Doctor On: Do DHT Blockers Work? And Why It Might Not?

hair follicle dht blocker
Written by
Morgan German
Medically approved by
Zac Hyde M.D.

Do DHT blockers work?

This question is often asked on social media, search engines, and dermatology clinics. The short answer is yes. DHT blockers actually work. Just think of finasteride - a DHT blocker, which is the only FDA-approved medication to treat androgenic alopecia.

While we covered androgenic alopecia in great detail in other blog posts, here is a quick definition:

Androgenic alopecia is a genetic condition that results from high levels of DHT, leading to hair loss. Blocking the action of DHT can stop the progression of AA.

In this article, we will try to answer the question regarding the DHT blocker, DHT hair loss, and DHT shampoo while relying on evidence-based science and clinical trials.

Read more:

What is DHT?

DHT, or dihydrotestosterone, is a sex steroid that's related to testosterone. Converting the latter to DHT requires the action of an enzyme known as 5-alpha reductase (5-αR).

In a study published by the Journal of Ethnopharmacology, researchers stated that DHT is indispensable for normal male development. In large amounts, however, this hormone can lead to a variety of problems, including:

  • Acne
  • Excessive body hair growth
  • Androgenic alopecia (male pattern baldness)
  • Enlarged prostate

What is a DHT blocker?

woman seeing hair fall due to dht

A DHT blocker is a compound that inhibits the conversion process of DHT. In other words, these blockers will act on any step that leads from testosterone to DHT.

The vast majority of DHT blockers target the receptors of the 5-αR enzyme family. This prevents the conversion of testosterone to DHT without targeting them directly.

According to Dermatologic Therapy, there are several types of DHT blockers, which could target one or more receptors within the 5-αR enzyme family.

This piece of information suggests that not all DHT blockers are created equally. Differently put, some might be more potent than others.

For instance, minoxidil, finasteride and dutasteride are significantly more potent than their herbal counterparts. This is because pharmaceutical companies isolate these compounds and dose them to maximize efficacy.

Do DHT blockers work?

DHT blockers actually work!

The FDA approved certain DHT blockers for the management of several health issues, including androgenic alopecia, male pattern hair loss and benign prostatic hyperplasia (BPH).

The two DHT blockers that we are familiar with are finasteride and dutasteride. The first targets a single receptor within the 5-alpha reductase enzyme. The second one, however, targets two types of receptors. Dutasteride has approval for the treatment of androgenic alopecia in South Korea and Japan.

In the United States, dutasteride is FDA-approved for the management of BPH. However, it didn't yet receive approval for the treatment of hair loss. Despite that, the Journal of Clinical and Aesthetic Dermatology considers this drug a valid option for the treatment of hair loss.

Note that doctors consider dutasteride much more potent than finasteride.

There are also less potent options out there such as a DHT blocker shampoo or a natural DHT blocker - which we will talk about now.

Natural DHT blockers for DHT level

man washing hair with dht blocker shampoo

While most people have heard of the two drugs we listed above, you might not know that there are a number of natural DHT blockers out there. These can be found in herbs, food, and even as an ingredient in a beverage, a supplement, and a DHT blocking shampoo.

Here are some examples of naturally-occurring DHT blockers:

  • Saw palmetto (Serenoa repens/serrulata)
  • Oyster mushrooms (Pleurotus ostreatus)
  • Shiitake mushrooms (Lentinula edodes)
  • Wax gourd/Winter melon (Benincasa hispida Cogn.)
  • Black pepper (Piper nigrum)
  • East Indian globe thistle (Sphaeranthus indicus Linn.)
  • Giant dodder (Cuscuta reflexa Roxb.)
  • Equisetum species (particularly horsetail - Equisetum debile) 
  • Stinging nettle (Urtica dioica)
  • Lingzhi mushroom (Ganoderma lucidum)
  • Lesser galangal (Alpinia officinarum)
  • Japanese climbing fern (Lygodium japonicum)

It is important to note that these natural DHT blockers have not been clinically tested on humans. In other words, all the evidence that we have on the effectiveness of these herbs comes from test tubes or animal studies.

Moreover, the potency of these herbs is much lower than finasteride or dutasteride. Despite that, saw palmetto has a lot of evidence that supports its effectiveness in keeping excess DHT production in check.

Why some DHT blockers do not work?

The answer to this question is a bit tricky.

You see, DHT blockers are effective for people with male pattern baldness or androgenetic alopecia. The pathophysiology of this disorder makes DHT blockers the ideal treatment.

Therefore, if you have other types of hair loss or hair fall, you may not notice any improvement despite taking DHT blockers.

On top of this, one DHT blocker may lead to different results for people. For instance, a study found that 77% of participants who took dutasteride for their androgenetic alopecia noticed a significant improvement in hair regrowth. The same participants took finasteride for 6 months without any results.

Researchers also emphasize the importance of having elevated levels of DHT in order for its blockers to work. Particularly, alopecia areata, which is an autoimmune disorder that causes hair loss and hair thinning, does not present with high levels of DHT.

Other causes that trigger male pattern hair loss include inflammation, immune dysfunction, and imbalanced nutrition.

In all the scenarios mentioned above, DHT blockers may not be effective at reversing or stopping hair loss. If that's your case, try changing your lifestyle by eating healthier food, exercising more, controlling your stress, and sleeping better. These changes may seem irrelevant, but they might yield impressive results.

The best way to determine if your DHT level is high is by consulting your dermatologist.

Minoxidil, finasteride and dutasteride

woman applying finasteride to block dht

Oral minoxidil, finasteride and dutasteride are generally well tolerated. However, they may cause some sexual side effects.

For instance, decreased libido, erectile dysfunction, and a lesser amount of sperm were all noted in 15.8% of participants. Of course, if you would benefit from these medications, a 15.8% chance of decreased libido may not be that significant.

Additionally, as your body adapts to the medications, these side effects tend to subside. For completeness' sake, some patients find that decreased libido continues despite stopping the medication. Doctors refer to this condition as post-finasteride syndrome. Note that the incidence of this condition is extremely low.

This syndrome occurs after stopping the intake of finasteride or dutasteride. Similar to fibromyalgia, post-finasteride syndrome is not acknowledged by all scientists and healthcare professionals. Despite that, the medical literature is increasing reporting cases of decreased libido after stopping finasteride and dutasteride. In fact, the National Institutes of Health included information about this disorder in the Genetic and Rare Disease Information Center - a website that specializes in rare disorders.

With all of that said, the most effective way to prevent these side effects is by not taking DHT blockers orally. Instead, opt for topical application of the medications. According to the Journal of Drugs in Dermatology, applying finasteride and dutasteride topically does not cause the same side effects as their oral counterparts.

The same review mentioned that combining finasteride and dutasteride in their topical forms does not cause any side effects and leads to superior results.

Before taking DHT blockers orally or applying them to your skin, make sure to consult with your doctor first.

Takeaway message

DHT blockers are effective medications that treat androgenic alopecia or male pattern hair loss. The topical DHT blocker form of these drugs seems to be more effective and causes fewer side effects compared to oral pills in hair loss treatment.

We hope that this article answered the question of do DHT blockers work and gave you a more comprehensive understanding of their pharmacology.

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