01/11/2026
Worried about hair loss with Testosterone Therapy?
Testosterone itself is not directly responsible for hair loss; rather, it’s its derivative, dihydrotestosterone (DHT), that plays a crucial role in androgen-mediated hair loss, particularly in individuals genetically predisposed to androgenetic alopecia or male pattern baldness.
Testosterone delivered through transdermal cream (especially on skin with high 5‑α‑reductase such as scrotal skin) tends to generate about 2–3 times more DHT elevation than typical injectable preparations like testosterone cypionate, for the same degree of testosterone replacement.
What is known quantitatively
1. Transdermal (cream/gel) vs intramuscular injections overall
A meta‑analysis of testosterone replacement trials found:
Transdermal TRT (gels/patches) increased serum DHT about 5.46‑fold over baseline.
Intramuscular TRT (which includes esters like testosterone cypionate/enanthate) increased DHT about 2.20‑fold over baseline.
Scrotal skin has particularly high 5‑α‑reductase activity, so scrotal cream is generally considered to produce even higher DHT/T ratios than standard non‑scrotal gels