HORMONAL INFLUENCE ON HEREDITARY HAIR LOSS

DHT and hair loss

Dihydrotestosterone (DHT) is an androgen that is formed from testosterone. In people with hereditary sensitive hair follicles, DHT can contribute to follicular miniaturization and gradual pattern hair loss. Read how this process works and why the reaction differs per person and per scalp area.

Briefly summarized

DHT is produced from testosterone by the enzyme 5-alpha-reductase and occurs normally in both men and women.
DHT does not cause hair loss in everyone: hereditary sensitivity of hair follicles is the determining factor.
With sensitive hair follicles, the growth phase can become shorter, and each subsequent hair can grow finer and shorter.
The visible pattern often differs between men and women and usually develops gradually.
DHT is particularly relevant in androgenetic alopecia; other forms of hair loss may have a different mechanism.

DHT FORMATION

What is DHT and how is it produced?

Dihydrotestosterone, usually abbreviated as DHT, is an androgen hormone. The body produces DHT locally from testosterone with the help of the enzyme 5-alpha-reductase. This occurs, among other places, in the skin, hair follicles, and other tissues.

DHT binds more strongly to the androgen receptor than testosterone does. Nevertheless, DHT itself is neither abnormal nor harmful: it is part of the normal hormonal balance in both men and women. The response of individual tissues determines the effect of the hormone.

Read about 5-alpha-reductase

HEREDITARY PREDISPOSITION

Why do some hair follicles respond to DHT?

In androgenetic alopecia, certain hair follicles are genetically more sensitive to androgens. DHT can bind to androgen receptors in cells around the dermal papilla, the control centre at the base of the hair follicle. This changes growth signals that affect the activity of the hair follicle.

Not every hair follicle responds equally strongly. Hair follicles at the back and sides of the head are often less sensitive than those at the hairline, crown, or central part. As a result, pattern hair loss develops in characteristic areas, while other scalp hair may remain.

Illustration: Why do some hair follicles respond to DHT?

FOLLICULAR MINIATURIZATION

How can DHT change the hair cycle?

In genetically sensitive hair follicles, the anagen growth phase may gradually become shorter. As a result, the hair has less time to build up length and thickness. At the same time, the period between two growth phases may become relatively longer.

Over successive cycles, the hair follicle produces increasingly shorter and finer hairs. Thick terminal hairs are gradually replaced by miniaturized hairs. This process usually takes place over years and explains why the scalp may become increasingly visible without all the hair follicles disappearing immediately.

DIFFERENT PATTERNS

What does DHT-related hair loss look like?

In men, androgenetic alopecia often begins with receding temples, a changing hairline, or thinning at the crown. Over time, these areas may progress toward one another.

In women, the front hairline is more often preserved, while the central part widens and density on top of the head decreases. The pattern and rate vary greatly from person to person. The underlying cause cannot always be determined with certainty based solely on the visible pattern.

Illustration: What does DHT-related hair loss look like?

ASSESSMENT AND APPROACH

How is DHT-related hair loss assessed?

A doctor or dermatologist assesses the pattern and rate of thinning, family history, and possible other causes. Dermoscopy can reveal differences in hair shaft diameter and other signs of follicular miniaturisation. A blood DHT level is usually not sufficient to diagnose androgenetic alopecia.

When androgenetic alopecia is diagnosed, a doctor can discuss appropriate treatment options and their advantages and disadvantages. Some medical treatments affect the DHT pathway; others stimulate hair growth through a different mechanism. Food supplements do not lower DHT or treat androgenetic alopecia, but they may support the hair’s normal condition.

Read about saw palmetto and hair loss

Important to know

DHT is a normal hormone, and a higher DHT level does not automatically mean that someone will experience hair loss. It is primarily about the genetic sensitivity of specific hair follicles. Sudden diffuse shedding, sharply defined bald patches, redness, scaling, or pain do not necessarily align with DHT-related pattern hair loss and warrant professional assessment.

Questions about DHT and hair loss

DHT stands for dihydrotestosterone. It is an androgen produced from testosterone with the help of the enzyme 5-alpha-reductase. DHT normally occurs in men and women and has effects in various tissues.

No. Hair follicles with an inherited sensitivity to androgens in particular can respond to DHT with follicular miniaturisation. That is why the age of onset, pattern, and rate of hair thinning vary greatly from person to person.

Yes, androgens can also be involved in female androgenetic alopecia. The visible pattern often differs: women usually develop a wider central parting and diffuse thinning on top of the head, while the frontal hairline is more often preserved.

Usually not. A normal DHT level does not rule out androgenetic alopecia, and a higher level does not prove the diagnosis. The local sensitivity of hair follicles is more important. Diagnosis is based mainly on the pattern, medical history, and examination of the scalp.

No. The appropriate approach depends on the diagnosis, age, sex, health, expectations, and possible side effects. Always discuss medical treatments that affect the DHT pathway with a doctor. Food supplements are not DHT blockers.

Have gradual pattern-related thinning assessed when the hairline recedes, the crown becomes more visible, or the part widens. Rapid hair loss, bald patches, pain, redness, or flaking also require assessment because another cause may be involved.

FIND WHAT SUITS YOU

What support is suitable for hereditary hair thinning?

The TRIX Hair Check helps you better map out your pattern of hair loss and shows which TRIX Basic products may be suitable. The Hair Check does not provide a medical diagnosis.

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