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It does appear that hair follicles in balding individuals are more sensitive to inhibition by DHT. The first link of hair loss to testosterone metabolism was the very ancient observation that men who were castrated at a young age did not develop pattern baldness. Modern mother has sex with son research has confirmed this but such men can develop baldness mother has sex with son if they receive supplemental testosterone. Individuals born with mother has sex with son a deficiency of 5-alpha reductase suffer neither scalp hair loss nor prostate hyperplasia. The deficiency reduces levels of DHT and spares sensitive hair follicles. (Imperato-McGinley J et al Science 1974; 186:1213-5) reported that adult males with congenital 5 alpha-reductase deficiency had decreased levels of dehydrotestosterone (DHT). These individuals had a small prostate gland throughout life and did not develop BPH. They also did not develop male pattern baldness or acne. On the other hand, the genes controlling 5-alpha reductase activity and DHT production are not the only factor involved in balding.
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