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Doctor's Guide to DHT Blockers - Do They Work for Hair Loss?

Tagged in: Hair Health

by Dr. Bryan Do, D.O. Last Updated: November 04, 2019

What is DHT Blocker and Is it Right for Your Hair Loss?

DHT blocker supplements have become one of the primary tools for combatting hair loss and maintaining healthy hair growth. However, DHT blockers are not a one-size-fits-all option. Depending on your personal needs and your form of hair loss, DHT blocker supplements may not be right for you. Read on to learn more about DHT blockers and whether they will work for your particular type of hair loss.

What is DHT?

DHT (dihydrotestosterone) is an androgen hormone produced through the conversion of testosterone by the enzyme called 5-alpha reductase (5-AR). DHT is present in both men and women. While normal levels of DHT promote normal body hair growth, high DHT symptoms may include baldness and prostate problems in men and female pattern hair loss in women.

DHT is more powerful than testosterone, and it attaches to the same androgen receptors. However, it attaches more easily and for longer periods of time.²

DHT levels are also related to your testosterone levels. Having more testosterone can mean higher levels of DHT because more testosterone can get converted to DHT.

Facts About DHT

In men, testosterone is converted into DHT by the enzyme 5-alpha reductase. There are two types of this enzyme. Type 1 is mainly found in your skin’s sebaceous glands, while type 2 is more prevalent in the hair follicles and genitourinary tract. Type 2 tends to be more prominently involved in the hair loss process.²

Nearly 10 percent of the testosterone produced by an adult is converted into DHT every day. In men, testosterone is mostly produced in the testes, while in women, it occurs in the ovaries and adrenal glands. DHT conversion can occur in the skin and other parts of the body outside the gonads.¹

Similar to testosterone, most DHT is bound to proteins in the blood. This includes albumin and sex hormone binding globulin. However, less than 1 percent of your DHT circulates freely in your blood, which is slightly less than the amount of free-circulating testosterone.³

DHT’s Effect on Hair Growth and Hair Loss

At moderate, well-regulated levels, DHT can play an integral role in your overall health and wellbeing. However, when left unchecked, high DHT levels can result in some serious health issues. In men, excess DHT can cause prostate issues, including prostate cancer and benign prostatic hyperplasia (an enlarged prostate).

More commonly, high DHT levels may result in male or female pattern baldness which is further described here. Although DHT plays an important role in the growth of hair on the face and body, your scalp reacts differently to DHT. When DHT attaches to androgen receptors on hair follicles, gradually causing the follicles to shrink. As the follicles grow smaller, the hair’s anagen (active growth) phase gets shorter, while the hair’s resting phase gets longer. Hair shafts become thinner with each cycle of growth until your hairs are reduced to vellus hairs.²

The exact mechanisms of DHT and the shrinkage of hair follicles remain unknown, though researchers found that follicle samples taken from a balding scalp contained more androgen receptors than samples taken from a non-balding scalp. Furthermore, in a surgical hair transplant, hair follicles from parts of the scalp that are less sensitive to DHT can be transplanted to parts that are more sensitive to restore hair growth.

This supports the ongoing hypothesis that DHT’s effect on hair loss may come as a combination of higher androgen receptors in certain areas of the scalp, higher DHT levels, and a genetically predisposed sensitivity to DHT.⁴

Why Does DHT Affect People in Different Ways?

While DHT is the main cause for male and female pattern baldness, there are plenty of people with high DHT who do not experience hair loss. The fact is, scientists still are not sure why some people experiencing hair loss while others do not. Studies do show that hair follicles taken from a balding scalp have far more androgen receptors than non-balding hair follicles, suggesting that more androgen receptors may be a factor in androgenetic alopecia.⁴

Most research believes that some people’s hair follicles are more sensitive to DHT, even in small amounts. This sensitivity is determined by genetics and location of the hair, but age, stress, and a wide range of other factors also contribute to hair loss.³²

DHT Blockers for Men vs. Women

DHT contributes to baldness in both men and women, so DHT blockers for women should provide similar effects in promoting hair growth. However, most studies show that women require higher doses of DHT blockers. For example, men are normally prescribed 1 mg per day of finasteride, but this was found to have no significant benefit for women. A dose of 2.5 mg per day was found to improve hair loss in women, while doses as high as 5 mg per day for a period of 12 months resulted in significant hair density and thickness.³³

The Risks of Too Much DHT

Along with its effect on hair growth, high levels of DHT can contribute to a variety of other health problems. In men, excess DHT is associated with an increased risk of prostate issues, including an enlarged prostate and prostate cancer.²

In women, an overproduction of DHT may actually experience hirsutism, or increased growth of body and facial hair.³ Women with too much DHT may also experience stopped or irregular menstrual periods and a sudden increase in acne.¹

How to Reduce DHT

There are a number of ways to block DHT and prevent the DHT hormone from causing hair loss.

DHT blockers are usually prescribed for hair loss caused by high DHT. For example, the prescription DHT blocker finasteride works by inhibiting the enzyme 5-alpha reductase. With less active 5-alpha reductase enzyme, less testosterone gets converted into DHT.² Less DHT means less female and male pattern hair loss.

DHT blockers can also work at various points in the DHT messaging system. For example, DHT blockers can interrupt the signal from DHT to cause hair loss. This is why the DHT blocking herb saw palmetto is thought to have less side effects than prescription DHT blockers. It is thought to block DHT signals that cause hair loss without affecting the amount of DHT in the bloodstream.

Some topical products such as shampoos, conditioners, and hair growth serums contain DHT blocker ingredients. These products work by reducing DHT levels on the scalp.

Do DHT Blockers Really Work?

Almost all of the studies on DHT blocking ingredients show promise. However, it’s important to understand that there is still no known solution that will completely reverse androgenetic alopecia. DHT blockers are simply a potential means of managing your hair loss and supporting healthy hair growth.

Furthermore, while there are numerous ingredients that have been studied for their potential effects on DHT levels, finasteride is currently the only FDA-approved DHT blocking ingredient prescribed for hair loss.⁶

While DHT blockers may help with male and female pattern hair loss, it’s important to understand that not all forms of hair loss are caused by DHT. These include alopecia areata, telogen effluvium, and trichotillomania. Hair also naturally thins as you age. This is all to say that DHT blockers may be effective, but they will not have any effect on non-DHT induced forms of hair loss and may even cause hormonal issues.⁷

Prescription DHT Blockers for Hair Loss

Finasteride

As mentioned, finasteride is currently the only FDA-approved DHT blocker. Studies found that doses of finasteride as low as 0.2 mg per day significantly reduced serum and scalp skin DHT levels, suggesting that it may be an effective treatment for androgenetic alopecia.²⁷

13 Natural DHT Blockers That Actually Work

In your search for an effective DHT blocker, you will likely see a whole host of ingredients, but not all the ingredients you see may be effective. Here are some of the best natural DHT blocker ingredients that are known to work.

Saw Palmetto

Extracted from the berries of a small palm tree, saw palmetto is a well-known DHT blocker that is prescribed as a natural treatment for benign prostatic hyperplasia and other prostate issues. Saw palmetto inhibits DHT production only in tissues. The more localized action of saw palmetto extracts may allow for safer use and fewer side effects compared to finasteride.⁸

Pygeum

Pygeum africanum is frequently used as an herbal supplement to support a healthy prostate and alleviate symptoms of benign prostatic hyperplasia.⁹ Studies in rats found that pygeum significantly reduced DHT levels and supported the regression of prostatic weight.¹⁰

Pumpkin seed oil

Rat studies have found that pumpkin seed oil presents an antiandrogenic effect while inhibiting the action of 5-alpha reductase. Studies on men with androgenic alopecia found promising results with 40 percent of participants experiencing increased hair counts.¹¹

Rosemary oil

Evidence from mouse studies suggests that rosemary oil (Rosmarinus officialis) may help to improve hair growth. The results show that rosemary oil may work by inhibiting 5-alpha reductase and preventing DHT from binding to androgen receptors in hair follicles.¹²

Caffeine

Studies on men with androgenetic alopecia found that caffeine contributed to a significant stimulation of hair follicle growth. The exact mechanisms involved require further study, but caffeine may inhibit 5-alpha reductase activity.¹³

Stinging Nettle

Commonly used as a potential herbal treatment for prostate issues, stinging nettle has been shown to inhibit 5-alpha reductase to effectively prevent the conversion of testosterone into DHT.¹⁷

Lycopene

Lycopene is a natural plant pigment found commonly in fruits and vegetables, including watermelon, grapefruit, pink guava, and tomatoes. Along with its antioxidant properties, lycopene may regulate the production of insulin-like growth factors and control DHT levels in prostatic epithelial cells, contributing to prostate health and potentially preventing hair loss.¹⁸

Green Tea

Along with its caffeine content, green tea contains a polyphenol known as epigallocatechin-3 gallate (EGCG). Studies have found that EGCG is an androgen antagonist that may help to reduce DHT receptor activity while inhibiting 5-alpha reductase.¹⁹

Fenugreek

Fenugreek (Trigonella foenum-graecum) has traditionally been used as a treatment for sex drive and issues related to blood sugar. In a study on fenugreek’s effects on the hormones of resistance-trained men, the herb was found to cause a significant decrease in DHT levels.²⁰

Soy

Known for its potential effects on hormones, soy is a source of several compounds that may block DHT and promote natural hair growth, primarily biochanin A, equol, and genistein. These three compounds have been studied for their potential to inhibit 5-alpha reductase.²¹

Tea Tree Oil

Tea tree oil, or melaleuca oil, is believed to have antibacterial properties. A study found that a combination of tea tree oil, diclofenac, and minoxidil was more stable and effective in promoting hair growth than minoxidil on its own, increasing the average hair count, thickness, and weight.²²

Lavender Oil

In a mouse study, researchers evaluated the effects of lavender oil on hair growth in relation to minoxidil. Results of the study found that mouse treated with minoxidil or lavender oil had significantly higher numbers of hair follicles, greater hair follicle depth, and thickened dermal layers. This suggests that lavender oil may present comparative effects to minoxidil in preventing hair loss and supporting hair growth, though the exact method of action requires further study.²³

Ketoconazole

Ketoconazole shampoo has been shown to act as an effective topical treatment for inhibiting 5-alpha reductase.²⁴ Further studies also recommend using ketoconazole shampoo 2% in conjunction with finasteride. Ketoconazole’s local disruption of DHT pathways may allow for a more complete inhibition of DHT production.²⁵

How to Choose a DHT Blocker

With such a wide range of ingredients and products, choosing the right DHT blocker for your needs can seem like a challenge. Here are some simple tips to help you find the best DHT blocker.

Look for proven ingredients

Always read the label of any DHT blocking product you are interested in. Keep an eye out for any of the above ingredients that are proven to inhibit DHT while supporting healthy hair growth.

Cost and efficacy are not directly related

An expensive DHT blocker does not necessarily equate to an effective product. The good news is that most DHT blocker shampoos are affordable. If you find a pricier DHT blocking product, you are more likely paying for hype and brand labels.

Avoid miracle claims

Any claims that a brand makes should be supported by scientific studies and clinical trials. Be wary of brands that claim miracle, overnight results. Even the best DHT blocker ingredients take time before you see results. Make sure to do your own research.

Avoid harsh chemicals

When topical DHT blocker products, treat your hair gently. Choose quality formulas that are non-irritating. Harsh chemicals may only contribute to hair loss, deprive your scalp of nutrients, and make your hair flat and lifeless.

Sulfates act as detergents that may be too effective in stripping your hair and scalp of moisture and essential oils. Sulfates can be irritating to your skin and scalp, resulting in dandruff while aggravating existing hair loss.³⁰

Make sure your products are paraben-free. Parabens mimic estrogen and may contribute to hormonal dysfunction.³¹ Look for DHT blocker shampoos that use healthier, cleaner, all-natural ingredients in their formulations.

Side Effects of DHT Blockers

DHT blockers are generally considered safe for use, but some people may experience DHT blocker side effects. These side effects are generally worse with prescription DHT blockers. In a meta-review, finasteride was found to contribute to an increased risk of sexual dysfunction, which included decreased libido and ejaculation disorders.³⁴These side effects ceased when finasteride use was stopped.

Natural DHT blockers have less side effects as they are not as harsh as prescription DHT blockers. In the case of saw palmetto, natural DHT blockers may also work to block DHT without affecting blood levels of DHT⁸ and can help you avoid DHT blocker side effects.

Pregnant and nursing mothers are advised to avoid DHT blockers of all kinds. DHT plays an important role in developing fetuses and infants. Teens should also avoid DHT blockers as DHT is integral to puberty.

While DHT plays a role in human health and development, too much of it can result in hair loss and other health issues. Inhibiting DHT’s activity may help to prevent hair loss and promote healthy hair growth. If you are experiencing hair loss, a DHT blocker supplement, like DrFormulas® HairOmega® DHT Blocker, may be the best place to start.

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About the Author:

Dr. Bryan Do, D.O.

Dr. Bryan Do, D.O. is an osteopathic physician whose research interests include gastroenterology, immunology, and dermatology. He is particularly interested in the role of probiotics in the gut-brain-skin axis and has written many articles on the topic. He graduated from University of California, Los Angeles (UCLA) before graduating from Marian University College of Osteopathic Medicine in Indianapolis, Indiana and becoming a Doctor of Osteopathic Medicine. Osteopathic physicians are taught to take a holistic approach to medicine and to consider mind, body, and spirit when treating a patient. Osteopathic physicians receive training in Osteopathic Manipulative Medicine (OMM) in addition to the standard rigorous medical school curriculum. Both physicians with a Doctor of Osteopathic Medicine (D.O.) degree as well as a Doctor of Medicine (M.D.) can practice medicine.

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