Does Testosterone Cause Hair Loss?
You may have heard that testosterone causes hair loss. The truth is more complex. Testosterone itself is not the main cause, but a hormone your body makes from testosterone can shrink hair follicles over time.
The Real Cause: DHT
Your body converts about 10% of testosterone into a stronger hormone called DHT (dihydrotestosterone). DHT binds to hair follicles with five times more strength than testosterone. In people with a genetic tendency for hair loss, DHT slowly shrinks hair follicles. This makes hair thinner and shorter until the follicle stops producing visible hair.
Genetics Play the Biggest Role
Not everyone with normal testosterone levels loses their hair. The key factor is how sensitive your hair follicles are to DHT. This sensitivity is inherited from your parents. People with androgenetic alopecia have more DHT receptors in their scalp and produce more of the enzyme that converts testosterone to DHT.
This explains why some men with high testosterone have full heads of hair while others with lower levels experience baldness. Your genes determine your risk more than your hormone levels.
What About Testosterone Therapy?
Research shows that 5-17% of people on testosterone replacement therapy develop some hair loss in their first year. However, this mainly affects those who are already genetically prone to baldness. The extra testosterone provides more material for DHT conversion.
The delivery method may also matter. Gels and patches can cause higher DHT spikes compared to injections.
Treatment Options
The FDA has approved two medications for pattern hair loss. Finasteride blocks the enzyme that converts testosterone to DHT, reducing DHT levels by 60-70%. Studies show it stops hair loss in 88% of men. Minoxidil increases blood flow to follicles and can slow further loss.
The Bottom Line
Testosterone does not directly cause hair loss. DHT and your genetic sensitivity to it are the true causes. If you are concerned about hair loss, talk to a dermatologist who can assess your risk and discuss treatment options.
Frequently Asked Questions
Does high testosterone mean you will go bald?
Can lowering testosterone prevent hair loss?
Will testosterone replacement therapy cause hair loss?
Do women lose hair from testosterone?
References
- Androgenetic Alopecia. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430924/
- Hair loss in athletic testosterone use in males: a narrative review. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11931090/
- Does testosterone replacement therapy cause hair loss?. Available from: https://blogs.bcm.edu/2025/08/11/does-testosterone-replacement-therapy-cause-hair-loss/
- Male Androgenetic Alopecia. Available from: https://www.ncbi.nlm.nih.gov/books/NBK278957/
- ICD-10-CM Diagnosis Code L64.9 - Androgenic alopecia, unspecified. Available from: https://www.icd10data.com/ICD10CM/Codes/L00-L99/L60-L75/L64-/L64.9
Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before starting any new skincare treatment, especially if you have underlying health conditions, are pregnant, or are taking medications.