Hair loss and DHT – how are they connected?

General Hair Loss

Hair loss is a condition that most men and women would rather avoid. It is a natural occurrence that happens as a person advances in age. There are other causes however, which are self-inflicted or brought about through outside stimuli. These hair loss causes should be diagnosed correctly in order to properly address it through treatment.

dht-hair-lossOne of the most if not the most common hair loss conditions among men and women today is androgenic alopecia. This is also called as male pattern hair loss or female pattern hair loss respectively. It affects about seventy percent of men in their late twenties to their early thirties with hair loss beginning in the temporal areas followed by the frontal central region just above the forehead, both receding backward. The central vertex area will recede next in a circular outward motion. These two receding areas will meet at the center on the top of the scalp and would eventually result in total hair loss leaving only the lower portion at the sides and back of the head untouched. Female pattern baldness on the other hand, affects about forty percent of women around the age of forty. Unlike in men, this begins in the crown of the scalp by a thinning of the hair. There is no receding hairline and will only progress to further shedding around this area. Female pattern baldness will rarely result in total hair loss.

The main cause of androgenic alopecia is the binding of dihydrotestosterone (DHT) with the androgen receptors of the hair follicle. This occurs through the fusing together of testosterone with the 5-alpha-reductase enzyme to form DHT. Testosterone is a male hormone that is not only present in males but in minimal amounts in females as well. The enzyme 5-alpha-reductase on the other hand, is located in the hair follicles. Scientists until a few years ago once attributed hair loss to the presence of testosterone in the system. This however, has been dispelled as it is largely due to the DHT attaching to the androgen receptors of the hair follicle. It must further be stressed that DHT is not the sole influence on how severe the onset of androgenic alopecia will be. A contributing factor is also the degree of sensitivity that androgen receptors play in attracting DHT to attach with it. The high volume of testosterone will not significantly impact hair loss even if it gets to bind with a large amount of 5-alpha-reductase enzyme to produce DHT if this cannot attach itself to the androgen receptors of the hair follicle. The fusing of DHT with its androgen receptors is ultimately the main cause of the hair loss.

Shrinking of the hair follicle occurs when the DHT blocks it from receiving the nutrient rich supply of bloodstream. The papilla of hair is the component that is responsible for taking in these nutrients. There would be an eventual shedding of hair strands when the hair follicle shrinks to a significant degree.

Treatment to effectively prevent DHT from forming is available in the form of the Food and Drug Administration (FDA) approved medication called finasteride. It is sold under the brand name Propecia and works by inhibiting the 5-alpha-reductase enzyme from binding with testosterone. This could further be complemented with the use of spironolactone that acts by blocking the DHT from binding with the androgen receptors of the hair follicle. It is sold under the brand name Aldactone though does not have any FDA backing. Both finasteride and spironolactone can have potential side effects. It is recommended to consult a qualified physician before proceeding with any treatment to remedy hair loss.


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