely, in the scalp, it causes hair to thin in the hairline, temples and crown. This is the primary cause of hair loss in men and women, characterised by a condition known as androgenic alopecia, also called patterned hair loss.

^{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 menopause.

How Does DHT Cause Hair Loss?

In people who are genetically predisposed to hair loss, DHT binds strongly to androgen receptors within scalp hair follicles. Over time, this triggers a process called follicular miniaturisation, in which follicles gradually shrink over successive hair cycles until they eventually stop regrowing. 

Miniaturisation Explained:

• Shortened Anagen Phase: This phase typically lasts 2-6 years and can be shortened by DHT, which prevents the hair shaft from reaching its healthy length. 
• Increased shedding: The shedding (telogen) phase becomes relatively longer
• Thinner hair shafts over time: Each new hair grows thinner, shorter than the last

Eventually, the follicle may produce only very fine, barely visible hairs. 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 DHT-induced damage and tend to remain thick and full. This explains why hair transplants use donor hair from these resilient regions.

How to Reduce Your DHT Levels

To manage male pattern hair loss effectively, we usually consider two approaches: directly lowering DHT levels in the scalp or protecting the hair follicle from its effects.

While some DHT-blocking shampoos exist, clinical management typically relies on evidence-based medications that work to reduce the DHT level in your skin, thereby reducing its effect on thinning your hair. The medications are explained below;

1. 5-alpha Reductase Inhibitors (DHT Blockers)

These medications work by switching off the enzyme (5-alpha reductase) that converts testosterone into DHT.

• Finasteride: Available as an oral tablet or a topical solution, Finasteride is the most common treatment for male pattern hair loss. Reducing DHT levels in the scalp can stabilise hair loss and, in many cases, promote partial regrowth.⁵ Because it targets the underlying cause, consistent use is required to maintain results.
  
• Dutasteride: A more potent alternative, Dutasteride blocks two types of the 5-alpha reductase enzyme (Type I and Type II). It is generally reserved for patients who haven’t seen sufficient results with Finasteride or those with more aggressive hair loss.⁶

2. Growth Stimulants (Non-DHT Related)

It is important to distinguish DHT blockers from other popular treatments like Minoxidil.

While Minoxidil is highly effective at increasing blood flow to the follicle and extending the anagen (growth) phase, it does not change your DHT levels.⁷ Because it doesn’t address the hormonal root cause, Minoxidil is often most effective when used alongside a DHT blocker to provide a two-pronged approach to hair health.

You can read more about combining both treatments in our article on using Finasteride with Minoxidil.

It is important to stabilise existing hair loss before embarking on having a hair transplant. This ensures the native hair stays in place around the transplanted hair, giving patients a longer-lasting outcome. 

Dr Roshan Vara, Co-founder and Surgeon at The Treatment Rooms London

Side Effects of DHT Blockers

Most people tolerate DHT-blocking medications like finasteride and dutasteride well, but a small number do notice side effects.⁵ These can include:

• Lower sex drive
• Changes in erections or ejaculation
• Breast tenderness and swelling 
• Temporary increase in hair shedding when starting treatment
• Headaches and dizziness 

You can read more on DHT blockers and their side effects. For many patients, these effects often settle with time or with dose or formulation adjustments. If symptoms persist, stopping the medication usually leads to improvement, which is why these treatments should always be taken with medical guidance. 

How Does Lifestyle Affect DHT Levels?

While lifestyle adjustments are often promoted as natural cures, their role in blocking DHT is speculative. For a patient with a strong genetic predisposition, lifestyle changes are most effective when used alongside medical treatments like Finasteride and Minoxidil.

Diet

A balanced intake of proteins, omega-3 fatty acids, vitamins, and minerals all helps support the function of hair follicles. Avoiding a high-sugar diet may be beneficial, as evidence suggests that high sugar intake may worsen androgen imbalances.⁸

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.

When to Consider a Hair Transplant

DHT-blocking treatments focus on preservation, but medication cannot always reverse established thinning. When significant hair loss has already occurred, hair restoration surgery may be considered.

Because the hair on the back and sides of your head is resistant to DHT, these follicles remain healthy even when moved to the hairline or crown. However, surgery is most successful when the underlying DHT-related hair loss is stabilised first.

Seeking Professional Advice About DHT and Hair Loss

Early intervention matters. While DHT-related hair loss is progressive, timely treatment can often slow or stabilise thinning before follicles are permanently lost.

We recommend consulting your GP or a qualified dermatologist to rule out other causes of hair loss. Once your hair loss has stabilised, often through the use of the treatments mentioned above, a surgical solution may be the next step to restore density.

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 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. You can read more about taking finasteride at a reduced dose here.

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 options 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 hair. 

They will be able to carry out 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. 

References

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2. Hemalatha A, Pavithra P, Nirmala E, Jayaraman Rajangam. Influential Effects of Dihydrotestosterone (DHT) in Women’s Health. Int J Pharm Pharm Res. 2023;27(4):173–88.

3. Asfour L, Cranwell W, Sinclair R. Male Androgenetic Alopecia. [Updated 2023 Jan 25]. In: Feingold KR, Ahmed SF, Anawalt B, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK278957/

4. Chaikittisilpa, S., Rattanasirisin, N., Panchaprateep, R., Orprayoon, N., Phutrakul, P., Suwan, A., & Jaisamrarn, U. (2022). Prevalence of female pattern hair loss in postmenopausal women: A cross-sectional study. Menopause, 29(4), 415-420.

5. Zito PM, Bistas KG, Patel P, et al. Finasteride. [Updated 2024 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513329/

6. Al-Horani RA, Patel P. Dutasteride. [Updated 2024 Mar 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK603726/

7. Suchonwanit, P., Thammarucha, S., & Leerunyakul, K. (2019). Minoxidil and its use in hair disorders: a review. Drug design, development and therapy, 13, 2777–2786. https://doi.org/10.2147/DDDT.S214907 https://emedicine.medscape.com/article/1070167-overview

8. Volk, K. M., Pogrebna, V. V., Roberts, J. A., Zachry, J. E., Blythe, S. N., & Toporikova, N. (2017). High-Fat, High-Sugar Diet Disrupts the Preovulatory Hormone Surge and Induces Cystic Ovaries in Cycling Female Rats. Journal of the Endocrine Society, 1(12), 1488–1505. https://doi.org/10.1210/js.2017-00305