Is Scalp Inflammation Causing Your Hair Loss?

Why?  That’s the first question many people have when they realize they’re losing their hair.  It’s a perfectly logical question.  Unless you experience alopecia, you don’t have a reason to research the cause.  After all, who expects to see their hairline receding or their part getting progressively wider?

The truth is that there are many reasons why you can experience alopecia.  Genetics and autoimmune disease top the list.  However, people often blame inflammation for their hair loss.  It’s a natural connection given all the recent press.  Inflammation is linked to a countless number of medical conditions.  Everything from heart disease to skin issues seems to be associated.  All hair loss isn’t caused by inflammation, though.  So, how do you know whether scalp inflammation is at the root of your hair loss?  Read on.  We’ll help you understand what conditions can cause inflammation on your scalp and how hair loss from inflammation differs from other types of alopecia.  We’ll also share the latest options for treating and preventing hair loss caused by scalp inflammation.  

What is Scalp Inflammation?

If your scalp is red, itchy, or burns, it’s possible that inflammation is to blame.  But, what exactly does it mean when your scalp is inflamed?  Inflammation isn’t a stand-alone diagnosis, it’s triggered by a specific condition such as an infection, alopecia, or an allergic reaction.  It’s not random.  Uncontrolled inflammation does, however, contribute to hair loss.  It’s important to identify the condition causing the inflammation so you can stop any resulting hair loss and stimulate regrowth.  

What Causes Inflammation on Your Scalp?

If you’re experiencing scalp inflammation, one of many different conditions may be to blame.  Dermatitis, autoimmune conditions, infections, and alopecia are just a few.  Here’s what you need to know about them.

Dermatitis

Contact Dermatitis

Contact dermatitis is a rash caused by an allergic reaction to a substance such as a particular shampoo, conditioner, gel, or hair spray.  The rash appears within days after you’ve been exposed.  Not much treatment is necessary to get rid of the rash.  It usually clears up on its own within two to four weeks if you stop using the substance that causes the reaction.  Over-the-counter antihistamines and topical cortisone creams can help expedite the process. 

Seborrheic Dermatitis

You have probably heard of cradle cap, a condition that infants often experience.  It causes scaly, crusty patches on their heads.  You may be surprised to learn that adults get it too.  Only it has fancier names and is called seborrheic dermatitis, dandruff, seborrheic eczema, or seborrheic psoriasis.  Adults with seborrheic dermatitis experience redness, scaly patches, and thick dandruff.  The condition is unpredictable.  Sometimes it disappears without treatment.  If it doesn’t, you can use a special shampoo to reduce the build-up of dead skin and reduce oiliness.   Unfortunately, seborrheic dermatitis can also flare up without warning, so you may need to treat the condition more than once.  

Autoimmune Conditions

Discoid Lupus Erythematosus (DLE)

Discoid lupus is a rare autoimmune condition that primarily affects women and often runs in families.  The condition causes red, scaly, crusty patches.  The patches are distinctive because the center is lighter in color and the rim darker than the rest of the surrounding skin.  If your dermatologist suspects you have DLE, he or she will take a biopsy to confirm the diagnosis.  Treatment ranges from cortisone to prescription medications depending upon symptoms and severity.  

Folliculitis Keloidalis

Folliculitis keloidalis is a chronic inflammation of the hair follicles.  People with the condition usually get red, itchy bumps that worsen over time.  Although the exact cause is unknown, some believe it could be an immune reaction, irritation from close shaves or helmets, or androgen sensitivity.  Depending upon the severity, steroids, antibiotics, and retinoids are prescribed.  

Infections

Scalp Ringworm (Tinea Capitis)

Ringworm of the scalp is a contagious fungal infection that causes scaly bald patches that itch.  Fun fact:  no worm is involved.  Ringworm got its name because it has a circular appearance.  Oral medication and medicated shampoos kill the fungus and prevent the spread of the infection.  

Bacterial Folliculitis

Staph bacteria live on your skin all the time, but when they infect your hair follicles, itchy, white, pus-filled bumps can occur.  This is called bacterial folliculitis.  Fortunately, this condition is easily treated with topical antibiotic creams, lotions, or gels.  

Scarring Alopecia

Central Centrifugal Cicatricial Alopecia (CCCA)

Central Centrifugal Cicatricial Alopecia is a type of scarring alopecia.  Although it can affect anyone, middle-aged women and women of color are most commonly diagnosed.  Diagnosis is typically based on biopsy results, clinical features, and exclusion of other types of hair loss.  Early diagnosis is critical to minimizing hair loss.  

Lichen Planopilaris

Lichen planopilaris is a form of scarring alopecia that mostly affects middle-aged women.  People with this type of alopecia notice their hair thinning and often experience scalp itching or tenderness.  Lichen planopilaris can affect the hair line with frontal fibrosing alopecia, or along the part line.  As with any type of alopecia, early diagnosis will help prevent further hair loss. 

How to Treat Scalp Inflammation

Medications available to treat scalp inflammation are used for different purposes.  Some are even the same as what is used for alopecia which is not inflammatory.  Some examples of commonly used medications include:

Medications to Treat Inflammation

  • Cortisone – Reduces swelling, itching, and redness
  • Clobetesol – Topical steroid that treats swelling and itching.  Stronger than topical cortisone.  May be combined with antibiotics and / or antifungal medication.
  • Retinoids – A synthetic version of Vitamin A that reduces irritation on the scalp and improves absorption of other medications

Medications to Treat Infections

  • Antibiotics – Treat bacterial infections
  • Nystatin – An antifungal medication 

Medications to Treat Autoimmune Flares

  • Plaquenil – An malaria medication used off-label to treat Lupus, arthritis, and other autoimmune-related inflammatory conditions
  • JAK inhibitors – Janus kinase (JAK) inhibitor baricitinib is a newer class of medications recently FDA approved to treat alopecia areata and some types of scarring alopecia.  The medications work by blocking the body’s inflammatory response.  

Medications for Hair Regrowth

  • Minoxidil (Rogaine) – A vasodilator that enlarges the hair follicles to allow for new growth.
  • Finasteride (Propecia) – A DHT blocker that has been proven to generate hair regrowth and reduce atrophy in patients with Lichen Planopilaris.

It’s important to note that self-medicating for scalp inflammation is never a good idea.  Medications for inflammatory conditions causing hair loss, whether prescription or over-the-counter, should only be used under the supervision of a licensed dermatologist.

Does Diet Help Treat Scalp Inflammation?

Diets designed to eliminate scalp inflammation have gotten a lot of recent media coverage.  Do they work?  The jury is out.  One research study found that the Mediterranean diet, and diet rich in protein and soy may be a potential adjunct treatment for nonscarring alopecia.  The study warrants further exploration. (01)  Anecdotally, people have found the Auto Immune Protocol (AIP) diet to help control burning and itching associated with inflammation.  There isn’t much research to support the theory.  There isn’t a downside to trying a diet, as long as you are getting plenty of protein and all of the necessary nutrients. In our opinion, it’s worth a try.  

Are Vitamins and Supplements as Effective as Prescription Medications for Treating Inflammation?

Many vitamins have a reputation for alleviating inflammation.  Turmeric, Vitamin B3, Vitamin E, and other vitamins are known for reducing inflammation without any adverse side effects.  One research study found that turmeric tonic significantly improved scalp psoriasis by reducing redness, scaling, and thickness.  (02)

In some cases, vitamins or supplements may work on their own.  In other cases, they may work as an adjunct therapy to prescription medications.  The key is to ensure that you’re using the proper vitamin to treat the scalp condition you are experiencing.  If you are interested in trying vitamins as part of your treatment protocol, but your dermatologist doesn’t mention them, be sure to raise the topic.  Your dermatologist can tell you if vitamins or supplements are a good option for you.  

Temporary or long-term scalp inflammation can be uncomfortable.  Consulting with a dermatologist will help you get it under control as quickly as possible to alleviate your symptoms and prevent hair loss.  If you are looking for hair regrowth solutions, our board-certified dermatologists and hair specialists are here to help. We’re happy to answer your questions and make recommendations based on your diagnosis and needs.  

Resources:

(01) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7109385/

(02) https://pubmed.ncbi.nlm.nih.gov/29607625/

Choosing the Best Shampoo for Thinning Hair

If you have thinning hair, you probably shampoo your hair as gently as you can to keep as much hair on your head as possible. But are you using the right shampoo for your hair? There are a broad range of shampoo and conditioner options to help prevent further hair loss. However, the ingredients and results may differ for each. Understanding product contents and how they work can help you figure out which hair loss shampoos are best for you. 

How do shampoos for thinning hair prevent hair loss? 

Hair loss shampoos are also known as “hair thickening” shampoos. These products aren’t an overnight solution to thinning hair, but they can make a difference in two ways: 

  • Fortifying, thickening, and strengthening individual hair strands to give the illusion of thicker hair. Many hair loss shampoos work with the hair that you do have by making each strand fuller and thicker. Some ingredients in these hair thickening shampoos penetrate into the hair shaft and fill in any spaces, causing the strand to swell and bulk up. These thicker strands then create the appearance of more hair. 
  • Encouraging the growth of new hair. Over-the-counter shampoos for thinning hair aren’t typically medicated, but they do contain ingredients that promote hair growth. For example, some may include vitamins and minerals that are known to make scalp healthier and boost hair growth. 

Shampoos for thinning hair contain ingredients that are categorized as thickeners, but they may also contain ingredients called opacifiers. (01)  These ingredients are added to improve the appearance of the existing hair, like pearlescent flakes to make hair appear thicker and healthier. Before taking a deep dive into the ingredients of hair loss shampoos, it’s important to remember that most of the results from thickening shampoos are temporary. That said, they’re still an excellent choice for someone concerned about hair loss. 

Most Common Ingredients In Hair Loss Shampoos

What sets hair loss shampoos apart from average run-of-the-mill shampoos are their ingredients. (01) Average shampoos often contain elements that are too harsh for thinning hair, raising the potential of further hair loss. Hair loss shampoos are much more forgiving, cleaning the hair without disrupting the hair’s full life cycle. 

The following are the most common ingredients found in hair loss shampoos. 

Biotin

Look at any hair strengthening shampoo on the market, and you’ll likely find biotin on the ingredient list. Why? Because biotin deficiencies result in weak and brittle hair and nails. (02) Biotin, also known as vitamin B7 or vitamin H, is a water-soluble vitamin that’s crucial for keratin production. Keratin and collagen are the primary structural components of each strand of hair, essential for hair growth. Many foods contain biotin, and this nutrient works best when consumed. Biotin is also available through supplements as a nutraceutical. However, hair loss shampoos and conditioners also contain biotin to help strengthen hair from the outside. 

Essential Amino Acids

Shampoos for thinning hair often include essential amino acids on their ingredient list. Like biotin, amino acids are vital for the production of keratin and collagen. Keratin and collagen require the following amino acids: (03)

  • Lysine
  • Arginine
  • Methionine
  • Cysteine
  • Proline
  • Glycine

To generate enough keratin and collagen needed for sufficient hair growth, the body needs a steady supply of amino acids. In particular, lysine and methionine are the most essential amino acids for hair. Hair thickening shampoos that contain these amino acids can help combat hair loss and encourage growth. 

Saw Palmetto

Saw palmetto, also known as serenoa serrulata, serenoa repens, or sabal serrulata) comes from palmetto berries (also called serenoa repens, serenoa serrulata or sabal serrulata). Studies show this berry extract acts as an anti-inflammatory for the scalp and skin. Furthermore, saw palmetto extract decreases sebum production and increases hair density in cases of androgenetic alopecia and polycystic ovary syndrome. (04, 05)

Niacin

Niacin (Vitamin B3 or nicotinic acid)  is a common ingredient in hair growth shampoos because it increases blood circulation, especially through the scalp. Improved blood flow feeds nutrients to hair follicles and encourages hair growth. Niacin also repairs DNA and boosts keratin production, helping to keep hair strong. (03)

Caffeine

Caffeine not only boosts the energy in your body, but it can protect hair follicles from dihydrotestosterone (DHT). DHT is converted from testosterone and – when linked to receptors in hair follicles – results in hair loss. By preventing DHT from negatively impacting hair follicles, caffeine encourages hair growth and retention in both female pattern hair loss and male pattern hair loss. Additionally, caffeine may stimulate already weakened hair follicles, potentially repairing damaged roots. (06)

Zinc

Known for its immune boosting properties, zinc is also a hair-strengthening mineral. Zinc balances sebum production and boosts scalp health. Many dandruff shampoos contain zinc because of its dandruff-busting capabilities. Shampoos for thinning hair, however, also include zinc for its ability to strengthen hair and keep hair follicles free from obstructions like oil and dandruff. (03)

Green Tea

Green tea is a popular drink, but it’s also a common ingredient in hair growth shampoos. Green tea inhibits the production of a 5-alpha-reductase inhibitor. The enzyme 5-alpha-reductase is responsible for the conversion of into DHT.  5-alpha-reductase inhibitors prevent the production of DHT, reducing hair loss. An additional benefit of green tea is its high antioxidant consent. Antioxidants combat environmental cell damage from free radicals, keeping your scalp and hair healthy. Green tea may also improve scalp health, balance sebum production, and treats dandruff. (07)

What to keep in mind when choosing shampoos for thinning hair? 

Choosing the right hair loss shampoo can be overwhelming, but following three simple rules can help you choose the one for you. 

Stick With Companies that Specialize in Hair Loss

When finding shampoos for thinning hair, stick to hair products from businesses that specialize specifically in hair loss. While cosmetic companies may know all about healthy hair, they may be unfamiliar with hair loss or balding. Whenever possible, take the time to find products sold or endorsed by reputable hair-loss companies. Although you may have to wait for shipping or make a special trip to another store, using shampoos from reputable companies that specialize in hair loss can make all the difference in how your thinning hair progresses. These companies understand hair loss and all its nuances, therefore their products are more likely to suit your needs. 

Pay Attention to the Ingredient List

Just like the way you check ingredient lists on food, you should check the ingredient lists on products you place on your body. When looking at the ingredient list, keep an eye out for items listed above. Furthermore, if you’re thinking about buying more than one product, keep using the same company product line. For example, a manufacturer of a hair loss shampoo may also have hair loss conditioner and hair loss hair spray from the same product line. 

Choose For Your Hair Type

Thickening shampoos may target various hair types. For example, one shampoo may be ideal for fine hair while another may be best for dry hair. Because these shampoos are formulated to work with a specific type of hair, you may need to find the one that matches with your hair type. The results can vary wildly depending on the different formulations, so finding the right shampoo for your hair type is essential. 

Don’t Wash Your Hair Away

Keeping your hair healthy means keeping it clean, but you don’t need to wash your hair away in the process. Finding an excellent quality shampoo for thinning hair may take some research, but it’s worth it to keep as much hair on your head as you can. Matching the right shampoo to your hair’s needs can help you resolve trouble spots and help reduce further hair loss. 

If you’re thinking you may need more than shampoo for thinning hair, contact our specialists at Happy Head. Our physicians tailor each hair treatment for every client, ensuring safe treatment aimed at your unique situation. Happy Head is so confident you’ll be satisfied with our services, we offer a six-month money-back guarantee. Contact us today for your personalized hair loss treatment! 

 

Resources:

(01) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4458934/

(02) https://www.webmd.com/connect-to-care/hair-loss/does-biotin-really-prevent-hair-loss

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380979/

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2840915/

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2840915/#CIT2

(06) https://pubmed.ncbi.nlm.nih.gov/32599587/

(07) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6930595/

5 Facts All Men Should Know About Hair Loss

Man looking at his hairline in the mirror, wondering what to do. Happy Head can help you stop hair thinning and loss in its tracks with custom topical solutions made with fda approved ingredients that are just for you.

A few weeks ago, my husband pointed out a Facebook meme that made us laugh. It showed two photos of hair and body care products. One photo included products that women use in the shower, and another photo showed the products that men use.  The women’s photo was loaded with products, including body wash, face wash, two different types of shampoos, and a couple of different types of conditioner. The men’s photo only had one product, a lone all-in-one bottle of body wash, shampoo, conditioner, shaving cream, and toothpaste. Not only was it funny, but it also depicted the scene in our shower pretty accurately. The truth is, though, although some men don’t give their hair a lot of thought, I don’t know of any who are thrilled about the idea of going bald. It’s a super sensitive topic. As nonchalant as my husband is about his hair, even a hint that his hairline is receding results in a very alarmed “What?” and a close scalp examination in the mirror that night.  Hair loss in men is common, but that doesn’t mean you’re okay with it. Nor does that mean that you have to accept your fate. So, if you’re a guy with some recession, thinning, or balding, this one’s for you. We’re here to fill you in on what you need to know about male pattern hair loss and what you can do about it.  

1. Hair Loss in Men is More Common Than You Realize

According to the American Hair Loss Association, by age 50, 85 percent of all men will have significantly thinning hair. (01)  Yes, you read that correctly. The majority of men will deal with some type of hair loss in their lifetime.  Men lose their hair for a lot of different reasons.  Balding or thinning hair can be due to autoimmune conditions, Covid, or even stress. The most common reason, though, is genetics. The vast majority of men with thinning or balding hair have androgenetic alopecia, male pattern baldness. Yup, that’s right. Your parents or grandparents may have passed along a baldness gene.  

Male pattern baldness, also known as androgenetic alopecia, occurs when your testosterone is converted to an androgen (a sex hormone) known as Dihydrotestoterone (DHT). The DHT attacks your hair follicles and causes a reaction called miniaturization which shrinks the follicles. When that happens, the hair that is already there falls out. New hair has trouble emerging through the shrunken follicles, and eventually, the hair stops growing.  

Although Male pattern baldness is the leading cause of hair loss among men; it’s not the only reason men lose their hair. Other forms of alopecia can cause hair loss among men as well. For example, Covid or other illnesses can cause a temporary hair loss called telogen effluvium. In this case, your hair will grow back within six to twelve months. Alopecia areata is an autoimmune condition that causes sporadic bald patches. Some men’s hair spontaneously regrows, but flares can occur at any time without notice.  Lichen planopilaris is another type of alopecia that causes inflammation, leading to scars over the hair follicles that prevent new hair growth.         

2. Timing is Everything When It Comes to Hair Loss Treatments

Many men avoid doctors like the plague. (02)  However taking a “let’s wait and see what happens” attitude isn’t recommended when it comes to hair loss. If you don’t get treatment when you first notice that your hair is thinning, then your hair loss will most likely progress, leaving you with a higher number on the Hamilton-Norwood Scale. In case you don’t know what that is, the Hamilton-Norwood Scale is a classification system developed to measure the extent of baldness. You don’t want to get high scores on that test.  

If you visit a board-certified dermatologist as soon as you see signs of thinning or balding, your doctor will identify the cause of your hair loss. Once you are diagnosed, your dermatologist can recommend treatments to stop your male pattern hair loss and to promote new growth.  

3. Hair Loss Consultations Are Not a Big Deal (Really!)

If the idea of any medical procedure secretly has you a bit nervous, don’t let that prevent you from seeing a dermatologist.  The exam is much easier than you would expect, and trust me, your dermatologist will not think you are vain for seeking treatment.  Dermatologists evaluate men for hair loss conditions all the time.  So, while you may be out of your comfort zone, your dermatologist certainly isn’t.   

Your dermatologist will ask questions about your health, medications, family history, and lifestyle during your exam. The more detailed information you provide, the better. Your dermatologist will examine your scalp to evaluate your hair loss pattern and possibly do a pull test. A pull test measures the severity of your hair loss. During the test, your dermatologist will gently tug on small sections of your hair to see if any strands fall out.  If six or more do, you have active hair loss. Dermatologists usually diagnose androgenetic alopecia based on visual exam. A blood test or a small biopsy may be ordered if he or she suspects another type of alopecia. Don’t stress if you need a biopsy. You’ll be numb, the biopsy area is small, and it heals within a week.

4. Today’s Hair Loss Treatments are Effective and Natural Looking 

After you get a diagnosis, you’ll have many treatment options. The good news is more data than ever is available on hair loss treatments. Research indicates that many are not only safe, they’re highly effective. Here are some examples of the most popular prescription hair loss treatments used:

Minoxidil 

  • FDA approved to treat hair loss
  • Available in oral or topical formulas
  • Brings oxygen to the hair follicles, enlarging them so existing hair does not fall out and new hair can emerge

Finasteride

  • FDA approved to treat hair loss
  • Available in oral and topical formulas
  • Prevents testosterone from converting to DHT and attacking your hair follicles
  • First-line treatment for androgenetic alopecia

Dutasteride

  • Used off label to treat hair loss
  • Only available as a pill like our SuperCapsule
  • Prevents testosterone from converting to DHT and attacking your hair follicles
  • Prescribed if patient does not respond to Finasteride
  • Lower dosage prescribed for Dutasteride than Finasteride

Cortisone

  • Available in pill and topical formulas
  • Reduces irritation and inflammation

Retinoic Acid

  • Available in topical formula
  • Proven to improve absorption of topical Minoxidil and Finasteride

Compounded Topical Formulas

Research has shown that combinations of topical formulas are more effective than monotherapy.  For example, topical Finasteride combined with topical Minoxidil works better than one of the medications alone. (03)  Finasteride and Minodixil combined with Retinoic Acid is more effective because the retinol helps the scalp better absorb the other two medications. (04)

Alternative Hair Loss Treatments for Men

You may also be a candidate for treatments such as Protein Rich Plasma (PRP), laser light treatments, and hair transplant surgery. Let’s talk about what these are and how they work.

Protein Rich Plasma

PRP acts similarly to Minoxidil by bringing oxygen to the hair follicles to enlarge them. During a PRP procedure, your dermatologist draws your blood. The blood is then separated. The plasma is then injected into sites where your hair is thinning or balding. 

Laser Light Treatment

You may have seen ads for laser light caps. Do they work? Well, the jury is out. The philosophy behind them is that the light increases blood flow to the areas on your scalp that are thinning. More oxygen and nutrients are able to reach the hair follicles, allowing the hair to grow thicker and longer. Although research indicates that laser lights show promise for treating hair loss, the most effective intensity and frequency is still to be determined. (05, 06)  

Hair Transplant Surgery

In the 70s and 80s, you could always tell when a man had hair restoration surgery. You could actually see little circular holes where the plugs were implanted. It looked like a doll’s head. Over time, dermatologists have been perfecting the surgery and today’s techniques give a natural appearance. Dermatologists now move individual hairs from a place where the hair is dense to an area where the hair is thinning. (07) You can’t even tell that the hair has been transplanted.  

5. Perceptions of Bald or Balding Men Have Changed for the Better

Men with thin or thinning hair tend to have lower self-esteem and lack confidence, which could explain negative perceptions of their appearance. (08)  The key is to work with what you do have so you feel as confident as possible.  

Yes, there was a time when bald or balding men were deemed less attractive. That’s no longer the case, though. Today, men who embrace their look are seen as intelligent, successful, and confident. (09) Jeff Bezos, Samuel L. Jackson, Ed Harris, and The Rock are prime examples. So if your hair is thinning or balding, work with your barber or hair stylist to find and own a fresh new look. That look can evolve as you undergo hair loss treatment.  

If you notice some recession, thinning, or balding, and are concerned, contact us for a discrete consultation from the comfort of your home, on your schedule. Our board-certified dermatologists and hair specialists are available to evaluate how much hair you’ve lost and your scalp’s condition. Most importantly, they can offer a customized prescription solution to give you the desired results.  

 

Resources:

(01) https://www.americanhairloss.org/men_hair_loss/introduction.html

(02) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560804/#:~:text=At%20the%20societal%20level%20masculine,not%20go%20see%20the%20doctor.

(03) https://pubmed.ncbi.nlm.nih.gov/32166351/

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2693596/

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8906269/

(06) https://www.karger.com/article/fulltext/509001

(07) https://www.aad.org/public/diseases/hair-loss/treatment/transplant

(08) https://pubmed.ncbi.nlm.nih.gov/16307704/

(09) https://journals.sagepub.com/doi/abs/10.1177/1948550612449490

 

Is There a Genetic Test that Can Predict Hair Loss?

Nowadays, there’s a genetic test for just about everything.  Even to determine our dog’s lineage.   Just one quick saliva sample or blood test and, within days, you can find out if you’re destined for cancer, diabetes, or heart disease.  There’s even a DNA test to determine whether you’re likely to experience anxiety.  

Suppose a genetic test can give you accurate information to guide your health care plan and prevent future disease.  Can it also accurately predict whether you’re predisposed to losing your hair?  If a genetic test shows that you are likely to inherit your Great Uncle Bernie or Aunt Bonnie’s hairline, is there a way to ensure that you don’t follow in their footsteps?  Are genetic hair tests reliable?  Do dermatologists use DNA tests to help make diagnoses? Before you click “Buy Now” to order a genetic test kit, keep reading.  We’re here to answer your questions about genetic testing for male and female pattern baldness.

Can Alopecia Really be Inherited?

When people hear the word “alopecia,” they often think of hair loss caused by a medical condition.  Types of alopecia such as alopecia areata and lichen planopilaris are caused by autoimmune conditions.  Androgenetic alopecia, however, is a type of alopecia that is inherited.  It’s the most common type of alopecia.  As many as 80 percent of all men will experience male pattern baldness in their lifetime. (01)  In addition, many women experience female pattern baldness, usually around menopause.  

What’s the Link Between Genetics and Pattern Baldness?

A study conducted on twins confirms what we’ve long suspected.  Male and female pattern baldness have a genetic component. (02)  About 79 percent of men who were balding in the study could attribute their hair loss to their genes.  But, there’s a catch.  Researchers are still working to fully understand which genes are affected.  We’re still learning.  Here’s what we do know.  There are 63 genes that could potentially cause baldness.  Six of those are associated with the X chromosome, where the Androgen Receptors (AR) are found.  It’s also possible that not one isolated gene is the culprit.  Several genes working together may be to blame.

Can You Take a DNA Test to Determine Whether You Will Go Bald?

Ads make genetic testing very tempting, especially if your Mom or Dad starts losing their hair in their 20s.  It would be nice to know whether you will lose your hair too.  But, unfortunately, we’re not quite there yet.  As mentioned previously, there are still too many unanswered questions about which genes are involved and how the genetic process affects your locks. Also, false positives are not unusual with genetic testing.  You don’t want a test to tell you that you’ll experience androgenetic alopecia if that isn’t really the case. (03)

How do you Know if the Type of Alopecia You Have is Genetic?

When men and women experience androgenetic alopecia, they see specific hair loss patterns.  The first sign for men is usually a receding hairline.  The hair loss then progresses to the top, creating a horseshoe pattern above your ears that circles around to the back of your head.  Female pattern hair loss typically presents differently.  Women usually notice thinning on the top and crown.  Often, women will notice a widening of the center part.  Many other conditions cause hair loss besides androgenetic alopecia.  If you think your hair loss is genetic, be sure to have your dermatologist confirm your findings.  Early diagnosis is key to preventing further hair loss and to stimulating new growth.  You also want to make sure you’re addressing the right condition with the right treatment.  

Do Dermatologists Use Genetic Testing to Diagnose Male and Female Pattern Baldness?

The truth is that dermatologists don’t need high-tech tests to determine whether or not patients have androgenetic alopecia.  Most of the time, they can tell from your hair’s appearance and your hair loss pattern.  If there is any doubt, he or she may use a densitometer to magnify your hair follicles to see if miniaturization is occurring.  Miniaturization is when the hair follicles shrink, causing existing hair to fall out and preventing new growth.  Your dermatologist may order a biopsy and blood test to rule out other causes. Patients often ask about the benefits of running a hair analysis based on what they hear about on social media.   Hair analysis is not used to diagnose male or female pattern baldness.  Instead, it’s used to determine whether there’s lead, arsenic, or another substance causing your hair loss.  

What Can You Do to Treat Hair Loss Caused by Genetics?

Treatment for male or female pattern baldness is designed to meet two goals.  The first is to stop the progression of your hair loss.  The second is to promote new hair growth.   The best way to accomplish those two goals is by using a combination of medications simultaneously.  Here are medications often included in treatment plans for androgenetic alopecia:

  • Minoxidil topical foam – A vasodilator that enlarges the hair follicles
  • Finasteride, Dutasteride, or Spironolactone  – Prevents testosterone from converting to DHT that attacks the hair follicles and causes hair loss
  • Topical or oral cortisone – Treats any redness or irritation (not needed for evey patient)

Some men are concerned about experiencing sexual side effects with oral Finasteride.  If this is the case, topcial Finasteride has been proven to be just as effective without the side effects. (04)  Even better, topical solutions which mix Finasteride with Minoxidil, Cortisone and Retinol offer an even more effective all-in-one solution.  The retinol improves absorption of the other three medications.  

Are There Other Causes of Hair Loss Besides Genetics?

Male and female pattern hair loss are the only types of genetically induced alopecia.  However, other types of alopecia exist and treatment plans are designed to treat the type of alopecia you are experiencing.  Examples of other types of alopecia include:

  • Temporary Alopecia (Telogen Effluvium) – Occurs due to sudden illness, stress, or shock and usually reverses itself without treatment
  • Autoimmune Alopecia (Alopecia Areata and Lichen Planopilaris) – People experience flares and periods of remission
  • Trauma-induced Alopecia (Traction Alopecia and Trichotillomania) – Alopecia results from hairstyles that pull on the hair follicles or when people pull out their hair as a stress response)

Can You Prevent Hereditary Hair Loss?

Let’s play pretend for a minute.  Let’s say that a genetic test does exist that will determine whether or not you will lose your hair.  The tests come back showing that you are genetically predisposed to androgenetic alopecia.   Is there a way to prevent hair loss before it begins?  Sure, eating right, exercising, and managing stress never hurt.  But, even with that, you can’t necessarily fight Mother Nature.  That would be nice, though.  If male or female pattern baldness does rear its head, then it’s time to take action.  

Can You Reverse Hereditary Hair Loss

If you’re experiencing male or female pattern baldness and want to learn more about products available, contact us.  Although there isn’t a way to prevent androgenetic alopecia from occuring in the first place, there are things you can do to reverse the condition.   Minoxidil, Finasteride and other medications have been found to be safe and effective. Our board-certified dermatologists and hair specialists are available to answer your questions and help you develop the ideal treatment plan for your needs and lifestyle. 

 

Resources:

(01) https://www.ncbi.nlm.nih.gov/books/NBK538178/

(02) https://academic.oup.com/biomedgerontology/article/60/8/1077/545174

(03) https://www.nature.com/articles/gim201838

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6609098/

 

Everything You Need To Know About Finasteride Interactions

If you have aging parents or grandparents and have seen their overflowing pill boxes, you know that it’s important to track their medications. One prescription can easily interact with another, and boom, you’re at the doctor’s office figuring out which drug is the culprit.  

Dermatologists and hair specialists often recommend prescription hair loss medications because they are safe and effective.  However, if you are taking other drugs or supplements at the same time, you should be aware of potential unintended interactions.  Since Finasteride, also sold under the brand names Propecia and Proscar, is FDA-approved to treat hair loss, it’s the one most often prescribed.  So, for that reason, we’ll tell you everything you need to know about what mixes well with Finasteride and what might not be the best combination.

Finasteride is a Leading Treatment for Male and Female Pattern Baldness

Research continually demonstrates that Finasteride, a medication originally developed to treat Benign Prostatic Hyperplasia (BPH), is one of the most effective ways to treat androgenetic alopecia.  The statistics tell the story.  After two years on Finasteride, 83 percent of men included in Merck’s research study did not experience further hair loss.  More than 70 percent showed increased hair growth. (01)  Finasteride works just as effectively for women. (02)  That’s why Finasteride is often dermatologists’ drug of choice when it comes to stopping further hair loss and stimulating new growth.  

Finasteride Increases the Testosterone Levels in Your Body

So, how does Finasteride help stop your hair from shedding?  It blocks an enzyme called 5-alpha-reductase (5-AR).  When 5-AR isn’t produced, testosterone can no longer be converted to an androgen called Dihydrotestosterone (DHT), which is what causes your hair follicles to miniaturize.  Finasteride also increases testosterone levels in your body.  More testosterone shrinks prostate size and helps your hair grow.  The only catch is that when you stop taking Finasteride, any new growth will be lost.   

Finasteride Interactions are Uncommon

Complications stemming from Finasteride use are rare.  That’s not to say that it doesn’t or can’t happen.  Certain medications can either increase or reduce the amount of Finasteride in your bloodstream.  Carbamezepine, Rifampin, and St. John’s Wart may reduce Finasteride’s efficacy by metabolizing the Finasteride faster in your liver.  Other medications such as Itraconazole and erythromycin may actually increase the levels of Finasteride in your blood.  Checking with your doctor is the best way to know if other medications you are already taking will contradict Finasteride.  

Avoid Interactions with Other Medications by Using Topical Finasteride Versus Oral 

If you have androgenetic alopecia and are worried about Finasteride interacting with the other medications you are taking, ask your doctor about using topical Finasteride.  Research indicates that topical Finasteride is equally as effective as oral. (03)   Think of topical Finasteride as a spot treatment.  It works directly on the areas where your hair is thinning to prevent further hair loss and stimulate growth.  Oral Finasteride, on the other hand, is systemic since it is metabolized in your stomach.  Topical Finasteride is the ideal solution for men and women who want the benefits of the medication without any potential drug interactions.  

Some Medications Make Finasteride Work More Effectively

Some medications have been found to increase the efficacy of Finasteride.  Because some medicines work synergistically, dermatologists and hair specialists often recommend that patients use multiple hair loss treatments simultaneously to maximize results.  

Minoxidil, also marketed under the brand Rogaine, is a topical hair loss solution that has proven to complement Finasteride. (04)  While Finasteride blocks the testosterone from converting to DHT, Minoxidil enlarges the hair follicles, preventing hair loss, and allowing new growth to break through.  Minoxidil is available in both oral and topical formulas.

Retinol is also a medication that is often prescribed with Finasteride.  Retinol, a derivative of Vitamin A, is often prescribed to reduce wrinkles and improve skin texture.  The medication increases collagen production and stimulates the production of new blood vessels bringing oxygen to the skin.  In addition, retinol has been proven to improve the absorption of topical Finasteride. (05)

When patients with hair loss experience inflammation, topical or injected cortisone is often prescribed in conjunction with Finasteride as well.

Taking Finasteride, Minoxidil, Retinol, and Cortisone all at the same time can seem like a lot of medications to remember.  Fortunately, topical formulas are now available that combine all into one convenient bottle.    

Alternatives to Finasteride

Other options exist if you are experiencing male or female pattern baldness and oral or topical Finasteride aren’t suitable for you.

Dutasteride

Finasteride is effective for most people.  However, an alternative medication is Dutasteride. Dutasteride works similarly to Finasteride by blocking the conversion of testosterone into DHT.  The difference between the two medications is that Finasteride inhibits the Type 2 5AR isoenzyme,while Dutasteride inhibits both Type 1 and Type 2.  In addition, Dutasteride’s prescribed dosages are typically lower than Finasteride’s because the medication is a bit stronger.  

Spironolactone

Spironolactone, also known as Aldactone, is used off-label to treat female pattern hair loss.  It was originally marketed to treat fluid retention caused by liver and kidney disease. The medication is only prescribed for women because it can cause feminizing features when used over time.  Research has not yet been conducted on a large sample size, but four women included in a study, saw reduced hair loss and experienced some growth. (06)

PRP

PRP, an abbreviation for Platelet Rich Plasma, is a three-step process designed to trigger hair growth by increasing the amount of oxygen available to the hair follicles.  First, blood is drawn. Then, blood is then separated into three groups using a centrifuge.  Lastly, the platelet rich plasma is injected into the scalp. PRP is often used in conjunction with other treatments to maximize results.  

Hair Transplant Surgery

If you are concerned about drug interactions, hair transplant surgery may be an option and a long-term hair loss solution.  During the past few years, many advances have been made in how the procedure is performed.  Rather than taking strips of hair to transplant, surgeons are now able to move individual hairs giving a more natural look.  

Low-light Laser Therapy (LLLT)

You may have seen ads recently for laser caps marketed for hair growth.  Most use light in the red or infrared range to penetrate the scalp and target the hair follicles.  Early studies show promise for the technology, but more research needs to be conducted on the efficacy.  One study found that LLT works better when used with Minoxidil or Finasteride.  The study also indicated that more data is needed to determine the optical laser power and wavelength. (07) 

Be Honest About Your Medical History

If your dermatologist recommends Finasteride or any other prescription hair loss treatment, the best thing you can do is be honest about your medical history.  In addition to telling your doctor about any other hormone, heart, or other medications you’re taking, remember to list any supplements. Also, although sharing information about smoking, drinking, or recreational marijuana use may seem embarrassing, remember that your dermatologist has seen and heard it all.  He or she is more concerned with giving you the best hair regrowth options and keeping you safe than passing judgment on your behavior.  

Is Finasteride Right For You?

If you have questions about whether Finasteride is right for you or could potentially interact with other medications you’re taking, let us know.  Our board-certified dermatologists have full medical degrees from accredited universities.  They are available and happy to review your medical history and suggest solutions based on the type of hair loss you are experiencing.  

Resources:

(01) https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020788s020s021s023lbl.pdf

(02) Note: Recommended doses differ for men and women

(03) https://pubmed.ncbi.nlm.nih.gov/34634163/#:~:text=Conclusion%3A%20Topical%20finasteride%20significantly%20improves,impact%20on%20serum%20DHT%20concentrations.

(04) https://onlinelibrary.wiley.com/doi/10.1111/dth.12246#:~:text=Efficacy%20assessment,combination%20therapy%20showed%20improvement%2C%20respectively.

(05) https://jamanetwork.com/journals/jamadermatology/article-abstract/557305

(06) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3769411/#:~:text=In%20a%20case%20study%20of,total%20number%20of%20anagen%20hairs.

(07) https://pubmed.ncbi.nlm.nih.gov/29270707/

 

What Causes Hair Loss at a Young Age?

Hair loss is never easy to accept, but most people know that it comes with getting older. Losing hair at a young age, however, is a different story. For teenagers and twenty-somethings, unexpected hair loss can be a distressing experience. Fortunately, there are ways to reduce the chances of further hair loss. Let’s take a deep dive into what causes hair loss at a young age and options for addressing the issue. 

Typical Daily Hair Loss

The body loses hair each day as a natural part of each hair’s growth cycle. The American Academy of Dermatologists estimates that a person loses about 50 to 100 strands daily. With approximately 100,000 hair follicles on an average human head, 100 strands a day doesn’t create a noticeable change. Hair loss that’s caused by hair’s natural growth cycle is called “shedding.” (01)

Furthermore, most people will experience some level of hair loss with age. Roughly 40% of women lose more hair each day than men, probably due to heated hair styling tools, regular hair coloring, and hormonal changes. (02) For both men and women, as people age, the rate of normal hair growth slows. 

Hair Loss as a Teen or Young Adult

Losing hair at a young age is not typical. The teen years and young adulthood are a crucial time for building identity and self-confidence; hair loss at this stage can lead to low self-confidence and increased self-consciousness. (03) The following are a few potential causes of hair loss at a young age. 

Alopecia areata

Alopecia areata is an autoimmune condition that results in balding patches throughout the head. In an autoimmune disorder, the body’s immune system mistakenly attacks healthy cells. Unfortunately, in the case of alopecia areata, it’s cells within hair follicles that are damaged by the immune system. As a result, the hair follicles weaken, which leads to hair loss.

About 2% of all people will develop alopecia areata sometime in life. Along with balding patches, the condition can also lead to hair loss on the body, eyebrows, or eyelashes. A majority of people who develop alopecia areata do so before the age of 30. In some cases, however, the condition may begin as early as adolescence or childhood. (04)

Malnutrition

A lack of appropriate nutrients can lead to malnutrition. It’s essential to understand the difference between calorie intake and nutrition. An individual may consume sufficient calories but remain malnourished. A diet consisting of high-calorie foods without an adequate amount of vital nutrients can lead to a state of malnutrition. Malnutrition may also result from not eating enough food or being unable to process foods appropriately.

To maintain a healthy head of hair, hair follicles need the proper nutrients from a well-rounded diet. The following are some of the most vital nutrients necessary for hair growth: (05)

  • Vitamin A
  • Vitamin C
  • Vitamin D
  • Vitamin E
  • Niacin
  • Zinc
  • Biotin
  • Iron
  • Selenium 

A few potential causes of malnutrition in adolescents and young adults are inadequate access to food, eating disorders, restrictive dieting, or health problems. Additionally, a teen diet full of junk food and low on nutrients can lead to hair loss!

A Family History of Hair Loss

People who have close relatives with hair loss are at a higher risk for androgenetic alopecia. Androgenetic alopecia, a genetic condition leading to hair loss, usually begins in adulthood. Although in some cases, this condition may start as early as adolescence. Both men and women can experience androgenetic alopecia, and other names for the condition are male-pattern baldness or female-pattern baldness. 

In males, androgenetic alopecia is usually a gradual balding at the crown or hairline. For women, the condition begins as a slow thinning of hair throughout the head. Both teenage boys and girls can develop androgenetic alopecia, particularly if there’s a family history of the condition. (06)

Polycystic Ovary Syndrome

Polycystic ovary syndrome, also known as PCOS, causes an excess of androgens (male sex hormones) in women and girls of reproductive age. This hormone imbalance can result in female hair loss, even in teenage girls. 

Women typically produce low levels of male hormones, but PCOS causes an overproduction of them.  Due to these extra androgen levels, a woman with PCOS might develop masculine features and hair loss, especially throughout the head. Thinning hair due to hormonal imbalance such as PCOS is called androgenic alopecia or female pattern hair loss. (07)

Thyroid Conditions

The thyroid is a small — but powerful — gland. This gland at the neck produces hormones that control metabolism, heart rate, and mood. The thyroid also manages how the body uses oxygen and controls growth, which is why a low-functioning thyroid (hypothyroidism) can lead to hair loss at any age. 

Thyroid hormones keep hair growing consistently. Without enough thyroid hormones in the system, the hair’s shedding phase lengthens. More hair is shed, and less hair grows, leading to hair loss. Symptoms of an under-functioning thyroid include: (08)

  • Depression 
  • Tiredness
  • Unexplained weight gain 
  • Constipation
  • Dry skin
  • Puffy or swollen face 
  • Joint pain
  • Irregular menstrual cycle

People of all ages can experience thyroid issues. In children and adolescents, untreated thyroid disorders can lead to developmental delays. Thyroid conditions require medical treatment and should not be overlooked. 

Lupus

Like alopecia areata, lupus is an autoimmune condition. Though lupus is typically known for its hallmark symptom of a “butterfly-shaped” rash on the face, another symptom people with lupus experience is hair loss. Unlike alopecia areata, however, two types of hair loss are associated with lupus: scarring and non-scarring. 

Non-scarring hair loss stems from the inflammation caused by lupus. Widespread inflammation can affect the scalp and hair follicles, resulting in non-scarring hair loss. With lupus, hair loss may occur all over the body, including the eyebrows and external limbs. 

Lupus also causes discoid sores that may result in permanent scars. These sores, lesions, and scars can damage hair follicles, resulting in “scarring” hair loss. The hair loss doesn’t cause scarring. Instead, the scarring from lupus can prevent hair from growing, possibly making hair loss in most areas permanent. (08)

Telogen Effluvium

Does stress cause hair loss? Sometimes. Telogen effluvium is a temporary hair loss caused by physical or psychological stress. Events like severe illness, psychological trauma, childbirth, or significant weight loss can result in telogen effluvium.

Telogen effluvium is a temporary form of hair loss that causes excessive hair shedding. Stress, illness, childbirth, or weight loss are some of the many potential causes. Fortunately, this condition typically resolves itself after the stress lifts. 

Traction Alopecia

A tight bun or high ponytail may look chic, but it can pull hair and cause hair loss. Tight hats or headgear may also cause loss of hair over time. This type of hair loss is called traction alopecia and occurs in both men and women. 

In traction alopecia, repeated pulling may cause small pimple-like bumps on the scalp. As traction alopecia worsens, hair begins to fall out. Other symptoms of traction alopecia are: (09)

  • Scalp Redness
  • Folliculitis
  • Scalp tenderness 
  • Itching
  • Scaling 

Identifying and addressing traction alopecia in its early stages is essential because if follicles become too damaged, they will no longer produce and hold new hair.

Hair Styling and Treatments 

Experimenting with hair color is part of adolescence for many teens, and a bottle or two of Manic Panic purple dye will (most likely) not result in hair loss. Bleaching hair, however, can dry hair out and make strands brittle, resulting in breakage. Furthermore, heated styling tools and chemical straighteners also damage hair and lead to broken strands. 

The good news is that these processes don’t usually affect the scalp or hair follicles. However, this can make the hair appear thinner and unhealthy. To prevent breakage, try to keep the use of heated tools to a minimum and use them at a low setting. 

Hair Loss in Teen and Young Adults: Should You Worry?

Thinning hair and balding can occur at any age for various reasons. Obtaining an assessment and treatment as soon as possible, especially for adolescents and young adults, can help prevent issues with self-esteem and improve the chances of successful hair growth. 

Happy Head includes an assessment from a licensed dermatologist with every subscription, ensuring that each person gets to the root of their problem! Every treatment is individualized, and ongoing support is there to help you every step of the way. Take advantage of Happy Head’s six-month money-back guarantee and see what Happy Head can do for you. 

Resources:

(01) https://www.aad.org/public/skin-hair-nails/hair-care/hair-loss-vs-hair-shedding

(02) https://www.ncbi.nlm.nih.gov/pubmed/29193553

(03) https://pubmed.ncbi.nlm.nih.gov/34984078/

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC55

(05) https://www.hairscientists.org/hair-and-scalp-con

(06) https://pubmed.ncbi.nlm.nih.gov/22106721/

(07) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8291365/

(08) https://www.webmd.com/connect-to-care/hair-loss/how-your-thyroid-may-be-causing-hair-loss

(09) https://www.medicalnewstoday.com/articles/320648

How to Avoid Side Effects from Finasteride

If you’ve seen television ads for any medication, you know that almost all of them have potential side effects.  By the time the announcer gets to the end of the (sometimes very long) list, you’re probably wondering why doctors even prescribe the medication in the first place.  But, of course, some medications have more side effects than others.  And, some medications get a bad rap just because one or two out of thousands had unusual reactions.  

Fast forward to Finasteride.  Finasteride, also known as Propecia or Proscar, is often prescribed to treat hair loss due to various conditions.  Finasteride was originally marketed to treat men with enlarged prostates.  During drug trials, doctors noticed that men who took Finasteride as a prostate treatment experienced hair growth.  Finasteride was then FDA-approved to treat hair loss too.  In this case, the side effect was a good one.  However, some male Finasteride users have reported some undesirable sexual side effects.  Should you be concerned?  Not really.  The side effects aren’t typical.  Plus, there are ways to avoid the side effects if that’s a concern.  We’re here to share why you shouldn’t worry if your doctor has prescribed Finasteride to treat your hair loss.         

 

Why is Finasteride Prescribed for Hair Loss?

Finasteride is what’s called a DHT blocker.  DHT is an acronym for dihydrotestosterone, which is an androgen, a male sex hormone. When men and women experience androgenetic alopecia, an enzyme called 5-alpha-reductase converts testosterone to DHT.  When this happens, DHT can bind to the receptors on your hair follicles, shrinking the follicles during a process called miniaturization.  Over time,  the anagen phase of the hair growth cycle is reduced.  The result is hair that is shorter and thinner.  Eventually, new hairs become so small that they can’t penetrate the hair follicle.  As a DHT blocker, Finasteride prevents this process from happening, so you maintain your existing hair and continue to grow healthy new hair.    

What Hair Loss Conditions Does Finasteride Treat?

Oral Finasteride is FDA approved to treat androgenetic alopecia, male and female pattern hair loss.  Male and female pattern hair loss is the most prevalent type of alopecia worldwide.  There isn’t a way to predict who will experience pattern hair loss.  The condition is genetic and can be inherited from either the maternal or paternal sides of the family.  There isn’t a specific test to diagnose androgenetic alopecia.  Dermatologists and hair specialists can make the diagnosis by evaluating a patient’s hair loss pattern. 

Finasteride is also used to treat other types of alopecia, including alopecia areata and lichen planopilaris, which are caused by autoimmune conditions.  However, the prescription is considered off label when prescribed to treat hair loss other than androgenetic alopecia.   

Is Finasteride Effective in Preventing Hair Loss and Stimulating Growth

If you’re wondering whether Finasteride is worth the risk of whatever side effects could occur, that’s a valid question.  Although deciding whether to use Finasteride is highly personal, research indicates that Finasteride is highly effective in promoting growth and preventing further hair loss.  Over 80 percent of men who use Finasteride see improvement, and over 65 percent see new hair growth.  Not only that, the results are long-term.  A study of 1879 men indicates that hair count present after one year was maintained during the second year of treatment.

What are Finasteride’s Side Effects?

Side effects caused by oral Finasteride are usually mild and disappear after you stop taking the medicine.  Here are a few signs to watch:

  • Anxiety 
  • Depression
  • Dizziness
  • Weakness
  • Headache
  • Inability to urinate
  • Testicular pain
  • Runny nose
  • Rash, itching, swelling of the face, lips, or tongue, or other signs of an allergic reaction
  • Swelling of your hands or feet

Although these side effects aren’t exactly desirable, they aren’t most mens’ biggest fear.  Most are more concerned about potential sexual side effects such as:

  • Decreased libido
  • Erectile dysfunction
  • Decreased semen volume
  • Breast enlargement & tenderness
  • Premature ejaculation

The good news is that these side effects aren’t common.  Some men who do experience the sexual side effects find that their symptoms disappear over time as their bodies acclimate to the medication.  If not, discontinuing the use of Finasteride usually resolves the issue.

How Common are Side Effects from Finasteride?

As mentioned previously, side effects from Finasteride aren’t common.  The main reason is that the dosage typically prescribed to treat alopecia is usually very low, much lower than the dosage prescribed for prostate treatment.  As a matter of fact, only 3.8 percent of men who took Finasteride experienced side effects during the drug’s clinical trials.  That’s compared to 2.1 percent of men who took a placebo.  

Want to Avoid Finasteride Side Effects?  Use Topical Finasteride Instead

If you’re still a little worried about using Finasteride, even though the risk of side effects is low, there’s a simple solution. Use topical Finasteride instead of oral Finasteride.  The topical solution has been proven to be just as effective in treating male and female pattern baldness without the same risk of side effects.  Whereas oral Finasteride is metabolized in your stomach, topical Finasteride is not systemic.  Even better, topical Finasteride has less impact on serum DHT concentrations.  Think of it as a highly effective spot treatment for your hair.     

Research also indicates that combining Minoxidil with Finasteride yields even better results than using either medication alone.  Adverse reactions among patients were rare, indicating that the combined medication is not only a good choice, but a preferable one.  

Are You a Good Candidate for Finasteride?

Finasteride is often prescribed to both men and women to treat androgenetic alopecia.  The medication is generally safe for most people.  There are some exceptions though.  Finasteride is not recommended if you have kidney problems, prostate cancer, liver disease, or any other liver-related issues.  The medication is also not recommended to women who are pregnant, trying to get pregnant, or are breastfeeding.

What Should You Do if you Experience sexual or Other Side Effects from Finasteride?

If you think Finasteride is causing side effects, stop taking the medication and contact your dermatologist.  The side effects usually go away after the medication is out of your system.  However, you’ll want to work with your dermatologist to identify a substitute.  

When considering a new medication, it’s important to do your research and feel confident about your choice.  Finasteride is no exception.  If you have questions and are looking for answers, we’re here to help.  Our board-certified dermatologists and hair specialists look forward to giving you the information you need, when you need it, to get the healthiest, most effective hair loss treatment.  

 

Resources:

(01) https://pubmed.ncbi.nlm.nih.gov/9951956/

(02) https://pubmed.ncbi.nlm.nih.gov/9951956/

(03) https://pubmed.ncbi.nlm.nih.gov/34634163/#:~:text=Conclusion%3A%20Topical%20finasteride%20significantly%20improves,impact%20on%20serum%20DHT%20concentrations.

(04) https://pubmed.ncbi.nlm.nih.gov/32166351/

 

The Real Story Behind Vitamins that Prevent Hair Loss

I hate to start with a spoiler, but I’m going to start with a spoiler.  Neither vitamins nor supplements are FDA-approved or regulated for any type of hair loss.  Or, for any other health condition for that matter.  This means that information required to establish safety and effectiveness has not been submitted to or approved by the FDA.  Yet, do an Amazon search using the terms “vitamins for hair loss,” and pages and pages of products appear with assurances that the vitamins will help you regrow your hair.  Biotin, keratin, saw palmetto, and proprietary collagen blends are just a few that pop up on the first page, with prices varying from $11 to over $176.  Trying to figure out which ones are effective and worth the investment can make your head spin.   

If your hair is thinning or balding, it’s smart to question whether vitamins will help or if manufacturer promises are too good to be true.  So which ones do dermatologists and hair specialists recommend?  We’re here to answer your questions and set the story straight.  

Get Diagnosed Before You Buy Vitamins to Treat Your Hair Loss

Before you even think about trying any vitamins, you need to start with a diagnosis.  After all, you need to know what condition you’re treating.  Here are the three most common types of alopecia that cause either temporary or permanent hair loss:

  • Telogen Effluvium

Telogen effluvium is a type of temporary hair loss that can occur up to several months after a traumatic or stressful incident.  The condition can be triggered by various events, including high fevers, surgery, certain medications, nutritional deficiencies, and autoimmune diseases.  When physiologic stress occurs, hairs that would normally be in a growing phase are abruptly pushed into a resting phase, resulting in shedding.  The shedding can occur in either small or large amounts.  While hair loss from telogen effluvium can be upsetting in the short term, the long-term prognosis for regrowth is good.  No medication is typically needed.  Hair usually grows back within six months to a year.  

  • Androgenetic Alopecia

Androgenetic alopecia is also known as male or female pattern baldness.  The hair loss condition occurs when too much testosterone converts to an androgen called dihydrotestosterone (DHT).  The condition is genetic and can come from either the maternal or paternal sides of your family.  The hair loss pattern among men with androgenetic alopecia differs from that of women.  Men tend to lose their hair on the front and top of their heads.  Women usually notice their hair loss first along their widening center parts.  Oral and topical medications have been proven to help prevent further hair loss and facilitate growth.  

  • Alopecia Areata

Alopecia areata is an autoimmune hair loss condition that can affect women, men, and children.  Hair loss is usually noticed first in small round or oval patches.  In some cases, hair spontaneously regrows, and in others, the hair loss becomes permanent.  Treatment usually focuses on treating any underlying conditions and using topical and oral medications.

Determining whether you have one of these forms of alopecia is a multi-step process.  Your dermatologist will likely order blood work as part of the diagnostic process.  The lab results will indicate whether vitamin deficiencies could be contributing to your alopecia.  If so, you may benefit from supplementation.  

Vitamins are Helpful When People with Alopecia Have Deficiencies

Much conflicting information exists about the role that vitamins and supplements play when it comes to hair loss.  More research is clearly needed.  The general rule of thumb when it comes to vitamins is to supplement if there’s a deficiency.  Particular deficiencies can be associated with the three types of alopecia we discussed.  Here are the three most common:

Vitamin D

Research has demonstrated that people with telogen effluvium, androgenetic alopecia, and alopecia areata are likely to have vitamin D deficiencies. (01)  The greater the deficiency, the greater the hair loss.  Vitamin D is absorbed into the skin by keratinocyte cells.  The cells process keratin which is found in your hair, nails, and skin.  When your body has a vitamin D deficiency, the keratinocytes in your hair follicles have difficulty regulating the growth and resting phases of the hair cycle.  

Iron

In addition to checking for Vitamin D3 deficiencies, dermatologoists typically check their patients’ iron levels. Iron deficiency inhibits hemoglobin production which produces the oxygen responsible for hair cell growth and repair.  Low iron is a common cause of alopecia and can easily be remedied with a supplement.  

Biotin

People don’t typically have Biotin, Vitamin B7, deficiencies in industrialized countries.  A regular diet typically provides enough nutrients to ensure adequate levels.  However, some research studies have demonstrated that biotin deficiencies often exist in people with hair loss. (02)(03)  Experts have conflicting views on whether biotin supplements are necessary, even when there’s a deficiency.  It’s best to consult with your dermatologist on this one.  

Should You Take Vitamins if You Don’t Have a Deficiency?

Even if you don’t have a deficiency, it’s tempting to take vitamins to see if they will help regrow or thicken your hair.  More isn’t always better though, especially in this case.  Taking too many supplements or the wrong type of supplements can create issues.  For example, extra vitamin A or vitamin E can cause hair loss, which is what you are trying to prevent in the first place.  

Prescription Medications Are Often Used With Vitamins to Get Better Results

If your dermatologist doesn’t think that you are a good candidate for vitamin supplementation, prescription medications may be a good alternative.  This is especially true if you have been diagnosed with male or female pattern baldness.  Medications commonly prescribed include:

Minoxidil (FDA Approved)

A vasodilator designed to enlarge the hair follicles so you can start to regrow your hair.  

Finasteride, Proscar, Propecia (FDA Approved)

A medication that blocks the conversion of testosterone into DHT that attacks your hair follicles.

Dutasteride, Avodart (Not FDA Approved)

A DHT blocker prescribed as a second-line medication if Finasteride does not give the desired results.

Spironolactone (Not FDA Approved)

A DHT blocker prescribed only to women as a second-line medication if Finasteride does not give the desired results.

Minoxidil and Finasteride are both available in oral and topical formulas.  Topicals are often preferred, especially among men, because they do not cause sexual side effects such as lower libido.  Topical medications have been proven to be just as effective as oral medications.

The most effective hair loss plans often combine vitamins and other over-the-counter treatments with prescription medications. Vitamin D, Minoxidil, and Finasteride would be a logical combination if a person with androgenetic alopecia has a vitamin D deficiency.  Prescriptions that effectively combine multiple topical medications into one are available and are convenient and easy to use.  

Some Supplements Have Shown Moderate Improvement in Hair Loss

Although they are supplements rather than vitamins, there has been a lot in the news lately about pumpkin seed oil, saw palmetto, and rosemary oil.  While not quite as effective as Finasteride, these supplements have demonstrated a significant increase in hair growth. (04)  These supplements may be a good adjunct therapy when combined with prescription hair loss medication.

Curcumin, the active ingredient derived from turmeric, is known as a natural anti-inflammatory.  Interestingly, curcumin did not improve hair growth on its own, but it did give positive results when combined with Minoxidil.  The hypothesis is that the curcumin helped the Minoxidil better penetrate the scalp.  However, more research still needs to be conducted.  

Garlic gel, derived from onions, scallions, shallots, leeks, and chives, doesn’t live up to the hype.  Users did not see a significant difference in hair growth.  

As with any product you try as a hair loss solution, make sure to consult with your dermatologist first.  Even products that seem innocuous can have side effects or contradict other medications.  Your dermatologist is the best person to evaluate your treatment plan and determine the best mix of prescription and over-the-counter options.  

What To Do If Vitamins Aren’t the Answer to Your Hair Loss

Vitamins can be helpful if your bloodwork indicates that you have certain deficiencies.  If not, proceed with caution.  Even the most effective supplements aren’t typically as strong as prescription medications to slow hair loss and stimulate growth.  If you need an alternative solution for your thinning or balding hair, Finasteride, Minoxidil, and other medications are effective and are available by prescription.  For more information about your options, contact us.  Our board-certified dermatologists and hair specialists are available to answer your questions and make recommendations based on the type of alopecia you have.  We can even customize a formula to meet your specific needs.

Resources:

(01) https://pubmed.ncbi.nlm.nih.gov/34553483/

(02) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989391/#:~:text=Biotin%20deficiency%20was%20found%20in,risk%20factors%20for%20biotin%20deficiency.

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388561/

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388561/

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388561/

 

Is Losing Facial Hair Normal?

There are countless options for getting rid of facial hair.  You can wax, tweeze, shave, thread, and even have laser hair removal.  Within minutes, you can get the clean, smooth look you want.  But what can you do if you lose hair in your eyelashes, eyebrows, mustache, or beard?  Finding a bald spot on your face is just as alarming as finding one on your head.  Not to mention that it can be a little challenging to cover up. 

However, neither men nor women often talk about losing facial hair, making a lot of people wonder if facial hair loss is even normal.  Is it?  Why does facial hair loss happen?  What can you do if your eyelashes are sparse or your eyebrows or beard are missing patches of hair?  Whether you’re male or female, we’re here to fill you in.  

How Much Facial Hair Loss is Typical?

Facial hair sheds during the hair growth cycle the same way the hair on your head falls out.   So losing a few whiskers or eyelashes when you wash your face is normal.  It just means those hairs were in the resting phase of the cycle.  You shouldn’t look any different when those hairs are missing.  Losing more than a few hairs and seeing a bald patch is a different story.  If that happens, it’s time to visit your dermatologist.

Alopecia Can Cause Bald Spots in Your mustache or Beard

Alopecia can affect more than just your scalp; it can also affect your facial hair.  You can get alopecia in your beard or mustache for a few different reasons. These include:

  • Ringworm infections
  • Telogen effluvium 
  • Chemotherapy treatment
  • Alopecia

In most cases, hair loss in the beard area is not permanent.  Ringworm infections typically resolve with anti-fungal medications.  If you’re unfamiliar with telogen effluvium, it’s hair loss caused by sudden stress.  Anxiety, a high fever from Covid or other illnesses, hospitalization, and other stressful events can trigger telogen effluvium.  It’s usually temporary.  Hair will grow back within six months to a year.  

Alopecia Barbae is Often Treated with Minoxidil and Cortisone Injections

Another reason why men can lose facial hair is due to alopecia barbae.   Alopecia barbae is a form of alopecia areata that affects the beard.  Like alopecia areata, alopecia barbae is an autoimmune condition where your body attacks your hair follicles, causing small circular patches.  Men who have alopecia areata may be more likely to get alopecia barbae.  Hair often spontaneously regrows; however, the condition can flare up from time to time.  Alopecia barbae is often treated with cortisone injections and topical minoxidil.  

Although the exact cause of alopecia barbae is unknown, genetics may be a factor.  Men with allergies, asthma, and other autoimmune diseases are more likely to be affected.  Once you have one autoimmune disease, it’s possible to get others.  

Because of the alopecia barbae’s unpredictable nature, men are often caught by surprise when they see bald patches.  Some men who have the condition report that their skin sometimes feels itchy and painful before their hair falls out.  The skin visible through the patches can be either smooth or rough.  Redness and inflammation can be present in bald spots as well.  Some also report that the hair that grows back in around the bald spot has a different texture than their other hair.  The hairs sometimes grow narrower at the bottom, also known as exclamation mark hairs.

Loss of Eyebrows and Eyelashes is Common Among Both Men and Women

Madarosis is the name of the condition that causes men and women to lose all or some of their eyelash and eyebrow hair.   The hair loss isn’t always symmetrical.  Madarosis can affect just one eye.  

Madarosis can be scarring or non-scarring, just like alopecia.  Scarring means inflammation blocks the hair follicles so new hair cannot emerge.  Scarring doesn’t occur immediately.  It happens over time.  Non-scarring means that the hair enters the resting phase of the growth cycle early, but the follicle remains functional.  

If you notice bald spots in your eyebrows or gaps in your lashes, it’s best to visit a dermatologist as soon as possible.  There are many possible explanations for madarosis, including:

  • Alopecia areata
  • Hormonal imbalances
  • Nutritional deficiencies
  • Thyroid disease
  • Infections
  • Medications

Early diagnosis and treatment will give you the best possible results. 

Eyelash and Eyebrow Regrowth Products are More Readily Available Than In the Past

Thanks to research, medications that help regrow facial hair are now available.  If your eyelashes or eyebrows are thinning, you may be a candidate for bimatoprost, the main ingredient in Latisse and Lumigan.  Bimatoprost is a glaucoma medication that is FDA approved to help grow eyelashes and eyebrows.   The medication was originally developed to treat glaucoma.  During trials, ophthalmologists noticed that bimatoprost had the side effect of increased eyelash hair. Bimatoprost has been studied over time, and research studies indicate that the medication is highly effective (01) in stimulating growth.  

Minoxidil Can Be Used on Facial Hair Too

Minoxidil, typically used on the scalp, is safe to use on your face.  As a vasodilator, minoxidil brings more oxygen to the hair follicles, making them wider so new hair can emerge.  Minoxidil is sold over-the-counter.  However, we recommend that you consult with a dermatologist who is a hair specialist before beginning treatment for your eyebrows, beard, or mustache.  If you discontinue use, any new growth could be lost, so you will want to have a licensed professional guiding you and monitoring your progress.  

Natural-looking Options Exist to Make Eyebrows and Eyelashes Appear Thicker

If medications aren’t an option for you, many temporary and permanent solutions are now available to cover up your face’s sparse, thinning, or bald areas.  Manufacturers have made false eyelashes so realistic that it’s often difficult to tell when people are wearing them.  Tattoo options such as microblading have become mainstream.  People like the natural look.  Make-up can go a long way if you don’t want to go the permanent route.  It’s amazing what a little dark brown eye pencil can fill in.  

Selecting ways to fill in facial hair is a very personal decision.  While some people are comfortable with make-up, others prefer a permanent solution, so they don’t have to reapply daily.  The key is to do what makes you feel the most comfortable.  

What to Do if You Think You’re Losing Facial Hair

If your beard or eyebrows look a little sparse, options exist to make you feel and look better.  As with scalp hair loss treatments, FDA-approved and prescription medications are the strongest, most effective way to go. If you choose this route, you’ll need a board-certified dermatologist to help you with a proper diagnosis and treatment plan.  If you don’t have access to a dermatologist and have questions regarding your facial hair loss, feel free to contact us.  We can point you in the right direction.  Plus, we’re putting the finishing touches on some new prescription-strength facial hair loss products.  We can let you know as soon as they’re ready.  

Resources:

(01) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6054329/

5 Tips for a Healthier Scalp & Improved Hair Growth

A healthy scalp means healthy hair growth. To get your scalp back on track for great hair growth results, there are a few things our happy head dermatologists recommend.

Addressing hair loss means getting to the root of the problem. And, quite literally, that means taking care of your scalp. A healthy scalp means better hair growth results and it’s a key component to preventing future hair loss. To help you get started, our hair growth experts share insider information on what happens when we neglect our roots and their top 5 tips for a healthy scalp.

What’s at the Root?

It’s not just about your strands, but what’s inside each hair follicle that can impact hair loss or keep hair growing. Your hair follicles keep strands in place, add natural moisture to your hair, and grow strands. For hair to remain anchored and thriving, the follicle needs to be clean, unclogged, and nourished with the proper nutrients. (01)

Your Scalp is Alive, Your Hair…Not So Much 

Your hair alone isn’t a live organism but a strand of dead cells. That said, all the factors that keep hair growing depend on living cells. As the hair begins to grow, it nudges itself up from the base of the follicle and through the uppermost levels of the scalp. Small blood vessels feed the cells in each follicle, providing nutrients to keep your hair growing. (02)

Almost every hair follicle is attached to a sebaceous gland, also known as an oil gland. These oil glands secrete a substance called sebum which coats and moisturizes the skin and keeps hair shiny and healthy. A hair follicle blocked by excess sebum, dandruff, or dead skin can’t grow or hold hair effectively. (02)

5 Healthy Scalp Tips

According to the American Academy of Dermatology, taking care of your scalp can boost the health of your hair and, perhaps, even improve your self-confidence. The following are five tips for a healthier scalp and hair. (03)

1. Protect Your Scalp from the Sun

Although you diligently use sun protection and SPF on your body and face, you may forget about your scalp. Thinning hair or bald spots leave the scalp vulnerable to the sun’s UV rays. Also, even a head full of thick hair can still need shielding from the sun. Where your hair parts or the crown of your head needs extra attention because these areas can sunburn in direct sunlight. 

To protect your scalp from the sun, apply sunscreen onto the exposed areas on your scalp whenever you’re outside for prolonged periods. The following are a few sunscreen options for your scalp: (04)

  • Avoid standard sunscreens used for the body because they make hair oily. 
  • A stick sunscreen works for small areas (like the crown or part). 
  • Powder sunscreen options are excellent for both bare and covered scalp areas but can be pricey. 
  • Sunscreens with a spray or mist are a cost-effective choice but can weigh hair down. 

One practical method to protect your scalp is by wearing a hat or some other type of head covering to block the damaging rays of the sun. 

2. Wash Your Hair Regularly

Maintaining a clean scalp is a critical way to keep your scalp and hair healthy. Unwashed hair can lead to oil, dirt, and cell buildup, which blocks hair follicles. However, over-washing your hair can also lead to problems like dryness and flaking. To determine how frequently to wash your hair, you must figure out your hair type. (03)

Oily hair needs almost daily washing. Dry hair, however, may require twice or once a week washing, depending on the environment and your activity level. For example, people with dry hair who live in humid areas and exercise often may need to wash their hair more frequently than someone with the same hair type who lives in a dry, cool climate and doesn’t sweat. 

3. Choose Your Shampoo Wisely

It’s tempting to purchase whatever shampoo is on sale at the drugstore, but the ingredients in the shampoo matter. For instance, many shampoos have sulfates to create a thick “lather,” which leads people to believe their hair is getting “clean.” Sulfates create bubbles for lather, but bubbles aren’t what clean your skin, hair, or scalp. 

Unfortunately, the addition of sulfates can strip beneficial oils from the hair. People with sensitive skin may develop skin irritations from sulfate shampoos. Using sulfates can result in dull, dry, and brittle hair — which then lead to heart loss or thinning. 

You can boost hair growth, however, through quality ingredients. Some ingredients that may improve scalp health: (04)

  • Peppermint oil 
  • Tea tree oil
  • Vitamin E oil 
  • Rosemary leaf extract 

Finding quality ingredients will help you find the right shampoo to clean your hair without stripping it of healthy oils. 

4. Eat a Healthy Diet 

Your scalp needs specific nutrients. Oxidative stress, damage to the body caused by free radicals, can cause hair loss. A nutritious diet filled with fresh produce and low on processed foods can counter oxidative stress through antioxidant consumption. (05, 06)

Found in nuts, fruits, and vegetables, antioxidants fight oxidative stress. The following are some examples of antioxidant-rich food sources: (05, 06)

  • Kale
  • Strawberries
  • Artichokes
  • Spinach 
  • Blueberries 
  • Beans 
  • Red Cabbage

Another nutrient that may help to thicken hair and keep the scalp healthy are omega-3 fatty acids. Found in fatty fish, nuts, and plant oils, omega-3 strengthens cells throughout the scalp by stimulating circulation. Additionally, omega-3 reduces inflammation and makes the scalp less reactive to irritants. (07)

5. Treat Your Scalp to a Massage 

Massaging your scalp can result in thicker and healthier hair. According to a small 2016 study, men who received a daily 5-minute scalp massage for 24 weeks ended up with thicker hair at the end of the study compared to the beginning. Gentle scalp massage may promote hair growth in cases of thinning hair or hair loss, like alopecia. 

A scalp massage stimulates hair follicles and encourages blood flow through the area. Improved blood flow delivers nutrients to hair follicles and fortifies follicles. Regular scalp massages are easy to do yourself, using your fingertips or a massage tool. Be sure to use a gentle touch and avoid tugging your hair. (07)

Following the five tips above can help to keep your hair strong by giving you a healthy scalp. Your scalp is where your hair starts, so it should receive the same amount of attention you give your hair. 

What Unhealthy Scalp Looks Like 

Most people don’t inspect their scalp closely, but maybe they should! Spotting signs of an unhealthy scalp can alert you to possible sources of hair loss. By addressing problems before they grow, you can slow or prevent hair loss.

  • Itching: Itching on the scalp can be a sign of an unhealthy scalp condition. Itching often occurs because of skin dryness on the scalp caused by an irritant, like a harsh soap, shampoo, or hair product. If the itching involves large areas or remains for long periods, it’s best to see a doctor to rule out dermatitis or psoriasis. 
  • Redness: Red areas on your scalp may indicate inflammation. These inflamed areas can occur as a response to an irritant or as a response to an infection. Eczema, scalp ringworm (tinea capitis), and psoriasis are some common causes of redness on the scalp.
  • Pain or Burning Sensations: Pain or burning sensations are rarely a good sign, and your scalp is no exception. If your scalp feels like it’s on fire or is painful to touch, it’s likely a sign of infection that needs medical intervention.

Getting to the Root of It All

There’s more to hair than the strand of the hair itself. Keeping hair on your head starts from your hair’s foundation — your scalp. Furthermore, if you’re considering a hair loss treatment, a healthy scalp is a must. Topical treatments work best when your scalp is in good condition.

Happy Head individualizes every hair solution, ensuring the appropriate amount of medication for your situation. With a six-month money–back guarantee, we’re confident you’ll be satisfied with your results and if you have any questions your dermatologist can help. All you have to do is take our quick, 5-question quiz here to get started.  

Resources:

(01) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369642/

(02) https://www.webmd.com/skin-problems-and-treatments/hair-loss/science-hair

(03) https://www.aad.org/public/everyday-care/hair-scalp-care/scalp

(04) https://pubmed.ncbi.nlm.nih.gov/26278532/

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5315033/

(06) http://Peppermint oil (04) Tea tree oil Vitamin E oil  Rosemary leaf extract (05)

(07) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4740347/#__ffn_sectitle