What Causes Hair Loss – DHT?

John Maddock

John Maddock

Hi, I'm John. About age 30 my hair started receding. After trying lots of products I eventually decided on a hair transplant. And now I have my hair back.

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What Causes Hair Loss – DHT?

What causes hair loss? There are different forms of hair loss but the most common is Androgenetic Alopecia, also known as Male Pattern Baldness in men (MPB), or Female Pattern Hair Loss (FPHL) in women. For 95% of male hair loss sufferers the type of hair loss experienced is MPB. FPHL accounts for approximately 50% of female hair loss sufferers. It’s varied more in women due to different hormonal factors or influences, such as contraception for example. For men MPB is a fairly safe assumption. For women, especially younger women experiencing hair loss I would advise speaking to your doctor. FPHL doesn’t usually present itself until your 50’s or 60’s. Whether you are male or female it does no harm to consult a doctor and have your prognosis confirmed before starting to treat your hair loss. Knowing your type of hair loss is essential before beginning treatment.

What does Androgenetic Alopecia look like?The hair on the top of your head is genetically predisposed to being vulnerable to hair loss. Men see the effects in the crown or at the hairline first. Your hair becomes thinner and your scalp may become more exposed, you may even notice hair falling out. You may see your hairline recede, or a bald patch starting to form at the crown. For some men a small amount of hair loss is completely natural as you age and it may stop. For others it may continue eventually leading to full baldness on top. 25% of men may see issues start to form around age 21. 60% of men see issues by their mid 30’s. Women normally retain their hairline, but notice tinning or short hairs that won’t grow past a certain length all over the top of the head. For women this doesn’t typically start until your 50’s or 60’s, but it can occur as early at your 30’s or 40’s.

Male-Hair-Loss-Chart
Female-Hair-Loss-Chart

What causes Androgenetic Alopecia and how do I treat it? The most widely acknowledged cause of Androgenetic Alopecia (MPB or FPHL) is Dihydrotestosterone (DHT). You will only make progress when you accept this and start to address the root cause of the issue, DHT. I spent nearly 3 years wasting time and money on other theories, such as diet, supplements, lifestyle changes, when and how I would wash my hair etc. This was a complete waste of my time and money. And I missed my window of opportunity to reverse my situation with products, leaving surgery as my only option to restore my hairline.

What is Dihydrotestosterone, or DHT? DHT is simply a by-product of your testosterone. Both men and women have testosterone and the body converts and uses it for different things. It plays an essential role in your development in your teen years for example. Testosterone is converted to DHT by an enzyme called 5-Alpha Reductase (5AR). Your skin produces an oily substance called Sebum, which protects and moisturises it. Sebum contains DHT. DHT attacks and weakens your hair follicles. First it weakens the follicles making them look thinner. Then the hairs start to fall out and not grow back. And then eventually the follicles die and are unable to grow hairs anymore. This process is called Miniaturisation. The hair on the top of your head is genetically predisposed to being more susceptible to the negative effects of DHT.

How can you combat DHT? Testosterone is converted to DHT by an enzyme called 5-Alpha Reductase (5AR). You can supress the action of 5AR with oral medications like Finasteride (Propecia tablets). Finasteride is said to lower your DHT levels by 60-70%. Lowering your DHT stops it attacking you hair follicles, giving them a better environment to grow in. This has been the most effective product I have used to date. Another option is to stimulate blood flow to the hair follicles with topical products such as Minoxidil (Regaine or Rogaine foam). Stimulating the follicles is said to prolong and promote hair growth. However it is important to note that products like this do no address the root cause, which we know is DHT. So whist Minoxidil is highly rated it is said to become less effective over time. Another option is to use supplements to either lower your DHT levels or increase your blood flow. Saw Palmetto for example is said to lower your DHT levels. I’ve seen some success with supplements, but so far I’ve found this method to be the least effective.

What is Miniaturisation? Miniaturisation is when hair follicles reduce in diameter and therefore produce finer, thinner looking hairs. The follicles will also have a shorter Anagen (growth) phase. So the hairs will also not grow as long as they used to. Miniaturisation continues making the hairs finer and finer until the follicles cannot grow hairs anymore. If you catch your hair loss early enough you can reverse Miniaturisation. If the follicles have stopped producing hairs though you may have missed your window of opportunity.  

Follicle Miniaturisation

What are the phases of hair growth, and what does this mean?

Phase 1 – Anagen (The Growing Phase). This phase lasts between 2 and seven years. As you age the Anagen phase can reduce.

Phase 2 – Catagen (The Transition Phase). This lasts about 10 days. The hair follicle shrinks and detaches from the dermal papilla.  

Phase 3 – Telogen (The Resting Phase). The resting phase lasts around 3 months. At any given point between 10 – 15% of our hairs are in this phase.

Phase 4 – Exogen (The Shedding Phase). Exogen is a part of the resting phase where the old hair sheds. You can shed between 50 and 150 hairs daily. This is normal and you may not even notice it.

Phase 5 – Kenogen (The Empty Phase). Between Exogen and Anagen the follicle can appear empty for a period.

Follicle Growth Phases

What this means is that if you start to treat your hair loss with products you will not notice a difference overnight. You may start to see improvements around 3 months. But it will most likely take a year for you to see the full effect of the product you are using.

Hair Transplant Common Questions

Check out the FAQ’s section for more.

How much does it cost?

Prices in Europe are between 50% and 75% cheaper than in the UK or US. Packages start from £1500 and include accommodation. I paid £2000 for 1000 grafts (3000 hairs) in Budapest, which is less than a 3 hour flight from the UK. I was quoted between £8000 and £12,000 for the same procedure in the UK. Adding £200 for flights I paid £2200 in total - so it is very affordable!

Does it hurt?

No! A hair transplant is painless. On the day of the transplant you are given a few local anaesthetic injections into your scalp. You may feel the first one or two. From that point on your are numbed and you don't feel anything. Most people actually fall asleep - I did for most of the day!

How long before it grows back?

A few weeks after your transplant your new hair starts to fall out. It then takes a couple of months to start growing again. Between month 1 and month 3 post-op your hair is thin. They call this the 'ugly ducking' phase. This soon passes and it starts getting really exciting. Around month 4 I had good coverage and was going to the hair dressers again. By month 6 you could not tell I had a transplant. When it got to 12 months post-op I was a different person.

Regaine is an FDA approved treatment for hair loss, suitable for both men and women. The active ingredient it contains is called Minoxidil. Minoxidil is clinically proven to prevent further hair loss in around 80% cases. It works by enhancing the blood supply to your hair follicles.

Naturelo Multivitamins are fantastic! They contain 110% of your recommended daily allowance of Biotin, as well as a host of other vitamins that are great for your hair and general well being. I love them!

Keratin is a basic protein that makes up your hair, skin, and nails. Biotin improves your body’s keratin infrastructure. It adds colour and thickness to your hair.

Alpecin Caffeine Shampoo is a really nice shampoo to use. It claims to boost blood flow to the scalp which promotes hair growth. It’s not as effective as Regaine, but it’s still a really nice cost effective shampoo.

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