Dr. Ben Behnam, Los Angeles-based board-certified dermatologist, hair loss specialist, and co-founder of Happy Head prescription grade hair loss solutions, was recently a guest on The Hair Therapy Podcast with Kate Holohan.  The podcast was loaded with information about the causes of hair loss and treatment options.  It’s amazing how many options both men and women suffering from hair loss now have.  If you missed it or are looking for a recap, we’re sharing the highlights from the discussion below.  You can find the full podcast here.

It’s No Longer Taboo to Talk About Hair Loss

Thanks to bloggers and influencers, it’s easier than ever for people to come forward with their hair loss and talk honestly about their issues.  People are showing candid photos of their alopecia on Instagram and other social media sites so others can follow them and say, “Hey, it’s not just me.  Other people are losing their hair also.”  They share what works for them, and they are talking more openly.  That’s really good to see. 

Women are Seeking Hair Loss Treatment Too

The ratio of male to female patients that we’re seeing in our office has also changed over the years. Five to seven years ago, about 80 percent of our patients were men.  We rarely had female patients make appointments to address their hair loss.  Now, our patient base is almost about 50-50.  A lot of women are currently seeking treatment, which is wonderful.  

Men are more likely to accept that they’re going to go bald.  We have Michael Jordan to thank for that.  About ten years ago, he shaved his head, making the look popular for guys.  But not too many women I know will plan to shave their heads and say, “I’m excited about this.”  

Losing Your Hair Can be Devastating

Hair at every age and every level matters because it’s part of who you are.  I see my patients affected socially, emotionally, and even economically.  And honestly, patients’ mentality is very important.  Some of my patients already have anxiety.  When hair loss becomes another trigger, it makes the anxiety and hair loss even worse.

When patients start to see hair regrowth, it helps them feel better about themselves.  They get the boost of confidence they need to become more emotionally stable. 

Early Hair Loss Treatment Can Lead to a Better Outcome

There are two ways you can lose your hair.  One, it’s going to fall out.  Two, is due to miniaturization.  Miniaturization is when the hair follicles literally shrink.  As the hair follicles shrink, the hair itself shrinks as well.  We have a big magnifier in our office, so we can actually show patients what the shrinking looks like.  Now, if you allow too much shrinking, then your hair goes to the point of no return.  So, if you can do something to revive the follicle, you can reverse the aging process.

Hair Loss in Men and Women Happens for Many Different Reasons

Many patients are genetically predisposed to hair loss, but they don’t know it.  Their hair is perfectly fine, and all of a sudden a stressful event such as a divorce or a bad break-up occurs, activating the underlying genetic predisposition.

In some cases,Telogen Effluvium occurs.  Typically, 90 percent of your hair is in the anagen phase, which is a growth phase.  Only five to ten percent is in the telogen phase, which is a resting phase when your hair falls out.   When people experience trauma, about 50 percent of their hair can shift into that telogen phase.  That’s why when some women experience a traumatic event they lose 50 to 60 percent of their hair in six months.  

Other hair loss triggers include:

• Rapid weight loss
• Illness (Thyroid, Covid, etc.)
• Hormonal changes from pregnancy or menopause
• Vitamin deficiencies (Vitamin D and iron are the most common)
• Smoking & vaping
• Poor diet with too many processed foods 
• Playing with or tugging on your hair
• Bleaching and other harsh chemical treatments
• Stress

Stress Wreaks Havoc on Your Hair

Stress is one of the hair loss triggers we, unfortunately, see all the time.  We’ve especially seen this during Covid.  

My patients tell me all the time, “When I get mad and angry, I lose my hair.”  I could never find a scientific reason until I came across the Scalp Tension Theory.  Most people, even dermatologists, have not heard of it.  The theory is that when you tense up, and you can really see this on a guy who’s balding or who is bald, you turn red, the scalp muscles tense, and your blood vessels constrict so blood does not flow to your scalp.  

Studies have shown that when you have a lack of blood to your scalp, a few things happen:

1. Less nutrition goes to your hair
2. No oxygen or decreased oxygen goes to your hair
3. Less Dihydrotestosterone (DHT), a form of testosterone, is produced, resulting in hair loss.  

The Scalp Tension Theory has been tested with Botox injections into the scalp.  Studies have been conducted over the past 20 years, but nobody talks about them.  A recent study that was conducted on women confirmed that the theory is correct.  When Botox was injected into the scalp every six months, the muscles relaxed, blood flow to the scalp increased, and growth was observed.  

Minoxidil is an Effective Hair Growth Treatment

Minoxidil  is a blood pressure medication that is a vasodilator.  It works a bit like Botox.  It increases the blood flow to the scalp, which is how it makes hair grow.  

Initially, Minoxidil was only available as an oral medication.  Today, topical two and five percent formulas are available over-the-counter under the name Rogaine.  I don’t recommend the two percent any more for women.  Instead, I recommend that women use the five percent for men twice per day.  In clinical studies, 48 percent of female patients see significant hair growth.  

One of the important things you need to know about Minoxidil is that you have to keep using it.  Once you start, you have to use it forever. 

There’s a Secret to Applying Rogaine, Minoxidil, and other Topical Treatments

To make Rogaine work better, I recommend a derma roller.  I find derma rollers especially effective for womens’ frontal hairline areas.  

A derma roller is just a roller with about 540 spikes at the tip.  It creates holes in the scalp, and the topical solution penetrates through those holes to give better results.  We tell our patients to wet their hair and then gently roll back and forth, left and right, for a few minutes.  Don’t hold it in one place in one area because that could cause scarring.  You don’t have to go very deep either.  We recommend just .25, a very mild depth.

I like the electronic derma roller as well as the derma stamp.  With the derma stamp, you’re just stamping the medication on, which is less likely to drag your hair out.  

There are Ways to Reduce Irritation from Topical Treatment

One of the most common side effects of Minoxidil is irritation.  This is because alcohol is in the formula and can be drying.  Some sensitive people experience redness and flaking.  The Minoxidil we use in Happy Head is prescription-grade at six percent for women and eight percent for men, which is higher than the over-the-counter doses.  To minimize irritation, we added an aloe base and a small amount of topical steroid to Happy Head. 

We have a few tips we tell our patients if they still get irritated:

1. Wash off the topical Minoxidil after one or two hours.  You don’t have to use it all day to be effective.
2. Purchase a topical serum from Amazon to use
3. Use a leave-in-conditioner

I also recommend easing into using topical medications, so your skin has time to adjust.  Make a calendar.  Week one, only use it on Monday.  Week two, use it on Monday and Friday.  Week three, use it on Monday, Wednesday, and Friday. Go slowly, and remember it’s not a race.

It’s Common to Need a Multi-treatment Approach to Reverse Hair Loss

Some people can see hair growth from just one medication, but it’s not unusual to need multiple prescriptions simultaneously.  We call it the kitchen sink approach when we strategically use a few different treatment options at the same time to get optimal results.  That’s what Happy Head, a hair growth formula that my brother and I created, is designed to do.  It combines multiple medications, Minoxidil, Finasteride, retinoic acid and hydrocortisone, in an aloe formula to work better than just one single prescription.  Since patients’ needs vary, the solution can be customized.

Clinical Studies Tell Us that Finasteride Promotes Hair Growth

Finasteride, an ingredient we include in Happy Head, is a prostate medication used off-label to promote hair growth.  Both oral and topical formulas are available. Finasteride works by blocking testosterone from converting to DHT in your scalp.  Documented clinical studies prove that oral and topical Finasteride is highly effective for treating both male and female pattern baldness.

Like the other medications we’re discussing, Finasteride can be customized for each patient.  Make sure you talk to your doctor to find out if Finasteride is right for you.  It is not safe to use if you are a woman of childbearing age.  Some men also experience side effects such as decreased libido when they take Finasteride orally.  Studies show that the topical formula could reduce the risk of sexual side effects. 

As mentioned previously, I always recommend starting slowly and working your way up to full dosage.  

Topical Hair Growth Treatments Like Happy Head Do Work

I have patients come back six months after their initial visits and tell me they don’t see any improvement.  I take a photo, and compare it to the previous one, and I swear that some patients have had so much hair growth that it’s unbelievable.  It’s difficult to see the progress because you can’t see the day-to-day changes.  Photos help, though, and patients are often shocked to see how thin their hair was before treatment and how thick it is now.  I recommend taking photos monthly and monitoring progress over time.

Focus on Being the Best Version of Yourself

It’s difficult not to compare your hair to other people’s, but you really can’t.  Everyone’s hair is different.  If you have fine hair, you will always have fine hair.  That won’t change.  The important thing to remember is that you want to have the best hair that you can have.

About Dr. Ben Behnam

Dr. Ben Behnam specializes in medical hair loss management and medicine.  He practices in Los Angeles, California, with his twin brother, Dr. Sean Behnam, who is also a board-certified physician, specializing in hair transplants.  The brothers have had their own clinic on the westside of LA called Dermatology and Hair Restoration since 2009. 

About Happy Head Prescription Grade Hair Loss Solutions

Two years ago, Dr. Ben Behnam and Dr. Sean Behnam launched the Happy Head website.  Happy Head was designed to make it easier for people to see doctors online and access prescription grade topical hair loss products such as Finasteride.  

Happy Head solutions can be purchased as is or can be customized to individual patients’ needs.  Since the medications are only available via prescription, doctors are available to review each patient’s case.  The process is fast, easy, and personalized.  
We’re pleased to offer patients who visit www.happyhead.com a coupon for 60 percent off of their first purchase. Be sure to check us out and let us know if we can answer any questions.