Testosterone Replacement Therapy (TRT) is a common treatment for men with low testosterone levels. It can improve energy, mood, libido, muscle strength, and overall quality of life. However, many men considering TRT have one big concern: hair loss.

Is there a direct link between TRT and balding? Can you prevent hair thinning while receiving testosterone treatment? And if hair loss does occur, what can be done about it? In this guide, we explore the relationship between TRT and hair loss, the role of DHT, and practical steps to help protect your hair while getting the benefits of hormone therapy.

What is TRT?

TRT, or Testosterone Replacement Therapy, is a treatment designed to raise testosterone levels in men with hypogonadism—a condition where the body doesn’t produce enough of this essential hormone. TRT is available in several forms, including injections, gels, patches, and pellets.

Men may seek TRT when they experience symptoms of low testosterone, such as:

• Low libido
• Fatigue
• Depression or mood swings
• Difficulty building muscle
• Increased body fat
• Reduced bone density
• Brain fog or trouble concentrating

TRT can effectively relieve many of these symptoms. But like any medical treatment, it comes with potential side effects, one of which may be hair loss.

Understanding the Link Between Testosterone, DHT, and Hair Loss

To understand whether TRT causes hair loss, we need to look at the role of DHT (dihydrotestosterone). DHT is a hormone derived from testosterone. It’s created when the enzyme 5-alpha-reductase converts testosterone into DHT in the body.

DHT plays an important role in the development of male characteristics during puberty. However, in adult men who are genetically predisposed to androgenic alopecia (male-pattern baldness), DHT can cause hair follicles to shrink. This process leads to gradual hair thinning, especially at the temples and crown.

Since TRT increases testosterone levels, it often causes a rise in DHT levels as well. If someone has a genetic sensitivity to DHT, this could accelerate hair loss.

In short:

• TRT increases testosterone
• Higher testosterone may lead to more DHT
• If you’re genetically sensitive to DHT, hair loss may occur

But that doesn’t mean everyone who gets TRT will lose hair.

Does TRT Always Cause Hair Loss?

No. Not everyone who undergoes TRT will experience hair thinning or baldness. It depends largely on your genetic makeup.

If you don’t have a family history of male-pattern baldness or haven’t experienced hair thinning previously, your chances of hair loss while on TRT may be low. However, if male-pattern hair loss runs in your family or you’ve already noticed a receding hairline, you may be more susceptible.

Other factors can also affect hair health, including:

• Poor nutrition
• High stress
• Smoking
• Certain medications
• Thyroid imbalances or other hormonal disorders

This is why it’s important to get a full health evaluation and not assume that hair loss is always caused by TRT alone.

How to Tell If You’re Genetically Prone to Hair Loss

Androgenic alopecia is a hereditary condition, and if your father, mother, or grandparents experienced thinning hair or baldness, there’s a chance you may have inherited the same trait.

Male-pattern hair loss often starts at the temples and crown, eventually forming an “M” shaped hairline. If you notice this pattern or gradual thinning, it’s a sign you could be genetically predisposed.

You can also:

• Look at both sides of your family: Contrary to popular belief, the genes responsible for hair loss don’t just come from your mother’s side.
• Get a DHT blood test: This can help assess your hormone levels and determine if DHT is contributing to hair thinning.
• Consult with a provider: A professional familiar with hormone therapy can help identify whether hair loss is due to DHT, stress, or another cause.

How to Prevent Hair Loss While on TRT

If you’re concerned about losing your hair during TRT, the good news is there are ways to help reduce the risk.

1. DHT Blockers (Finasteride or Dutasteride)

Finasteride (Propecia) and dutasteride are oral medications that inhibit the enzyme 5-alpha-reductase, which converts testosterone into DHT. By lowering DHT levels, they help preserve hair follicles.

• Finasteride is FDA-approved for male-pattern baldness
• Topical versions are available, which may reduce side effects
• Always consult a doctor before starting

Note: Some men report sexual side effects while using these medications. Discuss this thoroughly with a provider before deciding.

2. Minoxidil

Minoxidil (Rogaine) is an over-the-counter topical treatment that improves blood flow to hair follicles and stimulates regrowth.

• Available in foam or liquid
• Apply directly to the scalp
• Most effective in early stages of hair thinning

It can be used alongside TRT and DHT blockers.

3. Ketoconazole Shampoo

Originally developed as an antifungal, ketoconazole shampoo has shown promise in reducing scalp DHT levels.

• May help maintain scalp health
• Often used 2-3 times per week
• Can be used with minoxidil or finasteride

4. Latanoprost

Used in eye drops for glaucoma, latanoprost has been found to increase hair density and thickness when applied to the scalp. It may be especially helpful in younger men showing early signs of hair thinning.

5. Natural Approaches

Some men prefer a more holistic strategy. These may include:

• Rosemary oil: Studies show it may work as well as minoxidil in some cases
• Scalp massage: Increases circulation to the hair follicles
• Caffeine shampoo: May help reduce DHT activity in the scalp
• Nutritional support: Zinc, iron, biotin, vitamin D, and folic acid all play a role in hair health

6. Low-Level Light Therapy (LLLT)

LLLT uses laser or LED light to stimulate hair follicles. It’s non-invasive and can be done at home or in a clinic. Research shows it may help slow hair thinning and encourage regrowth.

7. Hair Transplant (FUE Method)

If hair loss has already progressed significantly, a hair transplant may be a good option. FUE (Follicular Unit Extraction) takes healthy follicles from other areas of your scalp and transplants them to thinning spots. It’s a permanent solution that offers natural-looking results when done by skilled professionals.

When to Consider TRT Despite the Risk of Hair Loss

If you’re dealing with severe low testosterone symptoms, the benefits of TRT may outweigh the risk of hair loss. Restoring healthy testosterone levels can help you feel better physically, mentally, and emotionally.

Schedule a consultation with Revive Life today to explore whether TRT is right for you. We’re here to help you feel like yourself again—stronger, healthier, and more confident.