If you are experiencing male or female pattern baldness, it is very likely that you have a hereditary condition in which your scalp is sensitive to DHT (dihydrotestosterone). This condition is called androgenetic alopecia, or male/female pattern baldness.
This sensitivity causes the hair follicles (a part of the skin from which hair grows) on the scalp to slowly shrink, leading to hair becoming thinner and thinner until it is virtually invisible. For this reason, DHT and hair loss treatment go hand in hand.
What is DHT?
DHT is an androgen (a sex steroid) that contributes to the development of male sex characteristics such as a deep voice, muscle mass, sex drive, and increased body hair. DHT is also linked to enlarged prostate in men.
DHT is a result of testosterone being converted to dihydrotestosterone by the enzyme 5-alpha-reductase (5-AR). Up to 10% of testosterone is converted into DHT.
The hair growth cycle explained
To understand how DHT causes hair loss, we first need to understand the hair growth cycle.
The hair that grows inside the follicle goes through a growth cycle, and within this cycle there are three phases:
Anagen – This is the growth phase, which lasts somewhere from 2 to 6 years. The longer it lasts, the longer the hair grows. usually about 80-90% of the hair is in this phase.
Catagen – It is a short phase of 2-6 weeks, in which the hair follicle renews itself and hair stops growing.
Telogen – The resting phase, which lasts 1-4 months. During this phase the hair follicle is dormant and hair falls out. Up to 20% of the hair is in this phase.
After the telogen phase, anagen begins again and this cycle repeats.
How does DHT cause hair loss?
DHT attacks the hair follicles on the scalp, causing them to shrink, and causing the shortening of the anagen phase and lengthening of the telogen phase.
As a result, hair cannot grow as long as before. The anagen phase becomes so short that new hairs barely reach the surface of the skin. They become thinner and weaker, as well as fall out faster.
Eventually, hairs are reduced to a Peach Fuzz – soft and light hairs that are barely noticeable.
There are several treatments available.
A few target DHT and significantly reduce its levels in the body, thus protecting the hair follicles from its damages and therefore causing the hair growth cycle to remain unmodified and healthy. Since DHT and hair loss are interconnected, these are very effective treatments.
Finasteride (brand name Propecia), is a perscribed medication that blocks (or inhibits) DHT. It works by binding into the 5-alpha-reductase (5-AR) enzyme (which is responsible for the conversion of testosterone into DHT) and hence prevents the conversion of DHT. However, since Finasteride is a drug, it does come with some side effects and is therefore not right for everyone.
Other natural supplemets like Saw Palmetto are believed to be effective as DHT blockers as well. They work in a similar way as Finasteride in binding to 5-AR, but with much less side effects. Although some studies have shown it’s effectiveness, it is not clinically proven since it is not a medication but rather a natural supplement. Other natural supplements such as Biotin, Pygeum bark, and pumpkin seed oil also work in a similar way.
Non DHT blocking hair loss treatments
Minoxidil is a topical solution, available as a foam or a liquid. It is applied directly to the scalp and it works by enhancing blood flow to the scalp. Unlike Finasteride, it does not affect DHT levels in the body.
The enhanced blood flow stimulates hair growth and slows down the hair loss process. Unfortunately, it does not completely stop hair loss because DHT is still present in the hair follicles. However, it does not cause the side effects associated with Finasteride, and it is still a pretty good treatment.
In fact, Minoxidil is the first ever FDA approved and clinically tested treatment for hair loss, and it is the most popular treatment (along with Finasteride).
Hair transplants have become increasingly popular in recent years, mainly due to the fact that they are a one time treatment (unlike the treatments mentioned above), and because they have vastly improved in the last 15 years.
Hair transplants provide a last resort treatment for many people who find other treatments ineffective or don’t want to experience the side effects, but can manage the high cost of these procedures.
Over the years many treatments have become available to people suffering from hair loss.
New treatments are always being researched, and they are expected to be available in the future and add more tools in this long battle of hair loss sufferers.
I personally use some of these solutions and I am hopeful that one day hair loss and baldness will become a thing of the past.