The Role of DHT Testing in Diagnosing Male Pattern Baldness

What is DHT?

Androgens are a group of steroid hormones that play an important role in developing male sexual characteristics. Dihydrotestosterone (DHT), androstenedione, dehydroepiandrosterone (DHEA), and testosterone are all androgens. DHT is the most potent androgen, the only androgen among the above whose conversion into estrogen is impossible.

DHT is a testosterone metabolite. Testosterone is converted into DHT by the action of the enzyme 5-alpha reductase. DHT is about 3-5 times as strong as testosterone. Most peripheral tissues produce DHT, but the liver produces most DHT in circulation.

A woman’s egg carries XX chromosomes, and the male sperm carries XY chromosomes. On fertilisation, the embryo’s genetic makeup, XX or XY, determines the gender of the foetus. During gestation, as the embryo develops, the role of DHT is limited to the differentiation and development of sexual organs. As the child grows into adolescence and adulthood, DHT plays an important role in developing male sexual organs.

What is Male Pattern Baldness?

Male pattern baldness or androgenetic alopecia refers to the hair loss men experience due to changes in hormone levels, occurring primarily on the scalp of the crown area. What starts as a receding hairline in the early to mid-20s starts to develop into a bald spot and then a bald patch by the mid-30s to late 30s. Male pattern baldness shows symptoms such as low self-esteem, depression, and poor body image in men. Several factors cause Androgenic alopecia, including race and genetic makeup. Most researchers feel strongly about a direct correlation between androgens and this type of baldness.

Role of DHT in Male Pattern Baldness

To understand the role of DHT in male pattern baldness, let us first look at the growth cycle of hair follicles. Each hair grows from a hair follicle on the scalp. Each of these follicles has a definite life cycle of three phases, anagen, catagen, and telogen.

The anagen is the main growth phase. In this phase, hair grows from mature hair follicles. This phase lasts between 2-6 years. Nearly 80% of the hair on our heads grows in this phase. Following this, there is a phase called catagen, which renews the hair follicle and lasts about two weeks. The renewed follicles are now dormant for about 3-4 months, a phase called the telogen, after which the follicles again go into the anagen phase.

To an extent, DHT aids the hair follicle’s growth in the early anagen phase by boosting mitosis or cell division. With a steady increase in DHT levels, the pressure of advanced mitosis puts pressure on the hair follicle, which, in turn, starts to shorten the anagen phase. With repeated pressure cycles under high DHT, the hair follicles fail to achieve optimum growth and become smaller and smaller. As a result, the hair becomes thinner and sparser due to an increased anagen-to-telogen ratio. This results in increased hair loss and the development of bald spots.

DHT Test for Male Pattern Baldness

Baldness in men can occur for many reasons, but Male Pattern Baldness is one of the most common causes. Your doctor may recommend a DHT test to investigate the cause of your baldness.

Other symptoms that could point to high levels of DHT include:

Slow healing of injury or taking a long time to heal
Decreased sex drive or infertility
Loss of muscle mass and bone density
Enlarged prostate
Prostate cancer
Coronary heart disease

If you are present with one or more of these symptoms in conjunction with U-patterned baldness, your doctor may likely recommend this test. The doctor may also recommend screening for prostate cancer and heart disease because of the link of elevated DHT with these conditions.

About the Test

The DHT test is a simple blood test. The test requires no prior preparation. The phlebotomist will draw a vial of blood from a vein in the forearm. The pain or discomfort associated with the needle prick is minimal. Medical experts may monitor you for a few minutes after the blood draw. Your lab will deliver the report within 24 hours. Approach a licenced doctor to interpret the results.

Treatment Options

Male pattern baldness can be benign in its physical impact but can have profound psychological and emotional impacts. The use of hair weaves, changes in hairstyles, and hair extensions are common ways to address the issue in the early stages, but medical treatments include the use of two medications: