FTM Hair Loss: Understanding and Managing Balding on Testosterone

John Elton, a legendary transgender musician, has dealt with hair thinning. This has been shown to go hand in hand with androgenetic alopecia. And for FTM, Hair loss and balding are not uncommon while you are on testosterone therapy.

Since hair loss runs in his family, Elton has had hair loss. It is worth noting that HRT may lead to gender euphoria. On the other hand, one of the typical impacts of testosterone therapy is hair loss. In this case, you will notice balding patterns. This accompanies hair thinning. Testosterone does have an effect. This can cause emotional distress to FTM.

But hey, when Elon did have a hair transplant, the world knew all hope was not lost. You will learn about FTM hair loss during testosterone therapy in this article. Solutions for hair loss treatment and how to overcome emotional distress during this time are addressed in this article.

Why Does Hair Loss Happen on Testosterone?

A. The Role of Testosterone & DHT

Hair loss and testosterone may go hand in hand. According to UCSF Transgender Care, most trans men notice some degree of frontal scalp hair thinning, especially in the area of their temples.

Depending on your age and family history, you may develop thinning hair. Other patterns include male pattern baldness. In the worst cases, even complete hair loss.

One leading cause of hair loss relates to the marriage between testosterone and DHT. DHT is the male sex hormone dihydrotestosterone (DHT). It causes hair loss for around half of all males over the age of 50 years.

Around 50 million males in the United States experience Male pattern baldness (MPB). This condition is characterized by a receding hairline. Sometimes hair thinning follows.

So, what has testosterone therapy got to do with DHT? You may ask. Well, according to scientific sources, testosterone changes the body’s DHT. As a result, you will notice that your hair falls off. This is a result of hair shrinkage from the final DHT.

B. Genetic Influence

We are all victims of genetic influence one way or another. And for FTM on testosterone therapy, a family history of baldness can predict the extent to which testosterone impacts hair loss.

For instance, if your cisgender kin of your biological family has hair loss patterns, you will most likely have hair loss during testosterone therapy.

C. Common Hair Loss Patterns in Trans Men

FTM on testosterone will notice the following hair loss patterns. These include;

• Receding hairline

You will notice the receding hairline by its M-shaped pattern. It starts from the temple. It then evens out to create a M balding pattern.

• Crown thinning (top/back of the head)

You will notice this hair loss pattern with its hair loss at the top crown of your skull. Hair thins at the top. However, the sides remain full.

• Diffuse thinning (overall loss across the scalp)

This is the most common hair loss pattern to note. It causes your hair to thin. This makes your whole scalp visible under lighting conditions.

FTM Hair Loss Treatments: What Works?

Myriad FTM hair loss treatments will help you. These include;

A. Minoxidil (Rogaine) – Stimulates Growth

Minoxidil is a hair chemical treatment. It works by increasing blood flow to hair follicles. In animal studies, Minoxidil has been shown to increase the opening of potassium channels.

This elongates hair. Minoxidil works best when you use it during the first stages of your hormone therapy and when you notice early-stage hair loss.

Pros

• You can get your Minoxidil at your nearby healthcare center.
• You will see hair loss treatment in months.
• Its topical application may have fewer results than the ora-type.

Cons

• While Minoxidil will help reduce the severity of your loss, it does not stop hair loss permanently.
• It can have drug interactions with other medications. Hence, always consult your healthcare provider before you start using Minoxidil for your loss treatment journey.

B. Finasteride (Propecia)

By now, you know that your testosterone dose will likely be transformed to DHT. The DHT later causes hair loss in the majority of men. But this is where the medication (Finasteride) comes in. It blocks the type 1 enzyme that transforms testosterone into DHT.

Finasteride will reduce your DHT levels by 70%. As a result, it will slow down hair loss. You will see your Finasteride treatment as other brands’ names. These include names such as Propecia and Proscar.

Pros

It is an effective treatment for hair loss.

Cons

• Side effects such as reduced sex drive may suffice.
• Problems such as body rashes have been reported. Always contact your healthcare provider if you suspect you are having medication reactions.

C. Dutasteride (Avodart)

An alternative but yet a stronger version of what Finasteride does is the medication Dutasteride. Dutasteride blocks both type 1 and 2 enzymes. These enzymes convert testosterone to DH. This medication is therefore more potent in reducing DHT levels in the body. It does this at a 90% rate.

Pros

• It is more effective compared to the Finasteride option.

Cons

• Users report a higher risk of hormonal side effects. These include low sex drive and ejaculation problems.
• Other side effects may also be severe, such as breathing problems. Always contact your healthcare provider if you suspect you are having medication reactions.

D. Topical Finasteride

A Low-risk alternative is the topical Finasteride. You will apply it directly to the scalp to avoid systemic side effects. As a result, this differs from oral Finasteride.

The oral type reduces DHT levels all over your body. The topical type works by reducing DHT levels in your scalp.

Pros

• It will give you hair loss treatment benefits without affecting your sexual health.
• It is readily available.

Cons

• There is less research available about its effects.
• Depression, brain fog, and enlarged breast glands also remain possible over time.

E. Hair Transplants

A permanent solution to your hair loss issue is a hair transplant. Here, your surgeon will transplant hair follicles from donor areas, such as the back or sides of the scalp. They will transplant it to the thinning areas.

Pros

• Most hair transplants have a 96% success rate.
• It is a permanent way to reverse hair loss during hormone therapy.

Cons

• It requires a healing time with full results in about 9-12 months.
• It is expensive, averaging 17,500 US dollars in Canada and 13,610 US dollars.

Managing FTM Hair Loss Naturally

You can also manage hair loss naturally. Consider the following natural methods;

• Scalp massage & microneedling

You can manage hair loss by working around your scalp’s blood circulation. Data from Healthline shows that massaging the scalp leads to the growth of hair follicles. It also leads to hair thickening.

Your dermatologist will perform microneedling by using fine needles. These will be used to puncture areas of your scalp. This process increases collagen production. It also improves blood circulation. Collagen is essential for hair growth.

• Low-Level Laser Therapy (LT)

Some FTM can opt for At-home laser treatments. This helps to maintain hair density. Here, the laser uses photons to alter the biological activity in your scalp. LLL T repairs scalp tissue. It also helps regenerate scalp cells for hair growth.

• Essential oils (Rosemary, Peppermint)

You can use natural hair growth-inducing plants to stimulate hair growth. Oils from specific plants have been chemically proven to induce hair growth. Examples include rosemary and peppermint.

• Reduce stress

Did you know that high cortisol levels, which manifest as stress, can cause hair loss? Well, yes. Unmanaged stress can cause hair loss.

However, anxiety and hair loss do not have to be permanent. Manage your stress through self-care and exercise methods. Also, seek professional methods when needed.

• Nutrition & supplements

Your body requires certain nutritional elements and supplements for hair growth. Such dietary elements include

Biotin, which you will find in foods like egg yolks, nuts, and legumes. You can also find it in capsule or tablet form.

You can add Zinc mineral to your diet. Zinc produces keratin for improved hair strength and structure. Zinc is found in beef, pork, chicken, oysters, and beans. You can find zinc in capsule and tablet form.

Iron is a mineral that promotes hair growth. Combining iron-rich foods like fish with Vitamin D-rich foods like green leafy vegetables will encourage hair growth.

Dealing with the Emotional Impact of Hair Loss

Hair loss, like any loss, can impact your emotional state. However, you can rise above it. Do the following;

Acceptance & Body Neutrality

Body acceptance and neutrality are key to dealing with the emotional impact of hair loss. For one, understand that your hair does not define your masculinity.

If anything, many Trans men embrace baldness. Shaving your hair can empower you to accept yourself as you are.baldness can also liberate you from the confines of masculinity and hair.

Hairstyling Tips to Minimize Thinning Appearance

Try managing your emotional lows from hair loss by using hair styling techniques. For instance, hair cuts such as buzz cuts and fades will help you balance hair thinning.

You can also strive to grow a beard to help add to your facial masculine frame.

Finding Support & Community

Lastly, finding a supportive community will give you the space to navigate hair loss. You will realize you are not alone when you engage with online forums such as Reddit, discord, and Facebook groups.

Trans-competent, safe, and unbiased doctors will offer you medical advice for hair loss.

Conclusion

Balding while on testosterone therapy is common, but do not fret, as solutions exist. You can use medications such as Minoxidil, Finasteride, and other lifestyle changes to reduce baldness patterns for FTM.

Natural remedies such as embracing baldness or using cut styles will go a long way in helping you manage your hair loss journey. And like Elton, a hair transplant is a definite choice for FTM seeking permanent hair loss treatment.

As you choose which hair oils, such as rosemary or peppermint, remember that hair does not determine your masculinity. You are masculine as you are, so own your unique look.