Steroids and Hair Loss: A Comprehensive Guide
As a doctor at My Hair UK, it’s essential to address the complex relationship between anabolic steroids, dihydrotestosterone (DHT), and hair loss. While steroids can significantly enhance muscle growth and athletic performance, their impact on hair health is often overlooked. Understanding how DHT interacts with hair follicles and how different steroids affect this process is crucial for anyone considering or currently using these substances. This article will explore the types of steroids commonly used, the mechanisms through which DHT influences hair loss, and the roles of medications like finasteride and dutasteride in mitigating these effects.
Understanding DHT
Dihydrotestosterone (DHT) is a potent androgen that plays a critical role in the development of male characteristics. your body naturally turns around 10% of the testosterone it produces daily into DHT, through the action of the enzyme 5-alpha reductase. While testosterone itself can bind to androgen receptors in various tissues, DHT has a much stronger affinity for these receptors, making it the more potent androgen when it comes to influencing both muscle and hair follicle activity.
Impact of DHT on Hair Follicles
DHT’s interaction with hair follicles is primarily negative, particularly for those genetically predisposed to androgenetic alopecia (commonly known as male or female pattern baldness). When DHT binds to androgen receptors in hair follicles, it leads to a process known as follicular miniaturization. This is characterized by:
Shortened Anagen Phase: The growth phase of hair follicles is reduced, leading to thinner, shorter hair strands.
Longer Telogen Phase: The resting phase of hair follicles is prolonged, causing hair to shed more frequently without regrowth.
Miniaturization: Hair follicles shrink, producing progressively finer hair until they cease to produce visible hair altogether.
This process ultimately results in thinning hair and bald patches, particularly at the temples and crown of the head.
The Interaction of Androgens with Hair and Muscles
Androgen Receptors in Hair Follicles and Muscle Tissue
Both hair follicles and muscle tissues contain androgen receptors, which are proteins that bind to androgens like testosterone and DHT. This interaction is crucial for both muscle growth and hair development. However, while androgens can stimulate muscle hypertrophy (growth), they can simultaneously promote hair follicle miniaturization in individuals genetically predisposed to androgenetic alopecia. DHT has a much higher binding affinity than testosterone which means it is much more likely to bind to an androgen receptor than testosterone is.
If you are not genetically predisposed to Male Pattern Baldness then it doesn't matter how much testosterone or DHT you have in your system, your hair will have very few androgen receptors so the hormone will not be able to bind to it and will be unlikely to cause hair loss. For those that are predisposed (which is around 80% of the population) steroid use will lead to further and faster hair loss.
How DHT Affects Muscles
DHT is a potent androgen and has been shown to contribute to muscle growth, enhancing strength and performance. However, this comes at the cost of hair health for those who are genetically susceptible. The duality of DHT's effects illustrates the complex relationship between androgens, muscle, and hair health.
This leads us to the problem - depending on the steroid used, you are either artificially increasing the level of testosterone on your body and you will continue to convert around 10% of this larger amount to DHT, so you then have more DHT to damage your hair follicles, or you are artifically increasing the level of DHT in your body directly giving the same effect, meaning faster hair loss in those predisposed to Male Pattern Baldness
So men who want to have bigger muscles and good hair have a problem - in 80% of men, an increase in one will lead to a decrease in the other. This is why a lot of bodybuilders - The Rock for example - are bald. If all of your parents and grandparents still have completely full heads of hair then maybe you'll be one of the lucky 20%, for everyone else it's a choice.
How Hair Loss Prevention Focuses On Blocking DHT
Given DHT’s role in hair loss, many hair loss prevention strategies focus on blocking its formation or action.
Medications: Finasteride and Dutasteride
Finasteride and dutasteride are both medications that inhibit 5-alpha reductase, (the conversion enzyme) thus reducing the conversion of testosterone to DHT. By lowering DHT levels in the scalp, these drugs can help prevent hair loss in individuals suffering from androgenetic alopecia. A common misconception is they will reduce testosterone. This is a myth, they will not reduce the amount of testosterone in your body, just reduce its conversion from testosterone into DHT. In fact testosterone levels might incerase slightly with their use as more testosterone is left with less being converted.
Finasteride is typically effective for treating male pattern baldness. It works primarily by blocking Type II 5-alpha reductase, which is responsible for most DHT production in hair follicles. Finasteride is prescribed either in oral or topical form, as a pill or a tablet and requires a prescription in the UK but is officially licensed to prevent hair loss.
Dutasteride, on the other hand, inhibits both Type I and Type II 5-alpha reductase, making it a more potent option for lowering DHT levels. This means it may offer greater benefits for hair regrowth, but it is not officially licensed to be prescribed for hair loss in the UK but it is often used off-label.
DHT-Based vs. Testosterone-Based Steroids
The distinction between these types of steroids is vital when considering treatment options for hair loss:
Steroids that are testosterone based can usually have their negative effects somewhat mitigated by taking either finasteride or dutasteride, as these drugs will reduce the extra DHT produced from introducing these into your system. However a lot of steroids are formulated around DHT or a synthetic variant of it, meaning you are effectively introducing DHT straight into your system. For these, finasteride and dutasteride would be completely ineffective, as they stop testosterone being converted into DHT, they do nothing for DHT compounds introduced into the body directly in its native form.
If you are looking to take steroids, and are wanting to reduce the negative effects of DHT then you need to consider using only testosterone based compounds and taking one of the two drugs above to reduce the extra DHT they will convert into, or accept the fact their use will lead to more rapid hair loss.
Common Testosterone Based Steroids:
Testosterone Cyprionate
Testosterone Propionate
Testosterone Enanthate
Sustanon
Equipoise (Boldenone)
Dianabol
Halotestin
Turnabol
Common DHT-Based Steroids
With these steroids, they will contribute towards hair loss in predisposed individuals more directly and there are no medications available that would slow or stop this currently:
Masteron
Primobolan
Anavar
Anadrol
Winstrol
Proviron
Superdrol
DHB
Reducing Hair Loss from Steroid Use
Ultimately, stopping the use of steroids is the most effective option for preventing hair loss. Steroids also come with a host of other negative effects on your body, can effectively thicken your blood, produce blood clots and enlarge your heart which can lead to a heart attack or stroke. Imagine the strain on the system from pumping water abound vs pumping treacle and you can imagine the difference.
Whilst we cannot condone their use, someone looking to continue taking them should seek medical advice from a professional, and if slowing hair loss is a priority then consider using only testosterone based compounds along with a suitable 5 alpha reductase inhibitor like Finasteride or Dutasteride to reduce some of the extra DHT produced, plus avoid the DHT based steroid compounds, and therefore help mitigate some hair loss.
Steroids and Hair Transplants
Hair Transplants are a popular solution for steroid related hair loss, as the transplanted hair is taken from the back of the head, and hairs from this area genetically have less androgen receptors so are less affected by the DHT hormone, meaning that hair will likely last for much longer. This is why men with male pattern baldness typically have lost hair on the top but not the back and sides of the head. So transplanted hair is less likely to be affected by steroid use.
The TL:DR of Steroids and Hair Loss:
DHT is the main cause of male pattern baldness related Hair Loss
But DHT and Testosterone are good for muscle building
Your Body turns 10% of any Testosterone it has into DHT every day
It does this by an enzyme called "5 alpha reductase"
Therefore if you increase Testosterone you increase DHT
Anabolic Steroids are typically either Testosterone or DHT based so taking will increase one or the other
If you take Finasteride or Dutasteride they reduce the amount of enzyme "5 Alpha Reductase" so less DHT can be converted from Testosterone
This will be effective in reducing the increased hair loss for Testosterone based steroids
Steroids that are DHT based will not be affected by finasteride and dutasteride so will not slow hair loss from these
Not taking steroids in the first place is a better idea to manage hair loss
For those experiencing hair loss due to steroids, seeking professional advice and exploring effective treatments can make a significant difference. Remember, early intervention is key to preserving your hair health.
If you have any concerns regarding hair loss or the effects of steroid use, don’t hesitate to contact My Hair UK for a consultation. Our team of experts is here to help you find the best solutions tailored to your needs.
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