Dihydrotestosterone (DHT) and its role in baldness

In men, testosterone plays a very important role in the development of male reproductive tissues such as the testicles and prostate. It also promotes secondary sexual characteristics such as the increase of muscle and bone mass and the growth of body hair.

For baldness, the problem arises when the enzyme 5-alpha reductase (5-AR) converts testosterone to Dihydrotestosterone (DHT). Normally, approximately 10% of testosterone is converted to DHT.

DHT accelerates hair loss and is more powerful than testosterone and attaches much more easily and for much longer.

When the enzyme 5-alpha-reductase converts testosterone into dihydrotestosterone (DHT), it atrophies the hair follicles, causing the scalp membranes to become rigid. As a result, the follicular structure becomes saturated and receives less blood supply and the new hairs are born weaker, increasingly thinner than normal and with an unhealthy appearance. This is why the follicles end up atrophied and the hair that falls out will never be replaced. This will lead to baldness.

In slightly more technical terms, DHT reduces the anagen phase and the telogen phase becomes much longer (these phases were previously discussed in the article on the Hair life cycle). Shortening the growth phase means that the hair cannot grow as long as it used to. Eventually the anagen phase becomes so short that new hairs barely make it above the surface of the skin. As the follicles become smaller, they also become thinner until they are reduced to "vellus hair" (a very thin type of hair that covers babies and mostly disappears during puberty.

Interestingly, without the presence of DHT, head hair could grow, but not beard, underarm hair or pubic hair. On the one hand DHT is essential for the growth of most hair, but bad for head hair.

Hair transplantation as a definitive solution to DHT alopecia

Finally, and perhaps the most important discovery of all, is that the hair on the front of the head has a much higher level of androgen receptors than the hair on the nape of the neck or sides of the head. That is why hair transplants are so effectiveThe transplanted hairs contain fewer receptors. Therefore, once correctly transplanted, they will no longer fall out.

If you are starting to lose your hair and would like to know more about your specific case, schedule a free appraisal appointment and we will gladly advise you in the best way. Complete the form below: