There are two ways to supplement with DHT inhibitors: topically and internally. Each method has its own distinct mechanisms of action. However, it is first important to understand why blocking DHT works to prevent hair loss and promote hair growth in the first place.
- DHT: The Cause Of Male-Pattern Baldness?
- The Two Types of Natural DHT Blockers: Explained
- 5 Topical DHT Blockers
- 5 Internal DHT Blockers
- How to Use Topical and Internal DHT Blockers
- FDA-Approved Treatments: An Overview
- DHT Blocker Side Effects
- Important! Why You Must Know About DHT Sensitivity
- Other Reasons You May Be Experiencing Hair Loss
- Frequently Asked Questions About DHT and DHT Blockers
NOTE: The majority of DHT blockers in this article have NOT been tested on humans and are not FDA-approved. Consult with your doctor prior to treatment.
DHT: The Cause Of Male-Pattern Baldness?
Male-pattern baldness, or Androgenetic Alopecia (AGA), is a common condition. It accounts for 95% of hair loss in men.
Scientists generally agree that the main culprit behind male-pattern balding is DHT (2). This stands for Dihydrotestosterone and is an androgen sex hormone produced from testosterone.
Testosterone, the sex hormone responsible for your “maleness”, combines with 5-alpha-reductase, an enzyme involved in steroid metabolism. This results in the production of DHT. If you have a predisposed sensitivity to DHT, it can wreak havoc throughout your body, especially your scalp.
Once there, DHT connects to the androgen receptors at the base of the hair follicles. For those who are sensitive to DHT, this leads to miniaturization of the hair follicles and, eventually, hair loss.
Theoretically, a logical possibility to stop this would be to block testosterone. While this might work to save the hair, it would result in some very unpleasant side effects: gynecomastia, decrease in strength, sexual dysfunction, infertility, and many more (3, 4, 5). Essentially, blocking testosterone will lead to a decrease in the characteristics that make you male.
The next best option is to lower DHT levels. While DHT is an essential hormone during adolescence, it has no clear function in adult males (unlike testosterone).
Below, you will find a list of DHT blockers. Some of these block DHT, while others inhibit the activities of 5-alpha-reductase, thereby preventing the production of DHT in the first place.
Regardless of their exact mechanism, all the blockers below can make a useful addition to your hair loss treatment routine.
The Two Types of Natural DHT Blockers: Explained
When it comes to blocking DHT or inhibiting 5-alpha-reductase, there are two ways to go about it. They each have their benefits and drawbacks.
Internal DHT Blockers
You take an internal DHT blocker orally. This is usually in the form of a pill or capsule. The active ingredient then enters the bloodstream and begins to interrupt the processes of DHT production and androgen receptor activity.
The levels of DHT within the body will decline. This means that less DHT is available to attach to the androgen receptors at the hair follicles. This is good for the hair follicles, but remember that internal DHT blockers are indiscriminate. They target DHT production throughout the body, and not only at the scalp.
The risk of side effects from an internal DHT blocker will depend on the dosage, as well as other factors. Regardless, internal DHT blockers have higher risks than topical DHT blockers.
If you have been researching hair loss for a while, it is likely that the first thing to find when you hear “internal DHT blocker” is finasteride. After all, it is arguable the most popular hair loss treatment drug.
We mentioned above that finasteride actually works to inhibit 5-alpha-reductase. This blocks the production of DHT.
External (Topical) DHT Blockers
If you are looking for less risk of side effects, then consider external (topical) DHT blockers.
As the name suggests, you apply external DHT blockers to the area you want to treat. They are absorbed into the skin and enter the bloodstream in order to interfere with DHT activity at the hair follicle.
The benefit to this is a smaller chance of systemic side effects. The flip side is that topical DHT blockers tend to be less potent than oral blockers. This is because the blood is generally a more effective delivery route than the skin. This can be a benefit for those who have suffered side effects from DHT blockers in the past, though.
5 Topical DHT Blockers
When you have a condition, it is common to treat the underlying cause in order to reduce symptoms and treat the condition effectively. For individuals with androgenetic alopecia, it makes sense then to treat the condition at the source and block DHT present within the scalp before it can do damage.
That is the logic behind topical DHT blockers.
Topical All-Natural Blockers
Here is a look at five topical DHT blockers you can start using today.
1: Saw Palmetto
This is a berry-producing plant native to the Americas. Researchers believe it inhibits the enzyme 5-alpha-reductase (6). This is the enzyme responsible for the conversion of testosterone to DHT. Saw palmetto, therefore, acts as a preemptive DHT blocker.
Scientists have also tested it head-on against finasteride for hair loss. In a 2012 Italian study, 100 men with mild to moderate pattern hair loss were randomly assigned to receive either:
- the standard finasteride dosage of 1mg daily or
- 320mg of saw palmetto extract daily (7).
Treatment in either arm lasted 24 months. The assessment of efficacy was based on the evaluation of a panel of dermatologists. 38% of men in the saw palmetto group had some regrowth, compared to 68% with finasteride.
Every one of these positive responders to treatment in the saw palmetto group had minimal regrowth. The same was true for about 90% of finasteride users. A handful of men in the finasteride group had better results, namely moderate or marked regrowth.
Interestingly, the percentage of men who lost hair over the 24 months was exactly the same across both groups, namely 10%. Meaning that 90% in either group were able to at least arrest their hair loss.
The results of the study suggest that the majority of men will be able to stabilize their hair loss by supplementing with saw palmetto.
2: Stinging Nettle
Stinging nettle is a plant indigenous to parts of North America, Europe, and Asia. You have probably personally experienced its ‘stinging’ effects when brushing past it. What you may not know is that stinging nettle extract is an excellent topical DHT blocker (8).
A 2011 research study considered the effects of stinging nettle on Benign Prostate Hyperplasia (BPH). This is another condition linked to DHT, like pattern hair loss. The researchers found that nettle decreased prostate size. This was a strong indicator of its 5-alpha-reductase inhibitory effects (9).
While this first study was on rats, a previous study performed by Safarinejad studied stinging nettle’s effects on BPH in human patients (10). In fact, this was a large-scale study with 620 patients in total.
The study lasted six months, and the results were collected using various models and techniques. These included:
- International Prostate Symptom Score (IPSS);
- Maximum urinary flow rate (Qmax);
- Postvoid Residual Urine Volume (PVR);
- Serum Prostatic-Specific Antigen (PSA);
- Testosterone levels; and
- Prostate size
After six months, both the IPSS and Qmax decreased significantly in the stinging nettle group. For example, the IPSS decreased from 19.8 down to 11.8. In the placebo group, it only decreased from 19.2 to 17.7.
Stinging nettle’s ability to inhibit 5AR makes it great for men with AGA.
3: Reishi Mushroom
As a newly-discovered DHT blocker, reishi mushroom is still gaining traction in the world of hair loss treatments. That does not make it any less effective at treating the underlying cause of AGA. Reishi mushrooms will actually make an excellent addition to your topical hair care routine.
In a 2005 study, researchers tested the DHT-blocking abilities of 19 different mushrooms (11). While most mushrooms did inhibit the activity of 5-alpha-reductase, Ganoderma lucidum (reishi) was the clear winner:
It actually inhibited over 70 percent of DHT. This was significantly better than the other mushrooms in the study.
By inhibiting 5AR, reishi is comparable to finasteride. Both inhibit 5AR and, as a result, reduce the amount of DHT that attaches to the hair follicles.
4: Rosemary Oil and Extract
On the topic of DHT blocking, specifically, animal research suggests topical rosemary extract can inhibit 5-alpha-reductase (X). This blocks DHT from connecting to the scalp’s androgen receptors and prevents miniaturization and hair loss.
According to a 2013 study, topical applications of 200 mg/mL and 500 mg/mL inhibited the conversion of 5-alpha-reductase by 82.4 percent and 94.6 percent, respectively (15). That is better than finasteride’s inhibition percentage (81.9 percent) in the same study.
5: Ecklonia Cava
An alga found off the coasts of Japan and Korea, E. Cava is a promising new lead for cessation of hair loss and the growth of new hair.
While E. Cava may make a delicious addition to your soups, its topical application inhibits 5-alpha-reductase and, therefore, DHT (18). When applied as a whole, E. Cava was shown to inhibit 5-alpha-reductase up to 61.5%. Even better, though, were the inhibition results of the polyphenol extract dieckol:
Dieckol is found in abundance within the alga. The highest concentration tested (100 mg/mL) actually proved to be just as effective as finasteride:
This means that E. Cava and its extracts are a good option to consider if you are looking to block DHT. It even contributes to the proliferation of new dermal papilla cells (19).
5 Internal DHT Blockers
Topically reducing DHT certainly has its place in the treatment of hair loss and promotion of hair growth, In the long term, however, internal DHT inhibition can be more beneficial.
Internal All-Natural Blockers
Here is a look at five internal DHT blockers that you can start using today.
1: Green Tea
Did you know that green tea extract can actually block DHT and treat the source of male-pattern baldness?
Green tea is a source of epigallocatechin (EGCG) (20). These are catechins, a type of plant phenol with a variety of beneficial properties. One such property is the inhibition of 5-alpha-reductase (21).
To reap the benefits of green tea supplementation, you have two options. You could either course increase your tea intake or consume a green tea supplement. The supplements come in capsule or powder form.
Two studies on animals have shown the benefits associated with flaxseed supplementation.
The first study, in 2013, measured the effects of various plant-based lignans on DHT (23). These plants included flaxseed, sesame, safflower, and soy. They were administered orally either in powdered form or in a petroleum extract.
The study was on castrated male rats, with a focus on prostate weight (as lowered weight indicates less androgenic activity).
Flax (both the powdered and ethanol extract) proved to decrease prostate weight, as well as lower testosterone levels. These are both strong indicators of 5-alpha-reductase inhibition.
The second study, in 2014, looked specifically at flaxseed’s hair growth benefits (24).
Sixteen rabbits were split into two groups. The first group received regular rabbit feed (control), while the second group received a feed infused with crushed flax (test).
Over three months, the researchers shaved a section on the rabbits’ backs once per month. Each time they measured hair growth, and these were the results:
As you can see, the group that received flaxseed supplementation (LSI) saw improved length, width, and weight of the hair.
Scientists could not exactly pinpoint the reason for such results. However, it is likely that DHT blocking (as per the first study) is one of the main contributors.
One of the easiest ways to work flaxseeds into your routine is by adding them (milled or powdered) to your smoothies. This adds a nice boost of fiber, as well as a slightly nutty depth. You can also sprinkle it on your salads or add it to stir fry. Another option is to make your own flaxseed dressing with a bit of honey and lemon!
3: Sesame Seeds
In the 2013 study on flaxseed mentioned above, sesame seeds were another plant-based lignan studied (27). In fact, the ethanol extract of sesame seeds was incredibly effective at reducing prostate weight and testosterone levels in the tested rats.
Similar to flax, sesame seeds are very easy to incorporate into your diet. Mix a few drops of sesame oil into your smoothies, soups, and salads. Alternatively, use it in place of canola or olive oil while cooking. Add a few sesame seeds to your favorite dishes, including chicken, fish, and pork for a slightly nutty flavor.
There are numerous ways to add this supplement to your daily diet. Take a look at some of my favorite hair loss supplements here.
Pygeum is a bark from the Pygeum Africanum tree. It is believed to significantly relieve the symptoms of men who suffer from Benign Prostatic Hyperplasia (BPH) (31).
BPH is an enlargement of the prostate that is common in older men. It can lead to obstructive and irritative lower urinary tract symptoms (32).
As we saw, DHT is a well-known aggravator of BPH. This means that its inhibition contributes to a shrinking of the enlarged prostate and a reduction in the irritating symptoms associated with the condition (33).
This was the finding of a 1998 review study, which considered the role of pygeum bark in the reduction of BPH symptoms (34).
Men treated with pygeum bark were twice as likely as the placebo group to report improvement of symptoms. In addition, nocturnal urination was reduced by 19 percent and residual urine volume (urine remaining in the bladder) by 24 percent. Peak urine flow increased by 23 percent.
To supplement with pygeum, you can add a high-quality supplement to your day. A dosage of 100mg per day is a typical recommendation (35).
5: Pumpkin Seed Oil
Of course, you can apply pumpkin seed oil topically. This provides gentle cleansing and is an excellent way to maintain a healthy scalp.
However, for those looking to treat male-pattern baldness, the pumpkin seed oil is most effective when ingested. Why? Pumpkin seed oil is believed to inhibit the activity of 5-alpha-reductase. When you take it orally, the oil can inhibit this enzyme most effectively.
How effective is this method?
In 2014, scientists in Korea asked this question (38). To answer it, they recruited 76 male subjects with mild to moderate AGA. Half received a supplement containing PSO (400 mg per day). The rest received a placebo capsule.
At the end of the 24-week study, 44.1 percent of the men in the supplement group saw a mild-moderate improvement in hair growth. Only 7.7 percent of the placebo group had this kind of improvement.
And here is the visual evidence that supplements containing PSO can be effective DHT blockers:
One thing to point out is that PSO was not the only ingredient within the supplement. However, it very likely did contribute to these hair growth effects. Just consider all of the benefits of PSO. These include anti-inflammatory and anti-carcinogenic (39, 40).
Pumpkin seeds are a great snack by themselves. You can eat them by the handful, or toss them onto salads, into soups, and even blended into smoothies and juices.
How to Use Topical and Internal DHT Blockers
If you would like to add topical or internal DHT blockers to your hair care routine, there are a few options. The most common way to use DHT blockers is topical. You can put them in shampoos and solutions or even apply them directly.
There are many products already on the market with DHT-blocking ingredients. These include our very own line – Hairguard.
Such products can have positive effects on hair follicles. They are also less likely to produce side effects as with internal blockers.
But there are also ways to add internal blockers to your routine if you so wish. Perhaps the easiest way is with supplements.
Over-the-counter supplements will often contain the recommended daily dose (or close to it) of a variety of vitamins and nutrients. And some of these can even be DHT blockers, such as those containing green tea, pumpkin seed oil, and flaxseed.
You can also add many of the internal ingredients mentioned above to your smoothies, juices, and other recipes.
FDA-Approved Treatments: An Overview
We mentioned an FDA-approved DHT blocker earlier. This is finasteride, a common hair loss treatment that doctors prescribe worldwide.
Finasteride works by inhibiting the activities of 5AR, reducing the concentration of DHT in the body.
Finasteride is not the only FDA-approved treatment. There is also minoxidil, a topical solution believed to work by stimulating blood flow to the scalp.
DHT Blocker Side Effects
Before you move ahead with any of the DHT blockers on the list, it is important to consider their potential negative effects.
There is a potential for side effects when you use a DHT blocker. The risk increases with internal DHT blockers, though it is possible to experience them with topical blockers, too.
When you are suffering from hair loss, it is easy to see DHT as the enemy. This is a very simplistic view.
DHT is an androgen sex steroid that plays a major role in male sexual development. It assists in the development of secondary sexual characteristics, such as body hair, facial hair, and pubic hair. DHT blockers can sometimes lower libido and decrease sexual function. This suggests that DHT plays a role in many things that make a man feel, well, manly.
Here is a closer look at the potential side effects associated with DHT blockers. They include:
- Loss of libido;
- Inability to achieve or maintain an erection;
- Inability to ejaculate;
- Loss of ejaculatory volume;
- Lowered sperm count.
In some cases, the use of DHT blockers can even cause enlarged breast tissue, testicular pain, and a rash.
This list of side effects is not meant to scare you away. It should help you to weigh up the pros and cons, however, as well as consider alternative options.
If you choose to go ahead, consider a low-dose internal DHT blocker or a topical DHT blocker. You should also consult with your doctor prior to starting a DHT blocker.
Do keep in mind that if you stop using a DHT blocker, you will likely experience increased hair shedding and hairline recession. This is because the benefits of DHT blockers only generally last as long as the treatment. Once you stop using them, your baldness will resume.
Important! Why You Must Know About DHT Sensitivity
You have now learned about the most powerful natural DHT blockers in the world. This is only a small part of the story though because high DHT levels are not the sole cause of hair loss. In fact, there is something much more important than blocking DHT: DHT sensitivity.
It is not the levels of DHT in the scalp that cause problems, but instead the sensitivity of the hair follicles. This sensitivity is linked to chronic scalp tension.
Mechanical Tension of the Scalp
Just as with the skin, there are multiple layers of the scalp that play different roles. From outermost to innermost, these layers are skin, subcutaneous, galea, and pericranium.
The galea is a fibrous, connective tissue. It covers the entirety of the scalp from just above the eyebrows (the frontalis muscle) to behind the ears (the occipitalis muscle) (48). This tissue may actually be responsible for the progression of pattern balding (49).
The tension theory of hair loss states that activation of the Hic-5 protein, an androgen receptor co-activator that improves the function of a cell’s androgen receptors, may be triggered by the mechanical tension of the galea.
But why would activation of Hic-5 mean hair loss? Because as an androgen receptor co-activator, this protein has been shown to induce androgen sensitivity in the hair follicles (50).
The solution, then, is to reduce scalp tension.
By reducing tension, you can reduce your need for DHT blockers like those mentioned above.
Other Reasons You May Be Experiencing Hair Loss
There are plenty of reasons that one may suffer from hair loss, and not all of them are related to DHT. Some of these are temporary, while others are permanent. Here is a look at some of them, as well as how to address them.
Is your hair loss patchy? Does the hair loss come on suddenly and resolve on its own? This might suggest alopecia areata.
Alopecia areata is an autoimmune disorder where the immune system attacks the hair follicles. The hair in that area will often shed entirely, leaving you with an irregularly shaped bald patch. The hair loss will often resolve as mysteriously as it appeared.
Fortunately, there are various treatment options available.
The most common treatment is a corticosteroid. A topical corticosteroid is often the first round of treatment. Oral steroids like prednisone can be prescribed in persistent cases.
There is presently no cure for alopecia areata.
Dandruff and Seborrheic Dermatitis
You may have thought that dandruff and seborrheic dermatitis were two distinct scalp conditions. These conditions are actually triggered by the same issue, but they fall on opposite ends of the spectrum.
Dandruff is the less severe of the two. It is characterized by itching, flaking, and can cause substantial psychological distress.
Seborrheic dermatitis is a more severe form of dandruff.
Both conditions are treatable, though the treatment will depend on many factors.
When formulating a treatment plan for dandruff or seborrheic dermatitis, your doctor will consider the severity of your condition. They will also consider your past treatments (both successfully and unsuccessfully) and current lifestyle.
The most common treatments for dandruff and seborrheic dermatitis include salicylic acid, selenium sulfide, tar-based shampoos, ketoconazole-containing shampoos, and zinc. Your doctor may also suggest lifestyle changes and changes to your hair care routine.
An imbalance of hormones can wreak havoc on the body. Depending on the hormone, it can even cause hair loss.
What causes a hormonal imbalance?
The most common cause is thyroid malfunction, where the thyroid either produces too much or too little essential hormones. The conditions which can most often trigger thyroid malfunction include Hashimoto’s disease, Graves’ disease, goiter, and thyroid nodules. You can experience both hypothyroidism and hyperthyroidism as standalone conditions, however.
Hair loss caused by a hormonal imbalance can often be reversed by treating the underlying condition.
Illness and Medications
Your body operates like a well-oiled machine, that is until something goes “wrong.” Then the body may only operate at a limited capacity. This means that certain non-essential functions, like hair growth, will suffer.
If the illness is prolonged, or if it is particularly intense, you may suffer from diffuse hair loss as a result.
The scientific term for this is telogen effluvium. This means that hair loss occurs during the telogen phase of hair growth. It is during telogen that your hair will shed, to make room for new anagen phase hairs. If too many of your hair follicles enter telogen at the same time, the result will be visible thinning.
The treatment for your illness may sometimes trigger hair loss, too.
Chemotherapy, for example, can trigger severe telogen effluvium. This can be so severe as to result in complete baldness.
In most cases, the hair will grow back out once the illness has passed or once you have stopped taking the medication. It may take several months for this to happen. After that point, however, you should notice steady hair growth.
While poor nutrition does not often lead to significant hair loss, it can cause just enough shedding and loss of volume to raise concerns.
If you suffer from certain gastrointestinal conditions, such as Chron’s and Ulcerative Colitis, you may suffer from malnutrition as a result of poor nutrient absorption in the gut.
The good news? Hair loss due to poor nutrition can often be treated with vitamin and nutrient supplements, as well as dietary changes.
You should get an entire blood panel from your physician so you can know what nutrients and minerals your body is lacking.
The nutrients and minerals most often linked to hair loss/growth include zinc, selenium, biotin, Vitamin D, and niacin.
Frequently Asked Questions About DHT and DHT Blockers
Here are some quick answers to the most asked questions about DHT and DHT blockers.
What is DHT?
DHT, dihydrotestosterone, is an androgen sex steroid and hormone. The hormone is a by-product, or derivative, of testosterone. It has many functions in the human body (both males and females), including sexual development, muscle growth, and even as an anti-inflammatory.
The androgen works by connecting to androgen receptors found throughout the body, including the prostate gland, skin, hair follicles, liver, and brain.
How Can I Tell If I’m Sensitive to DHT?
Are you unsure whether the cause of your hair loss is male-pattern baldness? This is a common problem among men (and women) who are suffering from hair shedding or hairline recession.
The easiest way for men to determine the true cause of their hair loss is to examine the pattern.
Men with androgenetic alopecia will experience a tell-tale pattern of balding. It will first become noticeable at the temples and hairline as the hairline recedes. The pattern will eventually form an M-shape that will only get worse with time.
It can be more difficult for women to determine if DHT sensitivity is the cause of their hair loss. Androgenetic alopecia in women typically presents as a general thinning of the hair over their entire scalp. It can sometimes be difficult to distinguish this from telogen effluvium.
When to see a doctor
If you are unsure of the cause of your hair loss, or if you would like professional confirmation, then you should visit a dermatologist. A dermatologist can examine your scalp and hairs under a microscope. This will shed light on the cause which you can then treat appropriately.
Why Am I Sensitive to DHT?
For many years, it was thought that people with pattern baldness had an excess of DHT. This is why drugs like finasteride became so popular.
The truth is that men and women with androgenetic alopecia do not necessarily have higher levels of DHT in their bodies. They will likely have a higher concentration of DHT at the scalp (which the Scalp Tension Theory of Hair Loss can explain). The true issue, though, is follicular sensitivity to the androgen hormone.
So, why are some individuals sensitive to DHT while others aren’t? We can ask the same question of other sensitivities. The answer? We don’t fully know.
If you subscribe to the Scalp Tension Theory of Hair Loss, this sensitivity may be explained by chronic scalp tension. If you subscribe to the DHT Theory of Hair Loss, then the answer may be a genetic predisposition. Or, it could be a combination of the two.
No matter why you are sensitive to DHT, one thing is for sure. You need to address this sensitivity if you wish to stop further hair loss.
Why Can’t I Block DHT Entirely?
If we know that DHT plays such a significant role in pattern hair loss, why do we not block it entirely?
As an androgen hormone with many roles, it would be detrimental to block our body’s DHT entirely. Doing so would have many immediate side effects, and there is no telling the extent of side effects from long-term blocking of the hormone.
The fact is, DHT is not all bad. You do not want to block DHT throughout the body. Instead, you should aim to reduce its presence at the hair follicles.
You can do so with some of the natural DHT blockers above, with topical finasteride, or with scalp tension relief. These methods will work to reduce DHT at the follicle without interrupting its important roles throughout the rest of the body.
There is no doubt that sensitivity to DHT plays a role in pattern hair loss. As such, by blocking – or minimizing – DHT you may be able to stop hair loss and even promote growth.
However, DHT should only form one part of any treatment strategy. Hair loss is a multifactorial condition. That means there are various contributing factors, aside from DHT. Check out the video below to find out more about them.