DHT (dihydrotestosterone) is the hormone most closely linked to pattern hair loss in both men and women. Understanding what it does helps explain why hair thins in a particular pattern and how several common treatments work.
What DHT is
DHT is an androgen made from testosterone by an enzyme called 5-alpha reductase. It plays normal roles in the body, including in male development. It is also active in the skin and hair follicles.
How DHT affects hair
In people who are genetically sensitive, DHT binds to receptors in certain scalp hair follicles and causes them to gradually shrink, a process called miniaturization. Each new hair grows back thinner and shorter, and the growth phase gets shorter, until some follicles stop producing visible hair. This is androgenetic alopecia. Genetics decide how sensitive your follicles are, which is why two people with similar hormone levels can have very different hair.
DHT in men
In men, DHT-related hair loss typically affects the temples, hairline and crown. See finasteride and a receding hairline.
DHT in women
In women, androgens are thought to contribute to female pattern hair loss, which usually causes thinning along the part and top of the scalp while the front hairline is preserved. Hormonal conditions such as PCOS, and the shift in hormone balance around menopause, can make androgen effects more noticeable. See female pattern hair loss.
How treatments target DHT
- 5-alpha reductase inhibitors, finasteride and dutasteride, lower the amount of DHT the body makes. Oral finasteride is FDA-approved for male pattern hair loss; dutasteride is used off-label. See dutasteride vs finasteride.
- Anti-androgens, such as spironolactone, block androgen receptors and are used off-label in women.
- Minoxidil does not affect DHT. It acts on the growth cycle and is often used alongside DHT-targeting treatment.
These are prescription decisions with real safety considerations, including pregnancy restrictions for DHT blockers and anti-androgens. The most consistent benefit is slowing or stopping further loss, and results vary.
Common myths
- High testosterone causes baldness. Follicle sensitivity matters more than hormone level.
- Shampoos and supplements block DHT enough to treat hair loss. Most have limited evidence compared with prescription options.
Next step
If you want a licensed provider to review whether DHT-related hair loss may be affecting you, start your online consultation.
Prescription required for prescription treatment. A licensed provider decides whether treatment is appropriate. Compounded medications are prepared by a licensed pharmacy for an individual patient and are not FDA-approved. Individual results vary. Prescribed Essence currently serves patients in California, Colorado, Florida and New York.
