Hair loss is one of the most common concerns for both men and women. Whilst there are many possible causes, the hormone DHT, plays a central role in the most common form of hair loss; androgenetic alopecia. This is also known as male or female pattern hair loss and affects millions worldwide. In this article, we’ll explore what DHT is and how it affects follicles to cause hair loss in men and women. We’ll also review the treatments that can slow or reverse DHT-related thinning.
What is DHT?
DHT, or dihydrotestosterone, is a hormone produced when the enzyme 5-alpha reductase converts testosterone into a more potent form. It plays an important role during puberty by contributing to the development of body hair, facial hair and other secondary sexual characteristics in men. Women also produce DHT, although in smaller amounts. In women it has roles in body hair growth and sebum production. Whilst DHT is essential for normal development, its impact in adulthood can be problematic. In people with a genetic sensitivity, DHT binds strongly to receptors in hair follicles, especially those on the scalp. This results in some people developing androgenetic hair loss whilst others with similar DHT hormone levels do not.
How DHT Causes Hair Loss
Hair follicles constantly cycle between growth, rest and shedding. In those with a genetic predisposition, DHT disrupts this balance and gradually weakens the follicles. The result is slow but persistent thinning of the hair. The main stages of this hair loss are:
- Genetic sensitivity: Some people inherit follicles with receptors that bind strongly to DHT. This makes them more vulnerable to miniaturisation. This is why why androgenetic alopecia tends to run in families.
- Miniaturisation: Once DHT binds to a follicle, the growth phase shortens and the follicle shrinks. Hairs become finer and shorter until they are barely visible.
- Progressive thinning: Over time, repeated miniaturisation causes the follicle to stop producing hair altogether. This is why androgenetic alopecia tends to worsen if left untreated.
DHT Hair Loss in Men & Women
Pattern baldness is the most recognisable form of DHT-related hair loss. The most typical form is male pattern hair loss which often starts with a receding hairline at the temples or thinning on the crown. These areas may gradually expand until only hair on the back and sides of the scalp remains. The severity of male pattern hair loss commonly graded using the Norwood scale, which ranges from minor recession to advanced baldness. The speed and pattern of loss vary between individuals, but once it begins it usually continues unless treated. Early recognition is vital, as treatments are more effective before extensive follicle loss has occurred. Despite the name, this form of hair loss can also sometimes occur in women but it is much more common in men.
Although women have lower levels of DHT, female pattern hair loss is still common. It typically presents as a gradual widening of the hair parting and thinning across the crown. Unlike men, women rarely develop bald patches but instead notice a diffuse reduction in density. This type of hair loss often becomes more noticeable after menopause when hormone levels shift. It can also appear earlier in women with conditions such as polycystic ovary syndrome (PCOS). The Ludwig scale describes severity, from subtle thinning to extensive reduction in volume. As with men, early intervention offers the best chance of preserving density. Again, although more common in women, some men can also develop female pattern hair loss.
Who is Most at Risk?
DHT alone does not cause hair loss in everyone. The development of androgenetic alopecia depends on a combination of factors. The main risk factors for DHT hair loss include:
- Family history: A strong family history of pattern hair loss increases the likelihood of inheriting sensitive follicles.
- Hormonal changes: Pregnancy, menopause or medical conditions that affect hormone levels can trigger or worsen thinning.
- Underlying health issues: Conditions such as thyroid disease, anaemia and nutritional deficiencies can contribute to loss when follicles are already vulnerable.
- Medications: Certain drugs can disrupt hormone balance or the hair cycle and accelerate shedding.These include some blood pressure, thyroid and cancer medications.
Treatments for DHT-Related Hair Loss
There is no permanent cure for androgenetic alopecia, but several evidence-based treatments can slow progression. In some cases it is possible to restore hair density if you start early. The key treatments include:
- Oral DHT blockers: Finasteride is licensed in the UK for male pattern hair loss and reduces scalp DHT by blocking 5-alpha reductase. Whilst it is effective for many men it can cause some serious side effects including mood disorders and sexual dysfunction that can persist. It is also not suitable for women of childbearing age. Dutasteride is a stronger DHT blocker that can also help regrow hair but is not licensed for this in the UK. It is however prescribed off-label for hair loss usually for men or post-menopausal women. Both medicines are available by prescription-only.
- Topical DHT blockers: Compounded Finasteride or Dutasteride in the form of serums, foams or creams can reduce local DHT with fewer systemic effects as they’re applied directly to the scalp. These are prescription-only unlicensed treatments available through specialist clinics and compounding pharmacies.
- Minoxidil: Available over the counter in 2% and 5% strengths as a solution or foam. Oral Minoxidil, higher strengths or compounded treatments (e.g. with Tretinoin or Finasteride) are available by prescription-only. Minoxidil does not block DHT but prolongs the growth phase of follicles and supports thicker regrowth.
- Platelet-rich plasma (PRP): This procedure uses concentrated growth factors from your own blood to stimulate dormant follicles. PRP is often combined with other treatments such as topical DHT blockers for better outcomes.
- Low-level laser therapy (LLLT): At-home and in clinic devices use light energy to activate follicle cells. This can improve hair growth and density.
- Hair transplant surgery: This is often the last resort for treatment resistant or bald areas. Follicular unit extraction (FUE) or follicular unit transplantation (FUT) move healthy hair follicles from the back and sides of the scalp into thinning areas.
Supporting Hair and Scalp Health
Whilst genetics and hormones are the biggest drivers of DHT hair loss, lifestyle factors also affect hair health. Maintaining a balanced scalp environment can help slow thinning and optimise the results of treatment. To support hair growth, try to focus on:
- Nutrition: A diet rich in protein, iron, zinc and omega-3 fatty acids supports follicle function.
- Stress management: Regular exercise, mindfulness or therapy can reduce stress-related shedding.
- Scalp care: Avoid harsh chemical treatments and use gentle scalp nourishing shampoos, conditioners, oils and styling products.
- Early professional advice: Seek medical input at the first signs of hair thinning to investigate underlying causes. This will enable you to start the right treatment early on and ensure the best outcome.
DHT is central to male and female pattern hair loss. By shrinking follicles over time, it leads to progressive thinning in those who are genetically sensitive. Although there is no permanent cure, there are a number of treatments that can slow or even reverse hair loss. They key is to start early in order to preserve the hair follicles. If you’re experiencing ongoing or sudden hair loss, seek medical advise to ensure prompt diagnosis and correct treatment.
We believe in a personalised approach to hair care which is why we offer personalised topical hair loss and regrowth treatments through our online skin clinic. Our doctors create custom hair growth treatments using actives such as Minoxidil, Finasteride, Dutasteride, Spironolactone, Melatonin, Caffeine and Tretinoin where appropriate for each and every patient. Start your virtual consultation and begin your journey to great hair today.
