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The Science of DHT: Why Hair Follicles Shrink

Understanding the biological mechanism of male pattern baldness, the 5-alpha-reductase enzyme, and how finasteride halts the process.

Updated April 2026Editorially ReviewedEditorial Independence

The Miniaturization Process

Androgenetic alopecia (male pattern baldness) is driven by two main factors: genetics and hormones. The specific hormone responsible is Dihydrotestosterone (DHT).

Testosterone is naturally converted into DHT by an enzyme called 5-alpha-reductase. In men who carry the genes for hair loss, the hair follicles on the top and front of the scalp are uniquely sensitive to DHT.

When DHT binds to the androgen receptors on these follicles, it triggers a process called *miniaturization*. The anagen (growth) phase of the hair cycle becomes progressively shorter. Over several cycles, the follicle physically shrinks, producing thinner, weaker hair (vellus hair) until it eventually stops producing hair entirely.

Halting the Cascade

Because the root cause of the loss is enzymatic conversion, the most effective medical treatment is to block the enzyme. Finasteride is a 5-alpha-reductase inhibitor. By taking it daily, the conversion of testosterone to DHT is severely restricted.

Clinical data shows that 1mg of oral daily finasteride lowers systemic DHT levels by approximately 70%. For the vast majority of men, this is enough to completely halt the miniaturization process and preserve existing hair.

Frequently asked questions

What is DHT?

DHT (Dihydrotestosterone) is an androgen sex hormone created from testosterone. In genetically predisposed individuals, DHT binds to receptors in the scalp, causing hair follicles to miniaturize.

How does finasteride block DHT?

Finasteride inhibits the 5-alpha-reductase enzyme, which is responsible for converting testosterone into DHT. By blocking this enzyme, systemic DHT levels drop by roughly 70%.

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