The hair on the body and head undergo a natural life cycle that is influenced by the hormonal balance. During the growth phase, the hair follicle actively produces hair, but over time it transitions into a resting phase in which the hair shaft detaches and is replaced by a new one. This cycle is influenced by hormones that shorten the growth phase in the hair follicles on the head. This causes the hairs to become thinner and grow more slowly, which can lead to gradual hair loss, especially in those with a genetic predisposition to hereditary hair loss.
How does testosterone treatment affect hair loss?
When starting a testosterone treatment, the body's hormonal balance changes. Testosterone is metabolized by the enzyme 5-alpha-reductase and converted to dihydrotestosterone (DHT), which has a more powerful androgenic effect than testosterone itself. DHT is the main factor behind androgenic alopecia (AGA), also called male pattern baldness. More things that are added with testosterone are:
Increased beard and body hair
Testosterone stimulates beard and body hair by converting thin vellus hairs into terminal hairs. How quickly and extensively this change occurs depends on genetics and individual sensitivity to androgens.
Miniaturization of the hair follicles on the head
Dihydrotestosterone (DHT) binds to androgen receptors in the hair follicles on the head, reducing blood and nutrient supply. This leads to a gradual miniaturization of the hair follicles, making the hair thinner and shorter until eventually it stops growing completely.
Typical patterns of hair loss
Hair loss in trans men often follows classic patterns, such as a V-shaped hairline at the temples, thinning on the scalp and, in untreated cases, a horseshoe-like hairline, similar to that seen in cis men.If hair loss occurs in cis men in the family, the risk of a testosterone treatment triggering or accelerating the process increases. Hair loss can begin as early as 6—12 months after the start of treatment and progress over several years.
What happens to the hair during estrogen treatment?
For those who take estrogen supplements, both estrogen and testosterone blockers reduce androgen levels, which can affect both hair loss and hair growth on the body.
Reduced body and facial hair
Estrogen inhibits the effect of testosterone, causing beard and body hair to become thinner and grow more slowly. However, beard growth does not disappear completely and often requires laser or electrolysis for permanent removal.
Slowed or prevented hair loss
If hormone therapy is started before significant hair loss has occurred, estrogen and testosterone blockers can lower DHT levels and slow further hair loss. However, already lost hair can be difficult to restore with hormone therapy alone.
Improved hair quality
Estrogen can make hair thicker, shinier and make it grow faster, thanks to increased sebum production that improves hair structure and moisture balance.
Treatment Options for Hormone-Related Hair Loss
For those who experience a lot of hair loss, there are several treatment options depending on the need and the desired result. At our clinic we offer PRP treatment, which stimulates hair follicles and improves hair quality, as well as hair transplantation which is a more permanent solution to restore hair density. For those who want to slow hair loss on their own, there is minoxidil, an over-the-counter drug available in pharmacies, as well as dermaroller, which can improve blood circulation in the scalp and stimulate hair growth. We are happy to help you find the right treatment for your needs. Read more about our treatments tailored to your gender identity here.
