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Is DHT the Cause of Your Hair Loss?

DHT is a hormone responsible for male physiology, including body hair. It can also be the cause of hair loss.

Middle-aged male looks at his hair in the mirror with a concerned expression.

Worried about the floor or your comb “stealing” your hair? For some, a mid-life crisis includes desperately trying to figure out the cause of hair loss. One cause of thinning hair is dihydrotestosterone or DHT, a hormone in the human body.

Learn how DHT relates to hair loss in both men and women and Traditional Chinese Medicine (TCM) approaches to encourage hair growth. 

What Is Dihydrotestosterone (DHT)? 

DHT is an androgen (male) hormone. It’s responsible for the development of male sexual and physical characteristics in the foetus and during puberty. DHT is converted from testosterone by enzymes called 5-alpha reductase. Males at birth have more DHT than females at birth.

DHT plays a key role in developing the penis, scrotum, and prostate gland in males. Facial, body and pubic hair growth during a boy’s teenage years are also thanks to DHT. Females have DHT, too, but in much smaller amounts.

The Natural Hair Growth Cycle 

Normal hair growth involves four stages: 

  • Anagen (growth): Cells in the hair follicle actively grow a strand of hair for about two to six years.  
  • Catagen (maturity): Short transitional period of about two weeks when the hair strand detaches from the blood supply.  
  • Telogen (resting): Growth stops, but the hair root remains in the follicle. This stage lasts around three months. 
  • Exogen (shedding): The hair strand falls out of the follicle as a new hair root grows to take its place, which can last about two to five months. 

At any moment, about 90% of your hair is in the anagen phase. Less than 5% is in the catagen phase, while the rest of your hair sheds. Losing about 100 strands a day is normal. 

How Does DHT Become the Cause of Hair Loss?

Close-up of a scalp with thinning hair.
DHT can bind to receptors in the hair follicle, causing it to shrink and lead to hair loss.

In adulthood, 10% of testosterone is converted to DHT. An imbalance in DHT levels can lead to the shrinking of the hair follicles. In some people, DHT binds to certain receptors in the hair follicle, causing them to narrow. This shortens the growth phase and lengthens the shedding phase, resulting in hair loss

DHT can also cause hair loss in females. A hormonal imbalance can lead to androgens like DHT becoming dominant, resulting in thinning hair. 

Treatments to Stop Hair Loss Due to DHT 

Hair loss can cause great distress as it can drastically alter your appearance. There are two medications approved for the treatment of DHT-related hair loss: 

  • Minoxidil (topical): Widens blood vessels to promote the anagen or active phase of hair growth. 
  • Finasteride (oral): Inhibits type II 5-alpha reductase enzyme and reduces the conversion of testosterone into DHT. Women who are trying or could be pregnant should not take this medication. For men who want to take this medication, some common side effects are a loss of sexual ability, desire, drive or performance. 

The Cause of Hair Loss: The TCM Perspective 

Healthy hair begins at the scalp. Follicles in the scalp draw nutrients from well-circulated blood, which is enabled by optimal qi flow. 

TCM believes that hair loss is a symptom of internal imbalances. In males, these imbalances include: 

  • Liver Qi (vital life energy) Stagnation  
  • Kidney Deficiency  
  • Blood-Heat with Dry Wind  
  • Spleen-stomach Deficiency with Dampness-Heat  

In females, a lack of blood plays a key role in hair loss, specifically due to Deficiencies in the Liver and Spleen.

Address the cause of hair loss with TCM 

According to research, Chinese knotweed (he shou wu, 何首乌) positively affects growth factors in the hair follicle. In TCM, healthy hair is a result of proper nutrition which contributes to qi flow, Liver and Kidney functions. Chinese knotweed can support qi flow in the body and supplement nutrition deficiency, which means more nourishment for your scalp and hair.

It’s taken orally, usually with herbs such as Rehmannia root (shu di huang, 熟地黄).

Hands holding a few pieces of dried Rehmannia root, held above a table with an empty plate and placemat.
Rehmannia root and Chinese knotweed are often included in herbal therapies to address the cause of hair loss.

Acupuncture also helps stimulate the nerves and blood vessels in hair follicles. The most commonly used acupoints are: 

  • Zu san li (ST36, 足三里): Regulates the Spleen and stomach and decreases inflammatory cytokines levels in the follicles. 
  • Bai hui (DU-GV20, 百会): Improves circulation and balances yin and yang levels in the body. 
  • Tai chong (LR3, 太沖): Revitalises the Liver, dispels Heat, and helps reduce stress.  

If you can see your scalp in the mirror easily, consider DHT a possible cause of hair loss. In addition to medication and the above therapies, ensure you take adequate micronutrients. These include vitamins A, C, B7 (biotin), B12, B6, omega-3 fats, and iron.

It can take a while for your hair to respond to treatment, but there is hope. Share your hair loss journey with us and inspire others! 

This is an adaptation of the article “DHT雄激素竟会导致脱发?”, which first appeared on the Health123 website.

References

  1. Cleveland Clinic. 2022. Hair Follicle. [online] [Accessed 3 March 2023]  
  2. Cleveland Clinic. 2022. DHT (Dihydrotestosterone). [online] [Accessed 3 March 2023]  
  3. StatPearls. 2022. Androgenetic Alopecia. [online] [Accessed 3 March 2023]  
  4. American Hair Loss Association. Causes of Hair Loss. [online] [Accessed 3 March 2023] 
  5. Faculty Reviews. 2022. Advances in hair growth. [online] [Accessed 3 March 2023] 
  6. Evidence-Based Complementary and Alternative Medicine. 2015. Hair Growth Promotion Activity and Its Mechanism of Polygonum multiflorum. [online] [Accessed 3 March 2022] 
  7. Frontiers in Medicine. 2022. Efficacy of Acupuncture and Moxibustion in Alopecia: A Narrative Review. [online] [Accessed 3 March 2022] 
  8. Cleveland Clinic. 2022. The Best Vitamins and Supplements for Hair Growth. [online]  [Accessed 3 March 2022] 
  9. Evidence-Based Complementary and Alternative Medicine. 2022. Traditional Chinese Medicine Treatment for Androgenetic Alopecia Based on Animal Experiments: A Systematic Review and Meta-Analysis. [online] [Accessed 3 March 2022]

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