HomeBlogHair LossCauses of Hair LossWhat Is DHT and How It Affects Your Hair Follicles ?

What Is DHT and How It Affects Your Hair Follicles ?

Understanding the complex biological factors that contribute to hair health is crucial, especially when considering the pivotal role of dihydrotestosterone (DHT). As the enigmatic hormone often connected with hair loss, delving into “what is DHT” can uncover the intricacies behind its notorious reputation. This hormone, while natural and essential for certain bodily functions, has garnered significant attention for its impact on hair follicles, oftentimes leading to the sensitive issue of hair loss for many. 

Shedding light on DHT and its effects not only addresses a common concern but also empowers individuals with knowledge to navigate the often-misunderstood landscape of hair health with confidence and clarity.

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Understanding DHT and Its Role in the Body

Dihydrotestosterone (DHT) is a potent androgen hormone that plays a crucial role in the development of male characteristics and overall sexual development, particularly in individuals assigned male at birth (AMAB). As the most potent form among androgens, which also include dehydroepiandrosterone (DHEA), androstenedione, and testosterone, DHT distinguishes itself by its inability to convert into estrogen, marking it as a pure androgen.

Role in Sexual Development and Differentiation

During embryonic development, DHT is instrumental in the sexual differentiation of organs. It works alongside other hormones such as testosterone and anti-Mullerian hormone (AMH) to promote the development of male sexual characteristics while inhibiting female differentiation. This action is critical for the formation of male external genitalia, including the penis, scrotum, and prostate. The transformation of circulating fetal testosterone into DHT by the enzyme 5-alpha-reductase type 2 is essential for these developments.

Influence on Physical Characteristics

Throughout adolescence and into adulthood, DHT supports the growth of the prostate and sebaceous glands, and it is significantly involved in the expression of male secondary sexual characteristics such as facial, body, and pubic hair growth. The hormone’s high affinity to the androgen receptor, coupled with its slow dissociation rate and long half-life, make it significantly more potent than testosterone. This potency is evident as DHT binds to androgen receptors approximately twice as strongly as testosterone and dissociates about five times slower.

DHT and Health Conditions

Elevated levels of DHT are associated with several health conditions, including benign prostatic hyperplasia (BPH), prostate cancer, and androgenic alopecia, commonly known as male pattern hair loss. In the case of BPH, the prostate can produce large amounts of DHT, which stimulates prostate growth and can lead to urinary and sexual difficulties. Similarly, increased DHT activity in the prostate may contribute to the development of prostate cancer. In terms of hair health, DHT plays a significant role in androgenic alopecia by increasing the activity at hair follicles, leading to hair loss.

Metabolic Functions and Exercise

Recent studies have also highlighted DHT’s role in metabolic processes, such as fat and carbohydrate oxidation. This involvement suggests that DHT could influence energy metabolism, particularly during physical activities like endurance exercise. An increase in DHT concentration has been linked to enhanced beta-oxidation activity in fat tissues, which could affect overall energy utilization and endurance capacity.

Understanding the multifaceted role of DHT in the body provides a foundational knowledge that is crucial for addressing conditions associated with its levels. By acknowledging the hormone’s impact, individuals can better understand the biological underpinnings of various health issues and physiological developments, paving the way for targeted treatments and management strategies.

How DHT Affects Hair Follicles

Dihydrotestosterone (DHT) is a potent androgen hormone with a significant impact on hair follicles, particularly noted in conditions like androgenic alopecia, commonly known as male pattern hair loss. This section explores how DHT interacts with hair follicles and the resulting effects that can lead to hair loss.

Interaction of DHT with Hair Follicles

DHT binds to specific androgen receptors on hair follicles, particularly those located in the scalp. The binding of DHT to these receptors is a critical factor that influences the health and life cycle of hair follicles. Research indicates that individuals with a genetic predisposition to hair loss have follicles that exhibit increased sensitivity to DHT. This sensitivity is due to variations in the androgen receptor (AR) gene, which increases the follicle’s receptivity to androgens like DHT.

Mechanism of Follicular Miniaturization

Upon binding to the androgen receptors, DHT initiates a series of cellular events that lead to the miniaturization of hair follicles. This process involves the shrinking of the follicle, which adversely affects its ability to sustain normal hair growth. The miniaturization process is characterized by a reduction in the anagen phase, or growth phase, of the hair cycle, coupled with an accelerated transition to the telogen phase, or resting phase. Consequently, this leads to shorter, thinner, and more brittle hair strands.

Genetic and Hormonal Influences

The impact of DHT on hair follicles is also modulated by genetic factors. Individuals with a heightened genetic sensitivity to DHT will likely experience more pronounced hair follicle miniaturization. Additionally, the activity of the enzyme 5-alpha reductase, which converts testosterone into DHT, is found to increase in balding scalps. This increase in enzyme activity leads to higher local concentrations of DHT, exacerbating the effects on susceptible hair follicles.

Clinical Observations

Clinically, the effects of DHT on hair follicles manifest as patterned hair loss, typically observed on the top and frontal regions of the scalp. This patterned loss is a hallmark of androgenic alopecia, where the hairline recedes over time, and hair at the crown thins progressively. The increased number of DHT receptors and the higher levels of DHT in these scalp regions are critical factors contributing to this specific pattern of hair loss.

Understanding the role of DHT in hair follicle health and dysfunction is crucial for developing targeted treatments for hair loss. By addressing the underlying hormonal influences and genetic predispositions, medical professionals can better tailor interventions that mitigate the effects of DHT on the scalp.

The Hair Growth Cycle

The hair growth cycle consists of four distinct phases: Anagen, Catagen, Telogen, and Exogen. Each phase plays a crucial role in the health and longevity of hair.

Anagen Phase

The Anagen phase, often referred to as the growth phase, is the most prolonged and active period in the hair growth cycle. During this phase, cells in the root of the hair divide rapidly, contributing to new hair growth. This phase can last between two to seven years, and the duration of this phase determines the length of the hair. The longer the Anagen phase lasts, the longer the hair grows. The follicles are deeply embedded in the scalp, receiving a rich supply of nutrients necessary for hair growth.

Catagen Phase

Following the Anagen phase is the Catagen phase, a transitional stage that lasts about two to three weeks. In this phase, the hair follicle begins to shrink due to the disintegration of the lower part of the follicle. The hair is detached from its blood supply and from the cells that produce new hair. This phase signifies the end of the active growth of a hair.

Telogen Phase

The Telogen phase, known as the resting phase, typically lasts around three months. During this time, the hair follicle remains dormant, and no new hair grows. At any given time, about 9% to 15% of all hair on the scalp is in this phase. It’s a period of renewal for the hair follicle, as it prepares itself for the next Anagen phase.

Exogen Phase

Exogen represents the shedding phase of the hair cycle. It is essentially an extension of the Telogen phase where old hair is shed, and new hair continues to grow. Approximately 100 to 150 hairs can be shed daily, a normal part of the hair renewal process. This phase is crucial as it allows for the removal of old hair to make way for new growth.

Understanding these phases helps in recognizing the normal process of hair growth and shedding. It also sheds light on various hair disorders, such as telogen effluvium, where an increased number of hairs enter the Telogen phase and shed excessively. By comprehending the dynamics of the hair growth cycle, individuals can better understand the causes of hair loss and the functioning of treatments targeting the hair follicle’s growth phases.

Mechanism of DHT-Induced Hair Loss

Dihydrotestosterone (DHT) is a potent androgen hormone that plays a significant role in hair health, particularly affecting individuals with male pattern hair loss (MPHL) or androgenic alopecia (AGA). The mechanism of DHT-induced hair loss primarily involves the interaction of DHT with androgen receptors located on hair follicles, particularly those in the scalp. This section delves into the biological processes that lead to hair follicle miniaturization and subsequent hair loss due to DHT.

Interaction of DHT with Androgen Receptors

DHT binds to androgen receptors on hair follicles with a high affinity. This binding is more potent than that of testosterone, as DHT remains bound to these receptors longer and activates them more intensely. The increased activity of the androgen receptors due to DHT exposure leads to changes in the hair follicles that result in hair thinning and loss.

Follicular Miniaturization Process

The primary effect of DHT on hair follicles is their miniaturization. This process involves the gradual shrinking of the hair follicles, which reduces their ability to produce healthy, thick hair. 

Over time, the affected follicles produce finer, shorter hairs, and eventually, the growth may cease entirely. The miniaturization is influenced by an inherited sensitivity of the scalp hair follicles to normal levels of circulating androgens, particularly DHT.

Genetic Predisposition and Hormonal Influence

Individuals with a genetic predisposition to hair loss exhibit increased sensitivity to DHT. This sensitivity is due to variations in the androgen receptor gene, which enhances the follicle’s receptivity to DHT. Additionally, the enzyme 5-alpha reductase, which converts testosterone into DHT, shows increased activity in areas of the scalp prone to hair loss, further elevating local DHT levels and exacerbating hair follicle miniaturization.

The Role of Microinflammation

Recent theories suggest that microinflammation around the hair follicle bulge region in the scalp may also play a role in AGA. This microinflammation could be a response to cellular stress caused by high levels of DHT and other metabolic byproducts affecting the hair follicles. However, it is more likely indicative of the body’s response to changes in the follicular environment rather than a direct cause of hair loss.

Understanding the mechanism of DHT-induced hair loss is crucial for developing effective treatments. By targeting the hormonal interactions and genetic factors contributing to hair follicle sensitivity, medical professionals can better tailor interventions that may slow or reverse the effects of DHT on hair loss.

Factors Influencing DHT Levels

Genetics

Genetic factors play a significant role in determining dihydrotestosterone (DHT) levels in individuals. Genetic mutations affecting the production of the enzyme 5-alpha reductase can lead to variations in DHT levels. This enzyme is crucial for converting testosterone into DHT. A mutation can result in 5-alpha reductase deficiency, leading to significantly lower DHT levels.

 This condition is inherited in an autosomal recessive pattern and affects the sexual development of genetically male (XY chromosomes) fetuses. Such individuals may exhibit underdeveloped external genitalia, undescended functional testicles, and a small or absent prostate.

Furthermore, genetic predispositions influence the activity of androgen receptors in hair follicles, affecting how these receptors respond to DHT. Individuals with higher levels of 5-alpha reductase enzyme and androgen receptor activity in their hair follicles are more likely to experience conditions like androgenic alopecia.

Hormonal Changes

Hormonal fluctuations significantly impact DHT levels, particularly through the interactions within the hypothalamic-pituitary-gonadal (HPG) axis. For instance, during puberty, an increase in hypothalamic secretion of gonadotropin-releasing hormone (GnRH) stimulates the pituitary gland to release luteinizing hormone (LH), which in turn boosts testosterone production from the testes. This increase in systemic testosterone is closely associated with a significant conversion to DHT in its target tissues, promoting the development and maturation of male secondary sexual characteristics such as facial and pubic hair, and prostate growth.

Additionally, conditions like polycystic ovary syndrome (PCOS) and congenital adrenal hyperplasia show altered DHT biosynthesis pathways, which can lead to hyperandrogenic states. These conditions are characterized by an increase in the backdoor pathway biosynthesis of DHT, further influencing its levels in the body.

Life Stages

Different life stages are marked by distinct changes in DHT levels due to varying activity of the HPG axis. For example, the fetal development stage involves the transformation of circulating fetal testosterone into DHT by 5-alpha-reductase type 2, which is crucial for male sexual differentiation. This includes the development of the male external genitalia such as the penis, scrotum, and prostate.

In adult males, DHT plays a role in maintaining male characteristics and is involved in conditions such as benign prostatic hyperplasia (BPH) and prostate cancer, where the prostate exhibits increased 5-alpha-reductase activity, leading to higher local DHT production. This increase can stimulate prostate growth and contribute to the pathophysiology of these conditions.

Understanding these factors is crucial for managing conditions associated with abnormal DHT levels effectively, providing a pathway for targeted therapeutic interventions and better patient outcomes.

Symptoms of High DHT Levels in Hair Loss

Dihydrotestosterone (DHT) is a potent androgen hormone that plays a significant role in hair health, particularly affecting individuals with male pattern hair loss (MPHL) or androgenic alopecia (AGA). The symptoms of high DHT levels in hair loss are primarily observed through changes in the hair growth cycle and the physical appearance of hair.

Increased Hair Follicle Sensitivity and Miniaturization

High levels of DHT contribute to the shrinkage of hair follicles, which adversely affects their ability to sustain normal hair growth. This process, known as follicular miniaturization, results in hair that is thinner and weaker than normal. Over time, these affected hair follicles produce shorter, finer hairs, and eventually, hair growth may cease entirely. This symptom is particularly noticeable in the patterned hair loss seen in androgenic alopecia, where the hairline recedes and hair thins at the crown of the head.

Accelerated Hair Loss

Individuals experiencing high DHT levels may notice an accelerated rate of hair loss. This is due to DHT’s ability to shorten the hair growth cycle, particularly by reducing the duration of the anagen (growth) phase and extending the telogen (resting) phase. Consequently, hair falls out more quickly than it can be replaced, leading to overall thinning and noticeable balding areas.

Changes in Hair Texture and Quality

As DHT affects the hair follicles, the texture and quality of hair may change. Hair strands become brittle, finer, and may lack the robustness and shine of healthy hair. These changes are a direct result of the compromised health of hair follicles under the influence of high DHT levels.

Genetic Predisposition and Increased Androgen Receptor Activity

A significant symptom of high DHT levels is the genetic predisposition to hair loss, where individuals have hair follicles that exhibit increased sensitivity to androgens due to variations in the androgen receptor gene. This increased receptivity enhances the impact of DHT on these follicles, making such individuals more susceptible to experiencing severe hair loss.

Understanding these symptoms helps in early detection and management of conditions influenced by high DHT levels. With appropriate interventions, it is possible to mitigate the effects of DHT on hair health and maintain healthier hair growth.

Medications

The management of DHT-related hair loss often involves medications that target the hormonal pathways influencing hair growth. Two primary drugs have demonstrated efficacy and safety through extensive clinical use:

  1. Finasteride: This medication is a 5-alpha-reductase inhibitor, primarily prescribed to treat male pattern hair loss and benign prostatic hyperplasia (BPH). By inhibiting the enzyme 5-alpha-reductase, finasteride reduces the conversion of testosterone to DHT, thereby decreasing the amount of DHT in the body. It is taken orally and may take several months to show effects. Continued use is necessary to maintain benefits, and it is particularly effective in younger men under 60.
  2. Dutasteride: Similar to finasteride but more potent, dutasteride inhibits both type I and type II 5-alpha-reductase. This dual inhibition can be more effective in reducing DHT levels and is used for cases where finasteride might not provide sufficient results.
  3. Minoxidil: Available as an over-the-counter treatment in forms such as liquid, foam, and shampoo, minoxidil does not inhibit DHT directly. Instead, it enhances blood flow to hair follicles, potentially extending their growth phase and improving hair density. It requires consistent application, typically twice daily for men and once daily for women, to sustain hair growth.

Topical Treatments

In addition to oral medications, topical treatments play a crucial role in managing DHT-related hair loss:

  1. Topical Minoxidil: Often recommended for both male and female pattern hair loss, this formulation can be applied directly to the scalp. It helps in increasing the blood flow and extending the anagen phase of hair growth.
  2. Topical Finasteride: A newer option, combining finasteride with minoxidil, this topical solution reduces systemic side effects and directly targets hair follicles with a high concentration of active ingredients.
  3. Ketoconazole Shampoo: While primarily an antifungal agent, ketoconazole also exhibits properties that may reduce scalp DHT levels and inflammation, contributing to a healthier hair growth environment.

Natural Remedies

While clinical evidence varies, several natural remedies are popular for their potential DHT blocking properties:

  1. Saw Palmetto: A natural 5-alpha-reductase inhibitor, saw palmetto is often used in supplements and topical treatments to help reduce DHT levels.
  2. Pumpkin Seed Oil: Some studies suggest that pumpkin seed oil may inhibit DHT formation, making it a popular ingredient in natural hair health supplements.
  3. Green Tea: Rich in EGCG (epigallocatechin gallate), green tea is believed to help reduce DHT levels in the scalp when applied topically, promoting healthier hair follicles.

Each treatment option varies in its approach, efficacy, and suitability depending on individual cases of DHT-related hair loss. Patients should consult healthcare providers to tailor treatments based on their specific conditions and medical history, ensuring both safety and effectiveness in managing hair loss.

Preventing DHT-Induced Hair Loss

Preventing DHT-induced hair loss involves a multifaceted approach that targets the underlying hormonal factors contributing to hair follicle miniaturization. By understanding and addressing these factors, individuals can take proactive steps to maintain healthier hair growth and potentially delay the onset of hair loss associated with elevated DHT levels.

Dietary Adjustments

Incorporating specific foods into one’s diet can help reduce DHT levels naturally. Research suggests that foods rich in lycopene such as tomatoes, watermelons, and carrots, as well as those high in zinc like spinach and kale, can inhibit DHT production. Additionally, foods that contain phytosterols, such as nuts and seeds, may help block DHT from attaching to hair follicles. Regular consumption of green tea is also recommended due to its high levels of EGCG, a compound known to support hair growth by blocking DHT.

Herbal Supplements

Certain herbal supplements are known for their potential to reduce DHT levels. Saw palmetto, for instance, is widely recognized for its ability to inhibit the enzyme 5-alpha reductase, which converts testosterone into DHT. Similarly, extracts from the bark of the African cherry tree, known as Pygeum, have shown promise in managing DHT levels due to their DHT-blocking capabilities. While more research is needed, these herbal remedies are considered a natural approach to managing DHT-related hair loss.

Use of DHT Blocker Shampoos and Topical Solutions

Shampoos and topical solutions that contain DHT blockers can directly combat high DHT levels on the scalp. Ingredients such as ketoconazole, pumpkin seed oil, and other natural extracts are known to reduce the production of DHT and rejuvenate the scalp by improving blood circulation and cleansing blocked pores. Regular use of these products can help reduce hair follicle sensitivity to DHT and promote a healthier scalp environment.

Medications

Pharmaceutical interventions such as Finasteride and Dutasteride are effective in reducing DHT levels by inhibiting the 5-alpha reductase enzyme. These medications are typically prescribed for treating conditions like benign prostatic hyperplasia (BPH) and male pattern baldness. However, they should be used under medical supervision due to potential side effects.

Lifestyle Modifications

Adopting a healthy lifestyle can also influence DHT levels and overall hair health. Regular exercise, stress reduction techniques, and quitting smoking can help mitigate the hormonal imbalances that contribute to hair loss. Additionally, scalp massages and proper hair care routines improve blood flow to the scalp, enhancing the delivery of nutrients necessary for hair growth.

By integrating these strategies into daily routines, individuals can effectively manage DHT levels and minimize their impact on hair health. While genetic factors play a significant role in how one’s body responds to DHT, these preventative measures provide a comprehensive approach to maintaining hair health and preventing DHT-induced hair loss.

Conclusion

Through this article, we’ve navigated the complexities surrounding dihydrotestosterone (DHT) and its pivotal role in hair health and hair loss, shedding light on the mechanisms that underlie conditions such as androgenic alopecia.

 By offering a deep dive into how DHT influences hair follicles, alongside the genetic and hormonal frameworks that modulate its levels, we’ve endeavored to equip you with the knowledge necessary to understand and confront hair loss. Emphasizing treatments and preventative strategies, from pharmaceutical interventions to natural remedies and lifestyle adjustments, our discussion underscores the importance of a proactive approach in managing hair health, always mindful of the diverse needs and experiences of those affected by hair loss.

In navigating the sensitive journey towards hair restoration, understanding is just the first step; action is equally crucial. Our comprehensive exploration aims not only to inform but to empower and guide you towards effective solutions tailored to your unique situation. We understand the emotional and physical toll that hair loss can engender, and our goal has been to present clear, empathetic guidance grounded in clinical knowledge and a deep understanding of your concerns. For those seeking personalized advice and a tailored hair loss treatment plan, do not miss the opportunity to restore your confidence with our professional hair restoration services; get a free hair analysis and quote from our experts today. This step represents more than just a consultation; it’s a leap towards regaining not only your hair but also your self-assurance and quality of life.

FAQs

What role does DHT play in hair follicle development?

DHT (Dihydrotestosterone) helps hair follicles grow deeper, reaching their normal size despite increased pressure from decreased cushioning tissues around them. Sufficient levels of androgens, including DHT, are necessary for maintaining healthy hair growth as long as the pressure on the follicles is properly managed.

How can one prevent DHT from damaging hair follicles?

To mitigate the effects of DHT on hair follicles, maintaining a diet rich in essential nutrients is crucial. Consuming foods high in zinc, biotin, and omega-3 fatty acids, such as nuts, seeds, leafy vegetables, and lean proteins, can support hair health and potentially reduce DHT levels.

Does decreasing DHT help in hair regrowth?

Yes, reducing DHT can indeed promote hair regrowth. DHT blockers have been identified as highly effective in treating hair loss. According to research by the American Academy of Dermatology, finasteride is particularly effective at blocking DHT, not only stopping hair loss but also encouraging new hair growth.

What factors contribute to an increase in DHT?

An increase in DHT levels can occur naturally with aging. However, lifestyle factors such as smoking, excessive alcohol consumption, poor dietary habits, high stress levels, and certain medications can also boost DHT production, leading to increased hair shedding, thinning hair, and male-pattern baldness.

Fahmida is an intern doctor in Bangladesh with eight high-impact publications in Q1 journals on emerging health issues and was awarded the “Inspiring Women Volunteer Award” in 2022 by the UN Bangladesh.


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