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4 Things to Know About DHT Blockers

Knox Beasley, MD

Reviewed by Knox Beasley, MD

Written by Geoffrey Whittaker

Published 09/17/2017

Updated 04/10/2023

Life is full of abbreviations... LOL. IMHO. NBD. WTF. We could rattle off dozens. But one you may not be as readily familiar with is DHT.

It's short for dihydrotestosterone, and if you know anything about hair loss, you know that DHT definitely isn't your BFF. 

Enter: DHT blockers — hair loss treatments that either cut down the levels of DHT in your body or inhibit the effects of DHT at the scalp level.

Not all DHT blockers are created equally though. While some are backed up by high-quality scientific research, others aren’t supported by, well... much of anything, really. In short, DHT blockers can vary hugely in terms of quality and effectiveness. 

It’s our job to help you navigate the lingo and the options to find some HLP — hair loss peace (we just made that one up). So below, we’ve explained:

  • How DHT can contribute to hair loss

  • How DHT blockers work to treat issues such as male pattern baldness

  • Which DHT blockers are worth using as hair loss treatments 

  • Which are best avoided

That’s the TL;DR — here’s the whole story.

What is DHT?

DHT is the sinister figure walking among your follicles. The main hormone involved in male pattern hair loss, DHT can attach to receptors in your scalp and damage your hair follicles. Over time, this can lead to a receding hairline, hair thinning and even severe hair loss.

DHT, or dihydrotestosterone, is a type of androgen (male sex hormone) — the most potent one produced by your body. Your body produces DHT as a byproduct of testosterone through the action of an enzyme called 5-alpha-reductase. 

Like other androgens, DHT is highly important for your development as a male —you could say it writes your genetic bro code.

During the fetal development process, it plays a key role in producing your male genitalia. During childhood and puberty, DHT is responsible for your body hair, facial hair, deep voice and other male features.

In short, DHT is one of the hormones that makes you, as a man, male, at least during the early phases of your life. 

DHT Hormone and Balding in Men

Unfortunately, not all the things DHT is responsible for are desirable, kind of like how you won’t enjoy spicy food as much the next morning. After puberty, DHT takes on another, crappier role as a hairline ruiner. 

When DHT binds to receptors on hair follicles, it causes them to go through a process called miniaturization, in which the anagen phase of the growth cycle becomes progressively shorter. This reduced anagen phase results in hairs that are likewise thinner and shorter. 

Over time, as each hair follicle goes through a shorter anagen phase, new hairs eventually become so small that they’re unable to penetrate through the skin, like those seeds you planted in third grade science class that never came up. 

This type of hair loss is referred to as androgenetic alopecia, or male pattern baldness. It tends to begin as mild thinning around your hairline, and over the course of years or decades, it may also affect your crown. Eventually, it can cause significant hair loss across most of your scalp.

Not everyone is equally sensitive to the effects of DHT, which is why some men go bald early in life while others maintain a full head of hair well into old age.

Researchers believe that men affected by androgenetic alopecia tend to have higher levels of the 5-alpha-reductase enzyme, which converts testosterone into DHT, as well as an increased level of androgen receptor activity in the scalp.

There’s a lot more to this — if you’re interested, our guide to DHT and male pattern baldness goes into more detail about what DHT is and the effects it can have on your hair follicles. 

Do DHT Blockers Actually Work?

So, do DHT blockers work? The answer to this question largely depends on your definition of “effectiveness.” 

DHT blockers do not magically reverse the effects of male pattern baldness. With the exception of hair transplant surgery, there’s no way to instantly restore a receding hairline or other consequences of pattern hair loss.

If you have realistic expectations though, then some DHT blockers — the ones supported by high-quality scientific evidence, at least —  can stop, slow down or partially reverse the effects of male pattern baldness.

But which one(s) you choose is important to your results. DHT blockers come in two main forms. Some, such as the hair loss medication finasteride, stop DHT from being produced from testosterone by blocking the effects of certain enzymes, such as 5-alpha reductase.

Others, such as DHT blocker shampoos, conditioners and hair oils, work by blocking the effects of DHT at specific parts of your body, such as the scalp. 

What Are the Best DHT Blockers? 

Like we said earlier, not all DHT blockers are equal. These treatments for hair loss aren’t all supported by a substantial amount of scientific evidence. 

Of the DHT blockers on the market, finasteride is far and away the best DHT blocker. It's approved by the FDA, it's backed up by plenty of actual research, and it's readily available following a consultation with a healthcare professional. 

OTC shampoos, conditioners and other supplements work differently and to varying degrees. 

Read on to learn more about these options.

Finasteride

Finasteride belongs to a class of drugs called 5-alpha-reductase inhibitors. It works by reducing the effects of the 5α-reductase enzyme, which is responsible for the conversion of testosterone into DHT. 

Although finasteride, also known by the brand name Propecia, starts working right away, its effects on hair growth aren’t immediate. You may need to use finasteride for six to 12 months before you’ll be able to see improvements in your hair’s thickness, density and coverage. But during that time, here’s what will be going on beneath your scalp:

  • Process. By blocking DHT production directly at the source, finasteride drastically reduces the amount of DHT that can bind to receptors in your scalp and other parts of your body. Research shows that finasteride can lower the amount of DHT in blood serum by as much as 70 percent.

  • Effect. Because of its effects on DHT, finasteride is highly effective at slowing down, stopping and even reversing hair loss from male pattern baldness.

  • Results. In a study published in the Journal of the American Academy of Dermatology in the late 1990s, researchers found that men with pattern hair loss who used finasteride had clinically significant increases in hair count around the crown of the head.

  • Better hair growth.A more recent study from Japan found that more than 91 percent of men who used finasteride to treat male pattern baldness experienced improvements in hair growth.

  • Fun fact: Topical finasteride is not FDA-approved (yet) but has shown promise in clinical studies.

  • You can get it. We offer oral finasteride online, following a consultation with a licensed healthcare provider who will determine if a prescription is appropriate.

DHT-Blocking Shampoos and Supplements 

While finasteride works by blocking DHT at its source, other DHT-blocking agents work locally (at the follicle) by preventing DHT from damaging hair follicles at the scalp level. 

Although DHT-blocking shampoos can produce improvements in hair growth, there’s not nearly as much scientific evidence to support their benefits as there is for finasteride.

DHT-blocking shampoos are widely available over the counter. They contain active ingredients that reduce the effects of DHT on your scalp and hair follicles.

Over the years, several active ingredients have been identified as possibly stopping the effects of DHT, making them popular choices for DHT-blocking shampoos. 

Look for the following ingredients when you’re comparing hair loss shampoos:

  • Ketoconazole. An antifungal medication, ketoconazole is commonly used to treat fungal skin infections such as athlete's foot (tinea pedis). It’s also known to inhibit 5α-reductase, the enzyme that converts testosterone into DHT. Research suggests that ketoconazole shampoo can increase hair density and stimulate hair follicles to enter the anagen phase of the hair growth cycle.  

  • Saw palmetto. Saw palmetto is a popular natural ingredient that’s produced from a palm called Serenoa repens. A study published in the journal Urology found that it can reduce DHT levels in prostate tissue when taken as a supplement. Other research has found that saw palmetto can produce improvements in hair growth for men with pattern hair loss. You can find saw palmetto in our hair thickening shampoo, which is formulated to target DHT and promote volume and moisture.

  • Pumpkin seed oil. Pumpkin seed oil is a natural product that’s been linked to improved hair growth. In one study, researchers found that it may stop prostate growth — an issue that’s often caused by high DHT levels — when used with saw palmetto. Other research suggests that pumpkin seed oil supplements can increase hair growth in men with male pattern baldness. 

In general, it’s best to use hair loss prevention shampoo with finasteride, rather than on its own as a hair loss treatment. Our guide to DHT-blocking shampoos explains more about how a hair loss shampoo can fit into your hair care routine for optimal results. 

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Side Effects of DHT Blockers

DHT blockers are safe and effective for most men, so you don’t have to worry about weird DHT blocker side effects like hairy palms from scrubbing these shampoos into your hair. However, some DHT-blocking medications may cause other side effects — including sexual ones. 

The most common side effects of finasteride include decreased libido, erectile dysfunction (ED) and ejaculation issues, such as a reduction in semen volume.

These side effects only affect a small percentage of men who use finasteride. For example, data from clinical trials shows that erectile dysfunction — the most publicized side effect of finasteride — only occurred in 1.3 percent of men who used it at the standard 1mg dose. 

Side effects from DHT blockers used in hair loss prevention shampoos are similarly uncommon, though some ingredients may cause irritation, dry skin, itchy skin or other minor side effects. 

If you experience any side effects while using finasteride or a topical DHT blocker, it’s important to let your healthcare provider know. 

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Other Treatments to Use With DHT Blockers

Finasteride, for all its benefits, is not a one-stop shop, buddy. And like your aunt’s geriatric cat, you’re going to benefit from more than one medication in your daily routine. 

Although DHT is the main hormone responsible for male pattern baldness, there’s more to hair loss prevention than just blocking it from affecting your hair follicles.

Other hair loss treatments may help to limit shedding and promote growth by: 

  • Moving hairs into the anagen phase of your hair growth cycle

  • Improving blood circulation 

  • Providing hair with the nutrients to grow to full strength, length and density 

In addition to the DHT blockers listed above, consider using the following treatments as part of your hair loss prevention routine:

Minoxidil

As the other side of the most famous duo in hair growth, minoxidil is a successful topical and oral medication for hair loss. It moves hairs into the anagen phase of the hair growth cycle by increasing blood flow to the scalp, which results in growing hair on your head. 

Some quick facts:

  • Although minoxidil doesn’t lower DHT levels, it’s one of the most effective medications available for treating male pattern baldness, especially when it’s used in combination with finasteride.

  • It’s a team player. In a study published in the journal Dermatologic Therapy, researchers found that 94.1 percent of men with androgenetic hair loss who used topical minoxidil and finasteride together saw improvements in their hair.

  • It can handle some hair loss by itself, too. In comparison, 59 percent of men who used minoxidil alone and 80.5 percent of men who used finasteride also showed improvements.

We offer minoxidil solution and minoxidil foam online. You can also buy finasteride and minoxidil together in our Hair Power Pack

Biotin Supplements

Who doesn’t love a good vitamin on a list of treatments? 

Biotin, or vitamin B7, is a water-soluble that’s found in certain foods. It’s also a popular dietary supplement that serves as an important nutritional building block for thick hair, strong nails and healthy skin. 

Like many vitamins for hair loss, research is mixed overall on the effectiveness of biotin as a hair growth supplement. However, some studies of supplements containing biotin suggest that they may offer benefits — especially on the rare occasion they're used in someone who's biotin-deficient.

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Finasteride & Minoxidil

This is the FDA-approved dynamic duo. When used together, men saw better results in clinical trials compared to using either alone.

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If you’re looking for something effective but don’t want too many steps in your routine, this once-a-day pill could be right for you.

Minoxidil Foam

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Using DHT Blockers for Hair Loss 

Hair loss from male pattern baldness can creep up on you in the form of rising DHT levels. Like global warming, it’s a problem that can sneak up on you if you don’t listen to experts. Also like global warming, it’s important to take action if you notice any of the early signs of balding

Knowing what action to take comes down to a few simple reminders:

  • Used effectively, DHT blockers like finasteride and our Hair Thickening Shampoo can help you to slow down or stop androgenic hair loss

  • In many cases, they can even stimulate growth and let you maintain a full head of thicker, healthier hair well into your 40s, 50s and 60s. 

  • But not all DHT blockers are created equally.

  • So, do your research. If you’ve noticed symptoms of DHT-related hair loss and want to take action, you can view our complete selection of hair loss treatments online.

The problem isn’t going to go away without being escorted out, so when you see DHT getting out of hand, it’s time to signal the bouncer. You can learn more about slowing down, stopping, and reversing hair loss using finasteride in our full guide to finasteride for men

18 Sources

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  8. Yanagisawa, M., et al. (2019, January). Long-term (10-year) efficacy of finasteride in 523 Japanese men with androgenetic alopecia. Clinical Research and Trials. 5, 1-5. Retrieved from https://www.researchgate.net/publication/337105943_Long-term_10-year_efficacy_of_finasteride_in_523_Japanese_men_with_androgenetic_alopecia
  9. Rafi, A.W. & Katz, R.M. (2011). Pilot Study of 15 Patients Receiving a New Treatment Regimen for Androgenic Alopecia: The Effects of Atopy on AGA. ISRN Dermatology. 241953. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3262531/
  10. Piérard-Franchimont, C., De Doncker, P., Cauwenbergh, G. & Piérard, G.E. (1998). Ketoconazole shampoo: effect of long-term use in androgenic alopecia. 196 (4), 474-7. Retrieved from https://pubmed.ncbi.nlm.nih.gov/9669136/
  11. Marks, L.S., et al. (2001, May). Tissue effects of saw palmetto and finasteride: use of biopsy cores for in situ quantification of prostatic androgens. Urology. 57 (5), 999-1005. Retrieved from https://pubmed.ncbi.nlm.nih.gov/11337315/
  12. Rossi, A., et al. (2012, October-December). Comparitive effectiveness of finasteride vs Serenoa repens in male androgenetic alopecia: a two-year study. International Journal of Immunopathology and Pharmacology. 25 (4), 1167-73. Retrieved from https://pubmed.ncbi.nlm.nih.gov/23298508/
  13. Hong, H., Kim, C.-S. & Maeng, S. (2009). Effects of pumpkin seed oil and saw palmetto oil in Korean men with symptomatic benign prostatic hyperplasia. 3 (4), 323–327. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2809240/
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  15. Badri, T., Nessel, T.A. & Kumar, D.D. (2021, December 19). Minoxidil. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK482378/
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Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Knox Beasley, MD

Dr. Knox Beasley is a board certified dermatologist specializing in hair loss. He completed his undergraduate studies at the United States Military Academy at West Point, NY, and subsequently attended medical school at Tulane University School of Medicine in New Orleans, LA. 

Dr. Beasley first began doing telemedicine during his dermatology residency in 2013 with the military, helping to diagnose dermatologic conditions in soldiers all over the world. 

Dr. Beasley is board certified by the American Board of Dermatology, and is a Fellow of the American Academy of Dermatology.

Originally from Nashville, TN, Dr. Beasley currently lives in North Carolina and enjoys spending time outdoors (with sunscreen of course) with his wife and two children in his spare time. 

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