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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
October 16, 2023
min read
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. Most treatments on the market, especially natural remedies and over-the-counter treatments, have limited scientific backing.

The most successful way is through prescribed medications, i.e. DHT blockers. DHT blockers work by inhibiting the conversion of testosterone into DHT. This, in turn, prevents the minimisation of hair follicles.

At Pilot, we offer both prevention and reversal programs for hair loss — more on that in a second.

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

Is hair loss from testosterone preventable?

While hair loss is not entirely avoidable — especially if you have a genetic history of hair loss — there are preventative steps you can take with clinically proven medications.

If you notice the early signs of hair loss and you want to stop it in its tracks, you may want to consider DHT-blocking medications.

Pilot's Keep Your Hair treatment is preventative for men in the early stages of losing their hair and it works to block the enzyme that converts testosterone into DHT, which should reduce hair loss.

This class of medication is called 5-alpha reductase inhibitors. The active ingredient stops your body from converting testosterone into the hormone that tells your follicles to give up.

Is hair loss from testosterone reversible?

Male pattern hair loss is treatable for many, with medications making it possible to regrow your hair. Pilot's Keep and Regrow Your Hair treatment plan aims to both stimulate hair growth and prevent further hair loss.

The medication contains active ingredients two active ingredients — one works to stop your body from converting testosterone into DHT, which is the hormone responsible for shrinking your hair follicles and resulting in subsequent hair loss.

The other active ingredient is an antihypertensive vasodilator. This works by increasing blood flow around the hair follicles, thus stimulating hair growth.

Simply take an online consultation and a local practitioner will prescribe the best treatment for you based on your individual hair loss experience. There's no need to book an appointment — our Australian practitioners can help you from the comfort of your own home.

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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