Does TRT Cause Hair Loss? A Comprehensive Guide

Testosterone replacement therapy (TRT) provides a wide range of benefits for men with low testosterone levels. However, some individuals express concern that TRT might contribute to hair loss.

In the sections below, we explore whether TRT can cause hair loss, explain the relationship between testosterone and hair health, and offer practical guidance for those considering TRT who may be worried about thinning hair or baldness.

Read on for more information!

Does TRT Cause Hair Loss? 

The simple answer is no, although the topic is more nuanced. A variety of hormonal and genetic factors contribute to male hair loss.

Testosterone serves as a precursor to several other hormones, including estrogen and dihydrotestosterone (DHT), a hormone linked to hair follicle sensitivity. The enzyme 5-alpha reductase (5α-reductase) converts testosterone into DHT. This enzyme is present in the prostate, testes, hair follicles, liver, and skin. Elevated DHT can contribute to hair follicle miniaturization, but this depends on genetic predisposition. Roughly half of men carry a variant of the androgen receptor (AR) gene associated with androgenetic alopecia, which makes hair follicles more sensitive to DHT.

Even when testosterone levels increase, whether produced naturally (endogenous) or administered through therapy (exogenous), this does not automatically result in hair loss. For men who are genetically prone, 5-alpha reductase inhibitors such as Finasteride and Dutasteride can counteract DHT’s effects on hair follicles. These medications are commonly prescribed when genetic factors or elevated testosterone contribute to hair thinning.

Ultimately, the question of whether TRT promotes hair loss depends on an individual’s response to DHT, not on testosterone levels alone. Men with naturally high testosterone can experience the same degree of hair loss as those on TRT if they share the same genetic susceptibility.

Given that low testosterone is associated with a range of unpleasant symptoms and long-term health consequences, it is often more beneficial to optimize testosterone levels and address any hair-related effects through targeted treatment rather than avoid therapy altogether.

The belief that TRT inherently causes hair loss is one of several myths surrounding testosterone therapy. At Lucidity Health, our goal is to clarify these misconceptions and help patients restore hormonal balance and overall well-being through individualized, evidence-based care.

Negative Symptoms of Low T vs Hair Retention

Low testosterone levels often come with myriad negative symptoms: 

• Cloudy thinking

• Lack of bone and muscle retention

• Anxiety or lethargy 

• Reduced libido

• Fatigue

• Increased body fat

Over the long-term, low testosterone levels can contribute to more serious negative health outcomes. This is basically to say that having low T levels can have a serious impact on an individual’s overall quality of life.

In the next few sections, we’ll provide a bit more information on the hair growth cycle, the risk factors of balding, and how Lucidity Clinic has treated patients in the past who are either particularly concerned about hair retention or have started to show minor signs of it as a consequence of TRT. 

Understanding the Hair Growth Cycle and Causes of Hair Loss

In this section, we provide a bit more information about the hair growth cycle. Feel free to skip to a section below if you’re more interested in Lucidity’s clinical experience at TRT treatments for men who, in some cases, may have a genetic disposition for low hair retention. 

The Hair Growth Cycle 

There are three phases in the hair cycle, cases in which the hair follicles are functioning healthily: 

Anagen - The growth phase (two to six years). 

Catagen - The transitionary phase, follicle regression (two to three weeks). 

Telogen - The resting phase, hair shedding (two to three months). 

Resilient and healthy heads of hair typically have most (80 to 90 percent) of their follicles in the anagen phase, meaning that hair is growing untrammeled. This describes the natural cycle of hair growth. 

Hair loss (alopecia) occurs when this cycle is interrupted by genetics, DHT or other external factors, including lifestyle, stress, diet etc. 

Male pattern baldness (androgenic alopecia) occurs when genetics / DHT interrupt the growth cycle, shrinking fair follicles, shortening the anagen cycle, and leading to thinning hair. In some cases, genetics may be particularly hostile to abundant hair growth, including:

Alopecia areata - an autoimmune condition that causes patchy hair.   

Telogen effluvium - hair loss due to stress, lack of nutrition, chemotherapy or other external factors. 

Hair loss can also occur due to thyroid disorders, scalp infections, and hair treatments with harmful chemicals. Family history, age and, as noted, androgen levels also clearly play a role in overall hair retention. Androgenic alopecia can be diagnosed with a blood test. 

Although Lucidity Clinic tends to focus on TRT and powerful biohacking therapies called peptides; upon completing laboratory studies for TRT, a suggested course of action can be soundly designed.

Hair-Related Treatments While on TRT

In this section, we discuss some of the treatments used to counter hair loss. 

Finasteride - A prescription oral medication that inhibits 5-alpha-reductase, reducing DHT levels to slow hair loss and promote hair regrowth in men with androgenetic alopecia.

Minoxidil - A topical solution that stimulates hair follicles, extends the anagen growth phase, and promotes regrowth in men with androgenetic alopecia.

Latanoprost - A prostaglandin analog primarily used for glaucoma that promotes hair regrowth in androgenetic alopecia by extending the anagen phase and stimulating follicle activity when applied topically.

Ketoconazole - An antifungal agent in shampoo form, this reduces scalp DHT and inflammation, supporting hair growth in androgenetic alopecia.

For hair retention and regrowth, Lucidity Clinic offers a custom-compounded topical solution containing Minoxidil 5% and Finasteride 0.1%. This combination therapy has been shown to effectively promote new hair growth and slow the miniaturization of hair follicles. It may be applied daily or several times per week and typically produces good to excellent results depending on individual response. The solution is safe and effective for both men and women.

Minoxidil acts as a vasodilator, increasing blood flow to the scalp and extending the hair growth (anagen) phase, which encourages thicker and longer hair. Finasteride, a 5-alpha-reductase inhibitor, reduces the conversion of testosterone into dihydrotestosterone (DHT), the hormone responsible for shrinking hair follicles in androgenetic alopecia.

Visible improvement can often be seen within 3 to 6 months, with optimal results appearing around 12 months. Both clinical studies and patient reports indicate that this topical combination can be as effective as oral finasteride while offering a more favorable safety profile.

Lifestyle Changes to Prevent Hair Loss

While the above pharmaceutical treatments are effective, they work better when accompanied by healthy lifestyle choices that do not detract from the goal of hair retention and restoration. 

A healthy diet, stress management, and vitamins to account for any vitamin deficiencies are all great ways to help limit any negative elements that could take away from the ultimate goal of promoting testosterone while mitigating hair loss. 

TRT and Hair Loss: Not Related to the Amount of Testosterone

Those who experience accelerated hair loss as a result of testosterone replacement therapy do so as a result of genetic predisposition triggered by DHT. 

Even men with low testosterone can experience hair loss because it is primarily influenced by genetic sensitivity to DHT rather than by the total amount of testosterone in the body. In most cases, increasing testosterone levels does not significantly raise the risk of DHT-related hair loss. 

Since the only alternative for someone with low endogenous testosterone who avoids treatment is to continue experiencing the associated symptoms and long-term health consequences, our preferred approach is to restore testosterone to healthy levels when confirmed by lab testing. If hair loss occurs, which is uncommon, it can be managed effectively with topical and even oral  therapies as well as supportive lifestyle measures.

TRT replacement with Lucidity Health

Lucidity Health offers testosterone replacement therapy to its patients on a number of different TRT subscription plans. 

The first step is to get your blood work done, so a medical practitioner can analyze it to ensure that you’re in need of testosterone supplementation before any prescription is given.

The blood draws are simple, easy, affordable, and an objective process that can be done at Lucidity’s lab, at a local draw site such as LabCorp, or with an easy at-home test. After that, a medical healthcare provider will analyze the results and determine whether there are signs of hormonal imbalance and discuss possible options to help you reach your goals.

Feel free to reach out to us for more information!