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Hair-transplantation

Dihydrotestosterone & its Influence on Hair Growth

Medical Director Dr. Hans-Georg Dauer

May 20, 2022

Every third man over 30 and every second man over 50 have one thing in common: they suffer from alopecia, better known as hair loss. But women also have reason to worry about their hair. Around 20 percent are affected by hair loss.

For many alopecia patients, hair loss runs in the family. In other words, it is genetically determined. In this case, dihydrotestosterone wreaks havoc in the body. But what is it, what does it do and how can we stop it?

What is Dihydrotestosterone (DHT)?

Dihydrotestosterone, or DHT for short, is a conversion of the sex hormone testosterone (metabolite), which belongs to the androgen hormone group. The so-called enzyme 5-alpha-reductase is responsible for the conversion. It initiates a chemical reaction that transforms testosterone into DHT. But this in itself is not necessarily a bad thing.

On the contrary, DHT is actually a good thing. It plays a central role in the development of the male embryo. It's just as active during puberty. Without testosterone, the boy cannot mature into a man. It plays a decisive role in beard growth as well as in general male body hair. DHT is even active in the function of the sebaceous glands and the development of the prostate.

But DHT is not only present in men. In small quantities, the degradation product of testosterone also occurs in the female body.

Good to know: It's not uncommon for us to confuse DHT with DHEA (dehydroepiandrosterone). Despite them sounding similar does not make them identical. On the contrary: Compared to DHT, the steroid hormone DHEA has a noticeably lower effect in the body.

How is DHT Formed?

DHT is produced from testosterone in the so-called target organs - for example in the prostate, the epididymis or the seminal vesicle. Medical experts, however, prefer to speak of a reduction of the male sex hormone testosterone by the enzyme 5α-reductase.

Hard to imagine, but DHT rarely travels alone in the body. Most of the breakdown product, a full 99 percent, is linked to globulins (Shbg), proteins that aid in the production of our sex hormones. Only 1 percent of DHT moves freely in the blood.

And it is precisely this unbound DHT that can bind unperturbed to androgen receptors in the target organs such as the prostate or seminal vesicle - just like testosterone. When the androgen receptors are in a resting state, they are linked to so-called heat shock proteins, which actively take care of the stability of the receptors in the cytoplasm of the cell.

If DHT now comes into contact with the androgen receptors, it triggers a conformational change. In other words, the heat shock protein and the hormone-receptor complex are released into the cell nucleus.

In the cell nucleus, this complex can now combine unhindered with so-called androgen-responsive elements of the DNA.

Would you believe it? DHT and testosterone work identically. However, DHT is even more potent than testosterone. The reason: It has a higher affinity to the androgen receptor, which noticeably increases its effectiveness.

How Does DHT Work in the Male and Female Body?

In men, DHT is a real all-rounder. It is not only involved in the development of the male embryo, but also controls the body and facial hair. DHT creates a masculine look, so to speak. At the same time, the all-rounder regulates the sebum production of our skin and forms the male sex organs, more precisely the prostate.

But that's not all: would you have thought that DHT is also responsible for the voice change? It gives men their distinctive, deep voice. Good news for passionate athletes: DHT is also indispensable for building muscle mass.

Oh, so DHT doesn't play a role in women? You thought wrong; dihydrotestosterone is also an important key player in the female body. In fact, DHT of all things serves as a precursor for the synthesis of female sex hormones. And that means, conversely, that testosterone not only forms the precursor for DHT, but also for the female sex hormone estradiol.

Besides, the androgens in the female body also take over independent functions. They strengthen the muscles, stimulate the sexual pleasure center and strengthen the bones. In addition, the physical and mental gender role of the woman is also formed.

But what happens if the DHT concentration is not in balance? What if it is too high?

Actually, this isn’t rarely the case. In the case of a congenital hyperplasia of the adrenal cortex, the DHT content quickly gets out of balance. The same happens with tumors of the adrenal glands or ovaries as well as with testicular tumors. Equally conceivable is the so-called PCO syndrome, a syndrome of polycystic ovaries. In this case, the testosterone level in the female body is too high.

But what are the consequences of increased DHT levels in the blood?

In men, too high of a DHT level, or more precisely 5α-dihydrotestosterone level, often causes an early onset of puberty. In women, on the other hand, masculinisation (virilisation) can be observed. In other words, their outer appearance suddenly appears more androgynous. It is not uncommon for women with elevated DHT levels to suffer from hirsutism. By this we mean a strong body and facial hair that is similar to the male growth pattern. This applies in particular to the beard, the chest or the back. This phenomenon is particularly common among female athletes who use doping to stimulate muscle growth. The reason: the increased proportion of male sex hormones in the female body upsets the hormone balance. The female hormones decrease, the male hormones increase. The appearance of the woman suddenly seems all the more masculine.

A rarer phenomenon is called adrenogenital syndrome. Here we are talking about a hereditary disease in which the female hormone synthesis is disturbed. Consequently, external male genitalia are formed, which doctors call pseudohermaphroditism femininus.

However, the DHT content in the blood can not only be too high, but also too low. In this case, the libido is usually disturbed or the sex organs are not properly formed. In the worst case, there is even a risk of impotence. By the way, the two most common known disorders with too low of a DHT content (androstanolone content) are called pseudohermaphroditism masculinus or Klinefelter syndrome.

How can the Level of DHT be Lowered?

You may be relieved: there are a few things you can do about your high DHT levels. What do you think of 5α-reductase inhibitors, for example? The name says it all: the drugs reliably bring 5-alpha-reductase to a halt. This means that less testosterone is converted into DHT. And the less DHT present in the organism, the better.

The most popular 5α-reductase inhibitors include finasteride, dutasteride or alfatradiol. All three inhibit the production of testosterone by paralyzing 5-alpha-reductase. And the less testosterone circulating in the body, the less DHT is produced - mission accomplished.

But not only drugs can noticeably reduce the DHT content in the bloodstream. Herbal secret tips are also worth a try, namely:

  • Sulforaphane (mustard oil glycosides): Vegetable fans, take note. Isothiocyanates from the sulforaphane family can be found in broccoli and all types of cabbage. Even kohlrabi, horseradish, arugula, cress, radishes, radish or mustard contain the green wonder weapon.
  • Theaflavin (black tea extract): From now on, you can reach for black tea with a clear conscience. Is there even a better supplier of theaflavin?
  • Fenugreek Seeds: Have faith in the active ingredients trigonelline and diosgenin in fenugreek seeds. Supposedly, they inhibit DHT production. By the way: We mainly enjoy fenugreek seeds as a spice.
  • Flaxseed: The marginal layers of the flax seed are little treasure chests: they are well filled with lignans. And it is precisely these secondary plant substances from the phytoestrogen family that are worth their weight in gold. The reason: they inhibit DHT.

Hereditary Hair Loss - What can I do About it?

We cannot change our genetics. But we don't have to accept them helplessly either. Fortunately, there is one or the other tool that effectively counteracts the balding of the head. At least that's what the statistics say. Curious, now? Then let's take a look at the most promising methods against hereditary hair loss, together.

Minoxidil - The Classic

Many alopecia patients treat their condition with minoxidil - whether with tinctures or shampoos. Because with regular use, the sought-after active ingredient is said to demonstrably stop the advancing hair loss and even allow new strong hair to grow back.

The exact mechanism of action of Minoxidil in the human body is not yet clearly understood. However, experts have a guess: Minoxidil is supposed to get the blood circulation of the scalp going. And the better the blood circulation works, the more nutrients and oxygen our hair roots receive. And consequently, the better their chances of survival.

But beware: Minoxidil is only a temporary solution to hereditary hair loss. As soon as we stop taking it, everything goes back to square one. It’s a treatment, not a cure.

Finasteride

Finasteride also enjoys great popularity in the treatment of alopecia. For good reason: the active ingredient blocks the enzyme responsible for the production of DHT, namely 5-alpha-reductase. The pleasing effect: there is significantly less DHT in circulation. And the less DHT in circulation, the lower the probability of hereditary hair loss.

Good to know: Just like minoxidil, the effect of finasteride wears off as soon as we stop taking the supplements. So it is again only a temporary solution.

The Hair Transplant

Tired of minoxidil and finasteride? Are you not seeking a temporary, but a permanent solution? Do you wish to declare war on your hereditary alopecia, once and for all?

Then we have the solution for you. Why not opt for a professional hair transplant at Hair & Skin? The big advantage: The transplanted hair roots remain with you for the rest of your life. They will no longer fall out. Sounds tempting, right? But what exactly does this procedure look like?

First of all, our experienced physician removes strong donor hair from a densely overgrown area. He usually focuses on the back of the head. This is where DHT is less successful. He then prepares the recipient area for the transplants. For this purpose, he opens tiny channels on the scalp and creates space for a vital hair coat.

In the next step, he inserts the hair roots step by step into the fine channels. In the process, the physician pays careful attention to the patient's natural direction of growth. After all, the result should appear as harmonious and even as possible.

And done! Now all you need to do is just be a little patient. It can take up to 9 to 12 months until we finally get to see the final result. But then we have a lifetime of joy in a powerful, dense and youthful fresh coat of hair.

DHT - What Functions does it Actually Have?

Again and again we read negative headlines about DHT.  But is the breakdown of testosterone really all that bad? No, not at all. DHT also has its positive perks.

Especially in the development from boy to man, we can not do without DHT. After all, it is actively involved in beard growth and the formation of the male sex organs such as the prostate. Of course, it also has a say in the function of the sebaceous glands.

It only becomes a concern when the DHT level in our blood gets out of balance - especially when it becomes too high. Experts are convinced that a strongly increased DHT concentration increases the risk of prostate cancer or prostate hyperplasia (a benign enlargement of the prostate).

DHT and Hair Loss: How are the Two Related?

At first glance, DHT and hair loss do not seem to have much in common. At second glance, however, they are suddenly more connected than expected. Did you know that DHT is a typical cause of hair loss? In fact, DHT is one of the most common triggers for this cosmetic blemish. Not without reason it is nicknamed the "hair loss hormone".

Whenever androgenetic alopecia or hereditary hair loss is the underlying cause, DHT is undisputedly involved. Because in this case, the hair roots react hypersensitively to DHT. They simply cannot cope with it. In addition to a hypersensitivity of the hair roots, however, too high of a DHT concentration in the body is often behind the constitutional hair loss.

Normally, DHT does not cause any problems in the body. It only sits in the scalp and binds there to special receptors in the hair roots. If the testosterone level is balanced and the hair roots do not react hypersensitively to DHT, this process runs smoothly. DHT stimulates protein production, which gives the hair cells a powerful growth spurt.

Problems only occur when the DHT concentration is too high or the hair roots react too sensitively to the hormone. In this case, far too much DHT attaches to the receptors in the hair root. It is overtaxed.

The reaction: The overstrained hair root forms back essential blood vessels so that it can no longer be supplied with sufficient nutrients and oxygen. A supply bottleneck occurs, which sooner or later shortens the growth phase (anagen phase) of the hair.

Due to the greatly shortened growth phase, our hair is now in an intermediate state for an extraordinarily long time, in which it is particularly fine and barely visible on the scalp. As a result, the hair root atrophies. Step by step it recedes - until it finally falls out.

Did you know? DHT does not necessarily affect body hair. Patients with androgenetic alopecia can have lush chest or back hair, but still have bald patches on the head.

Are you interested?

Then let HAIR & SKIN advise you at any time and book your free consultation appointment now.

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