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.