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FTM Hair Loss and DHT

The role of DHT in hair loss

Male pattern baldness is a common condition that affects a considerable number of people.

It is characterized by a gradual loss of hair from the scalp.

Although male pattern baldness is not life-threatening, it can have a significant impact on a person's self-esteem and confidence.

Hair loss is a common side effect of hormone replacement therapy for many female-to-male transgender individuals, but not everyone will experience it.

The extent of hair loss can vary depending on genetics, age, and other factors.

For instance, those with a family history of male pattern baldness may be more susceptible to hair loss related to DHT.

DHT is a hormone that forms when testosterone is converted by the 5-alpha reductase enzyme.

While DHT plays a crucial role in developing male characteristics, such as facial hair growth and a deeper voice, it can also cause hair loss.

DHT binds to hair follicles and causes them to shrink, which can lead to hair loss over time.

Therefore, it is essential to have an understanding of the stages of male pattern baldness and the Norwood scale, which is used to classify hair loss patterns.

The Northwood Scale

The Norwood scale, also referred to as the Hamilton-Norwood scale, is a commonly used classification system that assists healthcare professionals and hair loss experts in identifying and treating male pattern baldness in cis and transgender FTM men.

The scale utilizes a series of images to depict the various degrees of hair loss, ranging from stage 1 (least severe) to stage 7 (most advanced).

Male pattern baldness progresses through seven stages.

In the first stage, the hairline appears more youthful, with the hairline at its lowest point on the forehead.

In the second stage, the hairline matures and recedes slightly from the juvenile hairline. In the third stage, hair loss from the crown area becomes noticeable.

By stage 4, hair loss from the crown area becomes more severe, and a bald patch starts to appear on the top of the scalp.

In the fifth stage, the bald patch becomes more extensive, and hair loss at the temples becomes more severe.

In the sixth stage, only a narrow strip of hair separates the bald patch on the top of the scalp and the receding hairline at the temples.

Finally, in the seventh stage, only a horseshoe-shaped band of hair remains on the sides and back of the scalp.

Possible solutions

Hair transplantation

Hair transplantation is a surgical procedure that involves removing hair follicles from one area of the head, typically the back of the head, and transplanting them to the balding area.

This procedure has gained popularity over the years as a permanent solution for male pattern baldness, providing natural-looking results.

However, it can be expensive and may require multiple sessions to achieve the desired outcome.

It is crucial to select a qualified and experienced surgeon to ensure the success of the procedure.


There are various medications available for treating male pattern baldness.

The most commonly used medication is finasteride, an oral medication that reduces the level of DHT (dihydrotestosterone) in the body, the hormone responsible for hair loss in cis and trans men.

Another medication is minoxidil, a topical solution that stimulates hair growth. These medications are effective in slowing down or stopping hair loss, but their results require continuous use.

It is important to note that medications may not work for everyone and may have side effects.

For instance, finasteride may cause sexual dysfunction, while minoxidil may cause scalp irritation.

Therefore, consulting with a healthcare professional before starting any medication is recommended.

Rosemary oil has been used for centuries as a natural remedy to address hair loss.

Its anti-inflammatory properties are believed to help improve scalp health and stimulate hair growth.

To apply rosemary oil, mix several drops of it with a carrier oil, such as coconut or jojoba oil, and massage it into the scalp.

This helps enhance blood circulation to the scalp, which can promote hair growth.

Rosemary oil can also help to reduce dandruff and prevent scalp irritation, which can contribute to hair loss.

Additionally, it has a pleasant scent that can leave your hair smelling fresh and clean.

It is important to note that while rosemary oil may be effective for some people,

it may not work for everyone. Consult with a healthcare professional before starting any new treatment for hair loss.


Microneedling is a procedure that involves using a small roller with tiny needles to puncture the skin on the scalp. This stimulates the production of collagen and blood flow, which can promote hair growth.

The procedure is minimally invasive and can be done in a doctor's office or at home using a derma roller.

However, it's important to note that the procedure may cause some discomfort and may require several sessions to achieve the desired results.

Additionally, microneedling may not be suitable for everyone, so it's recommended to consult with a healthcare professional before starting the procedure.

Scalp Massages

Massaging the scalp can boost blood circulation to the hair follicles, providing them with the nutrients and oxygen they need to grow and thrive.

This improved blood flow also helps to eliminate toxins and waste products from the scalp, which can hinder hair growth.


Hair loss related to DHT can be a distressing side effect of HRT for many FTMs, transmasculine and Non Binary Individuals.

However, there are several options available to manage it. Working with a healthcare provider to explore options for managing hair loss is important, as they can help determine the most effective treatment plan for each individual.

While hair loss can be difficult to cope with, it is important to remember that it is a common side effect of HRT and that there are ways to maintain a positive body image during the transition process.

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