If you’ve noticed your hair starting to thin or recede, it’s easy to stress over what’s causing it to happen. Is it stress? A bad diet? Unlucky genetics? Or is it a lifestyle factor you can fix with the right habits?
The reality is that hair loss in men is primarily caused by a combination of genetic factors and a male steroid hormone called dihydrotestosterone (DHT).
DHT can seem complicated, but its role in hair loss is fairly easy to understand once you have a basic knowledge of how your body produces DHT, as well as the damaging effects that DHT can have on your hair follicles.
Below, we’ve explained what DHT is, how it’s produced by your body and the effects it can have on healthy hair growth.
We’ve also covered your options for reducing DHT levels, stopping hair loss and — if you have visible hair loss already — stimulating new hair growth.
What Is DHT?
DHT, or dihydrotestosterone, is a type of androgen hormone that’s produced by your body as a byproduct of testosterone.
Androgens are hormones that produce male characteristics. They’re responsible for maintaining several aspects of your health and function, such as your bone structure and voice.
Before you’re born, DHT helps to develop your penis and scrotum. As you enter adolescence, it promotes growth of your facial hair, body hair and pubic hair.
It’s one of several hormones that makes men, well, men.
What Does DHT Do?
DHT is created from testosterone. An enzyme called 5-alpha reductase, or 5AR, converts a small percentage of your testosterone into DHT in body tissue like your skin, liver and prostate gland.
Testosterone is also converted to DHT by the 5-alpha reductase enzyme in your scalp, including in your hair follicles.
Most men have much higher levels of testosterone than DHT. According to research, the normal level of DHT in your bloodstream is only around 10 percent of your level of testosterone.
However, because of its potency, DHT can have noticeable effects within your body, even if the total amount of this hormone that circulates in your bloodstream is relatively small.
For example, as an adult, DHT can attach to receptors inside your prostate gland and cause it to grow larger.
This is referred to as benign prostatic hyperplasia (BPH), or enlarged prostate. It’s a common issue for middle-aged and older men.
More famously (and probably why you’re reading this guide), DHT can bind to receptors in your scalp and stop your hair follicles from producing new hairs, resulting in a receding hairline, bald patch at your crown or other signs of male pattern hair loss.
How Does DHT Cause Hair Loss?
DHT causes hair loss by miniaturizing, or shrinking, the hair follicles around your hairline and on the top of your scalp.
Hair miniaturization sounds complicated, but it’s actually pretty simple. Every hair on your scalp, face and body grows as part of a multi-phase cycle that’s typically referred to as the hair growth cycle.
In the first phase of this cycle, called the anagen phase, each hair grows to its full length. After reaching the end of the growth phase, each hair goes through the catagen and telogen phases, during which it stops growing and is eventually replaced by a new strand of hair.
This continuous process lets you maintain a full head of hair even as your old hairs are shed on a regular basis.
When DHT miniaturizes your hair follicles, it shortens the anagen phase and prevents your hair from growing properly.
Over time, hairs affected by DHT become thinner and shorter, eventually resulting in hair that’s unable to grow through the outer layers of your skin.
This process usually begins at your hairline and crown, resulting in the classic receding hairline or bald patch that many men notice as their first sign of hair loss.
(Related: 9 Causes of Hair Thinning In Men)
Why DHT Affects People Differently
Just like your genes play a major role in determining your height, hair color, eye color and other physical characteristics, they also have a big influence on how susceptible you are to male pattern baldness.
After all, male pattern baldness is referred to as androgenetic alopecia — a word that’s made by fusing together “androgenic” and “genetic.”
Experts think some men have hair follicles that are more sensitive to DHT than others, meaning they miniaturize and stop growing new hairs faster when DHT attaches to receptors in the scalp.
Research also suggests that men affected by male pattern baldness have higher average levels of DHT than their peers, as well as greater concentrations of androgen receptors in the scalp.
This means that if you’re very susceptible to hair loss, you may not just be more sensitive to the effects of DHT than your peers — your body may also be more prone to converting testosterone into DHT, particularly in your hair follicles.
This type of hair loss doesn’t only affect men. Women also make small amounts of testosterone and, therefore, DHT. In women, this is called female pattern hair loss, or FPHL — clever title, we know.
DHT vs Testosterone
DHT and testosterone are both androgen hormones. However, their functions within your body are different.
As a man, testosterone is a critical hormone for your well-being throughout your life. Maintaining a healthy level of testosterone helps you maintain a normal level of arousal, muscle mass and bone health.
Testosterone is also important for maintaining optimal mental function, red blood cell production and energy levels.
As a man, you need testosterone throughout your entire life, from childhood and adolescence to adulthood.
Dihydrotestosterone, on the other hand, is important during childhood and puberty, but it doesn’t play such a major role in your ongoing development as an adult.
As an adult, DHT doesn’t appear to be involved in your mental function, bone health or ability to produce muscle.
Instead, the major effects of DHT in adulthood include contributing to prostate enlargement and causing pattern hair loss.
(Related: Can Finasteride Regrow a Receding Hairline?)
What Causes DHT to Increase?
If you’re genetically predisposed to DHT sensitivity, any kind of increase in your DHT levels may increase your risk of dealing with pattern hair loss. It’s a bummer, but it’s a part of life.
So, what could cause your DHT levels to increase? Well, since DHT is produced as a byproduct of testosterone, it stands to reason that anything that contributes to higher testosterone levels is also likely to contribute to more DHT.
As we’ve covered in our guide to increasing your testosterone levels, a variety of factors all play a role in your testosterone production. These include your diet, sleep habits, the amount of exercise you get and even things like your alcohol consumption.
Most habits that increase testosterone production are good for your health in general, and there isn’t any research showing that these habits cause any noticeable increase in hair shedding.
However, one thing you’ll want to be aware of is that any medications that increase the amount of testosterone in your body could cause increased shedding.
For example, testosterone injections used to treat low testosterone could make your DHT levels increase sharply, causing your hair loss to become more severe.
This is something you’ll want to talk about with your healthcare provider, particularly if you have low testosterone and use medication to treat it.
How to Reduce DHT & Prevent Hair Loss
Because DHT is the main hormone responsible for hair loss in men, the most effective way to slow down and prevent hair loss is to block DHT.
Currently, the most effective way to reduce DHT levels is with medication like finasteride. You can also block DHT at the scalp level using medicated shampoos that contain ingredients like saw palmetto.
Finasteride
Finasteride, which is available under the brand name Propecia, is a prescription medication approved by the FDA that’s used to treat male pattern baldness.
Finasteride reduces DHT levels by inhibiting the effects of 5-alpha reductase — the enzyme that converts testosterone to DHT. By stopping this conversion, finasteride drastically lowers the total amount of DHT your body produces.
You can think of finasteride as a shield that blocks DHT from miniaturizing your hair follicles and contributing to hormonal hair loss.
Research from clinical trials suggests that a normal dose of finasteride can lower DHT levels by 70 percent, which is enough to slow down, stop or reverse hair loss in most men.
This reduction in DHT levels means that your hair follicles are no longer under constant damage due to the effects of DHT.
Finasteride is easy to use. Most men start to notice improvements after around three months of daily use, with the most significant results visible after about one year.
DHT-Blocking Shampoo
If you’ve ever spent time browsing the men’s shampoo section of your local drug store, you’ve likely seen shampoos that are marketed as DHT blockers.
These products contain active ingredients that wash away excess DHT from your scalp, which may help protect against hair loss.
One popular ingredient in hair thickening shampoo is saw palmetto, which may help prevent the buildup of DHT on your scalp and protect your hair follicles.
Another is ketoconazole — a topical antifungal medication linked to improvements in hair growth in men, but isn’t directly linked to lower DHT levels.
Hair growth shampoos aren’t as effective as medications like finasteride, so they’re best used as one part of your hair care routine, not on their own.
Are There Side Effects to Blocking DHT?
Most men don’t experience any side effects from DHT blockers — unless you consider noticing thicker, fuller and healthier hair a side effect, of course.
However, a small percentage of men who use DHT blockers like finasteride do experience some side effects. These can range from a mild increase in your testosterone levels to ED.
Potential side effects of medications like finasteride include:
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Higher testosterone levels. Because DHT blockers like finasteride stop the conversion of testosterone to DHT, they may contribute to a slight increase in your total testosterone levels.
In a study published in the journal Urology in 2003, researchers found that long-term use of finasteride was associated with a modest increase in testosterone. -
Lower arousal. Most of the time, finasteride has no positive or negative effect on your arousal. While taking it, you’ll feel the same as normal. However, in a small number of men, finasteride can result in a noticeably reduced levels or arousal.
While the side effects listed above might seem off-putting, the reality is that the vast majority of men that use DHT blockers such as finasteride don’t get serious side effects.
To put things in perspective, a 2012 study of finasteride in Japanese men found that out of the 3,177 men who used finasteride, only 23 developed adverse reactions. Even at five times the regular dosage for preventing hair loss, side effects from finasteride are rarely reported.
It’s also worth noting that in the rare event of arousal effects occurring, they’ll almost always stop once you stop taking finasteride. It’s very uncommon for any negative effects to continue if you don’t actively take a DHT blocker.
Can You Have Too Little DHT?
Early in your life, DHT plays a critical role in your physical development. If you have low levels of DHT, you may be diagnosed with a condition called 5-alpha reductase deficiency.
5-alpha reductase deficiency is a serious condition, and it can affect your genital development, sexual identity and appearance. Many men with 5-alpha reductase deficiency have genitalia that appears female, or isn’t distinctly male or female in its appearance.
Although low levels of DHT can have a huge impact on your health and physical development early in your life, DHT isn’t so important when you’re an adult.
In fact, research generally suggests that as an adult, DHT doesn’t play a significant role in your physiology.
Put simply, the evidence we have right now doesn’t suggest that you can have overly low DHT levels by using medication like finasteride.
The Bottom Line on DHT and Hair Loss
DHT plays a major role in male pattern baldness. It’s the hormone responsible for that receding hairline you’re starting to notice, as well as other common signs of hair loss like a bald patch at your crown or diffuse thinning on your scalp.
If you’re starting to notice male pattern baldness, reducing your DHT levels is the most effective way to slow down, stop or reverse your hair loss.
If you’re not sure where to start when it comes to blocking DHT, keep the following in mind:
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Finasteride is your most effective option for reducing DHT levels. This medication blocks DHT at its source by inhibiting the enzyme that creates it. Finasteride is easy to use and can be taken once a day to lower your DHT production.
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DHT-blocking shampoo is also helpful. Look for active ingredients like saw palmetto, which may block DHT at the scalp level. DHT-blocking shampoo is most effective when it’s used with finasteride.
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Other non-DHT treatments can also help with hair loss. For example, the medication minoxidil works by stimulating hair growth at your scalp level, making it a great choice for use with finasteride and DHT-blocking shampoo.
This article originally appeared on Hims.com and was syndicated by MediaFeed.org.
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7 TikTok Weight Loss Trends Ranked By an Expert
Spend a while scrolling through social media, especially TikTok, and odds are you’ll encounter someone enthusiastically sharing their experience with a new fitness or weight loss program. These days, it can feel like health and wellness challenges are proliferating so quickly it’s hard to keep up. By the time you’ve got your fitness equipment ready to jump onto one, there’s a new one taking the internet by storm.
But how effective are the hashtag-friendly regimens we’ve been seeing more of lately, and what makes them so alluring anyway? Well, like most things, the answers depend on a lot of complicated factors. But there are some important throughlines.
In general, we tend to be drawn to challenges like the “30-30-30 approach,” which has recently gone viral on TikTok, when they speak to a need we’ve already identified for ourselves. If you know that you’ve been wanting to lose weight, the simple structure of 30-30-30 (eating 30 grams of protein within 30 minutes of waking up followed by 30 minutes of exercise) just might help you harness some motivation to get started on that journey. And if you experience some initial success within the framework of a specific, focused challenge—as opposed to a more nebulous resolution to lose weight—you may also notice an uptick in inspiration to keep going.
Another important factor helps explain why joining these programs can sometimes lead to a boost in willpower: Many popular challenges are social undertakings, explains Jessica Yu, Ph.D., a clinical psychologist and Sr. Director of Patient Experience at Hims & Hers. “There’s that sense of being part of a bigger movement,” she says. “Human beings, by nature, are social creatures, so we love the idea of being part of something that’s bigger than ourselves.”
So does that mean anyone interested in weight loss should rush to pick from the expanding menu of social media-friendly fitness regimens? Are we all doomed to repeat the chaotic, even dangerous missteps of the TidePod challenge era? Not quite.
We asked Craig Primack, MD, FACP, FAAP, FOMA, a physician specializing in obesity medicine and Senior Vice President of Weight Loss at Hims & Hers, to share his thoughts on some of the most viral weight loss challenges and trends circulating online. Here’s his take on seven popular methods, ranked from best to worst according to what’s most effective and sustainable.
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Cutting out alcohol for an entire month
“This one’s a bit of a no-brainer for anyone who’s normally a social drinker. Its positive effects extend to many different parts of the body, and it’s hard to argue with as a boost to weight loss: At the most basic level, cutting back on alcohol means cutting out unnecessary calories. That may be especially effective among young people, who are most likely to see their drinking habits contribute to obesity risk. Ditching the booze also means you’re likely to sleep better and have more energy overall, which makes it a lot easier to get consistent exercise. And, best of all, cutting alcohol for a full month might make it easier to realize that you don’t always need it in social situations. Some people who go back to consuming alcohol after an initial Dry January challenge say that they find themselves drinking less or reconsidering their relationship to alcohol.”
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Concentrating your eating in specific hours of the day
“Intermittent fasting has been obviously huge for about five to eight years now. It’s been shown to work just as well as standard, caloric-restriction dieting. It may even be a little bit better in people with insulin resistance or diabetes. It’s sustainable for some people, but not everyone. Time-restricted eating, the most common kind, is best when it makes sense for people’s lifestyles. For example, you probably aren’t going to succeed if you try to stop eating for the entire day at 2 pm. But it’s often possible—and effective—to structure your day so that you’re not doing much eating after, say, 7 p.m.”
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“There are lots of reasons to love this one—not even for weight loss, per se. Running, or even just walking, one mile a day is good exercise without being overpowering. Most people can do it, and it’s not timed. Exercise is a keystone habit, so when you’re exercising regularly, you’re also likely to sleep better. When you sleep better, you can diet better—and have energy to exercise. So on and so forth.”
(Related: Ozempic For Weight Loss)
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Setting your treadmill to an incline of 12 and speed of 3 miles per hour, walking for 30 minutes
“I would say this one’s firmly in the middle, neither good nor bad. I only heard about this recently, in part because there’s no medical science behind it. It was done by an influencer, who saw a noticeable change after she tried it. I don’t doubt that she found it helpful, but the average person who has a medium amount of weight to lose may find it very hard to start out at 12% incline for 30 minutes. If it had a ramp-up in the first two weeks—maybe starting at less of an incline or for fewer than 30 minutes—I would think it’s more sustainable. That said, if you are able to do it, I think it’s a solid one, especially if you’re aiming for four to five days a week rather than every single day.”
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A nutritional change program that requires eliminating foods such as dairy, grains and added sugar from your diet
“I think this is going to be one of the challenges that causes people problems because it’s avoidance-based. Avoid, avoid, avoid—and what a long list, too! It seems to encourage all-or-nothing thinking as well, which we know can be very counterproductive. If you take one bite of something with dairy in it, for example, you’d need to start all over again. That feels needlessly punitive to me. Unless you’ve got allergies, one bite of pretty much anything isn’t going to kill you.”
(Related: Weight Loss Medications: Are They Effective?)
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A “mental toughness” program in which you must adhere to a set diet, cut alcohol, drink a gallon of water, work out twice, read 10 pages of a non-fiction book and take a progress photo—every single day for 75 days (or, in the modified version, 30 days)
“Did you get tired just reading that? I did. And I really don’t like this one. First of all, because the diet portion isn’t set by the program, we actually don’t have any proof that someone sticking to whatever diet they pick for 75 or 30 days will have the desired effects. The exercise portion is outlandish for anyone who’s not already in a consistent fitness routine. Going from zero to 100 here would be close to impossible for most people—how many working people have an hour and a half in our days to start exercising twice and reading non-fiction books? The answer drops even lower if you consider people with kids. And if you fail any one day, you have to start all over again. I know two people who’ve done it and were really excited about the accomplishment, but I can tell you for sure that when their 75 days are over, they’re not sticking to the same regimen. It really doesn’t encourage good long-term habits.”
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Eating according to hunger and satiety cues
“I know that this works for many people, and some of my frustration is rooted in my own personal biases on this one. It’s also been around forever. There’s a book called Intuitive Eating that was first published almost 30 years ago. I understand the appeal of the premise—if you’ve been on a ton of diets before, of course it’s refreshing to consider acting like you’re not on one. But the average American who struggles with their weight doesn’t necessarily believe they’re on a strict diet day to day. Without clear guidance for how to shift your relationship to food and really listen to your body’s cues, this strikes me as too wishy-washy to really work. And, crucially, many people with obesity and other diseases don’t have the same food cues that other people do. They either get hungry faster or they stay hungry longer. To me, telling someone with a disease that affects their hunger cues to simply snap out of it feels a little like telling a depressed person to just cheer up.”
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Where does that leave people who are serious about weight loss and looking for the lifestyle-change support that challenges can provide? Well, a number of the challenges above are intriguing, as Dr. Primack notes. But if you want to help setting realistic goals or evaluating new reports about diet trends, try measuring any proposed regimen against the SMART criteria: Is it specific, measurable, achievable, realistic (or relevant) and timely? That can be an incredibly helpful tool.
And of course, don’t be afraid to seek out additional help from physicians and dietitians if you’ve been going it alone for a long time already. Losing weight can be challenging, but it doesn’t have to be lonely.
This article originally appeared on Hers.comand was syndicated by MediaFeed.org.
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Featured Image Credit: Elena Nechaeva/istockphoto.
