DHT Blockers: Fight Hair Loss with These Powerful Weapons

Men are willing to do just about anything besides see a doctor.   Given a choice, 72 percent of men would rather clean the bathroom, mow the lawn, or do any other household chores. A lot of men aren’t even getting their yearly check-ups. (01)   So when it comes to hair loss, not many guys are rush to the dermatologist for a diagnosis and medication.  But they should.  

The most powerful hair loss weapons against male pattern baldness are only available by prescription.  Sure, there’s an endless number of products sold over-the-counter claiming that they work, but the reality is that they aren’t powerful enough to get the job done.  This is true for women who have female pattern baldness too.   

If your hair is thinning or balding, a DHT blocker may be just what the doctor ordered.  Read on to learn more about what DHT is, why DHT is causing your hair loss, and why DHT blockers may be the solution to your hair loss issues.  

What is DHT?

Dihydrotestosterone (DHT) is a sex hormone, known as an androgen.   Androgens are typically produced in males’ testicles and women’s ovaries.  The adrenal glands also produce androgens.  DHT is a little different than other androgens, because it is converted from testosterone.  Men naturally have more testosterone in their bodies than women, however, an enzyme called 5-alpha reductase (5-AR) converts about ten percent of testosterone in all adults to DHT.  

How Does DHT Cause Hair Loss?

When too much testosterone converts into DHT, the excess amounts of DHT interfere with your hair’s growth cycle.  The hair follicles miniaturize, make existing hair fall out, and prevent new hair from breaking through.    

Will a Blood Test Tell Me If I’m Producing Too Much DHT?

It seems logical that DHT levels can be monitored since testosterone levels can be checked.  That’s not the case, though.  DHT levels may fall within the normal range on a blood test but still be elevated enough to cause male or female pattern baldness.  This is especially true if your body is sensitive to DHT.  When testosterone levels increase, DHT has the potential to be an even bigger problem.  

Can I Prevent Androgenetic Alopecia?

Unfortunately, there isn’t a way to predict whether or not you’re going to lose your hair.  Androgenetic alopecia, male and female pattern baldness, is genetic.  If a family member on either your maternal or paternal side has gone bald, there’s a chance that you could too. The only catch is that you don’t have a way of knowing whose or which genes you inherited.  

Men on testosterone replacement therapy or get testosterone injections often ask if the medication will contribute to their hair loss.  Depending on the patient’s sensitivity, the supplemental testosterone could cause an increase in DHT leading to increased hair loss.  

Is Overproduction of DHT Just a Guy Problem?

When people think of androgenetic alopecia, men typically come to mind.  Bruce Willis, The Rock, Matthew McConaughey, Jeff Bezos are all prime examples.  You don’t see too many bald or balding female celebrities.  The reality is that a significant number of women are affected although the number isn’t as high as it is for men.  One research study found that out of 954 patients diagnosed with pattern baldness, 23.9 percent were women. (02)  Women typically have a lower level of testosterone; however even when lower levels of testosterone convert to DHT, hair loss can occur.  

What Can You Do to Reduce the DHT Levels in your Body?

The most effective way to reduce your DHT level is to use a DHT blocker.  If you’ve been dealing with hair loss issues for a while, you’re probably well aware of the overwhelming number of over-the-counter (OTC) hair loss options.  It’s not unusual for patients to spend a lot of time and money with these products before giving up and turning to their dermatologists for prescription options. 

Prescription DHT blocking medications reduce the amount of 5a-reductase enzyme, which converts testosterone into DHT in your body.  Here are the DHT blockers most commonly prescribed by dermatologists and hair specialists:

Oral & Topical Finasteride 

Finasteride is one of the most well-known DHT blockers.  The medication was FDA approved in 1992 under the name Proscar to treat enlarged prostates and five years later under the name Propecia to treat androgenetic alopecia.  Although both men and women can use Finasteride, it is not recommended for use in women who are or could become pregnant.  

Oral Finasteride is highly effective as a hair loss treatment.  One research study found that 80 percent of participants who took Finasteride saw an increase in hair growth. (03)  However, some people who take oral Finasteride report undesirable sexual side effects, including decreased libido.  A good solution is using topical Finasteride rather than oral.  Topical Finasteride has been proven to be as effective as oral without the side effects in many studies. (04)  

Topical Finasteride Combined With Minoxidil

Minoxidil is not a DHT blocker, but it has an important role in hair growth for people with male and female pattern baldness.  Minoxidil is what’s called a vasodilator.  It enlarges the blood vessels so more oxygen reaches the scalp.  As a result, it makes the hair follicles bigger so new hair can emerge.  Minodixil and Finasteride are a dynamic duo when used together to fight hair loss.  The Finasteride prevents the testosterone from converting into DHT while the Minoxidil ensures that your scalp is conducive to new hair growth.  A research study conducted in 2020 found that the combination of Finasteride and Monoxidil was safe and more effective than monotherapy. (05)

Dutasteride

Dutasteride, also known as Avodart, is another DHT blocker originally developed to treat enlarged prostates.  It is also a 5-alpha reductase inhibitor.  Although Finasteride and Dutasteride work similarly, the medications have some differences.   Whereas Finasteride is FDA-approved to use for hair loss, Dutasteride can only be used off-label.  It has not yet been FDA-approved.  Finasteride is usually highly effective in treating androgenetic alopecia and is typically used as a first-line medication.  In cases where patients need an extra boost, Dutasteride can be helpful.  Research has shown that men who used Dutasteride for 24 weeks had thicker hair than men who used Finasteride. (06) 

Spironolactone

Spironolactone is FDA approved to treat high blood pressure, heart failure, and fluid retention due to kidney and liver diseases.  It is not FDA-approved to use for hair loss and is used off-label for women.  Spironolactone typically isn’t prescribed to men because it can cause feminizing side effects.  Like Finasteride and Dutasteride, Spironolactone slows down androgen production.  The medication has been found to be both safe and effective. (07)

How Do DHT Blockers Work?

Now that you have a better idea of what DHT blockers are available, the next question that needs to be answered is how do they work?  The mechanics behind the prescription medications approved or used as DHT blockers are similar.  First, preventing testosterone from converting to DHT inhibits the miniaturization of the hair follicles.  Secondly, when the levels of scalp DHT are lowered, the number of hairs in the anagen phase are maintained or increased.  Think of anagen as the active phase of the hair growth cycle.  This is when the cells in the roots of your hair divide rapidly and form new hair.  Elongating the anagen stage gives your hair more time to grow.  

Get More Information On Prescription DHT Blockers

If you’re experiencing androgenetic alopecia and want more information on DHT blockers, contact us.  If, like many, you haven’t yet been to a dermatologist, free phone consultations are available with board-certified dermatologists and hair specialists.  

Formulas are available for men and women and can even be customized based on your specific needs.  We are happy to remove or add ingredients as needed and appropriate.  You can also see before and after photos of our patients.  You can get an idea of what you can realistically expect to see after using Happy Head hair loss solutions that block the DHT causing your alopecia.

Resources:

(01) https://newsroom.clevelandclinic.org/2019/09/04/cleveland-clinic-survey-men-will-do-almost-anything-to-avoid-going-to-the-doctor/

(02) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5312176/

(03) https://pubmed.ncbi.nlm.nih.gov/15316165/#:~:text=In%20the%20clinical%20evaluation%20at,the%205%25%20topical%20minoxidil%20group.

(04) http://www.bioline.org.br/pdf?dv09011

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

(06) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388756/

(07) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3769411/

 

Diet and Hair Loss: Is There a Relationship?

 

When you’re losing your hair, you’ll try just about anything to make it stop.  Shampoos, conditioners, essential oils, vitamins… they’re all fair game.  The easier and less invasive, the better.  So, it’s only natural that diet is a hot topic.  Diet is a manageable lifestyle change that could make a difference.  

But, if you’re like most people, you probably have more questions than answers when it comes to how diet and nutrition affect your hair.  According to a 2017 study conducted by the International Food Information Council (IFIC), there’s a lot of conflicting information, causing confusion about what to eat.  Determining whether specific foods will help or hurt your hair loss condition is even more challenging.  We hear it all the time from patients.  “Can alopecia be reversed by changing my diet?”  “Which diet will best reduce the inflammation on my scalp?”  “Do I have to go gluten, dairy, and sugar-free?”  

Before you resort to radical measures, keep reading.  We’ll help you separate truth from fiction and share firsthand information from our own Dr. Ben Behnam, board-certified dermatologist and co-owner of Happy Head hair loss solutions.  

Can Improving Your Diet Prevent Further Hair Loss and Stimulate Growth?

Does what you eat affect your hair?  That’s the question that most people want to be answered.  After all, why bother changing your diet if it won’t make a difference?  The answer is yes; nutrition may indeed affect your hair.  One study found that nutritional deficiencies can cause telogen effluvium, androgenetic alopecia, or alopecia areata. It also found that over-supplementation can lead to hair loss as well.  

The Wrong Diet Really Can Cause Scalp Inflammation

Nutritional deficiencies aren’t the only problem.  Scalp inflammation caused by an unhealthy diet is another issue.  A high fat, high-cholesterol diet has been found to stimulate the inflammatory process on the scalp.  A study conducted in 2018 found that mice who were fed a traditional western diet experienced skin discoloration, inflammation, and hair loss.  The mice’s hair turned black, gray, then white before falling out.  The diet, which induced inflammation, mimicked the aging process in humans and aged the mice’s hair by 36 weeks.  The hypothesis is that when what you eat generates an inflammatory response, it causes your hair to age prematurely.  

Which Diet Should You Choose to Prevent Hair Loss?

Now that we’ve established that the wrong diet is a recipe for disaster when it comes to your hair, which diet should you consider?  Keto, Autoimmune Protocol (AIP), Mediterranean… the list of possibilities seems endless.   The truth is that further research is needed on the use of diet in alopecia treatment.  One study indicates that the Mediterranean diet, which contains foods with anti-inflammatory properties, may stimulate hair growth and health among people with androgenetic alopecia.  Figuring out the differences between each diet gets tricky, though. In many cases, overlap exists in the philosophies behind the diets.  

A Protein-rich Diet Helps Build Keratin

Regardless of which diet you choose, it’s important to select a protein-rich diet filled with fresh, unprocessed foods.  Hair is primarily composed of keratin, a mixture of filament-forming proteins.  To make keratin, your body needs protein.  All protein is not created equal, though, according to Dr. Behnam.  “Select pasture-raised chickens, raised on a farm and not in a cage,” says Behnam.  “When chickens are trapped in a cage, their testosterone levels increase from the stress of being in the cage.  When you eat caged chicken, you get extra testosterone that can potentially convert to DHT leading to more hair loss.”

Vegetarians Often Lack Enough Protein in Their Diets

Dr. Behnam finds that his patients who are vegetarians tend to lack the protein and vitamins necessary for adequate hair growth.  We’ll talk a little more about vitamins later, so let’s focus on protein for now.  Some excellent sources of plant protein can compensate for animal protein.  Those sources include nuts and nut butter, lentils, beans, peas, leafy green vegetables such as broccoli, spinach, and brussel sprouts.  

Dr. Behnam is a big advocate of protein powder, not only for vegetarians, but for all of his patients.  It’s important to use the right type, though.  According to Behnam, “Two types of protein powder are on the market.  One is whey protein isolate. Whey protein isolate powder is easily found in retail stores in muscle milk, and other types of sports shakes.  It’s less expensive.  The only problem is that whey protein isolate increases the concentration of amino acids such as valine and isoleucine, which lead to higher testosterone production.  That extra testosterone has the potential to convert to DHT and cause hair loss.  The solution is to use whey protein concentrate.  Whey protein concentrate is harder to find, but it will boost your protein without increasing your testosterone or DHT levels.”  

Do You Have to Give Up Caffeine?

If you can’t seem to get moving in the morning without a cup of coffee, don’t despair.  “Caffeine doesn’t affect testosterone levels,” says Dr. Behnam.  “You can enjoy it without worrying.  I recommend that you stay away from energy drinks, soy milk, and anything high in MSG, though.”  

Nutritional Supplements

Vitamins and supplements aren’t a big deal to most people.  You don’t need a prescription to get them, so they’re safe, right?  Not so fast.  Vitamins and supplements aren’t always as innocuous as they seem.  There are a couple of things you need to know:

  1. The FDA does not regulate dietary supplements
  2. Over-supplementation of selenium, Vitamin A, Vitamin E, and other vitamins have been associated with hair loss

That said, Dr. Behnam usually tests his patients’ Vitamin D and iron levels because deficiencies are prevalent and are well-documented reasons for hair loss.  Vitamin D plays a crucial role in the hair growth cycle.   While the exact reason why iron deficiency causes hair loss is unknown, reversal of iron deficiency in mice led to a reversal of hair  loss.  

Here’s the inside scoop on other essential vitamins:

Biotin

There has been a lot of hype about biotin supplements, shampoos, conditioners, and more.  Truth be told, biotin deficiency is rare.  Clinical trials have not shown biotin to be effective in stimulating hair growth without a true deficiency.  

Zinc

Zinc deficiency can be either acquired or inherited.  It is common among vegetarians since vegetables contain less zinc than meat.   Zinc deficiency causes telogen effluvium and brittle hair.

Vitamin A

Vitamin A is the main ingredient in retinoids and retinoic acid.  It has been proven to work in conjunction with Minoxidil and Finasteride to increase absorption of the medications.  Vitamin A deficiency does not cause hair loss, although a connection between over-supplementation and hair loss has been found.  

Vitamin E

It’s not common for people to have vitamin E deficiencies.  More research needs to be conducted, but in one small study with 21 participants, people who received vitamin E supplements had an increase in hair count compared to people in the placebo group.  Too much vitamin E is too much of a good thing.  It can increase the risk of bleeding and decrease thyroid hormone production, resulting in hair loss.   

Balancing Your Diet Is A Process

Learning how to eat for healthy hair takes time.  Sometimes you don’t know if changing your eating habits or adding a particular vitamin will help until you try it.  If you’ve already been diagnosed with male or female pattern hair loss or some other type of alopecia, supplementing your diet with topical medications such as Minoxidil, Finasteride, Spironolactone, or Duasteride may be a good option for you.  Topical medications have been found to be as effective as oral medications without the bothersome side effects.  Even better, like your diet, our formulas can be customized to meet your specific needs.  For more information, contact us to determine whether you are a good candidate for Happy Head or one of our other prescription-grade hair loss solutions. 

Resources:

(01) https://foodinsight.org/survey-nutrition-information-abounds-but-many-doubt-food-choices/

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

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6065400/

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

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

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

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

(08) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5582478/#:~:text=Despite%20its%20popularity%20in%20the,multiple%20factors%2C%20including%20patient%20history.

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

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

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

 

Signs of Balding and What to Look For

For both men and women, hair changes the older they become. Most adults understand that some hair loss is inevitable with age. But when it begins to occur, spotting the signs of hair loss and balding can still be tricky. Detecting the signs of balding is essential because early intervention is the key to successful hair loss treatment. 

What Are the Early Signs of Hair Loss? 

According to the American Academy of Family Physicians, about 50% of men and women will experience hair loss in their lifetime. And although hair loss occurs in more men than women, the emotional impact of hair loss affects both equally. Because emotions can affect how each person faces hair loss, becoming familiar with the signs can help individuals approach the experience objectively and sensibly. 

Here are a few signs to look for if you suspect you’re experiencing hair loss: 

Sunburns on Your Scalp

Like the skin on the rest of the body, scalp tissue is vulnerable to sunburns. Fortunately, a full head of hair offers excellent protection against the sun’s harsh rays. Thick hair typically provides enough sun protection to keep the scalp from sunburning. The more hair thins, however, the less cover there is to protect the scalp. Sunburns on the scalp develop when there isn’t enough hair to sufficiently shield the area from direct sunlight. If your scalp is typically not sensitive to sunlight, but you find that scalp sunburns are occurring more frequently – you may be experiencing balding or profuse hair loss.  (01)

A Receding Hairline

A receding hairline can be tricky to spot if hair loss occurs gradually. The process happens bit by bit, making it hard to determine whether a receding hairline is more about lighting and angles and less about actual hair loss. Before deciding your hairline is receding, become familiar with what kind of hairline you have. 

    • Low hairline. Low hairlines are closer to the brow line, with a smaller forehead space. A receding hairline is more challenging to spot with low hairlines because they are less noticeable. 
    • Middle hairline. Middle hairlines are what most people would consider a “normal” hairline. These hairlines are set toward the upper-middle portion of the forehead. A receding hairline typically appears as an M-shape with a middle hairline, with the hairline receding further up on the sides. 
    • High hairline. High hairlines start at the crown, making the forehead space appear larger. A high hairline may seem as if the hairline is already receding, although it simply is a person’s inherited appearance. 
    • Straight-lined. Straight-lined hairlines don’t follow the natural curvature of the head. Instead, the hairline flows straight across the forehead, with sharp 90-degree angles on either side. Some men may style their hair this way, or it can be an inherited trait. A receding hairline may create a crooked hairline where one was typically straight, making it easier to spot. 
  • Triangular hairline. Triangular hairlines start low at the temples and reach a high point in the center. Receding hairlines may be more apparent on triangular hairlines because of how low the hairline typically begins at the sides.
  • Uneven hairline. Uneven hairlines are common because most hairlines aren’t perfectly shaped or symmetric. Uneven hairlines can also result from excessive hairstyling or tight headwear, making receding hairlines difficult to detect. 

Men, in particular, are prone to a hairline that recedes when they start balding. For example, one of the most common signs of androgenetic alopecia, also known as male pattern baldness, is a receding hairline. Anyone wanting to check their hairline for signs of balding or hair loss should first familiarize themselves with their typical hairline. Taking periodic photographs can give you a baseline for comparison. 

A Bad Hair Day, Every Day

Are you noticing that your hair won’t fall in the same hairstyle you’ve worn for years? If you see that your hair is tougher to manage or doesn’t look the same way it used to, it may be a sign of hair loss or balding. Keep in mind that the weather, new hair products, or hard water can affect your hairstyle. However, if you’re struggling to shape your hair into its typical “look,” it might be because you’re working with less hair. Hair loss can influence how your hair flows and falls, changing how your hair appears in the morning or when styled. 

A Larger Crown Area

In men with androgenetic alopecia and females with female pattern baldness, balding may start at the crown. Hair follicles become sensitive to dihydrotestosterone (DHT), a by-product of the hormone testosterone, resulting in thinning hair, particularly in the crown area. Central centrifugal cicatricial alopecia (CCCA) is another type of hair loss that begins at the top of the head or the crown as an expanding bald area. (02)

Unfortunately, the crown area is probably not something most people see, making it hard to assess for changes. If you’re concerned about balding, it’s a good idea to become familiar with your crown area. Use two mirrors to get a good look at the crown of your head or enlist the help of another person. If you notice more scalp showing through than usual – or there’s an obvious gap that’s visible to others – then you may be experiencing balding or hair loss. 

More Stray Hairs Everywhere

Just like animals, humans shed their hair naturally each day. According to the American Academy of Dermatology Association (AADA), humans shed about 50 to 100 hairs daily. (03) Keep that number in mind when evaluating the stray hairs you see in the shower drain or on your pillowcase! 

In some instances, however, humans shed more hair than usual. Telogen effluvium, for example, occurs when stress or illness causes the temporary shedding of an excessive amount of hair.  Furthermore, women experiencing female pattern baldness may need to rely on this sign of balding (excessive stray hairs) more than others. 

Unlike men, women don’t typically lose all their hair or become bald in one spot. For women, severe hair loss is generally scattered throughout the head. Their crowns and hairline may remain the same, though the hair cover in these areas may be lighter. Because of this, women may need to rely on spotting hair loss by keeping tabs on the number of stray hairs they find instead. (03) 

Unreliable Signs of Balding

Often mistaken for definitive signs of balding, the following lead people to believe they are balding but are usually not connected to any actual hair loss. 

  • Hair that appears thin when wet. After a shower or swim, hair can look stringy, and your scalp might appear more exposed. This is typical for wet hair and not a sign of hair loss. 
  • An itchy, flaky scalp. Some people associate an itchy scalp with hair loss. In most cases, however, an itchy scalp is due to something easier to treat — like dandruff or eczema. 

It Looks Like I’m Balding. Now what? 

If you spot signs that you’re losing an excessive amount of hair or going bald, seek advice from a doctor right away. A thorough evaluation, whether in person or online, can determine whether you’re experiencing typical hair shedding or if you’re going bald. An expert can ease your fears by answering your questions and finding effective interventions. Treating hair loss as quickly as possible can keep you from losing more hair in the long run. 

At Happy Head, we schedule customer consultations with a board-certified dermatologist. Our doctors work with you to determine whether you’re a good candidate for our customizable topical hair loss medication. Want more information?  Start a free consultation now.

 

Resources:

(01) https://www.aafp.org/pubs/afp/issues/2009/0815/p356.html

(02) https://www.aad.org/public/diseases/hair-loss/types

(03) https://www.aad.org/public/diseases/hair-loss/insider/shedding

Smoking and Hair Loss: The Truth You Need to Know

Are you a smoker? If you're losing your hair, this might be the reason why. Happy Head dermatologists recommend stopping smoking.

If you’re a smoker, you’re probably already well aware of why you should quit. Between your family using every scare tactic in the book and chilling public service announcements featuring people suffering from various types of cancers and lung diseases, you know the risks more than anyone. Beating the addiction is hard, though. In fact, it’s so difficult that 80 percent of people who try to quit smoking on their own start again within a month. (01)

Just in case you need a little more incentive to kick the habit for good, consider this: according to several research studies, nicotine can induce hair loss. Sure, you know how harmful cigarettes and vapes are to your body, but you probably didn’t expect to go bald from them. What else do you need to know about the effects of smoking on your hair? Keep reading, and we’ll fill you in on the latest.  

Nicotine Accelerates Hair Loss

Not only can continual use of nicotine lead to a heart attack, but it is also believed that smoking may be responsible for accelerating hair loss. One study found that 85 percent of men who smoked had a form of androgenic alopecia, male pattern baldness. Among the men in the non-smokers’ group, only 40 percent exhibited signs of male pattern hair loss. The difference in hair loss was significant.  The study used the Hamilton-Norwood Scale, which categorizes hair loss on a scale of one to seven, with one being the least amount of hair loss. In the smoker group, 71 percent had grade III or grade IV hair loss. However, in the non-smoker group, only ten percent of the participants reached grade III or IV. (02)

Smoking Ages Your Scalp 

So the next question is, why do experts believe smoking leads to hair loss? You know how smoking is known for giving people leathery alligator skin? It has the same effect on your hair. The reason why stems from a few different factors.  

  • Smoking reduces the blood flow to your hair follicles.

When you smoke, your blood vessels constrict, limiting how much blood flows to your organs. Over time, the continual constriction stiffens the blood vessels and makes them less elastic. When this happens, your cells don’t get the amount of oxygen and nutrients needed to thrive. When your hair follicles are deprived of oxygen, miniaturization occurs, disrupting your hair’s growth cycle. The hair follicle shrinks and eventually blocks the growth of new hair.   

  • Breathing in smoke can damage your hair’s DNA.

Smoke causes environmental effects that inhibit hair growth. DNA contains genetic material that serves as our hair’s building blocks. When carcinogens from cigarette smoke damage the DNA, keratin, a protein that makes-up 95 percent of your hair, cannot be produced. 

  • Smoking causes inflammation. 

Smoking stimulates follicular inflammation, a key feature in male and female pattern hair loss. In a 2020 research study on androgenic alopecia, approximately 71 percent of biopsy samples of patients with male or female pattern baldness showed signs of inflammation. (03)

  • Smoking decreases estrogen levels.

It is well documented that smoking decreases estrogen levels in women, which can lead to earlier onset of menopause. When estrogen levels drop, hair grows slower and thinner. Lower estrogen levels also lead to an increase in androgens which cause female pattern baldness. (04)

  •  Smoking prematurely turns your hair gray.

In an observational research study, people who smoked were two and a half times more likely to have gray hair before age 30 than non-smokers. (05) The study mentioned that the cause of premature graying is not yet known. One hypothesis is that melanocytes, the cells responsible for producing color, are damaged in people who smoke.  

If You’re Thinking About Getting a Hair Transplant, Stop Smoking

Many reputable dermatologists and hair specialists refuse to perform hair transplants on patients who smoke. The reason why is because oxygen is critical to the survival of transplanted follicles and helping the wounds heal. Smoking causes poor blood circulation, which could result in the death of the skin tissue on the scalp and even post-operative infections. (06) Another reason why is because nicotine in the blood vessels increases bleeding and inhibits clotting during the healing process. 

Vaping Can Cause More Damage Than Traditional Cigarettes 

What about vaping? It’s safer than smoking cigarettes, right? Not exactly. Vaping has skyrocketed in popularity across all ages groups in the past few years due to the sweet taste and lack of stale smell. What many people don’t realize, however, is that JUUL, MarkTen Elite, PAX Era, and most other types of e-cigarettes contain more nicotine than traditional cigarettes.  

Although no studies are available, anecdotally, one can make the connection that nicotine from vape pens is equally harmful, if not worse, for your hair than traditional cigarettes. Regardless of the source, nicotine has been proven to cause oxidative stress, which can impair your hair’s growth and cause hair loss. (07)

The Jury is Out on Marijuana

Recreational marijuana is currently legal in 19 states, Washington D.C., and Guam. (08) Marijuana must not be harmful if it’s legal, right? Well, the jury is out. A study conducted in 2007 by the University of Debrecen indicates that the THC in marijuana can lead to hair loss. (09) 

Marijuana contains cannabinoid compounds. Tetrahydrocannabinol (THC) and Cannabidiol (CBD) are the most well-known. THC is the main psychoactive compound. It’s the one that makes people feel high.  CBD is derived from hemp plants and does not cause a high or lead to addiction. When it comes to your hair, THC is the troublemaker. According to the study, the THC in marijuana can attach to receptors in your body, including your hair follicles, which causes hair loss. Not much research has been conducted since to qualify or negate the study.  

We believe that the study is accurate because marijuana and other drugs can be detected in hair samples for up to 90 days prior to the test. (10)  It makes sense that if the THC attaches to the follicles and sticks around for a while, it could cause damage.  

Treatment is Available to Reverse Hair Loss Caused By Smoking

Treatment is available if you’re experiencing hair loss from cigarettes, vapes, or marijuana. The first step is to stop smoking to prevent further damage. The next step is to consult with a dermatologist who is also a hair specialist.  Although many hair loss remedies are available over the counter, the most effective ones are only available by prescription. A variety of medications can be prescribed to stimulate regrowth including:

Minoxidil

As mentioned previously, smoking can cause androgenic alopecia in people who are predisposed. When people get male or female pattern hair loss, their hair follicles shrink. Minoxidil enlarges miniaturized hair follicles to allow stronger, healthier hair to go to the surface of your scalp.  

Finasteride 

People who smoke and have male or female pattern baldness produce a chemical called Dihydrotestosterone (DHT) that is converted from Testosterone. DHT attacks the hair follicles and causes the hair to fall out. Finasteride is a DHT blocker that prevents testosterone from converting to DHT.  

Spironolactone

Sprionolactone is a DHT blocker.  The medication works similarly to Finasteride but is a bit stronger.  

Retinoids

Retinoids are often used in conjunction with Minoxidil and Finasteride to increase absorption of medications that treat androgenic alopecia.

In many cases, combinations of these medications are most effective in promoting hair growth among former smokers.  For example, Minoxidil combined with Finasteride and Retinol for absorption has been proven more effective than Minoxidil alone.  

Quitting is the Best Way to Preserve Your Hair

If you’re really worried about losing your hair, the best route is to quit smoking. Kicking the habit isn’t always easy, but it’s worth it. You’ll look better and your health will improve. 

According to the American Cancer Society, the best strategy is to quit one day at a time. A day turns into a week, a week turns into a month, the months turn into years, and before you know it, you’ll have broken the habit. Sure, it sounds simple, but we realistically know it’s not.  Here are some other helpful tips:  

  • Stay busy and spend time in public places where smoking is prohibited
  • Replace the feeling of holding a cigarette or joint with a paper clip, marble, or coin
  • Chew gum or eat lollipops as a substitute
  • Avoid places, activities, and people that you associate with smoking
  • Exercise
  • Create a support system of family members and friends who you can call when you have a craving

Many good resources and programs are available to help you as well. Here are three that we recommend. All of these organizations provide trusted information and support.

American Cancer Society 

If you’re considering quitting, you don’t have to do it alone. During The Great American Smokeout annual event, thousands of people commit to a smoking cessation program on the third Thursday in November.

American Lung Association

The American Lung Association offers a Lung Helpline & Tobacco Quitline staffed by licensed registered nurses, respiratory therapists, and certified tobacco treatment specialists. The staff is a wealth of knowledge and can help connect you with a support group, find a doctor, and even answer questions about health insurance.

National Cancer Institute

Smokefree.gov, sponsored by the National Cancer Institute, offers free tech programs to help you go smokefree. One innovative program is a texting service that gives encouragement, advice, and tips to help you quit. The organization also offers apps that allow you to tag locations and time of day you need support, as well as social media support.

If you are a current or former smoker and your hair is thinning or balding as a result, Happy Head is here to help. Contact us so we can review your history and customize a prescription-grade hair loss solution for you.

Resources:

(01) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2928221/

(02) https://onlinelibrary.wiley.com/doi/10.1111/jocd.13727

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7667670/

(04) https://www.karger.com/Article/Abstract/68894

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3673399/

(06) https://pubmed.ncbi.nlm.nih.gov/7484781/

(07) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2758082/

(08) https://www.usnews.com/news/best-states/articles/where-is-marijuana-legal-a-guide-to-marijuana-legalization

(09) https://faseb.onlinelibrary.wiley.com/doi/epdf/10.1096/fj.06-7689com

(10) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5396143/

Why Self-diagnosing Your Hair Loss is a Bad Idea

“When did you graduate from medical school?” my husband asks me on a regular basis.  I didn’t, but I am a self-proclaimed expert in the medical field anyway.  Why wouldn’t my Google education make me highly qualified to diagnose the whole family’s symptoms and illnesses?  Evidently, I’m not the only one self-diagnosing.  A survey conducted in March 2020  indicated that nearly one-third of all Americans do their own medical research. (01)

Being your own doctor can work against you though.  In fact, when I first started losing my hair, I didn’t even think to have it checked.  Based on what I read, postpartum hair loss is normal, and I had two babies in two years.  I would never in a million years have guessed that I had alopecia.  However, knowing what I know now, I do not recommend waiting to consult with a medical professional if you’re noticing an unusual amount of hair loss.  Treating hair loss early helps you prevent further shedding and even regrow your hair.  Here are seven more reasons why you should schedule an appointment with a board-certified dermatologist and hair specialist if you’re concerned about the amount of hair you’re losing. 

Reason #1:  Dermatologists are familiar with hair loss patterns associated with specific hair loss conditions.  

Your dermatologist has spent countless hours studying and memorizing the different types of hair loss.  Many times, just looking at patients’ hair loss patterns gives your dermatologist clues as to where to start with a work-up to get a diagnosis.  Common hair loss conditions and associated patterns are:

  • Androgenic alopecia (men) – Receding hairline and gradual thinning on top
  • Androgenic alopecia (women) – Widening of the part 
  • Alopecia areata – Patchy or circular bald spots on the head, eyebrows, or beard
  • Telogen effluvium – Overall thinning due to sudden hair loss
  • Fungal infection – Scaly patches that spread over the scalp
  • Alopecia totalis – Full-body hair loss

If your dermatologist suspects that you have androgenic alopecia, known as male or female pattern baldness, he or she may use the Norwood scale, a scale of 1 to 7, to track the progression of your hair loss.  The scale helps your dermatologist recommend the best possible treatment options to prevent further hair loss and stimulate growth based on the amount of recession or thinning you have.  

Reason #2:  Your doctor can determine the severity of your hair loss

Losing a certain amount of hair is normal and is part of the hair growth cycle.  How do you know if the amount you’re seeing in the sink or shower is too much?  You don’t.  However, once your dermatologist has an idea of your hair loss pattern, he or she has a number of tools and tests he or she can use to determine the extent of your hair loss.  The most common are:

Pull Test

A pull test is pretty much as the name indicates.  During the test, your doctor will gently tug on small sections of hair from parts of your scalp.  Usually, the litmus test is six or more strands.  If you lose that much, your hair loss is active.  

Scalp Biopsy

A scalp biopsy, also known as a punch biopsy, is often used to determine what type of alopecia you have. It allows pathologists to see inflammation and can distinguish whether the alopecia is scarring or non-scarring.  To take the biopsy, your dermatologist numbs the area and uses a pencil-sized device to remove a small amount of tissue that is sent to a lab for analysis. The incision is closed with a couple of small stitches.   

Trichometric Analysis

If your dermatologist wants to analyze your scalp and hair, he or she may do a trichometric analysis using a small handheld device with a high-definition camera.  The device magnifies images by up to 100 times so your hair, hair follicles, and scalp can be seen in great detail.  The tool shows how much hair is covering your scalp, and the diameter of each hair strand.  Dermatologists often use this camera to monitor progress after you begin treatment.  

Fungal Culture

If your dermatologist suspects that your hair loss is due to a fungus in your hair or scalp, he or she may run this test.  Fungal cultures determine if a condition called tinea capitis, scalp ringworm, is causing your hair loss.  During the test, a small sample of skin or hair is sent to a lab for incubation.   

Reason #3:  Your vitamin levels may need to be checked

Often one of the first questions dermatologists often ask new patients is whether they have recently had a routine blood test.  The reason why is because simple vitamin deficiencies can cause hair loss.  Fortunately, if this is the case, supplements will usually solve the problem quickly and easily.  The two most common vitamin deficiencies that cause hair loss are vitamin D and iron.  

Studies have shown that vitamin D has anti-inflammatory properties and affects the hair cycle. (02)  When your body has a vitamin D deficiency, regulation of the hair follicles is challenging.  Growth and shedding cycles are disrupted causing your hair to suddenly fall out.

Iron deficiency stunts the production of hemoglobin which transports oxygen to the cells in your body, including the cells that make your hair grow.  The hair follicles lack the nutrients they need to thrive.  With an iron deficiency, hair sheds and thins, giving the appearance similar to androgenic alopecia.

 

Reason #4:  Your hormones may be out of whack

 

Your dermatologist may also run blood tests to check for hormonal imbalances.  Hormone imbalances can cause hair to get dry, brittle, thin, or fall out altogether.  The only way to know if this is the case is to have your levels checked.  

Contrary to popular belief, high or low testosterone is not an indicator of hair loss.  Research has continually demonstrated that there is not a link between serum androgen levels and androgenic alopecia. (03)  Instead, male pattern baldness could be linked to an androgen sensitivity or high androgen density. 

Factors that can affect your hormone levels include:   

Menopause

Estrogen levels fall before, during, and after menopause while testosterone levels inversely increase.  During the process, the testosterone converts to dihydrotestosterone (DHT) which attacks your hair follicles, and makes your hair fall out.  

Stress

Stress is a bigger contributor to hair loss than most people realize.  When you are stressed out, your body creates cortisol which disrupts the function and regulation of your hair follicles as well as your hair growth cycle.  

Pregnancy

During pregnancy, estrogen levels rise, causing your hair to get fuller and thicker. After the baby is born, however, those levels drop rapidly, making the excess hair shed.  It can take a while for your estrogen levels and hair loss to balance out.  

Thyroid

Both hypothyroidism and hyperthyroidism have been linked to alopecia.  In a 2013 study, patients aged 21-40 with thyroid disfunction were likely to have diffuse alopecia and alopecia areata.  Patients older than 40 were more likely to have alopecia areata and androgenic alopecia. (04)  The findings confirm the importance of checking thyroid levels when there is a hair loss issue.  

Reason #5:  You could have a scalp infection 

A number of scalp infections can cause hair loss.  These infections can easily be confused with various types of alopecia, but once treated, hair typically regrows.  Examples include:

Ringworm

Ringworm is a fungal infection that forms scaly, raised, red patches.  Itching is a common complaint among patients with scalp ringworm and is typically treated with anti-fungal medications.  

Scalp Psoriasis

Psoriasis is an autoimmune condition that causes thick red patches, and sometimes scaling.  There isn’t a cure, but proper management can help prevent hair loss.

Seborrheic Dermatitis

Seborrheic dermatitis causes dandruff in adults, characterized by dry, flaky skin, and typically does not cause hair loss.  Shampoos and topical medications are often recommended. 

Lichen Planus

Lichen planus causes inflammation and can leave tiny red bumps on your scalp.  The cause is not known for certain, although autoimmune dysfunction is one of the possible causes.  Topical creams are often used to treat symptoms, but in many cases, lichen planus will disappear without treatment.  

Your dermatologist has been trained to address and treat all of these infections.

Reason #6:  Sometimes you need an outside perspective

When your dermatologist takes your medical history, he or she may be able to identify bad habits that are affecting your hair and contributing to your hair loss.  Some of these habits may include:

  • Smoking
  • Poor diet filled with processed foods
  • Stress
  • Tight buns, ponytails, braids, or other hairstyles that can pull on your hair and cause traction alopecia
  • Compulsively pulling on your hair (trichotillomania)

Reason #7:  The most effective medications are only available by prescription

Hair loss products are similar to skincare products in that very few over-the-counter (OTC) products are truly effective.  If you have a graveyard of barely or partially used tubes and containers under your bathroom sink, you get the picture.  The reality is that besides Minoxidil which is sold OTC as Rogaine in a 5 percent formula, you’re wasting your money on OTC hair loss products.  You’ll need a doctor to write a prescription.  Some of the most effective and widely used prescription hair loss medications that your doctor may prescribe are:

Minoxidil

Designed to enlarge the hair follicles and prevent miniaturization.  Used to treat a broad spectrum of hair loss conditions.  

  • Sold OTC in foam and liquid formulas
  • Available by prescription in higher dose pills and topical formulas

Finasteride

Prevents testosterone from converting to DHT, which attacks the hair follicles and causes hair loss.  Often used to treat male and female pattern hair loss.  

  • Available only by prescription
  • Reported sexual side effects such as lower libido by some users
  • Used by both men and women, but not recommended for women of childbearing age
  • Topical formula is proven to be equally as effective as the pill without the undesirable side effects since it is not systemic.  

Retinol

A derivative of Vitamin A that improves the absorption of Minoxidil, Finasteride, and other medications that stimulate hair growth.

  • Typically not used as a stand-alone hair loss solution
  • Low OTC doses not as potent as prescription doses

Spironolactone

A DHT blocker used to treat female pattern hair loss.

  • Available only by prescription
  • Safe for women who have not been through menopause

When to see a doctor

In a 2015 study conducted by the National Library of Medicine, nearly one-third of people surveyed reported avoiding the doctor, even those with major health problems. (05)  The result was later detection, reduced survival rates, and more suffering than necessary.  You won’t die if your hair falls out, but why lose your hair if you don’t have to?  If you are experiencing hair loss, be sure to seek medical treatment from a licensed dermatologist.   Early medical intervention not only prevents further hair loss but in many cases, can help you regrow your hair.  

If you have hair loss concerns and if accessibility and/or affordability is an issue, visit us at happyhead.com.  You will have the opportunity to consult with one of our board-certified dermatologists and hair specialists.  No insurance or co-pay is required.  You only pay for the product if deemed necessary and appropriate.

Resources:

(01) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084283/#:~:text=Surveys%20suggest%20that%20a%20large,self%2Ddiagnose%20using%20online%20information.

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

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7432488/

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746235/

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4351276/#:~:text=People%20often%20avoid%20seeking%20medical,survey%20reported%20avoiding%20the%20doctor.&text=Even%20individuals%20with%20major%20health,12%20avoid%20seeking%20medical%20care.

Marrin Costello Radio Podcast, Featuring Dr. Ben Behnam Intentional Conversations with Impactful People

Marrin Costello, an American businesswoman, designer, and brand architect, recently invited Dr. Ben Benham to participate in her weekly Apple podcast.  While Costello was studying at UCLA, American Idol featured her jewelry collection.  Costello’s collections have since been featured in Vogue, Huffington Post, In Style, and US Weekly, and she has become a recognized lifestyle influencer, style icon, and tastemaker.  As an entrepreneur, Costello uses her podcast as a platform to share the stories behind the scenes of successful businesses.  During the segment, Dr. Behnam, board-certified dermatologist and co-founder of Happy Head topical hair loss solutions, shared why Happy Head was founded, the company’s philosophies, and the secrets behind the start-up.  In case you missed the podcast, here are some highlights. 

 

Getting to Know Dr. Ben Behnam, Chief Medical Officer of Dermatology & Hair Restoration Specialists and Happy Head Hair Loss Formula Co-Founder

 

Costello:  I’m so excited to have Dr. Ben on the show. Dr. Ben and Dr. Sean Behnam are dedicated hair loss and hair restoration specialists and are the founders of happyhead.com.  Dr. Sean Behnam is a renowned board-certified hair transplant surgeon, and his practice specializes in hair loss, while Dr. Ben Behnam is a board-certified dermatologist who specializes in medical hair loss management and medicine. Doctors Ben and Sean Benham are dedicated researchers, innovators, and mentors who have spent their professional lives focused on hair. Most importantly, they are artists. A great hair transplant requires detailed artistry. They spend the time designing a hairline that suits you. Their goals and philosophies revolve around providing the most artistic results and the highest quality care. Today we have half of the dynamic duo. Dr. Ben, thank you so much for coming to the show.  

 

Costello:  I just found out that you and Doctor Sean are not only brothers; you are twins.  How did you guys know that you both wanted to go into medicine?

 

Dr. Ben:  Well, we actually didn’t, believe it or not, but we figured that out mid-college, around the sophomore year. We ended up at different medical schools, which was kind of good and bad. When we grew up, twins weren’t separated, so we were always in the same school and classes. Going to different medical schools was a little bit daunting. But cell phones became available in early 2000, so we were always on the phone together and went to different residencies. Afterwards, Sean focused on hair, and I focused on dermatology.  There’s quite a bit of overlap, so we decided to open our clinic together and named it Dermatology and Hair Restoration. Our practice has evolved over the last ten years, and we have been focusing more on hair. It’s really fun being in the same office. The best part is that I always have someone to count on when I have a question. When we have tough cases, we can discuss them, which is great because we’re bouncing ideas off of each other.  Bringing our different educational backgrounds and experiences together really benefits our patients.  They get two doctors rather than one.  

 

Focusing on Innovation

 

Costello:  What was your first experience in the workforce?  How did you go from studying medicine to opening up your practice?

 

Dr. Ben:  I worked with a good friend in Long Beach for about two years, and then Dr. Sean and I decided to establish our practice in Santa Monica.  We slowly got busier and busier.  We started doing procedures that were different than everyone else.  

 

We were one of the first groups to start doing Follicular Unit Extraction (FUE) hair transplants.  During FUE, individual hair follicles are moved to areas where your hair is thin or missing to give a natural look.  Traditionally hair transplants were done as a strip where you get a long scar. In 2008 and 2009, no one was doing the new advanced technique. We were one of the first groups to do it.  In fact, when we first started, we could only get 100 hairs a day because the technology wasn’t advanced. That built a little buzz around us just because no one else knew how or was doing it.  Over the years, we’ve been trying to advance our techniques.  Our goal is to be the best of what we do.  We are currently working on getting 3000 hairs in one day, which is unheard of in the US.  We always try to think outside of the box. 

 

Other things we are known for include: 

Platelet Rich Plasma (PRP) 

Developed and use a technique that is more effective than traditional PRP treatments.  Recently purchased equipment from France that allows us to do more PRP.

 

Stem cell transplants 

We’re now one of the leaders in stem cell transplants in the country.

 

Hyperbaric oxygen chamber

We recently purchased a hyperbaric oxygen (HBO) chamber.  HBO therapy is used after hair transplants to reduce postsurgical follicle shedding, folliculitis, and itching.    

 

Hair transplants

People from around the world fly in for hair restoration procedures.

 

Dr. Ben:  Dedication, hard work, and staying focused led us to Happy Head.  In 2017, we had a hair loss product in our office that worked very well compared to all the non-prescription hair serums on the market. We were testing it in our office between 2017 and 2019 and intended to launch Happy Head, but we were too busy to do it. As my wife says, it required the power of the pandemic to launch the website. The day the pandemic happened, we already had everything lined-up, ready to go. While we were shut down and at home, we launched the Happy website.  It took about six months to really get things up and running and expand nationwide. When we started selling Happy Head, we gave people access to a product we had in our clinic that people otherwise would not be able to get. Patients can go online, have a consultation, get a prescription, and have the product delivered within two to three days.  It’s difficult to touch a lot of people’s lives when you only have one clinic, yet with the power of telemedicine and Zoom, we were able to expand our reach and help boost a lot of people’s confidence.  Many patients have contacted me to let me know that we changed their lives.  

 

Developing Happy Head’s Formula 

 

Costello:  You mentioned that the Happy Head formula was already complete before the pandemic hit.  How long did it take you to create the formula?

 

Dr. Ben:  Happy Head’s formula is a prescription that has always been used in dermatology. Traditionally, people take oral Propecia for hair loss.  At that time, nobody had commercially marketed a topical Propecia, also known as Finasteride.  If you look at the literature, the first article published was back in 1996. No one bothered to look at the study, but some doctors were using a similar form of medication in their practice.  Everyone had it, but nobody wanted to commercialize it and make it available nationwide. So we took a similar formula, read a lot of studies, and over about a two-year period, made the product more stable, less irritating, and a better formula by removing some ingredients and adding some others to it.  It took us about two years of trial and error. 

 

Understanding Happy Head’s Customers

 

Costello:  Where do most of your sales come from?

 

Dr. Ben:  We’re purely an online business. When people see results, we get a lot of word-of-mouth advertising.  Many people with hair loss start by trying vitamins and over-the-counter serums that do not work. They then realize that they should try prescription medication. When we began Happy Head, only oral prescriptions were available, and many people were scared of oral hair loss medications. We were the only topical option in the market for a long time.  When people started Googling us, we were the only ones that showed up in the U.S.  

 

Giving Patients Access to Affordable Hair Loss Treatments

 

Costello:  If someone doesn’t have the financial means to visit your practice to work with you individually, would Happy Head be a good place for them to start?

 

​​Dr. Ben:  I think Happy Head is great place to start.  Happy Head was launched to make prescription hair loss medications accessible and reduce costs.   When you see a doctor in the office, you have to pay for the office visit and for the medication.  With Happy Head, patients only pay for the product.  We pay the doctor independently every time the doctor sees the patient.  We streamline the process to make it accessible and affordable.  

 

Juggling a Busy Dermatology Practice and the Happy Head Start-up at the Same Time

 

Costello:  You launched Happy Head during the pandemic, and then things started opening up again. It sounds like you were seeing patients, and then you weren’t. You were able to focus on the website. What happens now that the world is open and now that you’re managing both?

 

Dr. Ben:  During the pandemic, calls for hair transplants and hair loss skyrocketed.  When we returned to the office, we were still very busy with our practice.  I give my wife a lot of credit for Happy Head’s launch.  She was responsible for the branding and creative.  She put all of the pieces together.  Once we had the website up and running, I would wake up at 4:00 a.m. to work on Happy Head.  Our manufacturers and vendors are on the East Coast, and we had team members in the Philippines.   I worked from 4 to 9 a.m. each morning, then went to the clinic to see my patients until five.  After work, I would go home, be with my son, go to bed by 9 p.m., and start again at 4:00 a.m the next day.  I did that for about almost a year to a year and a half.  After that, the company was in a good place, and we could hand it off to our CEO, who now runs the company.  We have grown exponentially since he has come on board.  I’m currently the Chief Medical Officer responsible for making sure that our patients are doing well and expanding our product line.  I’ve learned that companies like this do not grow because of one person.  You need a group of people with a variety of talents.  

 

Overcoming Challenges 

 

Costello:  What are some of the challenges that you and your brother have overcome in your practice?

 

Dr. Ben:  We opened during the last recession which was in 2008. Starting a business during a recession is always tough because no one wants to lend money to you, and no one trusts you, especially at the beginning.  We had quite a bit of a challenge growing because we’re a very small group. It took us many years to get larger.  

 

We have a group of 1520 employees.  We are fortunate to have the best people, but running the group is still challenging. Many doctors sell out and give up their packages to get proper equity because they don’t want to deal with the day-to-day challenges. Another challenge in the past two years has been costs. Our cost of everything has gone up dramatically.  Gloves that used to cost $4 a box are now $20 a box.  The cost of stem cells has gone up 25 percent.  

 

Planning for the Future

 

Costello:  What does the future look like for your practice and for Happy Head?

 

Dr. Ben:  We direct a certain percentage of our gross income to technology every year. The investment allows us to experiment with new apps and software.  It makes the process easy for patients when they can make an appointment, get text reminders, check out, and pay their bills online.  We also believe that you always have to spend money on research. Research is the key to success in any business. 

 

What makes Happy Head unique is that it’s customizable.   Every other company in the world offers a one-size-fits-all solution.  Nobody wants to offer customization because it’s so difficult.  We took the hard approach, and I think it’s paying off.   We’ll change ingredients for customers and ship out a new bottle within 48 hours. No other company will do that. The future of hair loss, I believe, is topical compared to oral solutions.  However, the topical product will be genetically based. In the next five years, we will have improved genetic data.  We will be able to customize the formula based on your genetic composition. 

 

Access the Full Podcast

 

This recap is an excerpt of Dr. Behnam’s lively discussion with Marrin Costello.  To hear the full version, tune in to Marrin Costello Radio Podcast Featuring Dr. Ben Behnam, Intentional Conversations with Impactul People.  

 

For more information on Dr. Ben’s practice or to find out if Happy Head topical hair loss solution is right for you, visit us at happyhead.com for a free consultation.  

 

Your Summer Hair Care Guide

Trying to keep your hair healthy this summer? Make sure to keep it clean, add nourishing hair care, and eat well to avoid hair loss and stress that comes with it.

Dealing with summer hair can be tough. Trying to get my frizzy strands under control when the humidity is at its peak is an exercise in futility, but there is always the not-so-sleek ponytail to fall back on. Now that I have alopecia, summer brings on a whole new set of hair dilemmas. Will chlorine make my hair fall out? Are UV light treatments good for hair loss? Is the sun okay to be out in? Will a hat protect my hair or harm it? Is summer shedding really a thing? So I asked a few Happy Head team members to get answers to a few summer hair care questions. There are so many old wives’ tales out there that it can be challenging to separate fact from fiction. Read on to learn how to care for your hair during summer with this hair care guide and get answers to some commonly asked questions.

Fact #1: Everyone Loses Some Hair Daily

The first thing you need to know is that no matter what time of the year it is, seeing strands of your hair in the sink shouldn’t be a cause for alarm. People typically lose anywhere between 50 to 100 strands of hair per day. (01) There’s a difference between normal hair shedding and excessive hair loss, though. If you start to notice your hair gradually thinning, bald spots developing, or hair loss on your body, something else may be happening. It’s a good time to talk with Happy Head dermatologist if you are noticing some change in your hair shedding over time. We offer free consultations with a board-certified dermatologists and prescriptions for custom hair growth medicine all online.

Fact #2: Hair Loss Peaks During the Summer

If you think you’re seeing more hair in the sink now then you saw a few months ago, it’s certainly possible. It’s proven that people  lose more hair during the summer than any other time of the year. (02) When 823 women were tracked over a six-year period, researchers found that a maximum proportion of hair was in the telogen stage during summer. Telogen rates were the lowest during winter months. (03) The reason why still has yet to be determined.

One hypothesis is that people naturally keep their hair in the winter in response to cold weather. Like animals who grow a winter coat and shed it in summer, people may keep their hair to stay warm during the colder months. When the weather warms, the body reacts by shedding excess hair.

Figuring out whether the amount of hair you’re losing is typical can be challenging, especially during the summer. Ponytails, chlorine, salt water, and the sun can all contribute to damage and breakage, which you might think is hair loss. If you’re concerned, it’s always a good idea to consult with a board-certified dermatologist or hair specialist, especially if you notice thinning or bald patches.

Fact #3: Chlorine Does Not Cause Hair Loss

Although chlorine can damage your hair, it will not cause hair loss. In a study published by the Journal of Dermatology in 2000, researchers compared the hair of 67 professional swimmers to that of 54 non-swimmers. The study did not find evidence that the swimmers had more hair loss than the non-swimmers. The swimmers, however, did have hair discoloration and cuticle damage due to the chlorine. (04)

If you swim a lot in general or mostly on vacation, there are things you can do to prevent chlorine from damaging your hair. Here are some tips that will help:

  • Condition your hair before swimming (leave-in conditioner works)
  • Wear a swim cap
  • Shampoo your hair thoroughly after getting out of the pool
  • Replace lost moisture with a deep conditioner

Fact #4: Wearing a Hat Will Not Make You Bald

Hats that fit properly, and aren’t too tight, do not make your hair fall out. The reality is that it’s sweltering outside, and we’re seeing extreme temperatures all over the world. If you’re heading out to the pool or the beach, wear a hat to protect your hair and scalp. UVA (Ultraviolet A) and UVB (Ultraviolet B) rays damage your hair’s cuticles causing thinning, frizziness, discoloration, and dryness with prolonged exposure to the sun.

A hat is critical if you’re already using oral or topical medications such as Minoxodil, Finasteride (05), or Spironolactone. Medications can cause sun sensitivity in some people, resulting in sunburn or a rash. In some cases, UV light can cause a structural change to medications. As a result, some people produce antibodies that make them photosensitive. In other cases, the medication absorbs the UV light and releases the evolved drug into the skin. (06)

Fact #5: Hydrating Your Hair is the Best Way to Fight Humidity and the Elements

Hydration is your best bet if you’re worried about your hair being dry, brittle, dull, or frizzy. Here are some tricks that will help:

  • Use a sulfate-free hydrating shampoo
  • Deep condition regularly
  • Try heatless hair styling
  • Hydrate from the inside out by drinking plenty of water
  • Test out hydrating hair misting solutions made from natural ingredients

Fact #6: It’s Easy to Get Traction Alopecia During the Summer

Beware of pulling your hair back into tight buns and ponytails when your hair is wet. The pulling on your hair follicles can cause traction alopecia, which can be reversed early on but not after the hair follicles have been damaged. If you want to wear braids, keep them loose. Frequently changing up your hairstyle will also help prevent a particular hair loss pattern from forming.

Fact #7: Eating a Protein-rich Diet Will Help Your Hair Stay Healthy & Shiny Year-Round

Protein is the primary building block that makes up your hair. If you’re concerned about your hair staying healthy during the summer months, be sure to load up on healthy and lean proteins like avocados, nuts, grass-fed chicken, salmon, tuna, and seafood. Although the richest source of protein comes from animals, there are also plenty of plant-based protein sources for vegetarians. Egg whites, beans, and authentic Greek yogurt are all good sources. Protein supplements have also been proven effective in supporting healthy hair growth and are easy to pack for your vacation. (07) Although many people use whey protein isolate, whey protein concentrate is a better option, especially for people predisposed to androgenic alopecia.

Still Have Questions About Your Summer Hair Loss?

If you’re losing more hair than normal over the summer, it’s possible that you’re experiencing summer hair shedding or have telogen effluvium that resolves itself. However, if it turns out that you have a form of alopecia such as androgenic alopecia, the sooner you are treated, the faster you can stop the hair loss and start the regrowth process. Topical and oral hair regrowth options range from easy-to-apply over-the-counter topicals such as Minoxidil and Finasteride to oral medications such Spironolactone. Keep in mind that many hair loss medications are only available by prescription. If you have further questions, contact us for a complimentary consultation with a board-certified dermatologist and hair specialist.

 

Resources:
(01) https://www.aad.org/public/diseases/hair-loss/insider/shedding

(02) https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjd.16075

(03) https://pubmed.ncbi.nlm.nih.gov/19407435/

(04) https://pubmed.ncbi.nlm.nih.gov/11092265/

(05) https://onlinelibrary.wiley.com/doi/full/10.1002/jgf2.510

(06) https://www.webmd.com/skin-problems-and-treatments/sun-sensitizing-drugs

(07) https://onlinelibrary.wiley.com/doi/abs/10.1111/jocd.12400

When Will Your Hair Grow Back? Your Topical Hair Loss Treatment Timeline.

Do Finasteride and Minoxidil really work?  How long does it take to see results?  When patients call and ask about topical hair loss solutions, these are the first questions they usually ask.  After all, nobody wants to waste their time or money on products that aren’t effective.  However, wouldn’t it be nice if you had a crystal ball and knew ahead of time what your hair was going to look like after treatment?  Unfortunately, we can’t predict the future, but we can give you a realistic idea of what to expect.

How Do Finasteride, Minoxidil, and Other Topical Hair Loss Treatments Make Your Hair Grow?

Topical hair loss treatments work best on men and women with androgenic alopecia, also known as male and female pattern hair loss.  The ingredients in Finasteride, Minoxidil, Retin A, and other topical treatments differ and contribute to your hair’s growth in different ways.  Here’s a simple primer to help you understand what each of the medications does and how they work:

Finasteride (Propecia) (01)

Testosterone converts to dihydrotestosterone (DHT) and attacks your hair follicles when you have androgenic alopecia.  As a result, the hair follicles shrink, hair falls out, and hair stops growing.  Finasteride, one of the active ingredients in Happy Head, is an enzyme blocker that increases testosterone levels and prevents the testosterone from converting to DHT.

Minoxidil (Rogaine)

You may be familiar with Minoxidil which is sold over-the-counter at retail locations under the brand name Rogaine.  Whereas Rogaine is only available in two or five percent formulas, the Minoxidil in Happy Head has a higher six or eight percent concentration.

Minoxidil has a different purpose than Finasteride.  When a person has androgenic alopecia, the hair follicles begin to shrink, which is called miniaturization.  Because the follicle size is reduced or even closed off, hair cannot push through, resulting in hair loss.  Minoxidil enlarges the follicles so hair can emerge.  The medication also decreases the length of the resting phase when your hair doesn’t grow while elongating your hair’s active growth phase.

Retinoic Acid

Retinoic Acid, also known as Tretinoin or Retin A, is a derivative of Vitamin A.  Retin A boosts cell turnover and collagen production when used on your skin.  It works similarly on your hair to support growth. The medication is also known for improving the absorption of Minoxidil and other active ingredients.

What Does Combining Hair Loss Medications Do?

Research has consistently demonstrated that combining multiple hair loss medications is more effective than monotherapy. For example, clinical studies indicate that Minodxidil’s efficacy increases with Retinoic Acid. (02) Likewise, Minoxidil fortified with Finasteride is significantly stronger and more effective than over-the-counter Rogaine used by itself. (03)

Using Multiple Products Isn’t Convenient. Is There Another Option?

When you’re using multiple hair loss products, remembering what medications to take and when to take them can be a pain. Compounded Happy Head topical hair regrowth formula combines multiple proven medications into one easy-to-use formula.  The main active ingredients are Finasteride, Minoxidil, and Retinoic Acid.  Aloe, an inactive ingredient, is used as the base to prevent irritation.  Since Happy Head’s ingredients are only available by prescription, you’ll have a free consultation with a board-certified dermatologist and hair specialist before your prescription is filled.  Your doctor will help you customize the formula based on your specific needs.

How Long Does it Take to Get Results?

Now that you know what topical medications are available to treat your hair loss, you probably want to know how long they take to work.  Waiting for your hair to grow back is hard, especially if you have a bald spot that you’re trying to cover.  Immediate results would be nice, but you’re going to have to be patient.  Hair goes through a life cycle, which lasts several months.  Here are the phases of the life cycle:

1. Anagen (Growth Phase) – Your hair actively grows during the anagen phase.  During this time, your hair grows approximately half an inch per month.  Topical hair loss treatments are designed to prolong this phase.

2. Telogen  (Resting Phase) – Think of the telogen phase as a transitional phase when pigment production and cell division stop.  This phase lasts two to three weeks.

3. Catagen (Shedding Phase) – Each hair falls out of its follicle during the catagen phase.  This shedding phase typically lasts three to four months.  Topical hair loss treatments are designed to shorten this phase.

After a hair sheds, the anagen stage begins in the follicle, and new hair begins to grow. This process is different for people undergoing treatment for androgenic alopecia.  Before hair can grow, DHT production has to slow down, and the follicles need to open up.

Dr. Ben Behnam, board-certified dermatologist, hair specialist, and founder of Happy Head hair loss solutions recommends that patients consistently use products for at least six months to get the best results.  “The DHT blocker needs time to work and to prevent miniaturization,” says Behnam.   “That doesn’t happen overnight.”

Monthly Photos Help You Track Progress

Meanwhile, the best way to see progress over time is by taking monthly photos. People using topical Finasteride and Minoxidil often don’t realize that their hair grows because they see themselves every day.  Monthly photos will help.  The following photos were taken by Sean, a Happy Head customer, over six months.  You can see how his hair is gradually filling in over time.

 

 

 

 

 

How Often Do You Have to Use Finasteride and Minoxidil to Get Results?

Your dermatologist will recommend how often to use your topical prescriptions.  We typically recommend that patients apply Happy Head twice a day, in the morning and at night.  You don’t have to apply the formula precisely 12 hours apart.  The key is to be consistent with applying twice a day at the same time each day.  Regardless of which medication you are using, the more consistently you apply the product, the better the results.

If your hair feels greasy or limp after using topical hair loss solutions, consider washing your hair two to three hours after applying the product.  Your scalp will still benefit, and you can go to a meeting or a luncheon with freshly washed hair.

Does Topical Hair Loss Medication Work as Well as Oral?

Topical medications have been proven to be equally as effective in treating male and female pattern hair loss as oral medications. In a recent study conducted in February of 2022, topical spray-on Finasteride was compared to oral Finasteride. The study found that the effects of the topical formula were similar to that of the oral pill with “significantly lower systemic exposure.” (04) The topical Finasteride worked just as well with a lower likelihood of side effects.

Can I Stop Using Topical Hair Loss Treatments at Any Time?

As long as you use the treatment, you will maintain your new hair. If you stop using the treatment for a week or so, you should be fine. However, a three-month to six-month hiatus is a different story. When you stop blocking DHT and allow the hair follicles to miniaturize, you’ll lose the growth you gained.

Will Happy Head Work for You?

With so many different hair growth products on the market, it can be challenging to sift through all of the options.  There are shampoos, vitamins, supplements, treatments, the list goes on.  Trying so many different products gets expensive and frustrating.  So how do you know which medication is right for you?  The best way to know for sure is to contact us  for a complimentary consultation.  During your consultation, a board-certified dermatologist will review your history, determine whether you are a good candidate for topical hair loss medication and customize a formula if necessary.  The consultation is a no-risk way to get the information you need to make an educated decision about the best way to treat your hair loss.  Want more information?  Start a free consultation now.

Resources:

(01)  Finasteride is not recommended for women of childbearing age.  Always check with a physician before beginning any hair loss treatment.

(02) https://pubmed.ncbi.nlm.nih.gov/17449938/#:~:text=Abstract,regrowth%20than%20either%20compound%20alone

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

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

Why is Customization Essential for Hair Growth?

Life isn’t one-size-fits-all, so it’s good to have options. Each day we use items made to order just how we need them. From the food you order to the car you drive, the best choice is typically the one that suits your wants and needs. The medication you use to regrow your hair should be no different.

Hair Loss is Individual and Unpredictable

No one is immune to hair loss. The difficult truth is that anyone can lose their hair at any time in their life for a variety of reasons, both men and women. For example, androgenetic alopecia, the most common cause of hair loss, affects roughly 80 million US residents, with 50 million male and 30 million female. (01)

Although most reasons for hair loss have a hereditary component, others may experience a loss of hair because of other triggers like (01)

  • Ongoing distress or anxiety.
  • Diseases, including thyroid disease and lupus.
  • Going through severe emotional and physical stress.
  • Natural hormonal changes.
  • Major surgery, childbirth, severe infection, and experiencing the flu.
  • Cancer treatments.
  • Alopecia areata, affecting all ages.
  • Inadequate nutrients in the diet.
  • Use of birth control pills.
  • Ringworm on the scalp.
  • Prescription medications like blood thinners, arthritis medication, hormonal drugs, and cardiovascular treatments.

Hair loss occurs because of complex genetic, hormonal, chemical, and physical reactions in a person’s body. Because of its complexity, factoring in a person’s unique needs is essential to treating hair loss safely and effectively.

Why Are Hormones Important?

You already know that men and women are anatomically different. But men and women differ on the inside, too. And when it comes to hormones, men and women are definitely not the same.

Two main sex hormones, androgens and estrogens are present in both men and women. Testosterone is a type of androgen produced in both the testis and ovaries. The body then converts this testosterone to estrogen — smaller amounts in men and much larger doses in women.

It’s the ratio of these two hormones that make the distinct differences between men and women. Men typically have a testosterone to estrogen (estradiol) ratio of 3 to 1, while women cut a close-ratio of around 1 to 1 (depending on her age and her menstrual cycle). Keep in mind that estrogen is also measured differently and is much more powerful in small amounts than testosterone. Furthermore, men produce about 20 times more testosterone, but women convert 200 times more testosterone into estrogen than men. (02)

This cascade of hormones does much more than influence an individual’s sexual characteristics. These hormones impact a person’s bone density, cognitive processing, mood, digestion, muscle mass, skin, and — hair. Because hormones are so interconnected with the body’s processes, small changes in hormonal levels can significantly affect.

Hormones and Hair Loss

You may have heard that high levels of testosterone cause hair loss, but that’s not necessarily the case. Hair loss is more nuanced than simply having high testosterone levels. A person’s hormone levels can be impacted by stress, environmental pollutants, medications, illness, age, and genetics.

Male pattern baldness, for example, starts with a genetic component. However, this genetic component makes some men susceptible to DHT (a testosterone byproduct), which damages hair follicles and leads to hair loss. Men with a genetic predisposition towards hair loss will, most likely, lose their hair. (03)
Women also become more susceptible to hair loss as they age. As estrogen levels drop later in life, their hormone level ratio changes, leading to increased testosterone levels and hair loss. So, hair loss isn’t just a “guy thing.” It happens to women, also. (03)

Effective Hair Loss Treatments

Can hair loss be treated? Yes! Most definitely. But hair loss treatments should have both safety and effectiveness in mind.

  • A 2019 literature review published in the Journal of Drugs and Dermatology found that topical finasteride delivered improved haircounts and a reduction in DHT levels within the scalp. (04)
  • A recent 2022 study in the journal Advanced Dermatology and Allergology, found that topical minoxidil improved hair growth 57.33% in participants with androgenetic alopecia, the most common cause of hair loss in both men and women.  (05)
  • A 2015 study from the American Academy of Dermatology showed hair growth improvement in 74% percent of research participants when treated with spironolactone. The authors concluded that spironolactone works successfully as a treatment for females hair loss, in particular in women with high levels of androgen hormones.  (06)

Finasteride, minoxidil, and spironolactone are the most effective hair growth treatments in the industry, but they all work by impacting hair follicles and the hormones that affect their function. Because hair loss and hormones are linked so closely, it’s essential not to disrupt the body’s natural balance while providing treatment. Assessment and monitoring by a healthcare professional is vital for any safe hair loss solution.

Side-Effects of the Most Widely Available Hair Loss Treatments

Here are the most common side effects for the topical versions of the most widely used topical hair loss medications.

Side-Effects for FDA-approved Topical Finasteride (07)

  • Swelling of hands and feet
  • Increased liver enzymes
  • Contact dermatitis
  • Depression or anxiety
  • Headaches
  • Testicular tenderness
  • Scalp irritation
  • Reduced sex drive
  • Difficulty urinating
  • Dizziness or weakness

Side-Effects for FDA-approved Topical Minoxidil (08)

  • Itching or skin rash
  • Facial hair growth
  • Inflammation or pain at the hair root
  • Redness
  • Facial swelling
  • Acne (at the application site)

Spironolactone is a women-only hair loss treatment, which means that it’s recommended only for use with women. Topical spironolactone generally has fewer side effects than oral spironolactone.

The possible side effects of oral spironolactone in women include: (09)

  • Painful periods
  • Painful cramping
  • Irregular periods
  • Breast tenderness
  • Breast enlargement
  • Fatigue
  • Reduced libido
  • Headaches
  • Dizziness
  • Menstrual irregularities

The most effective hair loss treatments on the market, like minoxidil, finasteride, and spironolactone, are all dose-dependent. This means that higher doses lead to better results — and also more side effects.

Why Customization is the Best Approach to Hair Loss

When it comes to treating hair loss, a variety of factors have to be considered. A person’s age, sex, and medical history play significant roles in which type of treatment and what doses would be best for their situation. Therefore, taking these factors into consideration when deciding treatment can slow — and even stop — hair loss and also keep side effects to a minimum.

Customizing Your Order at Happy Head: Just for You

Achieving hair growth with finasteride, minoxidil, or  spironolactone with minimal side effects is managed through:

  • A topical combination of both finasteride and minoxidil, which are currently the only two FDA-approved medications for hair loss treatment.
  • A women only topical spironolactone is formulated with each woman in mind.
  • Customizing hair loss treatments according to each customer’s sex, age, health history, and needs.

Customization for hair loss treatments not only makes the treatments safer, but also makes it more likely that customers will adhere to treatment. Regrowing hair takes time, after all. If a customer experiences side effects like the loss of libido, decreased sperm count, or (in women) painful periods, they may stop the treatments before any hair growth occurs. Catering each treatment makes it more likely that customers will complete the treatment and experience satisfying results.

At Happy Head, every order is customized according to your sex, age, health history, and your individual needs. Any health information submitted is private and secured at high industry standards. We are HIPAA compliant and take your privacy seriously.

Happy Head’s customized approach involves four easy steps:

  1. Subscribe and pay for the first month on happyhead.com, then complete a health questionnaire.
  2. Upload photos of your hair and your ID/driver’s license for verification.
  3. A Board-Certified Dermatologist will review your information and follow up with you if they have any questions.
  4. A physician orders your personalized prescription, which is then freshly compounded and sent through 2-day shipping with FedEx. All products are discreetly packaged.

What makes Happy Head truly unique? It’s the only customizable hair loss solution on the market today. Contact Happy Head and regrow your hair safely and successfully.

Resources:

(01) https://www.aad.org/media/stats-numbers

(02) https://www.sciencedirect.com/topics/neuroscience/sex-hormones

(03) https://www.medicalnewstoday.com/articles/68082

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

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9131960/

(06) https://doi.org/10.1016/j.jaad.2015.06.063

(07) https://jddonline.com/articles/a-systematic-review-of-topical-finasteride-in-the-treatment-of-androgenetic-alopecia-in-men-and-wome-S1545961618P0457X/

(08) https://www.drugs.com/sfx/minoxidil-topical-side-effects.html

(09) https://www.ncbi.nlm.nih.gov/books/NBK554421/

Growing Older, Living Longer Podcast Featuring Dr. Ben Behnam

Our own Dr. Ben Behnam recently joined Dr. Gillian Lockitch on her Growing Older, Living Younger podcast.  Dr. Lockitch is a former Medical Biochemistry specialist, professor, researcher, and international speaker.  Her popular anti-aging podcast features practitioners and experts on mental and physical health, nutrition, personal care, fitness, and other areas that help people learn about how they can age youthfully.  In case you missed it, here’s a summary of the informative discussion.

Hair is an Important Aspect of Our Image

Dr. Lockitch:  Today’s quote is from actor Larry David, who said, “Anyone can be confident with a full head of hair, but a confident bald man; there’s your diamond in the rough.” That got me thinking about why our hair is such an important aspect of the image that we present to the world. Two things came to mind.

  1.  Hair is a constantly renewable resource, which means we can experiment to create the look we desire, knowing that if something doesn’t work, we can try again. We can cut our hair short. We can grow it long, color it, streak it, curl it if it’s too straight, or straighten it if it’s too curly.
  2.  First impressions of someone’s age is influenced just as much by the state and the quality of their hair as by the state of their skin. That’s probably why hair loss and thinning are frequent concerns that people express when they’re asked about aging.

We all know people who are gray or balding in their 30s, while others have a full, healthy head of hair in their 70s like me. Are we destined to follow the same hair growth and loss patterns as our parents or are there things that we can do to prevent thinning hair?

Miniaturization of the Hair Follicles Causes Balding and Thinning

Dr. Behnam:  First, you must realize that everyone is different. Hair follicles typically sprout out slowly, and hair comes through the scalp.  When we’re young, our hair grows long fairly quickly.

But, as we get older what happens is something called miniaturization, where testosterone bonds the hair follicles and prevents the hair from having that thick caliber to it. Miniaturization means that the hair caliber thickens. As the caliber of hair thickens, the hair itself shrinks and thins. The thinning is what gives the appearance of hair loss in both men and women.

Usually the hair is in a couple of different stages. About 95 percent of the hair is usually what we call the antigen phase, which is called the growing phase.  Five percent is in what’s known as the telogen phase, which is a resting phase. Hairs in the telogen phase are typically the ones that fall out.  Sometimes the ratio shifts if there is a certain type of hair loss, such as alopecia areata. Typically, that’s true for most people, though.

Genetics Play a Significant Role in How Your Hair Ages

Dr. Lockitch:  Do genetics play a role in hair growth?

Dr. Behnam:  Genetics is absolutely a component in hair growth. I have a lot of patients who say, “Well, Doc, my Mom and Dad both have great hair.  How come I’m losing my hair?”  It’s possible that both your Mom and Dad have certain hair loss genes you inherited.

Dr. Lockitch:  One of the really interesting things that we’ve learned about genes and genetics is the power of epigenetics. Are there things that we can do to change the genes that control hair growth to make them work more efficiently or restore our hair to how it was when we were younger?

Major Stressful Events can Trigger Hair Loss in Genetically Predisposed People

Dr. Behnam:  As of now, we can’t alter our genetic make-up.  However, your genetics only predispose you to hair loss. Other components and factors also play a role. Stress plays a major role in accelerating your genetic hair loss. I have patients, for example, who are in their early forties and have amazing hair. They will probably keep their hair unless something happens that triggers hair loss.  Major stressful events or traumatic events will accelerate underlying hair loss. One example is a 41 year-old guy who has great hair and all of a sudden loses his job, loses his house, and gets a divorce. Two years later, loses half of his hair. What happened? He was always genetically predisposed to losing his hair, but he never had those life stressors.

Hormones Also Contribute to Hair Loss

Dr. Behnam:  Hormonal imbalances also contribute to hair loss.   Imbalances that are typically seen in patients include:

  • Exogenous testosterone (artificially elevating your testosterone level)
  • Thyroid disorders (Hypothyroidism, Graves Disease, etc.)
  • Estrogen (Too low or too high)
  • Progesterone (Too low or too high)
  • Vitamin D deficiency
  • Iron deficiency

Although we are all genetically predisposed to hair loss, environmental factors play a big role.  In the majority of cases I see, a combination of the two typically causes hair loss.

Diet and Nutrition Affects the Quality and Structure of Your Hair

Dr. Gillian Lockitch:  Can we talk a little bit more about diet, nutrition and hair loss?  Tell me a little bit more about nutrition and the importance it plays in the quality and the structure of our hair.

Dr. Ben Behnam:  I discuss nutrition a lot with my patients.  You are what you eat.   Let’s say you want to build a house. You have all the construction workers there. They’re ready to go, but you don’t have any bricks. Can you build a house? No, you cannot. Nutrition is the same concept.  If you don’t have some of those essential amino acids or vitamins, you cannot produce hair.

When it comes to your hair, there are four pillars of nutrition:

  • Iron
  • Vitamin D
  • Collagen
  • Protein

I recommend at least 80 milligrams of iron for women. Vitamin D is also very important, so I usually recommend 2000 milligrams. That’s really critical. I’m a big fan of collagen; honestly I really don’t care where you get the collagen from. Collagen powders are key. You can also buy collagen tincture liquids. A lot of patients say that a few months after adding collagen to their diets, their hair starts to grow better.  Lastly, studies show that increasing your protein uptake helps. For example, eating more fish and chicken is great. Avocados and cashews are wonderful too.  We also find that adding more protein powder to your diet gives your hair a lustrous look.

Not all Protein Powders are Created Equal

Dr. Ben Behnam:  There are two types of whey proteins:

  1. Whey Protein Concentrate
  2. Whey Protein Isolate

Whey protein isolate is what people take for muscle building. It’s the most popular type of whey protein.  It’s actually bad for your hair. The reason why is because it increases the testosterone level in your body.  Whey protein concentrate does not increase your testosterone level, and is good for hair. So we always try to switch patients from isolate to concentrate.

Common Myths about Hair Loss Debunked

Dr. Lockitch:  What are the most common myths about hair loss?

Dr. Ben Behnam:  Myth #1:  People always say, oh, I heard that hair loss always comes from the Mom’s side, not from the Dad’s side. Well, that’s not true. Hair loss comes from both sides.

Myth #2:  People often think they can stop their hair loss medication after six months.   Unfortunately, hair loss is one of those things that once you start on a protocol or regimen, you have to do it forever. The reason is that you’re constantly at war with your testosterone.  If you’re not doing anything to prevent testosterone from causing miniaturization of your hair, guess who’s going to win?  So that’s a very common misconception.

Women Have a Different Hair Loss Pattern Than Men, But the Cause is the Same

Dr. Lockitch:  What about female hair loss?

Dr. Ben Behnam:  As with men, testosterone plays a big role in female pattern hair loss.  Women experience a different pattern of hair loss than men.  Typically men will start to lose hair in the widow’s peak and the crown area.   Women usually lose the top of their scalp between the front and the crown area.  The number one pill that women take for hair loss is Spironolactone, a testosterone blocker.

Not All Alopecia is the Same

Dr. Gillian Lockitch:  I know a couple of people who developed alopecia areata in their teens. What do we know now about alopecia?

Dr. Ben Behnam:  The word alopecia is a very generic term.  Male and female pattern hair loss is also called androgenic alopecia. Alopecia areata is a different type of alopecia.   My twin brother and I have alopecia areata. Both my first cousins have it, so it runs in my family. I got it when I was 34 years old. Alopecia areata is an autoimmune condition where the body attacks the hair follicle that prevents the hairs from growing. The treatment goal is to reduce the inflammation, which we often do by injecting steroids.

Some People Experience Alopecia Totalis, Complete Hair Loss

Dr. Lockitch:  Can alopecia areata occur as total hair loss?

Dr. Behnam:  Yes, alopecia totalis, also known as alopecia universalis, occurs in some people and is difficult to treat. Fortunately, a medication called Xeljanz is now available.  It’s an oral pill that helps patients with aloepcia totalis or universalis.   Honestly, it works. The problem is that in the United States the medication is only approved for rheumatology, not for dermatology. The majority of alopecia cases experience hair loss in patches, though.

Beware of Styling Habits that Can Cause Hair Loss

Dr. Gillian Lockitch:  I had mentioned that one of the wonderful things about hair is we can cut it, we can dye it, we can tint it, we can do all sorts of funny things. Are there any common mistakes that people make that cause their hair loss to get worse?

Dr. Ben Behnam:  I always say the less you play with your hair, the better.  It’s best to avoid:

  • Tight braids or anything that pulls on your hair
  • Heat from hair dryers
  • Hot oil treatments
  • Hair dye
  • Hair bleach
  • Brazilian blow-outs
  • Aggressive brushing

Covid Infection Can Cause Hair Loss

Dr. Lockitch:  You mentioned to me when we were off air that a lot of people ask about Covid-induced hair loss and whether it really happens.

Dr. Behnam:  We see a lot of Covid-induced hair loss in our clinic.  Like childbirth and other events that put stress on your body, Covid causes something called telogen effluvium.  If you remember what I said at the beginning of the show, when there aren’t any interruptions to your hair growth, 95 percent of your hair is in the antigen phase and only five percent is in a resting phase.  If you go through a traumatic, stressful event like hospitalization or giving birth, the ratio shifts from 95 percent of your hair in the antigen phase to 50 percent.  That’s why people can lose up to 40, 50 or 65 percent of their hair in just a few months.  It’s shocking because many of those patients had a lot of hair before.

To Preserve Your Hair, Live a Healthy Lifestyle

Dr. Lockitch:  For our audience members who are interested in living young as they grow older, what key takeaways would you tell people about their hair?

Dr. Ben Behnam:  People can deal with their hair issues by using medications or choosing a healthy lifestyle.  Adding Vitamin D and iron, using whey protein, and eating a healthy non-processed diet will not only help your hair.  It will help give your hair a much more youthful appearance.  It will also contribute to your overall health.

Dr. Lockitch:  As you contemplate your roadmap for healthy aging, be sure to discuss your intentions with your medical or other qualified health practitioner.

Getting Older, Living Younger Podcast

To hear the full podcast, tune in to Dr. Lockitch’s Growing Older, Living Younger segment.

About Dr. Ben Behnam

Dr. Ben Behanam is a board-certified dermatologist, hair specialist and co-owner of Happy Head hair loss solution.  His well-known practice, Dermatology and Hair Restoration Specialists, is located in Los Angeles, California.

Over time, Dr. Behnam realized that many men had side effects from the most common hair loss medication known as Finasteride. In 2020, he launched an online telemedicine company called Happy Head that allows easy access to patients across the country to a new formulation of topical Finasteride, which has potentially lower side effects than the oral version. Through this platform, he has helped numerous men and women retain and grow their hair.
For more information about Dr. Behanm or your hair loss options, visit us at Happy Head.