Hair Loss

A feared side effect of anabolic steroids is the hair loss. This is less because health threats threaten, however, hair loss is associated with many high mental stress.

The process is usually a creeping process that begins quite harmlessly. The scalp becomes a little more sensitive and in the morning a few more hairs lie on the pillow than usual. The attentive observer may also notice that there are more hairs in the drain and in the brush.

This is the point at which you should intervene immediately, because hair loss is a continuous process, which may develop even further in the course of a “cure”. A genetic pretreatment also plays an important role for the course. The consequences range from secretorial secrets to a general thinning of the hair or, in the worst case, to a bald head.

So that it does not come so far, we will introduce you in this article the most common products of the pharmaceutical and cosmetic industry against hair loss. And, of course, we also say what these remedies bring and the dosage to be applied.

Basic hair loss

If the application of anabolic steroids is initially left out, then the main cause of hair loss is the hormone DHT (dihydrotestosterone). This corporeal substance is formed from the hormone testosterone and from some of its metabolites. The conversion to DHT takes place with the help of an enzyme, which has the name 5-alpha-reductase. There are two subtypes of this enzyme – 5-alpha reductase type I for the front part of the scalp and 5-alpha reductase type II for the entire scalp.

DHT shortens the growth phase (anagen phase, standard 4-6 years) of the hair in high concentration. As a result, the hair is barely visible. In the anterior part of the scalp are both types of the enzyme 5AR, thus the so-called Geheimratsecke. In the posterior part of the scalp, only 5-alpha reductase type II acts and causes hair loss there, which can lead to the well-known “plate”. If a genetic pre-existing exists, or if the entire procedure is not treated with the help of suitable preparations, degeneration of the hair follicles (follicles) occurs. The hair follicles are damaged and weakened by the hormone DHT, after which they shrink into themselves.

If you let it come so far, you should say goodbye to the wish that the problem after a few days with a suitable preparation is eaten. Only the telogen phase (resting phase) of the hair is 2 to 4 months. This means in the plain text that visible successes can only be adjusted after 4 – 6 months.

It is important to recognize the signs. A first warning signal is the sensitization of the scalp. When the scalp is touched, an unpleasant sensation occurs, which can become painful in the further course.

Let us now look at how anabolic steroids are used. If testosterone is used, the exogenously added testosterone naturally also undergoes the conversion to DHT. The DHT level therefore increases to the same extent as the testosterone level and the risk of hair loss increases significantly. A cure with testosterone is therefore always a risk to the hair.

But what about the others, the synthetic anabolic steroids? Convert these to DHT?
It must be known that the anabolic steroids can be subdivided according to their chemical basic structure into testosterone droplets, DHT derivatives and nandrolone derivatives.

  • The so-called DHT derivatives, such as oxymetholone (anapolon 50), stanozolol (Winstrol), metenolone (primobolan) and drostanolone (Masteron), are definitely excluded for conversion to DHT via the 5-alpha reductase enzyme 5-alpha-reduced.
  • In the case of the testosterone derivatives, ie methandienone (dianabol) and boldenone, the conversion is structurally possible, but it does not take place in vivo (ie in the living organism) practically.
  • Nandrolone (Deca) converts to the DHN (dihydronandrolone) via the 5-alpha reductase enzyme. And DHN is much nicer to the hair roots than nandrolone itself. Or in other words, a less active hormone is produced from Nandrolone via 5-alpha-reductase, and this is the mechanism that makes Deca so little androgenic. With nandrolone derivatives, such as trenbolone, the 5-alpha reductase enzyme usually can not do anything (apart from some exotics).

Does a conversion to DHT occur only with testosterone itself? It looks like this. However, one can not conclude from this that only testosterone can lead to hair loss.
The other anabolic steroids also have more or less potent androgenic potential. This is especially true for Winstrol , Dianabol , Masteron and oxymetholone .

1. use of systemic antiandrogens
2. Application systemic 5-alpha reductase inhibitors
2.1. Dosage of systemic reductase
2.2. Finally, systemic reductase
3. Local preparations and description
3.1. Local preparations in detail
4. Closing remarks

1. Application of systemic antiandrogens

Cyproterone (acetate) – this is an extremely unsuitable possibility for men. Cyproterone acetate and ethinyl estradiol are the ingredients of the known pill “Diane” (for hormonal contraception for women). In a man, cyproterone acetate would end up in massive sexual displeasure.
Unesterified cyproterone is not available in Germany. Instead there is Androcur-Depot, which is an injection solution consisting of cyproterone acetate + benzyl benzoate dissolved in castor oil. Of course you should as a man also from this distance. The place of use is more advanced in advanced prostate cancer and in …

2. Use of systemic 5-alpha reductase inhibitors

This group includes the modern preparations with the active ingredients Finasterid (Propecia®, Proscar®) and Dutasteride (Avodart®).
Finasteride blocks the reductase isoenzyme type II, Dutasteride blocks both isoenzyme types (I and II). Since both the prostate and the scalp are predominantly reduced by 5-alpha-reductase type II, an inhibitor such as finasteride is sufficient to reduce androgenic side effects, such as hair loss and prostate gland growth.

Finasteride results in a DHT reduction of up to 70 – 75%. The 5-alpha reductase inhibitor dutasteride achieves an inhibition of DHT formation by up to 90-95%.
Note, however, that these values ​​refer to DHT in the blood. And more interesting than the DHT in the blood is the DHT quantity in the hair cell itself. For also in the hair cell is formed from testosterone via the enzyme 5-alpha reductase DHT.
And, unfortunately, there is no precise data on the reduction of DHT in the hair cell by finasteride. Possibly. It is 40 or 50%. Dutasteride is probably much more effective here (about factor 10).
It also appears that an increase in the dosage of 1mg finasteride / day to 5 mg / day does not make a big difference in blood-level concentration. In the hair cell this seems different – there the inhibitory effect is once again a good bit stronger.
Slightly problematic with Dutasteride is its long half-life of 4 weeks. Because of this, it takes a long time for the maximum drug level to build up. Finasteride, on the other hand, achieves its full effectiveness more quickly because its half-life is only 6 to 8 hours.

Due to its strength, dutasteride should be taken only at higher / high dose testosterone cures. It will certainly be necessary to ask at what dose a highly dosed regimen begins with testosterone; This question is easy to answer: From a dose of 250 – 350 mg testosterone / week one can assume that the cure is higher dosage. Finasteride is usually used as a reducate inhibitor. However, if one doses higher, a more potent reductase inhibitor and therefore the more modern Dutasteride in the present time can not be thought away any more. On the following table, we would like to make it clear to you where the place of use of these drugs is:

Testosterone dose Finasteride Dutasteride
<250 mg X X
<350 mg X X
> 350 mg X
500+ mg X

(Fig. 1 “x” = effective / “-” = not effective)

Strong inhibition of 5-alpha reductase may incidentally cause estrogenic side-effects, including decreased libido and gynecomastia. This is because oestrogenic side effects can also be due to the relative imbalance of the strongest estrogen / androgen substances, estradiol and DHT. And not just on the absolute values. The estradiol value therefore does not have to rise absolutely, so that estrogenic side effects can occur – it is enough if the ratio of estradiol to DHT moves towards estradiol.
Sometimes, one also hears the explanatory approach that less DHT leads to more estradiol. So similar to a pond, which has two drains, and in which one is plugged. This is not so, however, because the most important pathway of testosterone passes over the liver and not via estradiol or DHT.

Having a supply of aromatase inhibitors such as anastrozole or letrozole is therefore not wrong. This makes it possible to eliminate such problems quickly.
However, the decision to take should always be dependent on the selected testosterone dose and the preparation.

2.1. Dosage of systemic reductase inhibitors

Let’s start with the most famous of the reductase to – Finasteride:

The usual dosage is daily at 1 mg, and it can easily be increased to 2 mg per day. Some steroid users are now more frequently given doses of 5 – 10 mg per day. Probably 5 mg of the hair root again bring a slightly better effect than 1 or 2 mg, as we have already written above.
If, despite finasteride with a dose of 2 mg / day problems with hair loss occur, then one can go also to 5 mg. Of 10 mg, however, hardly any greater effect is to be expected than of 5 mg.
The use of finasteride should not only be performed during the cure. It is advisable to start a few days before and continue a few weeks later. Because a little more DHT than otherwise get the hair roots in any case. A “grace period” after that is therefore sensible.

Now we come to the next representative – Dutasteride:

The gänige dosage can be also easily determined – it is depending on exogenous Testodosierung between 0.5 mg and 3 mg. All in all, it can be said that per 100 – 150 mg of testosterone 0.5 mg of dutasteride are sufficient. As a small reference the following table:

Testodosis Dutasteride
<150 mg 0.5 mg
<300 mg 1.0 mg
<450 mg 1.5 mg
<600 mg 2.0 mg
<750 mg 2.5 mg
750+ mg 3.0 m

Due to the fairly long half-life, we should always start with a frontload. This depends on the amount of the later daily amounts, which must be multiplied by a factor of 5. The result is then applied for 5 days. So

calculate the daily amount for a front-load over 5 days: daily amount x 5

For a daily dose of 2 mg dutasteride is consequently charged for 5 days with 10 mg. The dose should be distributed throughout the day (up to 5 times of administration) to avoid intolerance. In the case of smaller totals, fewer details (2, 3, …).

2.2. Finally, systemic reductase inhibitors

Finasteride and Dutasteride are undoubtedly very efficient drugs when it comes to the administration of testosterone. The user must not forget, however, that 5-alpha reductase inhibitors (whether systemic or local – see below) can only be used in combination with testosterone. Only testosterone converts to the more active DHT in significant amounts via the 5-alpha-reductase enzyme. In all other anabolic steroids, however, this does not appear to be the case.
For Nandrolone (Deca), 5-alpha reductase inhibitors would be counterproductive because nandrolone is converted to DHN (dihydronandrolone) via the 5-alpha reductase enzyme, and this is exactly the mechanism that makes Deca nice to skin and hair.

3. Local preparations

Hair loss can also be treated very well locally under certain circumstances. There are several preparations and formulations on the market and we will try to get them through as completely as possible. Of course, not everything is gold, which in the future will be the most important facts about Minoxidil, Fluridil, Ell Cranell, Azelaic Acid, Spironolactone and Ketoconazole. The usual objectivity is understood.


The classic in hair loss control. Actually, Minoxidil is a drug used in high blood pressure; By chance, his property was discovered to promote growth and regeneration of the hair. Since then, Minoxidil (also known as Rogaine, Regaine, Xandrox) is quite popular. The exact mechanism of action has not been completely deciphered so far; The most famous theory speculates on an extension of the growth phase of the hair and the improvement of mitosis. For men, the strength is 5% (now also 10% and 15%), for women a lower concentration is appropriate (2%).
Unfortunately, minoxidil solutions are incredibly expensive in Europe; In the United States it is only about a 6-tenth of the local price.
Minoxidil should be applied twice a day. What is interesting is the systematic (ie internal) application of minoxidil. This is practically only made stationary and in 2/3 of the patients there is the so-called hypertrichosis. This is a very nonspecific increase in hairiness, which is not limited to the areas where hair normally grows. For it comes to hair growth in the whole face, so also on the temples, the forehead …

Eucapil (Fluridil)

A non-steroidal antiandrogen; Docked instead of DHT or other androgens on the androgen receptor of the hair roots and is to have a relatively good effect. The few studies I could find, however, come from the manufacturer.

Ell Cranell / Pantostin (active substance 17-alpha-estradiol)

Locally applied, alpha-estradiol appears to block the 5-alpha reductase. However, even the manufacturer states that his preparation is effective only with slight androgenetic hair loss.
17-alpha-estradiol has, by the way, no estrogenic effect. Although it is structurally similar to the “normal” oestradiol (17-beta-estradiol), the modification at position c17 causes it to lose its properties as a female hormone.

Azelaic acid

A very good 5-alpha reductase inhibitor according to studies; The active ingredient is used in Europe only for acne. It is very good in combination with minoxidil.

Spironolactone (Aldactone)

Actually a diuretic, but also has antiandrogenic properties – especially when used locally. Note: Spironolactone is not very stable in dissolved form, so the solution should be used within a few months. In addition, caution should be exercised when other locally acting preparations are applied to the scalp at the same time. The mixture with Spironolactone can stink quite disgusting …

Ketoconazole (Nizoral)

Ketoconanzol is an antifungal agent and therefore it is appropriate to
eliminate fungal hair loss and fungal-induced dandruff. The cause of hair loss is the fungus, not the scales.
Dandruff (dead cells, which are not due to too little sebum) are harmless and do not cause hair loss. Who suffers from hair loss could use purely prophylactically once a week Nizoral – it does not hurt in any case.

4. Conclusion

Finally, it can be said that counter-measures taken in time can probably reduce the hair loss. The emphasis is on “timely”, because a dead hair root can no longer be repaired. For this reason, one should protect the existing hair instead of taking care of the damage limitation afterwards. The preparations for the treatment of hair loss are readily available and often cost only a fraction of the total cost of a hardcore cure, so the prevention is definitely worthwhile.

Despite the flood of good and less good drugs against hair loss one must not forget one; Who is genetically preloaded and uses anabolic steroids, will have to reckon with massive losses of the head hair in the long term.

Sooner or later, the hair loses in every man’s abundance and then bald spots form. One is more pronounced, the other less pronounced. This is a normal process, and it does not have to be bad. You can not stop the hair loss permanently – but you can suppress it massively and thus delay the period to the clearly visible loss of hair.

Eternal youth, muscles like Arnold Schwarzenegger in his best years and full head hair – pure vitality! You can not have everything and you have to cut it. What is more important now? Full Hair or rather the 50 humerus …

The decision is yours. You decide about your future and about your appearance. With this text, we just want to show the possibilities that a hereditary, pre-stressed, bodybuilder has if he wants to make more of himself.

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