You see it happening slowly. A year ago, a photo clearly shows more hair. In the mirror, your hairline is a fraction higher than before. Or the hair on your crown starts to thin, become softer, less visible.
For most men, this has one cause: DHT.
Not stress, not brushing too hard, not the wrong shampoo. DHT. And what's remarkable is: almost every man has this hormone, but not everyone loses hair because of it. I'll explain why below.
What exactly is DHT?
DHT stands for dihydrotestosterone. It is a hormone that your body produces from testosterone, via an enzyme called 5-alpha-reductase. DHT is a potent androgen, a male hormone, and plays a role in various bodily processes, from the development of male sexual characteristics to the distribution of body hair.
The problem specifically lies in the hair follicles on your head. In men with a genetic sensitivity to DHT, this hormone binds to receptors in the hair follicles, initiating a process called miniaturization. The hair follicles shrink. The growth phase of each hair becomes shorter. And the hairs that still emerge become finer, thinner, and lighter, until they eventually fall out completely.
This is what doctors and dermatologists call androgenetic alopecia. Colloquially: male pattern baldness. About 95 percent of male hair loss falls into this category.
Why some men are more affected than others
It's not the amount of DHT in your blood that determines whether you go bald, but how sensitive your hair follicles are to that hormone. Someone with relatively low DHT levels can still have significant hair loss due to genetics, while another person with higher levels retains a full head of hair.
This sensitivity is hereditary. The genes that contribute to this come from both your father and your mother. The well-known folk wisdom that hair loss is inherited only through the mother's side is incorrect. It's a combination of multiple genes, and the pattern can vary from generation to generation.
Also playing a role: the density of DHT receptors in the hair follicles at certain areas of your head. This explains the classic pattern of male pattern baldness: a receding hairline, thinning hair on the crown, while the hair follicles on the sides and back of your head are much less sensitive to DHT. These hair follicles often remain, even in men experiencing significant baldness.
When does it start?
DHT-related hair loss can begin early. Some men notice it in their twenties, others only in their thirties or forties. There is no fixed age. However, the earlier it starts, the stronger the genetic predisposition generally is.
A signal that many men recognize: the hairline starts to recede slightly at the temples. Or more hair falls out when washing or drying than before. The hair on the crown appears thinner in certain light. These are classic early signs of androgenetic alopecia.
Once hair follicles have miniaturized, they are difficult to restore. This makes early intervention meaningful, not because you can cure hair loss, but because you can slow down the deterioration and keep existing hair follicles active longer.
What DHT does to your hair at a cellular level
Without delving too deeply into biology: the way DHT causes hair loss is not that hairs acutely fall out. It is a gradual process. Each hair cycle consists of a growth phase (anagen), a transitional phase (catagen), and a resting phase (telogen). After that, the hair falls out and a new hair begins to grow.
What DHT does to sensitive hair follicles: it progressively shortens the anagen phase. Where a hair normally grows for two to six years before falling out, in DHT-sensitive hair follicles, this can shrink to a few months. Each new hair that grows is also slightly thinner and shorter than the previous one. Over the course of years, this results in the pattern men recognize as baldness.
This process begins insidiously. It doesn't happen overnight. Many men only realize after years that it has been going on for a longer time, which also explains why early action makes so much sense.
What can you do?
The options can broadly be divided into two directions: inhibiting the production of DHT, or supporting the hair follicles so they suffer less damage from that hormone.
Finasteride is a medication that blocks the enzyme 5-alpha-reductase. This reduces the conversion of testosterone into DHT. DHT levels in the blood decrease by 60 to 70 percent. This is effective, but it is a prescription drug with potential side effects, including hormonal effects in some users. This is something to discuss with a doctor or dermatologist.
Minoxidil works differently: it improves blood circulation to the scalp and extends the growth phase of hair follicles. It does not directly inhibit DHT, but it can slow down deterioration and stimulate hair growth in some men.
Then there are botanical active ingredients such as Redensyl, Procapil, and Baicapil. These work at different points in the hair growth cycle and can support hair follicles, prolong the growth phase, and reduce sensitivity to signals that drive hair loss. For men who want to do something without medication, these are the most common alternatives. The Hairborn Growth Serum combines Redensyl, Procapil, and Baicapil, and 7 other potent active ingredients in one formula that you apply daily directly to the scalp, so the active ingredients reach where they need to work.
Misconceptions about DHT
A common misconception: more testosterone automatically means more DHT and thus more hair loss. The connection exists, but it is not nearly that simple. Men with higher testosterone levels do not automatically go bald. It always revolves around the sensitivity of the hair follicles, and that is genetically determined.
Another misconception: creatine causes hair loss. Creatine has an indirect effect on DHT conversion, but again: this can only play a role in men with a genetic predisposition. Without that predisposition, creatine does nothing to your hair.
And stress? Stress can cause hair loss through a different mechanism, telogen effluvium, where more hairs simultaneously leave the growth phase. That is temporary and reversible. But stress does not cause androgenetic alopecia. Stress does not create a genetic predisposition where none exists. It can, however, temporarily accelerate an existing process.