HOW DOES DHT IMPACT HAIR HEALTH AND HAIR LOSS
Hair loss is a common concern that affects billions of people worldwide. While there are various factors contributing to hair loss – one key player is a hormone called dihydrotestosterone or (DHT).
DHT is a potent sex hormone which is a derivative of testosterone. It’s produced within a variety of body tissues and when the enzyme 5-alpha-reductase acts on testosterone, converting it to DHT. This most potent of the male hormones is vital during embryonic life where it is involved in the sexual differentiation of organs. It also plays an important role during puberty when it impacts the development of secondary male sexual characteristics including facial hair growth and the deepening of the voice. Interestingly thereafter, though produced throughout life, it has no known beneficial impact. Its role in adulthood is largely confined to its negative effect on hair growth resulting in miniaturization and hair loss in genetically susceptible males and hypertrophy or overgrowth of the prostate gland which is associated with bladder emptying difficulty.
The process and impact of hair miniaturization caused by DHT is as follows:
- It first binds to androgen receptors: DHT finds its way to androgen receptors located on the follicles, which are small, sensitive structures within the skin that produce hair. This is the start of the hair miniaturization process.
- It shortens the Anagen (Growth) Phase: DHT causes the anagen phase of hair follicles to become shorter. This means that hair spends less time growing and more time in the resting and shedding phases.
- It causes thinning hair: As the anagen phase shortens, the individual hairs produced become thinner and weaker. Over time, overall hair density decreases, and visible thinning is present on the scalp.
- Follicles start shrinking: DHT leads to the shrinking of the actual hair follicles, making them less capable of producing new hair and healthy hair. Eventually, the hair follicles become dormant and cease producing hair altogether causing hair loss.
Interestingly, not all hair is affected equally by DHT which is great news for people struggling with hair loss. The hair on the back and sides of the head tends to be DHT resistant. This phenomenon is due to the genetic makeup of these hair follicles which are not sensitive to the hormone’s effects. This area is referred to as the safe donor zone where hair follicles can be harvested for hair transplant patients and moved to their balding and thinning areas in the process of surgical hair transplantation. When hair is transferred from this donor zone, it maintains its resistance to DHT and continues to grow!
In the treatment of male pattern or androgenetic hair loss, hair restoration specialists who treat hair loss do so by both trying to limit the process and by exploring curious patterns of genetic hair loss in men which spares the hair around the periphery.
These are the core components of treatment:
- DHT Blockers: DHT blockers are commonly prescribed to slow down or prevent further hair loss. These medications “block” the conversion of testosterone to DHT or reduce the hormone’s binding to hair follicles.
- Other Non-DHT active pharmaceuticals and laser light treatments that support the health of the hair follicle by other means.
- Hair Transplants Surgery: In cases of advanced hair loss, hair transplants may be recommended. This procedure involves harvesting DHT-resistant hair on the back and sides of the head and transplanting it into the areas of the scalp and face affected by hair loss.
So, what are DHT blockers? DHT blockers come in various forms and strengths, and they are not all equal in efficacy. The most common types of DHT blockers include:
- Finasteride: Sometimes referred to as the mainstream drug, Propecia, Finasteride is available as an oral medication that inhibits the action of the enzyme, 5-alpha-reductase, reducing the conversion of testosterone into DHT. It is FDA-approved to treat male pattern baldness also known as androgenetic alopecia. Finasteride is also available as a topical compound which is applied directly to the scalp. By reducing DHT levels, finasteride supports existing hair, and in some cases, stimulates the regrowth of miniaturized hair follicles. It is not typically recommended for women; however, it may be given consideration for some women who are post-menopausal.
- Dutasteride: Dutasteride is another oral medication that inhibits both Type I and Type II 5-alpha reductase enzymes. While dutasteride has been studied for its potential use in treating hair loss, it has not received FDA approval specifically for this purpose. It has been approved by the FDA for the treatment of benign prostatic hyperplasia (enlarged prostate) and is marketed under brand names like Avodart for this use. Despite its lack of FDA approval for hair loss, it may be prescribed for this purpose, particularly with patients for whom finasteride has not been effective.
- Ketoconazole Shampoos: Some shampoos containing ketoconazole may help reduce DHT on the scalp. While these shampoos are not nearly as potent as oral medications, they may serve as a complementary part of the hair loss management strategy and hair care routine.
- Natural DHT Blockers: Natural substances like saw palmetto and pumpkin seed oil are believed to have very mild DHT-blocking properties and may be found in a variety of shampoos and conditioners. While these may be good options for anyone who is not comfortable with medications, they do not have any proven track record for regrowing hair.
The results of using DHT blockers can vary from patient to patient. The response within an individual depends on several factors, including the extent of hair loss, the individual’s receptivity to the treatment, and the specific DHT blocker used. Most patients can expect to experience reduced hair shedding or a slowing of their hair loss which means they are keeping more of their native or natural hair as opposed to losing it. Hair thickness often increases. And in some cases, DHT blockers can stimulate hair regrowth. Some patients may experience significant regrowth while others may see a modest improvement. With hair loss, early intervention is key for optimal treatment outcomes and results. Consistent use of medical therapy is required to stabilize your hair loss and maintain hair health and growth.
DHT is a powerful hormone that must be monitored and kept in check if you have a genetic predisposition for androgenetic alopecia. While DHT blockers can slow down hair loss and promote hair regrowth in some cases, it’s important to consult with a Ziering physician who can develop a personalized treatment plan tailored to your specific needs and aesthetic goals.
Give your hair the help it needs to stop thinning and start thriving. Take the first step by scheduling a hair restoration consultation with Ziering Medical.