What Is DHT and Why Does It Cause Hair Loss?

Observing myself through the mirror in the bathroom requires me to tilt my head in order to see how much more light hair falls on me now above there. Perhaps, you may notice that your brush had collected more hairs than usual, or perhaps there are some additional hairs on this side in comparison to last year.

If your hair gradually starts fading away and you are also looking for the solution of this then you must have come across the DHT while online searching on the Internet. Now the question arises what is DHT, What kind of biological substance is this and how can one hormone take away such a big layer of hair from my head?

This blog will help you in revealing why DHT affects only hair follicles on your head and what kinds of treatment methods can help with it.

What is Dihydrotestosterone (DHT)?

DHT is a type of androgen that contributes to the development of male characteristics like body hair development and muscle mass growth.

The Biological Significance

Approximately 10 percent of the unbound testosterone present in the body of the adult is converted to DHT. It happens with the help of an enzyme called 5-alpha reductase, also referred to as 5-Alpha reductase.

5-Alpha reductase can be compared with an assembly line worker that makes testosterone into something much stronger. 

However, DHT is about five times more effective in terms of androgens than regular testosterone levels.

Paradoxical Dual Function of DHT

DHT is not always harmful to people's health. DHT plays a crucial part in pregnancy and adolescence. This hormone helps in:

• Development of Male External Genitalia
• Face, pubic and body hair development
• Vocal cords deepening during adolescence

In the case of adults, DHT's refers to the cause of two conditions of men: benign prostatic hyperplasia (prostate gland enlargement) and hair loss.

Why DHT Causes Hair Loss?

When trying to find out why DHT makes you lose all your hairs, you need to look into their full life cycle of your hair. There are three phases in the life cycle of a normal hair, each lasting several years.

1. Anagen phase: --This is the growth phase of the hair's life cycle which lasts 2-6 years. About 85-90 percent of my hairs are in this phase at the moment.
2. Catagen phase:--The hair follicle separates from the blood vessels for about 2 weeks.
3. Telogen phase:--This is the rest/shedding phase which lasts several months after which new anagen hairs appear.

DHT influences those people who are susceptible to hair loss in the process of follicular miniaturization.

Mechanism of Action

These hair follicle genes are genetically sensitive and are supposed to work in a certain order because of the reason explained above.

DHT flows freely in our body until it gets to the scalp where it bonds strongly with the androgen receptor found on the dermal papilla, which simply is the lower layer of your skin where you find the root of your hairs.

1. This nutrient suffocation caused by inflammation results in the development of scar tissues. It means that there is less supply of energy and nutrients necessary for the process of growth of hairs.
2. Anagen phase process is halted by the hormones resulting in shortening its period of time. Instead of lasting for four years, the follicle may only last up to one month.
3. Then, the resting phase is longer than normal for this medical condition. The follicle takes a long time without growing.
4. As you go through several hair regrowths in short times, your hair follicles physically become smaller.
5. Terminal hairs that were thickly pigmented and abundant in a full head of hair begin to die. They turn into thin and short transparent vellus hair that people call peach fuzz.

Sensitivity vs. Hormone Levels

The association between the overall level of hormones and hair loss is one topic that people usually inquire about. Many people are under the impression that whenever hair loss occurs, it is because of some abnormality associated with the increased level of testosterone and DHT.

This is just a misconception. In fact, in terms of medical science, there are no abnormalities found through testing for pattern hair loss in people suffering from this problem; all have normal levels of hormones like testosterone and DHT in laboratory testing.

Hair fall doesn’t depend upon the overall level of this hormone; but instead it depends upon the individual susceptibility of the person such as:

Androgen Receptor Density:

Hair fall is dependent upon the number of androgen receptor cells that exist per inch along with the sensitivity level of these cells in the head region. 

In case if there are too many cells that are highly sensitive to DHT in my head region as per genes, even a small amount of DHT could trigger this process known as miniaturization. 

Otherwise, despite having high androgens throughout lifetime, you won't lose much hair density post-retirement period.

The Predictable Pattern:

The hair follicles on the forehead, temples, and vertex parts of the head have numerous androgens receptors because they are highly concentrated in those areas. 

However, hair follicle cells located at the side and back part of the head have different structural characteristics due to the fact that few of them are sensitive enough to react to the damaging signals sent by DHT.

This is what makes the advanced cases of male pattern baldness leave a horseshoe shaped patch of hair at their bases. 

This can also explain why hair transplantation works in the sense that doctors take hair follicles from people who do not suffer from this disease and implant them in other parts of the body in order to prevent genetic losses like DHT sensitivity.

How DHT Impacts Men vs. Women?

Despite the similarities of the two in terms of atomic structure, DHT exhibits different features for men and women due to the difference in their endocrine system.

Male Pattern Baldness (MPB):

Men experience a very localized aesthetic pattern in terms of the Norwood scale.

It always begins with an M-shaped recession in the temple areas, followed by thinning hair over time together with its peak and finally leading to bridging all out resulting in hair only remaining. 

Since men have more testosterone than women, the process of converting DHT is accelerated thus making the hair loss process easy to notice.

Female patterns of hair loss (FPHL):

Women are also producers of testosterone and DHT in much smaller amounts as compared to men. 

Conditions that affect hormonal balance include age-related changes such as reduced levels of reproductive hormones among women who have experienced menopause and polycystic ovarian syndrome (PCOS).

Instead of having an M-shaped recession in the temples, women experience diffuse thinning on their whole scalp region. 

The damage occurs according to the Ludwig Scale where the damage gets wider in the middle part of the head while not much on the upper portion of the scalp.

How to Fight Back Against DHT?

Hair fall resulting from DHT is a time-related issue. Once a hair follicle is fully miniaturized and has been dormant for several years, there is little chance of bringing it back to life due to scar tissue formation in its micro environment.

Clinical approach for protection against hair fall is either preventive/blockade of receptors. 

Clinical Pharmaceutical Interventions:

The oral and topical Finasteride is considered an absolute standard in modern medical treatment. 

1. Finasteride:

Finasteride is a FDA approved drug which acts as a selective 5-alpha reductase inhibitor. 

Chemically inhibiting the action of 5-Alpha Reductase enzyme decreases DHT concentration in the blood and on the scalp by approximately 70%. 

This action interrupts the miniaturization process allowing the hair follicle to regenerate.

2. Dutasteride:

Dutasteride is a powerful dual action 5-Alpha Reductase inhibitor. 

This drug is used for treating pattern baldness, and it is effective in inhibiting 5-Alpha Reductase type 1 and 2 enzymes, decreasing systemic DHT concentration by up to 98%. 

Dutasteride is highly effective, but it has a long half-life and moderate toxicity.

Natural and Supportive Alternatives:

There are also certain organic compounds that have a slight 5-alpha reductase inhibitor effect, which can be used together with other therapies and without drugs.

1. Saw Palmetto:

The extract of palmetto is a natural medicine for the treatment of infertility in men and prostate disorders as a mimic of finasteride but in smaller doses.

2. Pumpkin seeds:

The application of pumpkin seed oil can aid in avoiding any additional hair loss since it maintains healthy follicles.

3. Rosemary & Peppermint oil:

The Rosemary and peppermint oils are used for enhancing the blood circulation in small capillaries of hair follicles and preventing local scalp irritation.

Choosing a good shampoo:

However, an appropriate selection of shampoo affects how much oxygen there is available for hair follicles growth because they are blocked by DHT treatment.

1. Anti-hair fall shampoo clears away DHT heavy sebum buildup on your head.
2. The best shampoo for hair growth contains saw palmetto and caffeine which stimulates weak root hairs so they don't shed easily.
3. Tinfal anti-hair fall shampoo is the best shampoo for hair fall in order to strengthen the fragile hair strands by reducing daily breakage and shedding.

Conclusion

Pattern baldness is caused by the DHT hormone because it acts as an undesired chemical messenger and thus deprives the roots of their nutrition, causing hair follicles to reduce in size. 

Terminal hair that is strong and colored becomes weak vellus hair because of the lack of growth from the follicles.

Genetic hair loss has become less inevitable in recent years. This can be done through the use of inhibitors of 5-alpha reductase to reduce the levels of DHT.

Frequently Asked Questions

Q1. Is there any relationship between high DHT and increased testosterone levels and muscularity?

No. The fact is that hair loss occurs when an individual has genetic predisposition to DHT and not because of total levels of hormones in one’s body. Even normal or low testosterone levels may cause hair loss in highly sensitive scalp follicles to DHT.

Q2. Does physical activity or weight lift cause increased DHT that leads to hair loss?

Actually, intense physical exercises will not make you lose your hair. Intense physical exercises may cause a temporary increase in the levels of testosterone hormone, but this is completely normal. This will not affect you in terms of increased scalp DHT levels.

Q3. Are there any long term effects of consuming DHT blockers as medicine?

The side effects caused by systemic drugs are infrequent and transient. The oral administration of 5-alpha reductase inhibitors like finasteride is known to cause very few sexual side effects affecting only 1% to 2% of people who use it. Generally, these side effects tend to go away entirely when the drug therapy is stopped or when the medicine is changed to an ointment patch.