Does Low Testosterone Cause Hair Loss?

Male pattern baldness, known medically as androgenetic alopecia, is a hair loss condition that affects more than 50 million men and as many as 30 million women, a statistic reported by the National Institute of Health (NIH.gov). Though incredibly common, hair loss conditions like androgenic alopecia can cause severe distress and decrease emotional well-being. Characterized by an M-shaped receding hairline with a bald spot on the crown in men and hair thinning along the part in women, male and female pattern hair loss occurs primarily due to a genetic predisposition for hair loss. Many patients believe that one of the significant causes of hair loss is low or exceptionally high testosterone levels. However, the reality of the situation is more complex. The first step to treating hair loss is to determine the type of hair loss and its root cause. When you have your first appointment with board-certified dermatologist Dr. Michele Green, she will examine the treatment area and determine the treatment option that will be the most effective for you.

Many patients feel that when treating hair loss, there are an overwhelming number of treatment options available on the market, and it can be hard to know which are effective. Some patients may be experiencing hair loss due to overactivity of the androgen dihydrotestosterone (DHT), which is a hormone that can bind to the hair follicle receptors, damaging the hair follicle and causing hair loss and male pattern baldness to be accelerated. If this is the case, Dr. Green may prescribe a DHT blocker, such as Finasteride, to prevent the formation of DHT in the body. If hair loss has already occurred, Dr. Green may prescribe patients Minoxidil (Rogaine), which helps improve blood flow to the scalp and strengthen the hair follicles for regrowth. Another treatment option available at Dr. Green’s dermatology office to promote new hair growth is Microneedling with PRP injections to improve circulation to the scalp and thicken hair follicles.

With over 25 years of experience in treating a wide range of medical and cosmetic dermatological concerns, Dr. Michele Green is well-known for her ability to create individualized treatment plans for each of her patients. Generating unique skincare plans to address various problems, including hair loss, hyperpigmentation, acne breakouts, acne scars, fine lines, wrinkles, high skin laxity, and more, Dr. Green has been recognized for her exceptional work in such publications as Castle Connolly, Super Doctors, and New York Magazine.

What is Dihydrotestosterone (DHT)?

There are several forms of the androgen, or male sex hormone, testosterone, that are found in the body. People assigned male at birth have higher levels of testosterone naturally than those assigned female at birth, though everyone has some form of testosterone in the body. One type of testosterone is called “free testosterone” and is not bound to a particular protein. Instead, free testosterone can travel around the body for absorption by different cells, helping with various functions, such as building muscle mass. Some forms of testosterone are bound to specific kinds of proteins, such as albumin in the blood or sex hormone-binding globulin. Dihydrotestosterone is created when testosterone binds to the 5-alpha reductase enzyme and is used in the skin, hair follicles, and prostate. During puberty for patients assigned male at birth, when hormone levels shift, DHT contributes to changes, such as lowering the voice, body hair growth, increased production of sperm, and testicle growth. While levels of DHT are essential for the development of the prostate, DHT can also bind to the hair follicles, affecting the growth cycle of the hair and causing the hair to become finer and finer until the follicle ceases to produce new hair growth. However, high levels of DHT do not necessarily mean that a patient will experience hair loss. Instead, the sensitivity of the hair follicles to DHT, which is genetically determined, will determine whether hair loss will occur more easily.

Does high testosterone cause hair loss?

One common assumption among patients is that high testosterone levels directly cause hair loss, but the true answer to the question is more complex. High levels of testosterone in the body may result in an increased production of DHT, which can accelerate the process of hair loss for patients genetically susceptible to balding. While high testosterone or DHT levels do not directly cause hair loss, high DHT levels have been linked with conditions such as prostate cancer and benign prostatic hyperplasia.

Does low testosterone cause hair loss?

Hormone imbalance can affect a patient’s day-to-day ability to function at their highest capacity. The many side effects of experiencing low testosterone levels (or “low T”) include loss of muscle mass, weight gain, erectile dysfunction, fatigue, low sex drive, and even depression. As men age, testosterone production naturally decreases and can affect body and facial hair growth. Still, researchers have not found a link between low testosterone levels and hair loss on the crown of the head. While low testosterone levels may correlate to less DHT being produced, the primary cause of hair loss is a genetic sensitivity to the binding of DHT to the hair follicles.

Does testosterone replacement cause hair loss?

Low testosterone levels can cause many issues, including decreased bone density, muscle mass, and strength, inability to sleep, erectile dysfunction, low sex drive, weight gain, and decreased mental and emotional wellness. Testosterone replacement therapy may be effective for patients with these conditions and can be administered in several ways, including injections, pellets, creams, and patches. For injectable testosterone replacement therapy, the testosterone is injected directly under the skin or into a muscle for absorption by the body. Gels are rubbed onto and absorbed through your skin, though a potential side effect of the treatment is skin irritation and transference of the medication to another should they rub up against the treatment area. Patches can be applied to the thigh or torso nightly, whereas pellets must be surgically implanted under the skin every 3-6 months. No matter how it is administered, testosterone replacement therapy can benefit patients with low testosterone levels and will not directly cause hair loss or male pattern baldness.

Does taking testosterone cause hair loss?

Testosterone replacement therapy is designed to raise testosterone levels in patients with Low T, restoring normal testosterone levels, which fall in the 300-1,000 nanogram per deciliter of blood range. Some patients worry that increased levels of testosterone in the body can contribute to hair loss and male pattern baldness. However, that is not necessarily true. Hair loss occurs when the hair follicles become thinner and weaker, eventually entering a permanent resting phase and causing the hair to fall out. When androgen levels increase in the body, the production of DHT in the 5-alpha reductase enzyme rises, which can be a risk factor for patients genetically susceptible to hair loss. The DHT binds to the hair follicle, causing them to weaken and accelerating the hair-thinning process. As such, increasing testosterone levels in the body does not cause hair loss, but it can accelerate the process already in motion.

Does testosterone cause balding?

High or low testosterone levels do not directly lead to balding; hair loss is associated with the sensitivity of the hair follicles, which is genetically determined. Hair loss occurs when hair follicles shrink, thinning to the point where the hair growth cycle ceases, and the hair follicle becomes dormant. This condition is known as androgenic alopecia and can affect both men and women though it most commonly occurs in men. Several stages of balding occur in patients with androgenic alopecia, beginning with a thinning of the front hairline until it recedes into an M-shape. As this happens, the hair starts to thin on the top of the head, leading to hair loss at the crown. Over time, the hair loss becomes so severe that these two areas converge until only a U-shape of hair remains around the outside of the head.

The most significant risk factor for experiencing androgenetic alopecia is having a family history of the condition rather than the level of testosterone present in the body. High testosterone levels can contribute to the increased production of the hormone DHT, which can bind onto the hair follicle, weakening and causing hair loss. However, the testosterone level does not determine how sensitive the hair follicle is to DHT. Some patients genetically have a higher sensitivity to DHT, meaning high levels of DHT can accelerate the hair loss process.

Is balding a sign of low or high testosterone?

While testosterone levels can affect the growth of body hair and facial hair, hormonal imbalance does not directly lead to hair loss on the crown of the head. High levels of testosterone can increase body hair and facial hair growth and, depending on your genetic predisposition, may accelerate the hair loss process due to the increased production of DHT, which can bind to sensitive hair follicles. Hair loss is not directly related to testosterone levels; hair follicle sensitivity determines the incidence of androgenetic alopecia.

Does testosterone cause hair loss in females?

While androgenetic alopecia is more common in men than women, female pattern balding can be distressing for more than 30 million women who experience the condition. People assigned female at birth have lower levels of androgens, such as testosterone, but still enough to experience androgenetic alopecia. Female pattern hair loss is similar to male pattern hair loss in that both are due to the action of DHT on the hair follicles but female pattern hair loss differs from male pattern hair loss in the shape that hair loss takes. Whereas male pattern hair loss forms an M-shape along the hairline with thinning on the crown, female pattern hair loss typically appears in a “Christmas tree” shape with thinning beginning along the part and expanding outward. Increased testosterone levels in women can cause various side effects, such as weight gain, acne breakouts, growth of chest hair or facial hair, and a potential loss of hair on the crown of the hair. Similarly to male pattern hair loss, there is a genetic component to female pattern hair loss, meaning that women with more sensitive hair follicles experience hair thinning with increased testosterone levels.

Can low testosterone cause hair loss in females?

High testosterone levels in male and female patients can contribute to increased production of DHT, which can accelerate hair thinning for genetically predisposed people. Typically, patients assigned female at birth have naturally lower levels of testosterone than men, as these androgens, or male expression hormones, are balanced out by female expression hormones, such as estrogen. While that is the case, testosterone levels can still affect many aspects of the female body, including muscle mass, bone density, menstruation cycle, and sex drive. However, there is no correlation between low testosterone levels and hair loss in females.

What causes high DHT levels in females?

Several conditions can lead to increased levels of DHT in patients assigned female at birth, including menopause, overactive thyroid, testosterone supplements, polycystic ovarian syndrome, and congenital adrenal hyperplasia. As women go through menopause, the body decreases the production of female expression hormones like estrogen, increasing the production of androgens, such as testosterone. When testosterone levels increase in the body, DHT levels increase as well. The same applies to testosterone supplements, which raise DHT levels and have additional side effects, including acne breakouts, chest hair growth, male pattern baldness, and lowering the voice. Polycystic ovarian syndrome is another condition that contributes to high DHT levels in females and occurs when the ovaries overproduce androgens, such as testosterone. When polycystic ovarian syndrome occurs and testosterone levels rise, additional side effects may include acne breakouts, body hair growth, and irregular menstruation.

Can testosterone replacements cause hair loss?

Patients experiencing low testosterone levels may find Low T affects many aspects of their lives. For both men and women, low testosterone can lead to fatigue, weight gain, decreased muscle mass and bone density, low libido, and depression, leading many patients to seek a solution in testosterone replacement therapy. Testosterone replacement therapy can be performed in several ways and will boost the levels of androgens present in the body, which can also increase the levels of DHT. Patients with a genetic predisposition to hair follicle sensitivity may find that increased levels of DHT accelerate hair loss on the crown of the head.

Do testosterone supplements cause hair loss?

Testosterone supplements can be prescribed for patients experiencing low levels of testosterone and can take the form of injections, a gel, patches, or pellets surgically implanted under the skin. While testosterone supplements can increase the levels of DHT found in the body, they are not directly linked to hair loss. When DHT binds to the hair follicles of patients with high hair follicle sensitivity, the hair follicle becomes weaker and thinner, eventually dormant, causing hair thinning to occur. Patients with hair follicle sensitivity may experience accelerated hair loss when taking testosterone supplements.

Is hair loss a sign of low testosterone?

Hair loss related to androgenetic alopecia occurs in patients with a family history of male pattern baldness due to an increased sensitivity of hair follicles to the hormone DHT. As DHT binds to the hair follicle, it becomes weaker and thinner, ultimately causing the hair to fall out and the hairline to recede. DHT is produced when testosterone binds to the 5-alpha reductase enzyme, and higher testosterone levels often lead to higher levels of DHT. As such, low testosterone levels are not directly related to hair loss.

Does testosterone increase hair growth?

The relationship between androgen hormones, such as testosterone, and hair growth is complicated. High levels of testosterone can increase body hair and facial hair growth but can also increase levels of DHT, which can, in turn, contribute to hair loss. Low testosterone levels can affect overall wellness by decreasing muscle mass, bone density, and sex drive. However, with lower levels of DHT produced, male pattern baldness may occur more slowly.

Is hair loss from low testosterone reversible?

Hair loss can be extremely frustrating and distressing for patients, causing many to seek a hair regrowth treatment option. Luckily, Dr. Green has several treatment options available at her New York City dermatology office to help restore strength to the hair follicles, thicken the hair, and promote new growth. One such treatment is oral Minoxidil, which was initially FDA-approved to treat high blood pressure but has since been used to treat male and female pattern baldness. Minoxidil can be used topically or orally, though topical Minoxidil can irritate the scalp, which is why some patients prefer to take the medication orally. The drug increases circulation and blood flow to the scalp, which helps to thicken hair follicles that DHT may have weakened. Further, the treatment prolongs the growth phase of the hair follicle, allowing hair to grow longer and for an extended period. With these actions together, Minoxidil helps reverse the effects of androgenetic alopecia without needing a surgical hair transplant.

PRP injections are another treatment available at Dr. Green’s office that helps reverse signs of hair loss. PRP injections, also known as platelet-rich plasma injections, are created with a solution comprising the patient’s plasma. The procedure begins with Dr. Green drawing blood and using a centrifuge to separate the platelet-rich plasma from the red blood cells. The PRP solution is then injected into the scalp to increase the concentration of proteins known as growth factors, which helps extend the hair growth phase, thicken the hair follicle, and heal the treatment area. Several studies have shown that PRP injections performed once every 2 to 3 weeks for several months can help increase the number of hair follicles, increase the thickness of hair follicles, and strengthen the root of the hair.

How to prevent hair loss while taking testosterone

One of the best ways to prevent hair loss when increasing testosterone levels with supplements or testosterone replacement therapy is to be prescribed a DHT blocker, such as Finasteride. Finasteride, known by its brand name Propecia, inhibits the production of DHT by inhibiting the essential enzyme in the creation of DHT. When oral Finasteride is taken daily, it can decrease DHT production by up to 70%, significantly slowing hair loss in most male patients. Studies have shown that Finasteride consistently decreases hair loss compared to patients who do not take the medication. Biotin, or vitamin B supplements, can also be taken while taking testosterone to maintain the strength of the hair follicles. Vitamin B supplements are less effective than prescription medication such as Minoxidil or Finasteride.

How to get started with hair loss treatment today

Androgenetic alopecia is a type of hair loss that occurs when an increase in androgen hormones leads to increased levels of dihydrotestosterone (DHT), which binds to hair follicles and weakens them. As the hair follicles become weaker, the hair begins to thin, leading to a receding hairline and balding at the crown of the head. Any type of hair loss is distressing, but with androgenetic alopecia, the underlying cause of hair loss is genetic, meaning that it cannot be entirely prevented. That said, the signs of hair loss can be slowed and reversed with several treatment options available at Dr. Michele Green’s dermatology office. Oral treatments, such as Minoxidil and PRP injections, can help to strengthen the hair follicle and prolong the growth phase, resulting in thicker, longer hair. DHT blockers, such as Finasteride, can be used to prevent the formation of DHT, which decelerates the rate of hair loss over time. No matter the underlying cause of hair loss, Dr. Green has solutions to protect you from significant hair loss. The best place to start is by consulting with a board-certified dermatologist, such as Dr. Green.

Dr. Michele Green is a world-renowned board-certified dermatologist with over two and a half decades of experience diagnosing and treating hair loss and thinning. Always at the forefront of innovative treatment options, Dr. Green has helped some of the world’s most discerning individuals with customized hair loss treatment plans best suited to their specific concerns and ideal aesthetic goals. She is consistently voted as one of New York City’s best physicians by Super Doctors, Castle Connolly, and New York Magazine for her dedication to her patients and expertise. When you consult with Dr. Green at her private dermatology office in Manhattan’s Upper East Side, she will work with you to better understand and treat your hair loss for thicker, healthier hair that lasts. Contact us online or call 212-535-3088 to schedule a consultation with Dr. Green and learn more about effective treatment options for hair loss.