Testosterone Hair Loss

Testosterone gets a lot of bad rap when it comes to hair loss. Androgenetic alopecia comes from the presence of the hormones testosterone and dihydrotestosterone. These hormones are the primary cause of hair loss in males.

However, many people are unsure of the link between testosterone and hair loss. There is a link, but how does it exactly work? And are all males going to lose their hair because of the presence of the hormone testosterone? 

Ovaries in the female reproductive system also produce the hormones oestrogen and testosterone. Although the quantity is fairly small, the presence of the hormone should mean that women should also lose their hair. However, that’s not always the case.

Not all men or women lose their hair simply because of the hormone testosterone. So, how exactly is it responsible for hair loss in both men and women and is it even responsible?

Here, we mean to answer just that question and clear up any confusion that you might have regarding testosterone hair loss.

What is Testosterone? 

It’s a sex hormone, yes, that’s found in both males and females. It is responsible for the development of secondary sexual characteristics in males such as:

  • Deepening of the voice
  • Pubic hair
  • Facial hair (beard)
  • Strengthening of bone and muscle mass
  • Regulating the sex drive (libido)
  • Fat distribution

The hormone is even used for the treatment of certain illnesses as well, such as hypogonadism.

High levels of the hormone testosterone also come with health benefits for males. For instance, a lower risk of a heart attack. But, on the other hand, it can also increase risk-taking behaviour in both males and females. 

What’s confusing is that some say that very high or very low levels of testosterone and hair loss are related. There are also different types of testosterone present in the body. Some roam freely without being bound to any proteins, and then there are others, such as dihydrotestosterone (DHT). 

Now, be careful about not confusing the hormone dihydrotestosterone with testosterone. Testosterone converts into dihydrotestosterone with the help of the enzyme 5-alpha reductase. 

Testosterone to DHT

However, dihydrotestosterone is far more potent, 5 times to be exact, and a lot of the time, the effects of testosterone on the body take place after its conversion into dihydrotestosterone. The hormone dihydrotestosterone is present in the skin, liver, hair follicles, and prostate. 

Its presence in hair follicles is why it’s blamed for hair loss, and rightfully so. When getting treatment for hair loss in males, they usually begin by targeting the testosterone hormone. 

For instance, finasteride is usually prescribed to stop hair loss. It works by blocking the action of 5-alpha reductase, the enzyme responsible for converting testosterone into dihydrotestosterone. But is that all there is to it? 

Testosterone And Baldness 

Those who suffer from male pattern baldness experience a recession in their hairline, with more hair loss occurring at the sides in the shape of an M.

It also progresses in other areas of the scalp, such as the vertex or crown of the head. However, hair on the sides and the back stays put. This is the donor hair that’s used for hair transplant surgery.

What’s difficult to understand is that the sensitivity of the hair to the testosterone hormone in certain areas of the body leads to hair loss.

However, that’s not always the case with hair loss and testosterone. Hormonal changes can lead to thicker facial hair growth even as the person continues to lose hair on their scalp. 

The freely flowing dihydrotestosterone in the bloodstream travels to the hair follicles in the scalp region and binds to the receptors there.

Hair loss proceeds in a manner where a person notices a decrease in the thickness of the hair. The hair growth cycle shortens. 

Stages of follicular miniaturization

Hair miniaturizes while becoming shorter and finer/thinner. People with pattern baldness have fewer quantities of testosterone in circulation as more of that hormone gets converted into dihydrotestosterone. 

High levels of the dihydrotestosterone hormone can cause more than just a few problems in males. To begin with, it can cause acne, receding hairline, loss of hair at the crown and temple regions of the scalp, prostate cancer, heart disease, etc. 

A low level of this hormone is also problematic. It can cause underdevelopment of the sexual organs, leading to the development of swollen and enlarged breasts in males (gynecomastia), and cause prostate tumours.

The illnesses arising due to an imbalance in the DHT hormone and their treatments can also cause hair loss. 

Does Testosterone Cause Hair Loss? 

You shouldn’t exactly blame this hormone. Testosterone and hair loss has more to do with your genetics.

The levels of the dihydrotestosterone hormone increase as more circulating testosterone converts into it.

The receptors on the hair follicles of the scalp are more sensitive to the presence of this hormone which comes from the conversion of testosterone. 

The sensitivity of those receptors in actuality leads to the loss of hair. Yes, the presence of testosterone triggers it, but that’s because of the greater receptivity of those receptors on the hair follicles, so they are easily affected.

Mechanism of androgenetic alopecia

Other than your genetics, stress, age, lifestyle, and health also determine whether you’ll lose your hair or not. However, it remains true that your genes play the most significant role. 

If you’re experiencing hair loss due to stress, it will be something that won’t affect those related to you. Genetics, on the other hand, doesn’t work that way. If you’re balding, the chances are that your children and grandchildren will also go bald.

Research has also shown that premature male pattern baldness is also linked with lower levels of testosterone, epitestosterone, follicle-stimulating hormone (FSH) and a protein, SHBG (sex hormone-binding globulin). 

Hair Loss And High Testosterone

Many people believe that hair loss and high testosterone are linked with each other. However, there’s more to it than that.

Does High Testosterone Cause Hair Loss?

Higher testosterone levels are believed to cause more hair loss because of more dihydrotestosterone (DHT).

However, according to research published in JAMA Dermatology, there’s no link between the levels of sex hormones and hair loss.

It depends on how sensitive your hair follicles are to androgens or how many androgen receptors you have.

Therefore, having more testosterone doesn’t mean that you’ll lose more hair. But it can cause other symptoms in males, such as:

  • Aggressive or risky behaviour
  • Acne
  • Excessive body hair
  • Sleep apnea
  • High blood pressure
  • Benign prostatic hyperplasia

While high testosterone hair loss may not occur, keep in mind that hormonal imbalance alone can trigger hair loss because of a shock to the body.

Does High Testosterone Cause Hair Loss In Females?

Whether high testosterone levels in females lead to hair loss is not entirely clear.

According to a review published in the International Journal of Molecular Sciences, women who produce too many male hormones usually develop female pattern baldness as they age.

Female pattern baldness

Additionally, women with hyperandrogenism (a condition that results in high testosterone levels) also commonly experience hair loss. Therefore, it’s possible that high testosterone causes hair loss in females.

Conversely, hair loss has been reported in women even in the complete absence of testosterone in the blood.

Low Testosterone And Hair Loss

Low testosterone hair loss is also believed to occur. However, again, the explanation is not so simple.

Does Low Testosterone Cause Hair Loss?

Several studies have shown that testosterone levels do not influence hair loss. Therefore, low testosterone is unlikely to cause hair loss.

However, low testosterone in males can cause other signs and symptoms, such as:

  • Low sex drive
  • Fatigue
  • Hot flashes
  • Erectile dysfunction
  • Shrunk testicles
  • More body fat
  • Depression

Again, bear in mind that hair loss on low testosterone can occur due to hormonal imbalance.

Can Low Testosterone In Females Cause Hair Loss?

It’s possible for low testosterone levels to cause hair loss in women.

Testosterone therapy has even been shown to improve hair growth in androgen-deficient women.

In a study published in The British Journal of Dermatology, 48 out of 76 patients had increased hair growth after treatment with testosterone for androgen deficiency.

Therefore, in women, testosterone hair growth can occur by replacing the hormone.

How To Prevent Hair Loss While Taking Testosterone?

You might need to prevent hair loss while taking testosterone although research has shown that its levels don’t cause more or less hair loss. It comes down to your androgen receptors.

Additionally, in women, testosterone therapy has been shown to improve hair growth rather than cause hair loss.

Still, if testosterone medication is making you lose your hair, you should consult with your doctor for any changes in your treatment plan.

How Is Testosterone Hair Loss Treated? 

Topical minoxidil and finasteride are usually prescribed for the treatment of permanent hair loss from testosterone.

hair loss drugs

One works by dilating the blood vessels, thus increasing the flow of blood to the hair follicles. This entails a greater supply of oxygen and other nutrients to the hair, which helps them grow. 

Finasteride, as mentioned above, nips the evil in the bud by not allowing the conversion of testosterone to DHT.   

Do Testosterone Blockers Stop Hair Loss?

DHT blockers can stop the conversion of testosterone into dihydrotestosterone. That, in turn, can help stop hair loss from testosterone. Moreover, it can increase hair growth.

While finasteride is the most effective DHT blocker, there are others, such as:

Several DHT-blocking products do not have solid scientific evidence behind their efficacy, so consult your doctor before using one. It will save you time and money.

Is Hair Transplantation Done For Testosterone Hair Loss?

One of the most effective treatments against testosterone and hair loss is hair transplant surgery. The hair on the back and sides of the head are not sensitive to the effects of the dihydrotestosterone hormone, which is why they don’t fall away.

testosterone hair transplant

You’ll notice that people who are bald have a ring of hair on the lower region of the scalp. That’s what the surgeons take advantage of when performing an FUE hair transplant or FUT hair transplant.

Because of their resilience against dihydrotestosterone, they won’t fall after the hair transplant surgery takes place, so you can continue enjoying the results of your surgery for a lifetime. 

Wrapping Up the Discussion 

So, can testosterone cause hair loss? There’s still a lot of confusion about the link between testosterone and hair loss. For instance, it’s still a mystery why hair follicle receptors in some areas of the body are more sensitive to the hormone dihydrotestosterone.

Even in the same region, such as the scalp, some hair follicles are more sensitive to it than others. But for testosterone and hair growth, surgical treatments, topical solutions, PRP injections, and medications are available. 

Of them, a hair transplant in Istanbul offers permanent, lifelong results for testosterone baldness. Although, you should further discuss your treatment options with a board-certified medical professional.

Reviewed and Approved by Dr. Cagla Yuksel.


Do testosterone supplements cause hair loss?

High or low levels of testosterone do not cause hair loss. However, testosterone supplements can indirectly lead to hair loss by causing a hormonal imbalance.

Do testosterone injections cause hair loss?

Hormonal fluctuations caused by testosterone injections can shock the body and cause a type of hair loss known as telogen effluvium.

Does testosterone increase hair loss?

Research shows that the levels of testosterone in the blood do not cause more hair loss. It depends on the androgen receptors on your hair follicles.

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