Does High Testosterone Cause Hair Loss? Understanding the Connection

For a lot of men, noticing hair thinning is one of those moments they never forget. You run your hand through your hair, and it just doesn’t feel as thick as it once did. Maybe you can see a little more scalp than before. An interesting question that comes up often, particularly among men undergoing testosterone replacement therapy is, does high testosterone influence hair loss?

Hair loss can be confusing and frustrating. But if you understand how hormones like testosterone and DHT affect your scalp and hair growth, you’re in a better position to do something about it. This article discusses the relationship between testosterone and hair loss and presents potential hair loss treatments to stimulate hair growth.

Key Takeaways

• Testosterone doesn’t cause hair loss directly. Male pattern baldness happens when testosterone converts to DHT, which shrinks hair follicles.
• Androgenetic alopecia is mainly genetic. Hair thinning along the hairline and crown occurs if follicles are sensitive to DHT.
• Other factors can speed up hair loss. Age, anabolic steroids, testosterone therapy, hormonal imbalances, nutritional deficiencies, and stress may accelerate balding in men predisposed to it.
• Healthy habits support hair growth. Avoid harsh chemicals, get enough sleep, and eat a diet rich in iron, zinc, and biotin.
• If your hair is thinning, you have treatment options. Finasteride reduces DHT. Minoxidil increases blood flow to hair follicles, so they stay in the growth phase for longer. Laser therapy and hair transplants are also available.
• Act quickly if hair loss starts. Sudden thinning or bald patches should be evaluated by a dermatologist promptly.

What Is Testosterone?

Testosterone is the main male sex hormone. It helps you build muscle mass, promotes facial hair growth, and deepens your voice during puberty, contributing to secondary sexual characteristics. Women have smaller amounts of testosterone, too but for this article, we will focus on the characteristics of testosterone that shape how men look and feel.

To understand its full impact and learn more, see the benefits of TRT as well as the side effects of TRT.

DHT and Testosterone Levels

Testosterone doesn’t usually act alone. Once it’s in your system, some is converted into another hormone called dihydrotestosterone, or DHT for short.

DHT is influential in developing masculine traits, too, like body hair, muscle growth, and a healthy prostate. However, if you’re genetically sensitive to it, DHT can gradually shrink the hair follicles on your scalp and lead to thinning hair over time.

How DHT Impacts Hair Growth

DHT is stronger than testosterone. This means it binds more tightly to androgen receptors than testosterone does. If you’re genetically sensitive to it, DHT can also shrink the hair follicles on your scalp.

Over time, these follicles don’t produce strong, thick strands anymore. Instead, each hair grows finer and shorter. Eventually, some follicles stop making hair altogether, affecting your hair regrowth. That’s why you might see a receding hairline or thinning on the top of your head. These are classic signs of androgenetic alopecia, or male pattern baldness.

Interestingly, the same hormone that can cause you to lose the hair on your head (DHT) often makes facial and body hair grow thicker, since different hair follicles respond to androgens in varying ways (Kaufman, 2002).

Not All Hair Loss Is the Same

Male pattern hair loss, also called androgenetic alopecia, is the most common kind of hair thinning in men. But it’s not the only type.

Male Pattern Baldness

If you have noticed thinning on your crown and/or hair loss along your temples, you likely have androgenic alopecia, or male pattern hair loss.

Autoimmune Responses

Some men lose hair in patches because of autoimmune issues.

Lifestyle Stressors

Others shed more than usual after stressful events, illnesses, or big weight changes. Those situations don’t have much to do with testosterone or DHT.

If you’re unsure which type of hair loss you have, it’s smart to check with a dermatologist. A quick exam usually clears things up and can help you identify the best treatment option to restore hair growth.

Why Do Some Men Lose Hair and Others Don’t?

You might wonder why your friend has a full head of hair while you’re seeing your hairline move back.

Genetics and Male Hair Loss

Genes are involved. If your family has a history of androgenic alopecia, the chances are higher that you may experience it too.

Other factors, like age, hormone levels, and even lifestyle, can contribute to advanced hair loss over time. 

For example, men who use anabolic steroids or certain testosterone replacement therapies often experience faster hair thinning, as explained in Kaufman’s paper in Dermatologic Clinics on androgen metabolism (Kaufman, 2002).

What Is the Hair Growth Cycle?

Each hair follicle goes through a growth cycle that repeats:

• Growth phase (anagen): Hair grows steadily. This can last several years.
• Transition phase (catagen): The follicle shrinks a bit. This part only lasts a few weeks.
• Resting phase (telogen): The hair stops growing and eventually falls out. Afterward, a new hair follicle starts the cycle again.

When DHT shortens the growth phase, hair strands have less time to thicken. That’s why hair can start looking thin and patchy.

Can Changing Your Habits Make a Difference?

While you can’t change your genetics, good habits can support healthier hair. Eating a diet with enough iron, zinc, and biotin helps keep hair follicles working properly, since deficiencies in these nutrients have been linked to hair thinning and poor regrowth (Sinclair, 2004; American Academy of Dermatology Association, n.d.). 

Some people find that regular exercise and good sleep help support hormone balance and reduce stress, factors that can indirectly protect against hair loss (Mayo Clinic, 2022; Shapiro, 2007).

It’s also a good idea to avoid tight hairstyles, harsh chemical treatments, or frequent heat styling. Those things won’t cause male pattern baldness on their own, but they can damage fragile hair that’s already thinning.

Hair Loss Treatments

Finasteride

If you have experienced hair loss linked to DHT, you have options for treating hair loss. Finasteride is a well-known hair loss treatment. It is available as a prescription pill or topical ointment. It lowers DHT levels by blocking the enzyme that converts testosterone (Kaufman, 2002). This can slow hair loss in some men and, sometimes, help you regrow some hair  (McClellan & Markham, 1999). 

It is important to note that finasteride is not typically considered a first-line therapy for all patients. Clinical trials have shown that 1–2% of men may experience sexual side effects, including erectile dysfunction, reduced ejaculate volume, decreased sperm count, and difficulty achieving orgasm. These potential adverse effects should be weighed carefully when deciding on treatment, and discussed openly with a healthcare provider (Kaufman et al., 1998; Amory et al., 2007; Gupta & Charrette, 2014).

Minoxidil

Minoxidil is a topical treatment you apply directly to your scalp. It promotes blood flow to your hair follicles, stimulating hair growth. It doesn’t block DHT but can help hair follicles stay in the growth phase longer (Rossi et al., 2012).

Topical minoxidil is generally well tolerated, but some users may experience local side effects, such as scalp redness, dryness, itching, or peeling. These reactions are usually mild but can lead some patients to discontinue use.

An alternative option is oral minoxidil, which is used off-label for treating hair loss. It works through the same mechanism of action (vasodilation and enhanced blood flow to follicles) but carries a lower risk of topical skin irritation. Oral minoxidil may be a suitable choice for patients who cannot tolerate the topical formulation. However, it should be prescribed and monitored carefully by a healthcare provider due to potential systemic effects.

There are also low-level laser devices that may improve blood flow to the scalp. And for men who want a permanent solution, hair transplant procedures move healthy follicles to thinning areas.

When Should You See a Doctor About Hair Loss?

Everyone sheds hair every day. The average person typically sheds around 50 to 100 strands. But if you notice bald spots, rapid thinning, or sudden shedding, don’t ignore it. The sooner you understand what’s causing hair loss, the more choices you’ll have to treat it.

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References

American Academy of Dermatology Association. (n.d.). Hair loss: Overview. Retrieved from

Mayo Clinic. (2022). Hair loss.

Kaufman, K. D. (2002). Androgen metabolism as it affects hair growth in androgenetic alopecia. Dermatologic Clinics, 20(3), 573–579.

Ellis, J. A., Sinclair, R., & Harrap, S. B. (2002). Androgenetic alopecia: Pathogenesis and potential for therapy. Expert Reviews in Molecular Medicine, 4(22), 1–11.

McClellan, K. J., & Markham, A. (1999). Finasteride: A review of its use in male pattern hair loss. Drugs, 57(1), 111–126.

Rossi, A., Cantisani, C., Melis, L., & Carlesimo, M. (2012). Minoxidil use in dermatology, side effects and recent patents. Recent Patents on Inflammation & Allergy Drug Discovery, 6(2), 130–136.

Sinclair, R. (2004). Male pattern androgenetic alopecia. BMJ, 328(7452), 1463–1466.

Rafi, A. W., & Katz, B. E. (2019). Advances in the treatment of hair loss. F1000Research, 8.

U.S. National Library of Medicine. (n.d.). Dihydrotestosterone. Retrieved from

Shapiro, J. (2007). Hair loss in men and women. BMJ Clinical Evidence, 2007, 1711.