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Can testosterone cause baldness? Exploring DHT and hair loss

It could explain why as many as 1 in 2 men experience male pattern hair loss.

Written by
Rebecca Mitchell
Medically reviewed by
Last updated
April 29, 2024
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Can testosterone cause baldness? Exploring DHT and hair loss
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Hair loss, as with many things, can have a range of potential causes. Whether it be stress, certain medications, genetic predisposition or hormone fluctuations, men can experience hair thinning or hair loss at any time in their life.

But, it's also important to note the role testosterone can play — specifically, a branch of testosterone called dihydrotestosterone (DHT). This relationship with testosterone could explain why as many as 1 in 2 men experience male pattern hair loss over the age of 40 [1].

To find more out about the link between testosterone and baldness, and what you can do if hair loss is troubling you, keep reading.

What is testosterone?

Testosterone is the primary male sex hormone. It regulates a number of bodily functions in both men and women and plays a key role in development. During puberty, testosterone is key in the development of the penis and testes, as well as the growth of body hair, facial hair, muscle mass and body shape.

Sex hormones play an important role in sexual and reproductive function, particularly in regard to fertility, sperm generation, erectile function and libido [2].

What is DHT?

DHT is the abbreviated, common name for dihydrotestosterone. DHT is an androgen (male sex hormone). DHT is responsible for a number of male characteristics, but it is the most significant hormone when it comes to matters of the hair growth cycle [3].

Per your body's natural activity, the 5-alpha reductase enzyme converts regular testosterone to DHT. Overactivity in this process and increased levels of DHT can lead to thinning hair or male pattern baldness.

Male pattern baldness, also known as androgenetic alopecia, is thought to depend on your genetic response to DHT [4].

What is male pattern baldness, aka androgenetic alopecia?

Androgenetic alopecia — commonly referred to as male or female pattern baldness — is a naturally occurring type of hair loss. In men, thinning hair can begin at the front of the scalp, and then begin at the vertex — the top or crown of the head [8].

It is gradual and typically occurs after puberty (any hair loss occurring before puberty is more likely due to other causes) [8].

How does testosterone affect hair loss?

It is commonly agreed that male androgenetic alopecia is caused by a genetic response to excessive DHT.

Androgenetic alopecia, or androgenic alopecia, is the most common form of hair loss in men. It affects 30-50% of men by the age of 50 and as many as 1 in 2 men over the age of 40 [4][1].

The main cause of androgenetic alopecia is your genetic response to DHT [6]. DHT has been found in greater levels on scalps experiencing hair loss or hair thinning, leading some to believe it plays a role in this process [6].

Having said that, it is not the levels of DHT that cause hair loss necessarily. Instead, it is your predetermined genetic response that causes male pattern baldness [4][8].

In other words, the greater your androgen sensitivity the more hair loss is likely to occur [7].

Does high testosterone or low testosterone lead to hair loss?

Levels of testosterone and its relationship to androgenetic alopecia can be confusing. While high levels of DHT are observed on the scalps of those with male pattern baldness, the hormone level is not responsible for the hair loss itself.

Instead, it is your body's hormone receptors and the individual genetic response to androgens that are considered the cause of hair loss.

Does genetics cause hair loss?

Genetics is a major factor in hair loss in both men and women. Hair loss occurs when the hair follicles shrink, and for most, this happens increasingly over time.

Studies of both men and women have found hair loss relates to how our hair follicles are genetically programmed to respond. For example, androgenic alopecia is more likely if your hair follicles are more sensitive to DHT — a factor that is determined by genetics [4].

This genetic link is also why male pattern baldness is more common in some ethnic groups (e.g. caucasian men) than others (e.g. Chinese or Japanese men) [1]. Having said that, there is currently no genetic test that can predict whether an individual will experience male pattern hair loss [1].

Furthermore, myths that baldness is 'inherited' from your mother are not true, with both maternal and paternal genes playing a part [8].

Do bald men have higher testosterone?

No, bald men do not have higher testosterone levels, generally speaking. Free testosterone levels can vary between individuals with varying levels of hair growth.

Having said that, bald men do have higher levels of DHT — a type of testosterone that plays a significant role in hair growth cycles.

How can you treat hair loss caused by testosterone?

There are a few ways to treat or prevent hair loss.

At Pilot, we believe in treating each person with an individualised approach to their hair loss. When it comes to hair loss, there's no one-size-fits-all approach. You need the right treatments, in the right dosages, tailored just for you.

Our hair treatment plans have been developed by Dr. Russell Knudsen, a hair loss expert with over 35 years of experience. Using a combination of lifestyle changes and clinical-strength ingredients, which improve the delivery of vital nutrients to the follicles, while also blocking the hormone which impacts hair growth, we're happy to report that over 80% of our patients are able to retain their hair.

When it comes to hair loss, though, time is of the essence.

Other options for treating hair loss include hair transplant surgery and laser therapy as well as more temporary measures like hair pieces.

Other causes of hair loss

It is important to note that hair loss occurs for different reasons in different individuals. It can also be accelerated or exacerbated by various things.

When determining any approaches to hair loss treatment, your GP should also consider other causes, such as:

  • Autoimmune conditions;
  • Hormone imbalances;
  • Infection or other health issues (including conditions related to mental health);
  • Radiation or chemotherapy, and/or
  • Stress [1].
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