Clinically reviewed by Dr. Ponlawat Pitsuwan, Physician, Doctor Bangkok. Last reviewed: July 2026
DHT is a potent hormone made from testosterone that drives male pattern baldness in genetically sensitive men. It is not the level of testosterone that matters most for hair, but how your follicles respond to DHT. Treatments work by reducing DHT or protecting the follicles.
Hair loss comes up surprisingly often when I talk to men about testosterone. Some worry that treatment will make them go bald; others assume that thinning hair means their testosterone must be high. Both ideas are common, and both are more myth than fact. The real story is about a hormone called DHT and how sensitive your hair follicles are to it.
This article explains what DHT is, how it causes male pattern baldness, how it relates to testosterone and TRT, and what can be done about it. For the wider men’s health context, see our main guide to testosterone therapy in Bangkok.
What DHT is
Dihydrotestosterone, or DHT, is a hormone your body makes from testosterone using an enzyme called 5-alpha-reductase. DHT is more potent than testosterone at the receptor level and plays important roles in male development. But in the scalp, in men who are genetically predisposed, it is also the main driver of hair loss.
How DHT causes male pattern baldness
In sensitive follicles, DHT gradually shrinks the hair follicle in a process called miniaturisation. Each hair grows back finer and shorter, the growth phase shortens, and eventually the follicle stops producing visible hair. This is why male pattern baldness follows a predictable pattern: a receding hairline and thinning at the crown, where follicles are most DHT-sensitive.
Why genetics matter more than hormone levels
Men with plenty of testosterone can keep a full head of hair, while others with lower levels go bald early. The deciding factor is inherited follicle sensitivity to DHT, not how much testosterone or DHT you have circulating. So a bald patch tells you little about your testosterone level.
DHT, testosterone and TRT
Because testosterone is the raw material for DHT, testosterone therapy can, in theory, accelerate hair loss in men who are already genetically prone to it. In practice the effect varies from man to man, and many notice no change. This is a reasonable thing to raise with your doctor if hair matters to you, and it is one of the trade-offs we discuss before starting treatment. It has no bearing on unrelated concerns such as erectile dysfunction, which is assessed separately.
Treatment options
The main medical approaches either reduce DHT or support the follicles directly. Some medications block the enzyme that converts testosterone to DHT, lowering scalp DHT; others are applied to the scalp to prolong hair growth. Each has benefits and possible side effects, and results take months. Your doctor will advise which options suit you and explain what to expect, rather than promising guaranteed regrowth.
When to see a doctor
See a doctor if your hair loss is sudden, patchy, comes with itching, scaling or pain, or is accompanied by other symptoms such as fatigue, as these may point to a different cause rather than ordinary pattern baldness. If you are considering or already on TRT and are concerned about your hair, discuss it before or during treatment so it can be factored into your plan.
Concerned about hair loss or how it relates to testosterone? At Doctor Bangkok, a 24/7 walk-in clinic in Sukhumvit, a physician can assess the cause and talk through your options. Read our full testosterone therapy guide or contact us to book.
Frequently asked questions
Does high testosterone cause baldness?
Not directly. Baldness is driven by how sensitive your follicles are to DHT, which is inherited, not by how much testosterone you have. Men with normal or even low testosterone can still lose their hair.
Will TRT make me go bald?
It can accelerate hair loss in men already genetically prone to it, but the effect varies and many men notice no change. If hair is a concern, raise it with your doctor before starting so it can be part of the discussion.
Can lowering DHT regrow my hair?
Reducing DHT can slow loss and, in some men, lead to modest regrowth, but results vary and take months. No treatment guarantees a full head of hair, and your doctor will set realistic expectations.
Is DHT bad for me overall?
No. DHT has important roles in male development and health. It only causes problems for the scalp in men whose follicles are genetically sensitive to it. Treatment aims to manage that specific effect.
Should I get my hormones tested if I’m losing hair?
Ordinary pattern baldness usually does not require hormone testing. But if the loss is sudden, patchy or comes with other symptoms, a doctor may test to rule out a different cause.
Dr. Ponlawat Pitsuwan
Physician, Doctor Bangkok
Dr. Ponlawat practises at Doctor Bangkok, a private medical clinic in central Bangkok. He counsels men on the hormonal side of hair loss, helping them understand the role of DHT and weigh treatment options with realistic expectations.
Dr. Ponlawat Pitsuwan is a physician at Doctor Bangkok, a private clinic in central Bangkok. He sees expats, residents, and medical tourists for general medicine, wellness consultations, and IV therapy. His focus is straightforward, evidence-based care delivered in plain language.