TRT and Hair Transplant: Can I Get A Hair Transplant on Testosterone Replacement Therapy?

TRT and hair transplant is a common concern among men who are undergoing hormone treatment and considering surgical hair restoration. Testosterone replacement therapy (TRT) can influence hair loss patterns, making it essential to understand how TRT and hair loss are connected and whether timing matters, such as TRT before hair transplant or TRT after hair transplantation. 

In this blog, we explain how testosterone replacement therapy affects hair follicles, what patients should consider before planning a hair transplant, and how to optimize long-term results while continuing TRT safely and effectively.

What Is Testosterone Replacement Therapy (TRT)? 

TRT is a treatment for men who have low testosterone levels confirmed by laboratory testing and associated clinical symptoms.  While it is considered the standard treatment for reproductive organ insufficiency in younger men, the balance of benefits and risks in older patients is still debated. 

Testosterone replacement therapy is not suitable for everyone. Due to potential risks, possible side effects, and the lack of complete long-term safety data, the treatment must be carefully planned and medically supervised. 

TRT can increase energy levels and muscle strength; however, in patients with a genetic predisposition, it may also have potential side effects, including an increased risk of androgenetic alopecia (AGA).

Does Testosterone Replacement Therapy (TRT) Cause Hair Loss? 

In recent years, several studies have explored the effects of TRT on hair health and androgenetic alopecia (AGA). 

By increasing testosterone levels, TRT may also raise levels of dihydrotestosterone (DHT). Research shows that hair loss is primarily determined by the sensitivity of hair follicles to DHT, rather than DHT levels alone. In men without a genetic predisposition, the risk of hair loss remains relatively low, even when DHT levels increase.

Some studies, particularly those involving transgender men, suggest that TRT may accelerate the rate of hair loss. 

Other research, however, has found no direct correlation between high testosterone levels and male pattern hair loss, reinforcing that follicular sensitivity to DHT is the key factor. 

Overall, the connection between TRT and hair loss varies from person to person and is strongly influenced by genetics and hormonal balance.

Can Patients Using TRT Undergo a Hair Transplant?

TRT and hair restoration compatibility depends on genetic sensitivity to DHT, hormonal stability, and proper medical planning. Patients on testosterone replacement therapy can safely undergo a hair transplant when hormone levels are monitored and treatment is managed by experienced dermatologists or hair transplant surgeons. 

Testosterone replacement therapy itself is not a direct contraindication to hair transplantation.

Hair transplantation remains the most effective surgical treatment for androgenetic alopecia (AGA), and excellent results can be achieved with correct planning and patient selection. 

In men with normal reproductive function, TRT should be carefully managed from both a hair loss and aesthetic perspective, as it may increase DHT levels. When necessary, medications such as finasteride or dutasteride may be considered to reduce the effects of DHT and protect existing hair. 

Hormonal changes related to TRT, especially increased DHT, may contribute to ongoing hair loss. However, scientific evidence shows that: 

• Transplanted hair follicles, taken from the donor area, are typically resistant to DHT. 
• In genetically predisposed patients, native hair may continue to thin, but transplanted hair is generally preserved. 

This makes TRT and hair transplant procedures a viable and effective option when managed by experienced hair surgeons. 

Important Considerations for TRT Before Hair Transplantation 

Proper evaluation before surgery is essential for patients using TRT before hair transplant procedures. 

• The impact of TRT on hormone levels and the rate of hair loss should be closely monitored. 
• TRT may increase DHT levels, which can elevate the risk of androgenetic alopecia (AGA). If necessary, DHT-suppressing treatments should be evaluated before surgical planning. 
• All medications, supplements, and ongoing treatments must be discussed in detail with the hair transplant surgeon. 

Careful planning ensures that patients undergoing a hair transplant on TRT achieve safe and predictable results.

Doctor Recommendations for TRT After Hair Transplantation 

Post-operative care is critical to graft survival and long-term success, particularly during the first four months after surgery. 

For patients continuing TRT after hair transplant, the following recommendations are essential:

• Newly transplanted grafts should be carefully protected. 
• Hormone levels should be monitored regularly throughout TRT. 
• A healthy lifestyle, including balanced nutrition, adequate sleep, and effective stress management, should be maintained. 

When properly managed, TRT after hair transplant does not negatively affect transplanted hair and can be safely continued under medical supervision.

TRT and Hair Transplant: Medical Insights from Hair Restoration Experts at Civas&Akpınar

The key to success with TRT and hair transplant is choosing a doctor-led clinic that carefully considers all medical and surgical factors during planning. Outcomes depend on personalized assessment, genetic predisposition, hormonal balance, and continuous expert medical oversight. 

At Civas&Akpınar Hair Transplant Clinic, every patient is evaluated directly by our experienced dermatology specialists, Dr Civas and Dr. Akpınar. This comprehensive medical assessment ensures that testosterone replacement therapy is safely and strategically managed alongside the hair transplant process, without compromising graft survival or long-term results. 

With proper evaluation, close follow-up, and individualized treatment strategies, patients can effectively manage TRT and hair loss, protect existing hair, and achieve natural, long-lasting hair transplant results, even while continuing TRT. 

Considering a hair transplant while on TRT? Book a personalized consultation with our dermatology specialists to assess your hormonal status, hair loss pattern, and donor area, and receive a treatment plan tailored specifically to your needs.

Frequently Asked Questions (FAQ) about TRT and Hair Transplant

Does testosterone replacement therapy cause hair loss? 

Testosterone replacement therapy may increase levels of dihydrotestosterone (DHT), a hormone associated with androgenetic alopecia (AGA). However, hair loss is primarily determined by genetic sensitivity of hair follicles to DHT, not testosterone levels alone. 

Can you have a hair transplant on TRT? 

Yes. A hair transplant on TRT can be safely performed when proper medical evaluation and planning are carried out. TRT is not a direct contraindication for hair transplantation, provided hormone levels and hair loss progression are carefully assessed by experienced physicians. 

Should I stop TRT before a hair transplant? 

In most cases, TRT before hair transplant does not need to be discontinued. However, hormonal status, DHT levels, and the rate of hair loss should be evaluated prior to surgery. Any decision to pause or adjust TRT should be made in collaboration with your hair transplant specialist. 

Is it safe to continue TRT after hair transplant? 

Yes. TRT after hair transplant can usually be continued safely under medical supervision. Regular monitoring of hormone levels is recommended, especially during the first few months after surgery, which is the most critical period for graft survival. 

Does TRT affect the survival of transplanted hair? 

No. Transplanted hair follicles are taken from the donor area, which is typically resistant to DHT. Even in patients on testosterone, transplanted hair generally remains permanent, while native hair may continue to thin in genetically predisposed individuals. 

Can TRT accelerate hair loss after hair transplantation? 

Testosterone replacement therapy may accelerate hair loss in existing native hair in patients with genetic susceptibility to androgenetic alopecia. However, this does not usually affect transplanted hair. Proper medical management can help minimize the impact of TRT and hair loss naturally. 

Are medications like finasteride or dutasteride needed with TRT? 

In some cases, DHT-suppressing medications such as finasteride or dutasteride may be considered to reduce the effects of elevated DHT levels while on TRT. The decision should be individualized based on hair loss pattern, medical history, and patient preference. 

Does TRT affect long-term hair transplant results? 

When properly managed, Testosterone replacement therapy does not negatively affect long-term hair transplant outcomes. With close follow-up and tailored treatment strategies, patients can achieve long-lasting, natural-looking hair transplant results while continuing TRT.