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BIOLOGY

Does Testosterone Cause Hair Loss in Men?

Explore the relationship between testosterone and hair loss in this informative article, as we debunk common myths and provide valuable insights into understanding the facts.

July 28, 2023
Medically-reviewed and fact checked by Ryan Lester, PA-C

No one looks forward to losing their hair as they get older.

Male pattern baldness, also known as androgenic alopecia, is a common condition characterized by hair loss in a specific pattern on the scalp. It is influenced by both genetic and hormonal factors, particularly the effects of dihydrotestosterone (DHT), a hormone derived from testosterone.

In this article, we'll talk about how testosterone affects hair loss and discuss various treatment options.

Testosterone and Hair Loss

Losing hair is a common problem that affects a lot of men all over the world. It can be caused by age, genetics, hormonal changes, and medical problems, among other things.

What is the relationship between testosterone and hair loss? Does testosterone replacement therapy (TRT) cause hair loss?

Let's begin by discussing the different types of hair loss that can occur in men.

bald man drinking coffee

Types of Baldness in Men

Baldness is a common condition that affects millions of men around the world. 

Androgenetic Alopecia

Androgenetic Alopecia (AA) is a form of male pattern baldness caused by inherited sensitivity of scalp hair follicles to normal levels of circulating DHT. It usually affects men but can also occur in women.

Involutional Alopecia

Involutional Alopecia is hair loss caused by aging. It is a natural process that occurs gradually, often beginning after the age of 40. This type of baldness does not usually respond to treatments such as minoxidil or finasteride.

Alopecia Areata

Alopecia Areata is an autoimmune disorder in which the body's immune system attacks the hair follicles, leading to loss of hair on the body and/or scalp.  In some, this can result in complete loss of hair (alopecia totalis) but in about 85% of people with the condition, the hair returns within 2-3 years.

Telogen Effluvium

Telogen Effluvium is one of the most common causes of hair loss.   It can be caused by drugs, trauma, physical or emotional stress. This can cause a large number of hairs to enter the telogen phase prematurely, leading to excessive shedding and/or thinning of the hair.

What is Testosterone Replacement Therapy (TRT)

Testosterone replacement therapy (TRT) is a medical therapy in which testosterone medication is prescribed to treat symptoms caused by low testosterone levels. It can be done using injections, pellets, creams, or pills.

TRT can help to:

  • Increase muscle mass and strength
  • Decrease body fat
  • Improve sex drive and sexual performance
  • Improve bone density
  • Improve sleep
  • Improve energy
  • Improve blood pressure, blood sugar, and triglyceride levels, which could help to reduce the risk of developing cardiovascular disease, cancer, diabetes, and dementia as one ages.

Although it is an effective treatment for men with low testosterone levels, there are potential side effects associated with TRT. One of the most common side effects is hair loss which is typically seen in those that have current hair loss or a family history of male pattern baldness. 

When considering hair health, the primary variables to consider are testosterone, dihydrotestosterone (DHT), and individual genetic predisposition.

Testosterone

Low T, or low testosterone, is a common reason why patients choose to undergo TRT. To determine how TRT could affect your hair, it's essential to know your starting testosterone levels.

The loss of hair is not directly attributed to testosterone but raising your testosterone levels can also raise your DHT levels, hastening the onset of male pattern baldness. Hair loss or thinning from TRT typically reverses to baseline if testosterone is stopped; however, most men choose to remain on testosterone once they start because of the benefits they see and feel.

Dihydrotestosterone

When it comes to hair loss, DHT is often the reason why.

DHT is a hormone that is synthesized from testosterone by an enzyme called 5-alpha reductase. It is a potent androgen that plays a vital role in the development of male sexual characteristics during puberty. While testosterone is responsible for the development of male sexual characteristics, DHT is responsible for hair growth in men and women.

One of the most common myths about DHT is that it is the same as testosterone. While they are both androgens, they have different effects on the body.

In genetically susceptible individuals, DHT binds to hair follicles on the scalp and miniaturizes them, leading to male pattern baldness. This condition affects up to 70% of men at some point in their lives and is characterized by a receding hairline, bald patches, and/or thinning hair.

Bald father and his son

Individual Predisposition

Male pattern baldness is hereditary. If your dad or grandfather has a medical history of hair loss, it is more likely that you will experience the same.

In addition, your overall health and lifestyle may affect how testosterone affects your hair growth.

Are you a smoker? Do you exercise every day? These factors can all contribute to hair loss.

To Sum It Up: Does TRT Cause Hair Loss?

TRT doesn't directly cause hair loss.

The effects of TRT on hair loss depend on the individual and their medical conditions. If you have a predisposition for male pattern baldness, then it is likely that even if you do not undergo TRT, you may still experience hair thinning.

However, if your testosterone levels are low and you decide to undergo treatment, it is possible that increasing your levels of testosterone can lead to increased DHT levels, which can worsen hair loss.

You should discuss any potential risks with your doctor before beginning TRT. You may also want to consider other treatments, such as minoxidil or finasteride, which can help reverse or improve hair loss.

If you are thinking about using testosterone to treat low T, it is important to talk to your doctor about these possible side effects of hormone treatment.

Can You Reverse Or Slow Down DHT In Men?

The effects of DHT on hair follicles in men can be significant if left unchecked. Fortunately, it doesn't have to stay that way for very long. Thanks to medications and modern medical advancements, reversing or slowing down hair loss in men is now possible.

One of the most popular ways is to block the conversion of testosterone into DHT with medications like finasteride (Propecia) or dutasteride. This approach has been around for quite a while, so its efficacy shouldn’t be doubted!

How to manage hair loss after TRT

If you are experiencing hair loss after starting TRT, it is essential to speak with your healthcare provider, as they can help determine the underlying cause of your hair loss and develop a personalized treatment plan.

Managing hair loss after TRT may involve a combination of lifestyle changes, medications, and hair restoration procedures, depending on the severity and cause of your hair loss.

Lifestyle changes

Eating a balanced diet rich in vitamins, minerals, and proteins can help provide the essential nutrients for healthy hair growth.

Modification

One approach to managing hair loss after TRT is to modify the dose of testosterone being used. Sometimes switching to a different form or adjusting the frequency of administration can also be helpful. 

Medications

Other medications, such as minoxidil, spironolactone, and latanoprost, can also be effective at preventing and even reversing hair loss.

Hair restoration

Hair restoration procedures, such as hair transplants and scalp micro pigmentation, can also help restore hair density and improve the appearance of hair loss. However, these procedures can be expensive and may not be suitable for everyone.

Importance of Consultation

At Wellcore, we understand that hair loss can be an emotionally challenging experience. Everyone should feel well supported.

Our Client Success team is here to answer any questions you may have about your individual needs or the treatments available to help manage hair loss while undergoing TRT. They will provide you with a personalized TRT plan based on your medical needs and desired outcomes.

We aim to support you and help you get the greatest solutions and outcomes to move you toward your health-related goals. Contact us today to learn more and get started.

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