Male pattern balding, also called androgenic alopecia, is one of the most common reasons that men lose hair as they get older.
Women can also experience this type of hair loss, but it’s much less common. About 30 million women in the United States have this type of hair loss compared to 50 million men.
Sex hormones in the body are believed to be the most significant underlying factor behind male pattern hair loss.
Dihydrotestosterone (DHT) is an androgen. An androgen is a sex hormone that contributes to the development of what are thought of as “male” sex characteristics, such as body hair. But it can also make you lose your hair faster and earlier.
There are treatments meant to slow the onset of male pattern baldness by specifically targeting DHT. Let’s discuss how DHT works, how DHT relates to your hair and to testosterone, and what you can do to stop, or at least delay, male pattern balding.
DHT is derived from testosterone. Testosterone is a hormone that’s present in both men and women. It and DHT are androgens, or hormones that contribute to male sex characteristics when you go through puberty. These traits include:
- a deep voice
- increased body hair and muscle mass
- growth of the penis, scrotum, and testicles as sperm production begins
- changes in how fat is stored around your body
As you get older, testosterone and DHT have many other benefits to your body, such as maintaining your overall muscle mass and promoting sexual health and fertility.
Men typically have more testosterone present in their bodies. About 10 percent of testosterone in all adults is converted to DHT with the help of an enzyme called 5-alpha reductase (5-AR).
Once it’s freely flowing through your bloodstream, DHT can then link to receptors on hair follicles in your scalp, causing them to shrink and become less capable of supporting a healthy head of hair.
And DHT’s potential to cause harm goes beyond your hair. Research has linked DHT, especially abnormally high levels of it, to:
- slow healing of skin after an injury
- enlarged prostate
- prostate cancer
- coronary heart disease
Having too little DHT
High levels of DHT can increase your risk for certain conditions, but having too little DHT can also cause problems in your sexual development as you go through puberty.
Low DHT may cause delays in the onset of puberty for all sexes. Otherwise, low DHT doesn’t appear to have much effect on women, but in men, low DHT may cause:
- late or incomplete development of sex organs, such as the penis or testes
- changes in body fat distribution, causing conditions such as gynecomastia
- increase in risk of developing aggressive prostate tumors
Why DHT affects people differently
Your proclivity to hair loss is genetic, meaning that it’s passed down in your family.
For example, if you’re male and your father experiences male pattern balding, it’s likely that you’ll show a similar balding pattern as you age. If you’re already inclined to male pattern baldness, the follicle-shrinking effect of DHT tends to be more pronounced.
The size and shape of your head may also contribute to how quickly DHT shrinks your follicles.
Hair everywhere on your body grows out of structures underneath your skin known as follicles, which are essentially tiny capsules that each contain a single strand of hair.
The hair within a follicle typically goes through a growth cycle that lasts about two to six years. Even if you shave or cut your hair, the same hair will grow back out of the follicle from the root of the hair contained within the follicle.
At the end of this cycle, the hair enters what’s known as a resting phase before finally falling out a few months later. Then, the follicle produces a new hair, and the cycle begins again.
High levels of androgens, including DHT, can shrink your hair follicles as well as shorten this cycle, causing hair to grow out looking thinner and more brittle, as well as fall out faster. DHT can also make it take longer for your follicles to grow new hairs once old hairs fall out.
Some people are more susceptible to these effects of DHT on scalp hair based on variations in their androgen receptor (AR) gene. Androgen receptors are proteins that allow hormones like testosterone and DHT to bind to them. This binding activity typically results in normal hormonal processes like body hair growth.
But variations in the AR gene can increase androgen receptivity in your scalp follicles, making you more likely to experience male pattern hair loss.
Testosterone is the most abundant and active androgen in the male body. It’s responsible for numerous sexual and physiological processes, including:
- regulating androgen hormone levels throughout the body
- regulating sperm production
- preserving bone density and muscle mass
- helping distribute fat throughout the body
- regulating your mood and emotions
DHT is an offshoot of testosterone. DHT also plays a role in some of the same sexual functions and physiological processes as testosterone, but it’s actually much stronger. DHT can bind to an androgen receptor longer, increasing the impact of testosterone production throughout your body.
There are plenty of medications for DHT-related hair loss, and many of them have been
- Blockers. These prevent DHT from binding to 5-AR receptors, including those in your hair follicles that can allow DHT to shrink follicles
- Inhibitors. These reduce your body’s production of DHT.
Finasteride (Proscar, Propecia) is an oral, prescription-only medication. It’s documented as having at least an 87 percent success rate in one
Finasteride binds to 5-AR proteins to block DHT from binding with them. This helps keep DHT from binding to receptors on your hair follicles and keeps them from shrinking.
Minoxidil (Rogaine) is known as a peripheral vasodilator. This means that it helps widen and loosen blood vessels so that blood can more easily pass through.
It’s typically used as a blood pressure medication. But minoxidil can also help promote hair growth when it’s applied topically to your scalp.
Biotin, or vitamin H, is a natural B vitamin that helps turn some of the food and liquids you consume into energy your body can use.
Biotin also helps boost and maintain levels of keratin, a type of protein present in your hair, nails, and skin. Research isn’t conclusive as to why biotin is important to your body’s keratin levels. But a 2015 study suggests that biotin can help hair regrow and keep existing hair from falling out.
You can take biotin as an oral supplement, but it’s also present in egg yolks, nuts, and whole grains.
Pygeum is an herb that’s extracted from the bark of the African cherry tree. It’s usually available as an herbal supplement taken orally.
It’s well known as a potentially beneficial treatment for an enlarged prostate and prostatitis due to its DHT-blocking ability. Because of this, it’s also thought to be a possible treatment for DHT-related hair loss, too. But there’s very little research to support pygeum bark’s use alone as a successful DHT blocker.
Pumpkin seed oil
Pumpkin seed oil is another DHT blocker that’s been shown to be successful.
Very little research exists on whether caffeine can promote hair growth. But a
- making hairs grow longer
- extending hair’s growth phase
- promoting keratin production
Vitamin B-12 and B-6
Deficiencies in B vitamins, especially B-6 or B-12, can cause a number of symptoms, including thinning hair or hair loss.
B vitamins are essential nutrients for your overall health, and while taking B-12 or B-6 supplements may not help restore lost hair, they can help make your hair thicker and healthier by improving blood flow to scalp follicles.
Some documented side effects of DHT blockers include:
- erectile dysfunction
- ejaculating too early or taking too long to ejaculate
- excess fat development and tenderness around the breast area
- feeling sick
- darkening and thickening of facial and upper body hair
- congestive heart failure from salt or water retention, especially possible with minoxidil
DHT isn’t the only reason you may be seeing your hair thinning or falling out. Here are a few other reasons you may be losing your hair.
Alopecia areata is an autoimmune condition in which your body attacks the hair follicles on your head and elsewhere in your body.
Though you may notice small patches of lost hair at first, this condition can eventually cause complete baldness on your head, eyebrows, facial hair, and body hair.
Lichen planus is another autoimmune condition that causes your body to attack your skin cells, including those on your scalp. This can lead to follicle damage that makes your hair fall out.
Conditions that cause your thyroid gland to produce too much (hyperthyroidism) or too little (hypothyroidism) of certain thyroid hormones that help control your metabolism can result in scalp hair loss.
Celiac disease is an autoimmune condition that causes digestive dysfunction in response to eating gluten, a protein commonly found in foods like bread, oats, and other grains. Hair loss is a symptom of this condition.
Various scalp conditions, especially fungal infections like tinea capitis —also called ringworm of the scalp — can make your scalp scaly and irritated, causing hair to fall out of infected follicles.
Bamboo hair happens when your individual hair strand surfaces look thin, knotty, and segmented, rather than smooth. It’s a common symptom of the condition known as Netherton syndrome, a genetic disorder that results in excessive skin shedding and irregular hair growth.
DHT is a well-known, major cause of male pattern hair loss linked to both your natural genetic predisposition to hair loss as well as natural processes in your body that cause you to lose hair as you age.
Plenty of hair loss treatments addressing DHT are available, and reducing hair loss may make you feel more confident about your appearance in your everyday life. But talk to a doctor first, as not all treatments may be safe or effective for you.