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Anabolic steroids, testosterone and hair loss: is there a correlation?

Published Last updated Content: Swiss Hair Life editorial team

Medically reviewed by Dr. Sabrina Tahery (Medical Lead Oftringen) and Dr. Moustafa Kassar (Medical Lead Zurich) · Medically updated

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Anabolic steroids, testosterone and hair loss – is there a link?

Many people who take anabolic steroids or testosterone preparations sooner or later ask themselves: can testosterone trigger hair loss? Especially when they suddenly find more hair than usual in the washbasin or on the pillow.

The answer is: Yes, with a genetic predisposition and a sharply elevated DHT level, hair loss can occur.

In this article, we explain clearly and simply what role testosterone, DHT and genetic factors play, why some people are more affected than others and how you can strengthen your hair despite hormonal changes.

Key points at a glance

  • Anabolic steroids and high-dose testosterone raise the DHT level.
  • In people with a predisposition to hereditary hair loss, it can then appear earlier and be more pronounced.
  • Typical areas are the forehead, the temples and the crown (vertex).
  • Hair that has shrunk considerably often does not fully come back after stopping.
  • If you notice hair loss, have your hormone levels and the cause checked by a doctor.

What are androgens and what do they do in the body?

Androgens are male sex hormones, which include testosterone and dihydrotestosterone (DHT). They control many physiological processes in the body, including:

  • muscle building and fat distribution
  • libido and reproduction
  • hair growth and sebum production

Important to know

Part of the testosterone is converted into DHT by the enzyme 5-alpha reductase. This conversion makes physiological sense, as DHT performs certain tasks more strongly than testosterone. How DHT acts in the body, however, depends not only on the amount produced, but above all on the genetic properties of the androgen receptors.

What does DHT do in the body?

DHT controls many physiological processes:

  • development and function of the prostate
  • activity of the sebaceous glands
  • development of male characteristics during puberty
  • body hair
  • muscle and bone stability

What happens when testosterone and dihydrotestosterone levels are elevated?

Everyone needs testosterone and DHT in a certain balance for the body to function normally. When anabolic steroids or testosterone preparations are taken, the testosterone level rises sharply. Part of this excess is converted into DHT by the enzyme 5-alpha reductase, which results in DHT concentrations well above the normal physiological level.

The mechanism in people with genetically sensitive androgen receptors:

  • Hair follicles react more strongly / more sensitively to DHT.
  • When the DHT level is too high, too much DHT binds to these receptors.
  • The follicles are overstimulated.
  • The biological signals in the follicle change.
  • The growth phase (anagen phase) becomes shorter.
  • The follicles shrink.
  • Hairs become thinner and fall out earlier.

Result: hair follicles that are sensitive to DHT show increased miniaturisation, thinning hair and ultimately hair loss. People with a predisposition often notice hair loss while taking anabolic steroids earlier and more severely than they would without them.

Medical note

“Testosterone is essential for life. An excessively high level, caused by anabolic steroids, increases the DHT concentration and, through overstimulation, activates a biological mechanism that makes the hair follicles shrink. Although the androgen receptors are generally stimulated more strongly in the process, genetically sensitive androgen receptors show an exaggerated response that triggers a whole series of further mechanisms. These ultimately lead to miniaturisation of the hair follicles and a shortening of the hair growth phases, which in the long term leads to the typical thinning and loss of hair. Miniaturisation often begins at the forehead and crown, because these areas are particularly sensitive, but in principle it affects the entire top of the head.”

Anabolic steroids or medical testosterone therapy?

There is a big difference between anabolic steroids taken without medical supervision and testosterone therapy prescribed by a doctor for a proven deficiency. With therapy, the testosterone level is brought into the normal range and checked regularly. Even then, a predisposition to hair loss can become noticeable. If you notice hair loss during therapy, raise it with your doctor and do not stop the therapy on your own.

Is the hair loss reversible?

Partly. After stopping anabolic steroids, the DHT level falls again and the additional pressure on the hair follicles decreases. Hair follicles that are only weakened can recover. Hair follicles that have shrunk considerably over a longer period often no longer produce strong hairs. The hereditary predisposition remains in any case. The sooner you act, the more of your own hair can be preserved.

How to support your hair follicles

Even with an elevated DHT level, you can support your hair:

  • PRP (platelet-rich plasma) treatment: can support existing hair follicles and the regeneration of the scalp
  • Gentle hair care: no harsh chemicals, gentle brushing and combing
  • A healthy, balanced diet: get enough protein, zinc, selenium, iron and vitamin D
  • Stress reduction: chronic stress can accelerate hair loss

If you are taking hormones at the same time, only use medication for hereditary hair loss such as minoxidil or finasteride after a medical assessment. Find out more in the article Can hereditary hair loss be treated?

How to stabilise your hormone balance

If your hormone levels are out of balance, there are various ways to counter hormone-induced hair loss and protect your hair follicles:

  • reducing or stopping anabolic steroids (under medical supervision)
  • supporting recovery: sleep, rest periods, sufficient calories and nutrients
  • PRP treatment to support the existing hair follicles
  • regular blood tests to monitor hormone levels

Most important of all is always a professional assessment to establish whether the hair loss really is hormone-induced or whether there are other causes. For an overview, see our guide Possible causes of hair loss.

Is a hair transplant an option?

Yes, if bald areas have developed and there is enough donor hair. However, it only makes sense once the hair loss has stabilised. If you continue to take anabolic steroids, you risk your own hair around the transplanted areas continuing to thin. We discuss this openly in the consultation; find out more about the hair transplant.

Frequently asked questions

Does testosterone cause hair loss?

Not testosterone itself directly. Part of it is converted into DHT, and in sensitive hair follicles a high DHT level can accelerate hereditary hair loss.

Does hair grow back after stopping anabolic steroids?

Partly. Weakened hair follicles can recover, but those that have shrunk considerably often cannot. The hereditary predisposition remains.

Does this also affect women?

Yes. In women, anabolic steroids and androgens can have other masculinising effects besides hair loss, some of which are irreversible. A medical assessment is particularly important here.

Which blood tests make sense?

Typically hormone levels such as testosterone and, depending on the situation, other values. Your doctor decides which ones make sense.

Key takeaways

Androgens such as testosterone and DHT are natural and important hormones. Only when they are massively increased by taking synthetic substances such as anabolic steroids can an imbalance arise that puts a strain on genetically sensitive hair follicles. An excessive DHT stimulus causes the follicles to overreact, shorten their growth phases and miniaturise. The result is thinning hair and hair loss.

A medical assessment, hormonal stabilisation and supportive treatments help to slow down or stabilise the process.

If you take anabolic steroids and are unsure whether your hair loss is related to them, you can contact us at any time. We advise you competently, individually and discreetly, in the free hair analysis or at a personal appointment.

References

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