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Does TRT Cause Hair Loss? Testosterone & Hair Loss

What Is TRT?

Testosterone Replacement Therapy (TRT) is a medical treatment used to address low testosterone levels in men, a condition known as hypogonadism. TRT aims to restore normal testosterone levels, improving symptoms such as low energy, decreased libido, and mood changes. However, one of the potential side effects of TRT is hair loss, especially in individuals predisposed to male-pattern baldness.

trt and hair loss

The Link Between TRT and Hair Loss

1. DHT Conversion

When testosterone levels are increased through TRT, a portion of the hormone is converted into dihydrotestosterone (DHT) by the enzyme 5-alpha reductase.

  • DHT is known to shrink hair follicles, leading to a condition called androgenic alopecia (male-pattern baldness).
  • Individuals with a genetic sensitivity to DHT are more likely to experience hair thinning or receding hairlines during TRT.
trt and hair loss

2. Hormonal Imbalances

TRT can sometimes cause fluctuations in hormone levels, potentially triggering telogen effluvium, a temporary condition where hair enters the resting phase prematurely, resulting in diffuse shedding.

trt and hair loss

Who Is at Risk of Hair Loss During TRT?

  • Genetic Predisposition: If you have a family history of androgenic alopecia, you are more likely to experience hair loss on TRT.
  • High DHT Levels: Individuals with naturally high DHT levels or increased sensitivity to the hormone are at greater risk.
  • Prolonged Use: Long-term TRT may amplify the effects of DHT on hair follicles.

Can TRT Cause Permanent Hair Loss?

Hair loss caused by TRT is generally related to androgenic alopecia, which is permanent if untreated. However, hair shedding due to telogen effluvium is typically temporary and resolves once hormonal levels stabilize.

Managing Hair Loss During TRT

1. Use of DHT Blockers

  • Finasteride (Propecia): A prescription medication that inhibits the conversion of testosterone to DHT, helping to prevent hair follicle miniaturization.
  • DHT-Blocking Shampoos: Over-the-counter shampoos with ingredients like ketoconazole may reduce scalp DHT levels.
trt and hair loss

2. Hair Growth Stimulants

  • Minoxidil (Rogaine): A topical treatment that promotes hair regrowth and improves follicle health.
  • PRP Therapy: Platelet-rich plasma injections can rejuvenate damaged hair follicles and stimulate growth.
trt and hair loss

3. Adjust TRT Dosage

Work closely with your healthcare provider to find a TRT dosage that balances testosterone levels without significantly increasing DHT production.

trt and hair loss

4. Healthy Lifestyle Choices

  • Maintain a diet rich in vitamins and minerals such as biotin, zinc, and iron to support hair health.
  • Reduce stress levels through relaxation techniques like yoga or meditation, as stress can exacerbate hair loss.
trt and hair loss

Alternatives to TRT for Low Testosterone

If hair loss is a major concern, consider discussing alternative treatments with your doctor, such as:

  • Clomiphene Citrate: A medication that stimulates the body’s natural testosterone production.
  • Lifestyle Changes: Regular exercise, weight management, and balanced nutrition can naturally boost testosterone levels.

When to Seek Professional Help

If you notice significant hair thinning or shedding while on TRT, consult a trichologist or dermatologist for tailored treatment options. They can assess the cause and recommend therapies to minimize hair loss.

F.A.Q. (Frequently Asked Questions)

Hair loss caused by telogen effluvium may reverse after stopping TRT, but androgenic alopecia is usually permanent unless treated with medications like finasteride.

A dermatologist can conduct a scalp examination and review your family history to determine the primary cause of hair loss.

No, not everyone experiences hair loss on TRT. Genetic predisposition and individual hormone levels play a significant role.

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About the Author: Dr. Rasime Erkan
rsme erkn
Dr. Rasime Erkan was born in Kayseri and moved to Istanbul at the age of two, where she completed her education. She graduated from Istanbul Faculty of Medicine in 1981 and began her professional career at a private hospital in Istanbul. She completed her specialization at the Department of Dermatology, Istanbul Faculty of Medicine, successfully passing her board certification exam in 1988. Throughout her career, Dr. Erkan has provided dermatological treatment to over 8,000 patients and has trained dozens of doctoral students. Since 2015, she has been working at the Hair Center of Turkey clinic, where she has organized and supervised more than 1,000 hair transplant operations. Additionally, she has reinforced her expertise by providing dermatological treatment to numerous patients following their hair transplant procedures. With her extensive knowledge in the diagnosis and treatment of dermatological diseases, Dr. Rasime Erkan continues to make valuable contributions to the clinic.
25/02/2025Uncategorized
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