Does Testosterone Cause Hair Loss

Does Testosterone Cause Hair Loss?

Testosterone itself does not directly cause hair loss. However, it is involved in a hormonal process that can lead to hair thinning in individuals who are genetically predisposed. The key player is a hormone called dihydrotestosterone (DHT), which is derived from testosterone. In certain people, DHT binds to receptors in the scalp and gradually causes hair follicles to shrink, leading to what’s known as androgenetic alopecia, or male and female pattern hair loss.

This type of hair loss is not caused by having more testosterone in general, but rather by how the body converts testosterone into DHT and how sensitive the hair follicles are to that conversion. Someone can have average or even low testosterone levels and still experience hair loss if they have a strong genetic sensitivity to DHT.

Can High Testosterone Cause Hair Loss?

High testosterone levels may contribute indirectly to hair loss by increasing the amount of DHT produced in the body. DHT is significantly more potent than testosterone when it comes to influencing hair follicles. If someone naturally has high testosterone, or if they are using testosterone supplements, anabolic steroids, or hormone replacement therapies, this can increase DHT levels and accelerate hair loss—but only if the person is genetically susceptible.

In other words, high testosterone doesn’t automatically mean someone will lose their hair. It becomes an issue when that testosterone is converted into DHT, and the follicles respond poorly to it. This is why some men with high testosterone have a full head of hair, while others with moderate levels experience significant thinning. Genetics and DHT sensitivity are what make the difference.

How Does DHT Affect the Scalp?

DHT affects hair by gradually shrinking the hair follicles in specific areas of the scalp, usually the temples and crown. As the follicles shrink, the hairs become finer, shorter and lighter in colour. Over time, these hairs stop growing altogether. This process is slow and progressive, often beginning in the late teens or twenties for men, and sometimes later for women.

The areas of the scalp that are most sensitive to DHT are genetically determined. Some people are more resistant to DHT and never experience this type of hair loss. Others have a strong family history and start seeing changes early in life, regardless of lifestyle or hormone levels.

Does This Affect Women Too?

Women also produce testosterone and DHT, but in smaller amounts. In female pattern hair loss, DHT can still contribute to thinning—particularly at the crown or parting—but the pattern is usually more diffuse than in men. High testosterone in women, such as from polycystic ovary syndrome (PCOS), can increase DHT and lead to more pronounced hair changes, along with other symptoms like acne or excess facial hair.

That said, not all hair loss in women is hormone-related. Stress, iron deficiency, thyroid issues and menopause can all lead to shedding or thinning, so a full medical evaluation is essential if symptoms appear.

What Can Be Done?

If DHT is believed to be a factor in hair loss, several treatments are available to manage it. These include topical treatments like minoxidil, prescription medications like finasteride or dutasteride (which block the conversion of testosterone into DHT), and other options like DHT-blocking shampoos or low-level laser therapy.

For women, treatment will depend on the underlying cause. Hormonal testing and tailored medication may be appropriate if testosterone is unusually high. In both men and women, early intervention offers the best chance of slowing or reversing the process.

Not Everyone With High Testosterone Loses Hair

A key misunderstanding is that high testosterone levels automatically mean someone will go bald. That’s not true. Many men with high testosterone never experience hair loss, and many with normal or even low testosterone do. The critical factor is how the body processes testosterone into DHT and how sensitive the hair follicles are to DHT exposure.

This sensitivity is mostly genetic, and it affects how hair follicles react to even small amounts of DHT. That’s why two people with similar hormone levels can have completely different experiences with hair loss.

Lifestyle and Hormone Levels

Testosterone levels are influenced by diet, sleep, stress, weight, and overall health. While lifestyle changes that boost testosterone—like exercise or protein-rich diets—have many benefits, they may marginally increase DHT as well. For most people, this is not enough to trigger hair loss unless they are genetically predisposed.

On the other hand, artificially boosting testosteronethrough anabolic steroids or testosterone replacement therapy (TRT) often results in much higher DHT levels, and in those cases, accelerated hair loss is a more common side effect. Athletes or bodybuilders using these substances often report hair thinning or receding hairlines, not because of testosterone alone, but because of elevated DHT.

Female Considerations and High Testosterone

In women, excess testosterone or DHT is often a sign of an underlying condition like polycystic ovary syndrome (PCOS). This can lead to scalp hair thinning while also increasing body or facial hair. However, just like in men, not all women with higher testosterone experience hair loss. The severity and pattern depend on genetic sensitivity and hormone balance.

Women experiencing hormonal symptoms along with hair thinning should always consult a healthcare provider for a hormone check, as the causes can vary from androgens to thyroid or iron issues.

Natural Variation in DHT Levels

DHT levels vary from person to person and even throughout the day. Small changes in testosterone may not dramatically affect DHT in everyone. Additionally, other enzymes and hormones in the body regulate how much testosterone gets converted into DHT. For example, the enzyme 5-alpha-reductaseis responsible for this conversion. Individuals with higher levels of this enzyme may produce more DHT and may therefore be at a greater risk of hair follicle miniaturisation.

Preventive Steps and Monitoring

If you're genetically at risk and concerned about hair loss, you don't necessarily have to avoid anything that might raise testosterone. Instead, focus on monitoring your hair health early, adopting good scalp care habits, and looking into mild DHT-blocking products like shampoos or supplements. Regular check-ups, including hormone tests, can also help you spot changes before they lead to visible thinning.

Final Word

Testosterone alone doesn’t cause hair loss—but when it’s converted into DHT, and when someone has a genetic sensitivity to that hormone, hair follicles can start to shrink and weaken. High testosterone may speed up this process in those who are predisposed, but it is not a universal cause. Understanding your own risk factors, including family history and hormone levels, is key to managing or preventing hair loss linked to DHT. If in doubt, seeking advice from a GP or trichologist can help you explore your options with confidence.