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DHT and hair loss

DHT and hair loss. What is DHT? How is DHT made? And how does DHT cause hair loss? If you want to know the answers, read on.

In this article, we delve into the science behind DHT and hair loss, Learn what this enzyme is, what it does and how it can alter your hair health.

Any research article, blog post or clinical study on the topic of hair loss should cover the connection between DHT and hair loss.

, is a type of hormone produced within the body. In males, DHT plays a role in the development of secondary sex characteristics in the womb and during puberty. After puberty, however, elevated DHT can lead to medical conditions including hair loss (

The hormone testosterone is the starting point of the chemical reaction that yields DHT.

 (5-AR) is needed to produce DHT. It facilitates the chemical reaction which yields DHT from testosterone.

Testosterone binds to the 5-AR enzyme at a particular location called the active site. The molecule is reduced, which means that it gains hydrogen (H) atoms — 2 to be exact. The new molecule is DHT.

The chemical formula for testosterone is 

The chemical formula for dihydrotestosterone is 


DHT and hair loss: How does it cause hair loss?

While DHT and testosterone are quite similar structurally, DHT’s additional hydrogen atoms make it a more potent androgen. This means that DHT is more likely to bind to androgen receptors. Among other sites throughout the body, androgen receptors can be found within hair follicles rooted in your scalp.

Normally, only about 10% of testosterone in circulation is converted into DHT (

). This specific rate of conversion helps to ensure that despite its higher binding affinity, the amount of DHT remains proportionally lower to the amount of testosterone in circulation.

So how does DHT cause hair loss? The concentration of DHT within the scalp can increase for a variety of reasons (

). This increases the likelihood of DHT binding to androgen receptors within the scalp.

When DHT becomes attached to androgen receptors within hair follicles, it can stunt hair growth and signal premature termination of the hair growth cycle. The effects of DHT on your locks can range from mild thinning or slight loss of volume to more noticeable hair loss over time. Individuals with a genetic predisposition to this type of hair loss are more sensitive to fluctuations in DHT within the scalp.

What is the role of genetics in DHT and hair loss?

Your genetic profile can greatly affect local rates of DHT synthesis throughout the body. Mutations in the genes 

 can affect the expression of 5-AR and consequently, the production of DHT throughout the body (

Does having too little or too much DHT impact hair loss?

Mutations of the SRD5A2 gene are particularly relevant to hair loss, as they largely impact 5-AR expression within the scalp skin. A genetic condition known as 

 results from a heritable mutation in the SRD5A2 gene that limits or prevents expression of a specific type of 5-alpha reductase — 5-AR II.

Excess 5-AR II activity can result from overexpression of the SRD5A2 gene. While you can inherit this type of genetic mutation from one of your parents, gene expression can also be influenced by 

 or external factors such as diet, stress, sleep and exercise. Increased 5-AR II enzyme activity in particular has been linked to hair loss in men.

DHT plays a role in female health and development, although the exact influence this hormone has is still being explored. It is thought to participate in hair growth, libido, reproductive health, body composition, mood regulation and more.

Fluctuations in DHT can negatively impact health and wellbeing in females. Elevated DHT in females are tied to 

 (PCOS) and hair loss, while lower DHT levels could lead to decreased libido or fertility issues.

We know that DHT can be bad news for your hair. Here's what you can do about DHT and hair loss. 

 to confirm that DHT is at the root of your hair loss. They can help you select a treatment to prevent further hair loss and even grow your back some of your hair. 

Medications like finasteride and dutasteride work by interfering with the production of DHT by the body. Over time, they reduce the amount of DHT at the scalp and combat the hormone's negative impact on hair health.

If you are concerned about side effects associated with these medications, precision 

 formulations may be a better option for you. 

DHT is a hormone closely tied to pattern hair loss in men and in women. It is synthesized from testosterone by the 5-alpha reductase enzyme. A variety of factors including genetics and having too little or too much DHT can impact overall health, hair quality, sexual development and sexual function in both men and women.

Hormones and hair loss: Hypothyroidism

It’s estimated that about 1 in every 300 men and women in the United States suffers from hypothyroidism (

). Hypothyroidism occurs when the body does not produce enough of the thyroid hormones, T3 and T4. Thyroid hormone imbalances have been linked to hair loss.

In this article, we discuss how thyroid hormones work, why they’re important and also address how and thyroid dysfunction and hair loss can look and what to do if you think you might have hair loss due to hypothyroidism.

There are two thyroid hormones: tetraiodothyronine (T4) and triiodothyronine (T3). These hormones help control metabolism and cell growth by increasing energy and enzyme production, as well as activating genes that play a role in cell maturation.

Thyroid hormones are made by a specialized organ called the thyroid gland, which is located in front of the neck. Cells located within the gland called follicular cells are actually responsible for producing T3 and T4.

Sometimes, problems arise within the negative feedback mechanism. When blood levels of thyroid hormone levels remain consistently low, a condition called hypothyroidism can result. There are different subtypes of hypothyroidism that are based on specific causes. You may have heard of a subtype called autoimmune hypothyroidism. This occurs when the body’s immune system attacks the thyroid gland and destroys follicular cells.

Yes, some men and women suffering from a thyroid hormone imbalance may experience hair loss, in addition to other changes that could include altered hair texture and appearance.

This is because thyroid hormones play a critical role in regulating the growth and division of cells that make up the hair follicle, which includes protein and pigment-containing (hair colour) cells that eventually comprise the hair shaft (

 of the hair follicle are extremely sensitive to changes in hormone levels. These cells are involved in coordinating the hair growth cycle. The surfaces of these cells possess receptors that respond specifically to thyroid hormones (

Changes to the appearance of your hair can be unsettling, regardless of the cause. But there are some key differences between 

 and thyroid-related hair loss.

Unlike male pattern hair loss which is characterized by thinning along the hairline and on top of the head, hair loss associated with hypothyroidism tends to be more widespread and may not necessarily be restricted to the scalp (e.g. thinning eyebrows). Some individuals with thyroid-related hair loss may also notice changes in hair texture such as increased hair brittleness.

Here are some points you may wish to discuss with a physician when trying to determine the cause of your hair loss.

What other symptoms (if any) are you experiencing?

Where is the hair loss occurring? Does it only affect the scalp?

Do you have a family history of male pattern hair loss or autoimmune disorders?

Was the onset of hair loss sudden (within 2-3 months) or more gradual (over several months or years)?

Can thyroid hormone hair loss be treated?

Fortunately, in most causes thyroid-related hair loss is temporary and reversible. If a physician determines that hypothyroidism is the cause of your hair loss, finasteride and other hair growth agents may not be necessary, or even appropriate to treat your thinning hair. Finasteride is only effective in treating androgenetic hair loss.

Instead, a physician may recommend treatment with thyroid supplements that can help restore thyroid hormone levels and prevent additional shedding. During the treatment period, it’s important that TSH levels are closely monitored by a medical professional, since abnormally high levels of thyroid hormones can also trigger hair loss (

Hormones are essential to growth and development in general, but can also have a dramatic effect on hair. In the case of thyroid hormone abnormalities, early identification and treatment can help minimize the impact of hair loss on self-esteem, confidence and your relationships. If you are experiencing unusual hair loss, consider talking to a physician today.

Does working out cause hair loss?

Regular exercise is essential to maintaining optimal health. But does working out also cause hair loss? Fortunately, current research suggests that in most cases, the answer is no. In this article, we cover what happens to the body during exercise, whether these changes have an effect on hair and what role pre and post-workout nutrition might play.

What happens to the body during exercise?

During exercise, the body produces more testosterone and the stress hormone cortisol. Reactive oxygen species (ROS), which are metabolic byproducts, also increase in concentration. Let’s look at why.

To meet the body’s increased energy demands during physical activity, the body produces more cortisol. Cortisol helps break down proteins, sugars and fats and also regulates metabolism. Similarly, more testosterone is secreted to help break down carbohydrates and build muscle (

). ROS are produced as these energy sources are used up.

Specifically, cortisol levels increase in proportion to the type and intensity of exercise (

). There are factors like age that can affect what peak concentrations of these molecules are. However, the key thing to remember is that these quickly return to baseline (normal) levels after a workout.

Yes and no. We have to look at the type of hair loss. Exercise-related changes in cortisol and ROS concentrations are typically short-lived and occur at levels that can be managed by the body. While it’s true that cortisol and ROS can have detrimental effects on hair quality, these effects are typically associated with long term, continuous exposure.

Long-term elevations of cortisol and ROS can cause the breakdown of proteins and other building blocks of hair and skin (

). They can also disrupt the hair growth cycle itself. Rapidly growing cells are especially sensitive to these kinds of chemical changes, which can result in brittle and weak hairs that fall out prematurely.

In the case of 

, hormone levels usually peak several minutes into exercise and return to normal within 1-2 hours. Clinically, this type of testosterone spike does not have a significant effect on the development of a progressive hair loss disorder such as male pattern hair loss.

Lastly, regular workouts should be paired with regular shampooing. Oil, sweat, bacteria and skin buildup on the 

 can cause it to become irritated and inflamed over time and potentially promote the development of skin conditions like dandruff. The effects are not immediate, but prolonged inflammation can also be detrimental to hair growth.

Athletes turn to nutritional supplements to boost performance and recovery. But you may be wondering whether key ingredients in these supplements cause hair loss. The answer is probably not. Here’s why:

Pre-workout formulations can vary, but often contain a combination of these ingredients: caffeine, creatine, BCAAs (branched amino acids) and a nitric oxide precursor (

). They serve different purposes, from providing energy and increasing metabolism to building muscle and aiding blood flow.

One study has linked creatine use to elevated DHT levels (

). But you should be aware that the findings did not directly link creatine and hair loss. Additionally, the study involved giving participants loading doses of the supplement, which exposed them to much higher concentrations of creatine than what is normally ingested.

Remember, that just because DHT levels increase, it does not mean that hair growth is affected. As discussed above, your genetics affect how the body responds to hormones and changes in hormone levels. Also, there is some evidence to suggest that common pre-workout ingredients like 

 might actually be beneficial to hair growth (

).

If you’re following a balanced diet that meets the demands of your training and the recommended dosing of the supplement(s) of your choice, you probably don’t need to worry about any negative effects on hair. In some cases, dietary changes or 

nutritional deficiencies can trigger temporary shedding

. If this is a concern for you, we recommend speaking to a healthcare professional.

You can continue to workout without worrying too much about how it might impact your hair. While physical activity can trigger an increase in testosterone, this is temporary and is unlikely to have a significant impact on male pattern hair loss.

That being said, there are other types of hair loss. If you do experience shedding associated with exercise, you could be experiencing telogen effluvium, or short-term hair loss triggered by stress. Examples include a sudden increase in training intensity and/or duration, or changes to diet or the presence of nutritional deficiencies. If this sounds like you, you may want to consult with a healthcare professional to ensure that any underlying health issues are ruled out.

Scalp Health 101

The scalp is more than just a layer of skin on your head. It’s the foundation of great hair. In this article, we cover how to recognize a healthy scalp, why it’s important to take care of scalp skin and provide practical tips that you can implement today to start building great habits.

 consists of five layers of specialized tissues that protect the skull and brain from pathogens and physical trauma. From the outside in, these layers are the skin, connective tissue, aponeurosis (tissue connecting muscle to bone), loose areolar tissue (nutrient exchange and cushioning) and periosteum (the layer that directly covers bone). Compared to skin elsewhere on the body, the scalp contains a high number of terminal (mature) hairs and oil-producing glands (

).

Hair follicles located throughout the scalp give rise to hairs that insulate the head, protect it from the elements and play an important role in sexual signaling and appearance (

Experts agree that a healthy scalp is free from redness or excessive flakiness that could indicate infection or inflammation. It should also look hydrated, but not overly oily.

If you do notice redness, unusual bumps or lesions, flakiness or irritation, we recommend that you consult with a doctor to identify the cause of your symptoms. Dandruff, seborrheic dermatitis (a more severe form of dandruff) and psoriasis (scaly, red patches) are among some of the most common scalp problems. Fortunately, these are manageable with treatment.

There is a close relationship between scalp health and 

. Research has shown that growing hairs are impacted by the health of the scalp even before they emerge from the skin. In the early stages of development, hairs are especially sensitive to something called oxidative stress (

).

Oxidative stress results from the build-up of molecules called free radicals. They are natural by-products of metabolism, but are also created when microorganisms (e.g. bacteria and/or fungi) and certain autoimmune or skin conditions trigger an inflammatory response. Excessive sun exposure, pollution and smoking can also increase free radical levels in the skin.

Free radicals are extremely reactive and easily interact with biological building blocks, such as fats and proteins. These building blocks are critical to the normal development of hair and damage to these components can lead to suboptimal hair growth and quality. Additionally, the tissues that anchor hairs in place within the scalp may also be weakened. As a result, hair can feel coarser, be more prone to breakage and lose its sheen.

How to improve scalp health: 5 easy steps

Here are 5 basic principles of scalp care that you can integrate into your daily routine:

Research has shown that the growth potential of hair is influenced by the health and biochemical environment of the scalp. By keeping the scalp clean, hydrated and protected from environmental and chemical triggers and being mindful of nutrition and stress levels, you’re taking the right steps to ensure that your hair looks its absolute best.

The Hair Growth Cycle

The hair growth cycle describes the process through which the hair follicle produces a healthy hair. It involves three main stages: anagen (active growth), catagen (regression) and telogen (rest). In addition to these three main stages, some clinicians also refer to a fourth phase called exogen, which is when the existing hair is shed.

The entire hair growth cycle can last up to 10 years. Individual hairs spend a predetermined amount of time in each of these stages before they're shed to make room for new hairs. The length of each of these phases depends on a number of factors, including adequate nutrition and hormone levels (

). Certain medical conditions and medications can also affect the hair growth cycle.

What are the stages of the hair growth cycle?

There are three main stages of hair growth. The hair follicle cycles continuously through these stages.

The hair follicle and its role in the hair growth cycle

The hair follicle undergoes physical changes as it moves through the hair growth cycle. This mini organ can be broken up into two main parts that each passes through different 

. The upper region of the hair follicle crosses the epidermis (the uppermost layer of skin) and the lower region (the bulb) extends into the layer underneath it called the dermis.

The hair bulb contains rapidly dividing cells that eventually become part of the visible hair shaft. This is especially important during the anagen stage, when hairs grow at a rate of about half an inch per month. These cells and the hair follicle are kept alive by the dermis which contains a network of blood vessels.

What can go wrong with the hair growth cycle?

Disruptions to the hair growth cycle can lead to premature hair thinning and/or hair loss. There are a few hair loss disorders that are related to problems with the anagen and telogen stages of hair growth.

In some men, the binding of DHT to hormone receptors on dermal papilla cells located in the hair follicle can shorten the active growth phase and prolong the rest phase (

). When this affects a large number of hair follicles, the result is the characteristic thinning seen with male pattern hair loss (androgenetic alopecia).

Another abnormality of the anagen stage is a condition called anagen effluvium. This is a rare type of hair loss that affects hairs that are actively growing. These hairs are shed before they have a

chance to fully develop. This is most often observed in individuals diagnosed with alopecia areata (an autoimmune disorder) or those undergoing chemotherapy treatment.

When the telogen stage is affected, hair loss is referred to as telogen effluvium. This is most often cause by sudden changes to health or psychological stress. Stress causes hair follicles to enter the rest stage early and hairs are shed shortly after.

Each of these hair loss conditions is treated in a specific way. We recommend that you speak to your doctor if you notice any unusual changes in hair growth.

The hair growth cycle is a coordinated process that consists of three primary stages. It helps ensure the proper growth and development of mature hair strands and the continued production of new hairs. But it's a sensitive process that may be influenced by genetics, medical and environmental factors.

If you're noticing changes in hair growth or hair texture, you may want to speak to a doctor about possible underlying causes. In most cases, if hair growth issues are identified early and treated (if necessary), normal hair growth can resume.

What is the Hamilton-Norwood Scale?

Male pattern hair loss tends to occur in a predictable way. These patterns of shedding have been formalized in a clinical scale called the Norwood scale. Why is this important? It turns out that the staging of hair loss is an important part of determining the course of treatment.

Not sure if finasteride is right for you? A doctor can quickly determine whether you’ll have a good clinical result based on your Norwood score. Here, we provide a detailed overview of the scale, how it’s organized and why it can reveal information about the success rate of hair loss treatment.

The Norwood scale is a tool that was created to standardize the assessment of male pattern hair loss. The first version of the scale was developed by Dr. James Hamilton in 1951. The 1951 version of the scale featured eight types of baldness identified using roman numerals I through VIII.

Groups I-III described less severe cases of alopecia, while groups IV-VIII referred to more advanced stages of hair loss. Within these broader categories, a number of subtypes were also identified.

Two decades later, the scale was modified by Dr. O’Tor Norwood, a dermatologist and hair transplant surgeon. This revised scale was more detailed as a result of the addition of two formal subcategories.

These subcategories made it possible to classify hair loss that occurred only at the hairline or at the top of the head (

). Norwood also removed a “wildcard” category (Type III) which was previously used as a catch-all for any unusual balding patterns that did not fit conventional criteria for hair loss.

The Norwood scale is arranged in a grid-like system that combines three basic patterns of balding commonly associated with 

Bitemporal regression when hair on both sides of the forehead recedes in a symmetrical manner.

Vertex balding when balding occurs at the top of the head and spreads out radially.

Frontal balding when the entire hairline begins to shift backwards.

Over time, these patterns gradually merge together to result in the appearance of overall baldness. The Norwood scale captures seven possible combinations of these three balding patterns:

- little to no evidence of a receding hairline (essentially a normal scalp)

- the beginnings of hair loss at both temples

- considered the minimum amount of hair loss needed to clinically diagnose balding; bitemporal recession is quite noticeable (these regions may be bald or only sparsely covered)

- frontal balding and balding at the top of the head (crown) are now more severe; as a result of hair loss in these regions, the remaining band of hair in the mid-region of the scalp connecting hair on both sides of the head has become more prominent

- the band of hair separating the front of the head from the crown has narrowed; a sparse patch of hair between the temples may persist

- the band of hair that once separated the front of the head from the crown regions has now disappeared

- only a narrow strip of hair that wraps around the back of the head and sides remains, forming the classic “horseshoe” shape

There is room for variation within these seven main categories. If someone has a receding hairline (e.g. Types II-V) but no hair loss at the top of the head, this combination is referred to as a Type A variant (e.g. Type IIA, Type IIIA, etc.) (

). Meanwhile, if hair loss has occurred primarily at the top of the head, with or without hair loss at the temples, this specific combination is called Type III Vertex.

These variations bring the total number of different types of male pattern hair loss to twelve. While the scale is comprehensive, some researchers have commented that the level of detail could negatively impact the reproducibility of assessments using this tool (

). For this reason, newer classification systems are being developed with the aim of further simplifying the tool, without compromising accuracy or reliability.

Can the Norwood scale tell us if hair loss be reversed?

Yes, but timing is key. Research has shown that AGA is strongly associated with age. As a result, advanced hair loss (Hamilton-Norwood Type IV and above) is more frequently observed in older men. However, we also know that much younger men can suffer from hair loss and early intervention can help prevent, or even reverse it.

In 2015, a study explored the relationship between efficacy of once-daily finasteride treatment and the severity of AGA. Over 900 participants were enrolled, 801 of which were followed over a period of 5 years with regular photographic assessments.

The trial data revealed that the greatest improvement in hair regrowth was seen in individuals who started treatment earlier and specifically in men aged 40 or younger with a Hamilton-Norwood classification of Type IV or less (

If you have a family history of male pattern hair loss and have started to notice changes in your hair or scalp health, we recommend that you consider talking to a doctor about next steps. Once a medical professional has assessed the extent of your hair loss, he or she will be able to make the appropriate recommendations for treatment to ensure that thinning hair is stopped in its tracks.

Causes of Hair Loss

Sex steroid hormones drive the development of androgenetic alopecia (also known as male pattern hair loss). These hormonal effects are largely influenced by genetics. However, there are many other reasons why your hair may be falling out.

Causes of hair loss include:

Abnormal levels of non-sex steroid hormones

Certain medical conditions or medications

In this article, we discuss these four factors, as well as the hair loss disorders they might trigger in greater detail. Since these conditions are all treated differently, it’s important to discuss any unusual shedding with a physician.

Dihydrotestosterone (DHT) is recognized as a primary cause of male pattern hair loss. DHT acts on the dermal papilla, the region of the hair follicle that controls the production of androgen (male sex steroid) receptors and the 5-alpha reductase enzyme. This increased hormonal activity triggers follicular miniaturization and eventually, hair loss.

In some men, normal levels of androgens are sufficient to trigger hair loss (Cranwell & Sinclair, 2016). This suggests that factors other than androgens may play a role. In fact, researchers have identified other hormones and hormone-like molecules that can affect the dermal papilla and cause changes in hair growth.

Examples of these molecules include: melatonin and thyroid hormones (Heilmann-Heimbach et al., 2020). Each of these molecules has the potential to bind to dermal papilla cells in the hair follicle and trigger biochemical changes. These changes can go on to impact cell growth and metabolism within the hair follicle and surrounding tissues.

Possibly. We know that vitamins and minerals are important facilitators of the growth of hair follicles, but exactly which ones do and what their optimal levels are, is still a matter of debate (Almohanna et al., 2018).

While most people don’t have dietary deficiencies serious enough to cause extensive loss of hair, there are two micronutrients that are worth paying attention to: Vitamin D and iron. Your diet should include the daily recommended amounts of these micronutrients.

What illnesses and medications cause hair loss?

Certain health conditions, medications and even major surgery can be causes of hair loss. Systemic, chronic and inflammatory illnesses such as lupus, inflammatory bowel disease and psoriasis may cause diffuse shedding (Harrison & Bergfeld, 2009). These health conditions are associated with increases in chemical signalers that can damage healthy tissues over time.

Additionally, many common medications, such as those prescribed to control blood pressure and mood disorders, may trigger hair loss as a side effect.

Drug-induced hair loss is typically noticeable within 12 weeks of starting a medication and continues as long as one remains on therapy (Harrison & Bergeld, 2009). If you suspect that medication may be causing your hair loss, you must consult a physician prior to making any changes.

Aside from inflammatory disorders, fungal or bacterial infections may also cause hair loss. The latter are often accompanied by scalp redness, sores, lesions or swollen glands and should be examined and treated by a physician (Phillips et al., 2017). One example is Tinea capitis, a common fungal infection that results in patchy bald spots that usually resolves with the help of an oral or topical antifungal.

Absolutely. Periods of stress are accompanied by increased secretion of corticotropin-releasing hormone (CRH) in the brain. CRH is a molecule that triggers inflammation, as well as the downstream production of the stress hormone, cortisol.

Inflammation is part of the immune response. It’s counterproductive to hair growth because it encourages hair follicles to move into the catagen (regression) phase of the hair growth cycle.

During the regression phase, the follicle stops producing the hair fibre and shrinks in preparation for the rest phase (Heilmann-Heimbach et al., 2020). Early regression has been linked to the production of shorter, weaker hairs. When this happens en masse, telogen effluvium, or sudden stress-related shedding, may occur.

In addition to this, high levels of stress hormones may interfere with cell signaling pathways and accelerate the breakdown of key structural components of skin, such as 

 (Thom, 2016). You could start noticing dryer, itchier skin or changes in hair texture as a result.

While androgens such as DHT are associated with premature shedding, it is important not to overlook other causes of hair loss. Based on the discussion above, it’s clear that not all hair loss requires pharmaceutical intervention.

In some cases, lifestyle adjustments can have positive effects on your hair and beyond. This is why it’s important to keep your physician up to date about any changes to your health, including increased shedding. This proactive approach can help ensure that any issues are promptly identified and treated if necessary.

Almohanna, H. M., Ahmed, A. A., Tsatalis, J. P., & Tosti, A. (2018, December 13). The role of vitamins and minerals in hair loss: a review. 

https://doi.org/10.1007/s13555-018-0278-6



Basile, L. M. (n.d.). Thyroid and hair loss: symptoms and remedies. 

https://www.endocrineweb.com/news/thyroid-diseases/thyroid-conditions-hair-loss-help



Cranwell, W., & Sinclair, R. (2016). Male androgenetic alopecia. 

https://www.ncbi.nlm.nih.gov/books/NBK278957/



Fischer, T. W., Slominski, A., Tobin, D. J., & Paus, R. (2007, October 25). Melatonin and the hair follicle. 

https://doi.org/10.1111/j.1600-079x.2007.00512.x



Fischer, T. W., Trüeb, R. M., Hänggi, G., Innocenti, M., & Elsner, P. (2012). Topical melatonin for treatment of androgenetic alopecia. 



Guo, E. L., & Katta, R. (2017, January 31). Diet and hair loss: effects of nutrient deficiency and supplement use. 

https://www.mayoclinic.org/diseases-conditions/hair-loss/symptoms-causes/syc-20372926



Harrison, S., & Bergfeld, W. (2009. June). Diffuse hair loss: its triggers and management. 



Heilmann-Heimbach, S., Hochfeld, L. M., Henne, S. K., & Nöthen, M. M. (2020, June 7). Hormonal regulation in male androgenetic alopecia - sex hormones and beyond: evidence from recent genetic studies. 



Heilmann-Heimbach, S., Hochfeld, L. M., Paus, R., & Nöthen, M. M. (2016, April 26). Hunting the genes in male‐pattern alopecia: how important are they, how close are we and what will they tell us? 



Katzer, T., Beck, R., & da Silva, C. (2019, August 10). Physiopathology and current treatments of androgenetic alopecia: going beyond androgens and anti-androgens. 



Miller, J. J. (n.d.). Anagen Effluvium. 

https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/anagen-effluvium/



Pahwa, R., Goyal, A., & Jialal, I. (2022). Chronic inflammation. 

http://www.ncbi.nlm.nih.gov/books/NBK493173/



Phillips, T. G., Slomiany, W. P., & Allison, R. (2017, September 15). Hair loss: common causes and treatment. 

https://www.aafp.org/pubs/afp/issues/2017/0915/p371.html



Rushton, D. H. (2002, August 20). Nutritional factors and hair loss. 

https://doi.org/10.1046/j.1365-2230.2002.01076.x



Selective serotonin reuptake inhibitors (SSRIs). (2019, September 17). 

https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825

https://dermnetnz.org/topics/telogen-effluvium/



Thom, E. (2016, August). Stress and the hair growth cycle: cortisol-induced hair growth disruption. 

https://jddonline.com/articles/stress-and-the-hair-growth-cycle-cortisol-induced-hair-growth-disruption-S1545961616P1001X/

https://www.hormone.org/your-health-and-hormones/glands-and-hormones-a-to-z/hormones/thyroid-hormones



van Beek, N., Bodó, E., Kromminga, A., Gáspár, E., Meyer, K., Zmijewski, M. A., Slominski, A., Wenzel, B. E., & Paus, R. (2008, November 01). Thyroid hormones directly alter human hair follicle functions: anagen prolongation and stimulation of both hair matrix keratinocyte proliferation and hair pigmentation. 

The Journal of Clinical Endocrinology & Metabolism

What is Androgenetic Alopecia?

Having great hair is an instant confidence boost. But for some, androgenetic alopecia (also known as male pattern baldness) can put a damper on things. It’s a common and progressive hair loss condition that can lead to drastic changes in the appearance of hair if left untreated.

In this article, we break down exactly what androgenetic alopecia is and the latest theories about what causes it.

Androgenetic alopecia (AGA) is a form of hereditary and hormonal hair loss that results in balding along the hairline, temples and at the top of the head. It's a progressive condition that can start anytime after puberty and affects approximately 50% of men by the age of 50, with a higher incidence among Caucasian men (

The specific hormone implicated in AGA is 

, which is related to testosterone. Together, testosterone and DHT belong to a class of hormones called androgens.

While DHT is present throughout the body and serves key functions in biological males, increased sensitivity of hair follicles to DHT can trigger the development of AGA in genetically predisposed individuals (Rossi et al., 2016). These genetic differences cause scalp tissues to respond to, produce and metabolize (break down) DHT differently.

A primary cause of male pattern hair loss is increased activity of DHT. When DHT attaches to its hormone receptor on hair follicles in the scalp, a process called follicular miniaturization is triggered.

AGA affects millions of people worldwide. It is a treatable condition and individuals usually respond well to therapy, provided hair loss is identified and treated early.

Being proactive about AGA is not just a matter of saving your hair. At XYON, we understand the potential impact of hair loss on all aspects of your life. If you know that you have a family history of balding or have started to notice thinning hair or unusual shedding, consider talking to a doctor to determine if treatment may be necessary.

Start a 

 today with an independent, board-certified dermatologist if you think you might be experiencing hair loss.

Follicular miniaturization and androgenetic alopecia


Follicular miniaturization is a gradual process that involves changes to the timing of the hair growth cycle and shrinking of the hair follicle. The causes of miniaturization are still being studied, but one theory is that the attachment of DHT triggers premature cell death (

). When the dermal papilla cells of the hair follicle are affected, the follicle may not regenerate properly.

Miniaturized hairs have a distinctive appearance. They are referred to as vellus hairs and are often shorter, finer and lighter in colour. In advanced AGA, hairs may become too fragile or short to break the surface of the scalp, leading to the appearance of bald spots (

).

Miniaturization can also progress to the point where hairs lose contact with the skin structures that hold them in place. When this occurs, hairs fall out leaving behind empty follicles (

). At this stage, follicles are said to be dormant and hair loss is very difficult, if not impossible to reverse. This is one of the reasons why timely and consistent treatment of AGA is so critical.



Microinflammation and androgenetic alopecia


In addition to hormones, researchers have also looked at other factors that may contribute to male pattern baldness. One proposed mechanism is microinflammation, or localized, long-term inflammation of the hair follicle.

Inflammation is one aspect of the body’s overall immune response and can be triggered by environmental, biological or physical factors such as:

Toxins produced by the overgrowth of bacteria naturally present on the scalp

Excessive sun exposure, which causes cells to produce metabolic byproducts that can cause damage to building blocks of cells, like fats, proteins and DNA (

These agents prompt the body to release molecules that coordinate an inflammatory response. Some of these molecules have been associated with premature cell death (apoptosis), leading some scientists to speculate that inflammation could play a role in follicular miniaturization.

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