Hair loss is not an uncommon phenomena and the reasons behind it are many. A 2009 study in the International Journal of Trichology, by a team of researchers led by Dr. Krupa Shankar, found that, “Hair loss is a common cosmetically and psychosocially distressing condition. Androgenetic alopecia (AGA) is the most common cause of hair loss among males… Fifty-eight percent of the male population aged 30-50 years had androgenetic Alopecia.”

Anabolic steroids, whether one denies or accepts, are being commonly used in sports. Our debate here is not whether it should be used or not but our primary concern here is to discuss the link between anabolic steroids and hair loss.

To understand this one needs to understand DHT or Dehydrotestosterone. DHT, is a metabolite of testosterone and a sex steroid found in the body. When testosterone gets converted into dihydrotestosterone (DHT) it becomes 3-4 times stronger than testosterone. DHT is the most potent steroid found in the human body. DHT is formed when testosterone interacts with enzyme called 5-Alpha Reductase.

The enzyme 5-alpha-reductase is found in abundance in tissues like prostate, skin, scalp, liver and the Central Nervous System. It is used to increase the potency of testosterone in the body especially when androgenic action is needed. The areas we discussed above are the ones in which it is very difficult for testosterone to reach directly to its receptor without getting converted to DHT.

But, because DHT has high androgenic potency, it is also produces certain side-effects associated with strong androgenic properties like over-activation of the sebaceous glands which produces excess oil and thus increases acne.

Acc. to 2007 study in a German Journal der Deutschen Dermatologischen Gesellschaft, by a research team led by Bodo Melnik , suggests that, of the ten most common side effects of anabolic steroids, acne was third following psychological changes such as aggression and depression, among clinically visible symptoms it even ranked first. Anabolic steroids lead to hypertrophy of sebaceous glands together with increased sebum excretion, increased production of skin surface lipids and an increased population of acne. The mechanism of action of anabolic steroids is dependent on the chemical modification of each individual derivative. Melnik & team, found that, analysis of sebaceous glands in anabolic steroids treated athletes in a 4-week training phase showed a significant increase of size of the sebaceous glands by app. 90% with the number of sebocytes in the differentiating as well as the undifferentiated cell pools both increasing significantly.

It is also known to cause male pattern hair loss rather strongly as the DHT molecules attach to the scalp, over-stimulate the hair follicles and cause the root to die and the hair follicle falls out.

Anabolic steroids also produce similar side effects. However, DHT also has many benefits in the body like it optimizes the functioning of the central nervous system. This means a better neuromuscular coordination and a much better adaptation and response to training.

DHT has the following actions on men:

• It is necessary for the proper development of the male genitalia during foetal life.
• It is responsible for prostate growth.
• It leads to male pattern baldness or hair loss.

We all know that testosterone is important for the formation of male characteristics, but DHT is even more important in that regard. Without DHT boys would have an appearance like a girl. DHT is the one which decides in the womb whether the foetus will be a male or female. It is actually the most androgenic of all hormones. But apart from the androgenic side-effects, DHT is extremely potent and leads to hardening of muscles, lack of water retention, better fat loss, increased sex drive and increased strength gains.

The loss of hair from the scalp which is caused due to the use of anabolics is called androgenetic alopecia. In males thinning of the hair line and crown as these areas have higher number of androgen receptors and so, are affected the most. Men are advised anti-alpha-reductase-enzyme medicines and women are given anti-androgenic medicines. In females there may be an issue of hair thinning but in most cases the problem is of excessive hair growth. This problem is called as Hirsutism. This problem is only with some people and can be stopped if the anabolics are stopped. If the hair fall still continues, please consult your physician for professional advice.

Both for acne and hair fall, if you are administering anabolic steroids, the first suggestion is the complete cessation of these anabolics. In most cases, these side effects are auto-reversible. But if the side effects persist, please consult your physician for the requisite medication for the above issues.