Androgenetic alopecia, also known as male or female-pattern baldness, is the leading cause of hair loss in the world. According to the US National Library of Medicine, it plagues as much as 50 million men – and 30 million women. The culprit behind this disorder is Dihydrotestosterone, a male hormone otherwise known as DHT.
What is DHT?
DHT is an androgen or male hormone produced by the reproductive organs - the testes in males and the ovaries in females.
Androgens are essential for the sexual development of men before birth – and during puberty. Apart from that, these hormones also govern hair growth and libido.
DHT stems from testosterone, which is converted with the help of a substance called 5-alpha reductase (5-AR). Since it can attach better to hair receptor sites, DHT can exert more negative effects on the hair compared to testosterone.
DHT and Hair Loss
DHT affects the hair through several mechanisms:
• DHT shrinks the hair follicles.
This leads to the creation of shorter and thinner hair strands. Instead of thick locks, soft, light hairs known as vellus hairs grow. Since they are not well-attached to the scalp, these strands fall rather easily.
• DHT leads to a shorter hair growth phase (anagen).
When this happens, hair is unable to grow as long as it did before.
• DHT prolongs the resting phase (telogen) of hair.
This causes a delay in the growth of new strands that will replace the ‘lost’ ones. Hair thinning is more apparent since there are no new (or delayed) ‘replacements’ for the strands that were shed.
DHT and Genes
Genetics also affects a person's sensitivity to DHT. This is especially the case for the AR gene, which can lead to heightened DHT activity in the scalp.
With that being said, problems with the AR gene have been linked with a higher risk of androgenetic alopecia. In fact, such changes have been commonly seen in men who suffer from hair loss at a young age.
DHT has also been linked with prostate problems such as benign prostatic hypertrophy and prostate cancer.
Symptoms of Androgenetic Alopecia
• Male-pattern baldness
Androgenetic alopecia accounts for 95% of all hair loss cases in men. It is quite alarming as it affects 2/3 of American men aged 35 and above. By the age of 50, approximately 85% of males develop thinning hair.
Male-pattern baldness is characterized by hair loss that occurs at the hairline. It gradually recedes, which forms a hallmark M-shape. As the strands become shorter, finer, and thinner, baldness worsens and transforms into a horseshoe or U-shaped pattern.
• Female-pattern baldness
In women, thinning hair starts at the top (crown) of the head. While the front hairline remains the same, it may recede as time progresses.
In comparison to men, female-pattern baldness never leads to total/near-total hair loss.
While DHT is implicated with scalp hair loss, it can also lead to the development of unwanted facial hair in women.
Treatments for Androgenetic Alopecia
Although treatment is advisable, it’s not entirely necessary if you are okay with your appearance. If you are bothered by your thinning strands, cheap and safe options include changing your hairstyle, hair weaving, or wearing a hairpiece.
If any of these are not enough for you, you may opt for the following medications:
Otherwise known as Rogaine, this drug is directly applied to the scalp. It works by stimulating the follicles, resulting in slower hair loss – coupled with the growth of new strands. Unfortunately, androgenetic alopecia may recur once you stop using this medication.
Side effects include drowsiness, tiredness, dizziness, and temporary swelling.
Popularly known as Propecia or Proscar, Finasteride is a drug taken by mouth. It interferes with the production of DHT, the hormone that triggers hair loss. While it works better than Minoxidil, hair thinning will recur once you stop taking Finasteride.
Taking Finasteride may lead to a decreased sex drive, erection and/or ejaculation problems, breast size increase (in men) and/or tenderness, and skin rashes.
Natural Remedies Against DHT
While Minoxidil and Finasteride are the more popular treatments for androgenetic alopecia, some natural remedies may help reduce hair loss as well. They include:
• Saw Palmetto
Saw palmetto is derived from the berries of the Serenoa repens tree. This extract contains many beneficial substances, including carotenoids, fatty acids, and plant sterols.
Saw palmetto is one of the best natural remedies against DHT since its mechanism is the same as Finasteride. According to a study, it can block 5-AR, the substance that helps transform testosterone into the more potent DHT.
Apart from curbing hair thinning, saw palmetto’s anti-5-AR actions make it beneficial against prostate enlargement, some lung conditions, and thyroid problems.
• Horsetail Extract
Horsetail extract is another natural remedy that may help minimize hair fall. According to a study, it may inhibit the action of 5-AR, which works to convert testosterone to DHT. Horsetail extract may also help decrease the secretion of Interleukin-6 (IL-6), a crucial inducer of hair loss. For one, it can interfere with hair shaft elongation. IL-6 can also prod the hair to enter the catagen, a transitional phase characterized by the halting of hair growth.
• Grape Seed Extract
As the name suggests, grape seed extract is obtained from the grounded seeds of red wine grapes. It has a high proanthocyanidin content, a plant compound that has various health effects on the body. In terms of hair health, proanthocyanidins work by preventing the conversion of testosterone to DHT.
Grape seed extract is also rich in antioxidants that may help prevent sun damage, which is another factor that could trigger hair fall.
Also known as Vitamin H, Biotin helps increase the levels of keratin. This protein is vital for the hair, as well as the skin and the nails. Apart from capsule supplements, you can also get biotin from whole grains, nuts, and egg yolk.
DHT, which is converted from testosterone, plays a big role in hair loss. It can lead to a shorter growth phase and miniaturized follicles – which result in thinner, shorter hairs. Since it prolongs the resting phase of hair, it can delay subsequent growth as well.
DHT, which is the primary cause of hair loss in both men and women, may be counteracted with the use of certain medications and supplements. With that being said, it’s always best to check with your physician regarding the best treatment for your hair problems.