The enzyme 5α-reductase is crucial to the conversion of testosterone to DHT—so much so that men who have a genetic deficiency in this enzyme have female hair patterns and very little beard and mustache facial hair.3, 84 There are two forms of 5α-reductase—types 1 and 2—both of which convert testosterone to DHT.3 However, research indicates that type 2 5α-reductase is the form of the enzyme most active in the scalp.3
Caucasians as an ethnic group have more scalp hair, experience greater rates of male AGA than those of Asian and African descent, and also have correspondingly higher levels of androgens that convert to DHT with the help of the 5α-reductase enzyme.2, 19, 84 Further evidence supporting the importance of the conversion of testosterone to DHT in balding comes from studies which show drugs that inhibit the 5α-reductase enzyme have anti-balding effects.3
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