Tag Archive for: hair loss

Is Propecia (aka Finasteride) the Right Medication for You?

After months of stressing out about how much hair you’ve lost, you finally pay a visit to your dermatologist.  You talk to your doctor, have an examination, and finally get the news you’ve been dreading.  You have androgenetic alopecia, another name for male or female pattern baldness.  You were trying to process the diagnosis and heard the dermatologist mention the medication Propecia, but couldn’t fully concentrate on what he or she was saying.  You were too focused on the fact that you are losing your hair.  Now that you’ve calmed down, you have decisions to make. Should you try taking Propecia or not?  Will it work?  Is there a less expensive generic version?  Does it have any side effects?  If these or other questions are swirling around in your head, you’re in the right place.  We’re here to give you all of the information you need to help you decide whether Propecia is right for you. 

Why is Propecia Prescribed?

Propecia, the brand name for the generic medication Finasteride, is FDA-approved to treat male pattern baldness. Although the medication is not FDA-approved to treat women, it is often prescribed off-label for female pattern baldness.  Both Propecia and Finasteride work the same.  The difference between the two medications is the price.  Since Propecia is a brand name, it is more expensive due to associated marketing costs.

Is Propecia a New Hair Loss Medication?

Propecia has been available to treat hair loss for over 25 years.  The medication was first used in 5-milligram doses in 1992 by urologists to treat enlarged prostates among men aged 50 and older.  During trials, it was discovered that a side effect was hair growth.  In 1997, one milligram of Propecia was formally approved for hair loss in men who are 18 and up.

How Does Propecia Treat Androgenetic Alopecia?

Propecia inhibits type II and type III 5-alpha-reductase isoenzymes.  In simple terms, that means it prevents testosterone from converting into an androgen called dihydrotestosterone (DHT).  Blocking DHT is important because excess DHT shrinks your hair follicles and interrupts your hair’s growth cycle.  When your hair follicles shrink, hair becomes thinner and weaker.  Hair falls out easily and doesn’t grow back.  

How is Propecia Dosed to Treat Male or Female Pattern Hair Loss?

As mentioned previously, Propecia was originally marketed to treat benign prostatic hyperplasia at 5 milligrams.  The dosage typically prescribed to treat male pattern hair loss is significantly less.  Your doctor will determine the right dose for you; however, one milligram is the most common prescription for men.  Women usually need a higher dosage than men.  Doses prescribed for women can range anywhere from 1.25 to five milligrams.  

Does Propecia Effectively Treat Hair Loss?

If you’re wondering whether or not you should give Propecia a try, the data is favorable.  Propecia is effective in preventing further hair loss and growing new hair.  Research has demonstrated that Propecia reduces serum DHT by 70 percent. (01)  With the medication, testosterone cannot convert to DHT, which can damage the hair follicles. Furthermore, one study indicates that 48 percent of users achieved growth after one year.  After two years, that number increased to 66 percent.  The study also shows that Propecia halts hair loss.  After two years, 83 percent of users in the study had no further hair loss. (02)  It’s important to know that results are only seen while using Propecia.  If you stop using the medication, new growth will likely fall out and your hair will look like it did before taking it.  Further hair loss can also occur.

Can You Combine Propecia With Other Hair Loss Medications?

Dermatologists often find that combining Propecia with Minoxidil gives better results than using Propecia alone.  The two medications serve different purposes.  Propecia blocks the DHT from converting, while Minoxidil sends oxygen to the hair follicles, helping them open so healthy new hair can break through.  You may also hear about retinol.  When using topical Propecia, retinol has been proven to improve absorption of the medication, giving better results.  

How Long Does it Take Propecia to Work?

It’s normal to be anxious to see results after starting a hair loss medication.  When you take Propecia, you may see hints of new growth around the three or four-month mark.  However, it typically takes six months to notice significant improvement.  It generally takes a year to see full results.  

Does Propecia Have Any Side Effects?

Many men are apprehensive about taking Propecia because they have heard it can cause undesirable sexual side effects.  Some report erectile dysfunction, decreased libido, and ejaculation disorders.  The side effects are rare, only affecting approximately one percent of men who take oral Propecia. If side effects are a concern, topical Propecia is an alternative that has been proven equally as effective without the same risk of side effects.  Topical solutions work specifically at the site of the hair follicles without risking systemic exposure. (03)

Can Women Take Propecia?

Although Propecia is not FDA approved for women, many dermatologists prescribe the medication off-label for their patients with female pattern baldness.  Both oral and topical Propecia has been proven effective for treating women. (04)  Topical Propecia is absorbed into the skin of the scalp without systemic effects.  Oral Propecia can be prescribed for women who are post menapausal, but isn’t recommended for women of childbearing age unless oral contraceptives are also being taken.  

Are There Alternatives to Propecia to Treat Androgenetic Alopecia?

Other hair loss treatments exist, but keep in mind that prescription medications are most effective.  Minoxidil is often used in conjunction with Propecia for both men and women.  Propecia is effective for most, but in cases where stronger medications are needed, Dutasteride can be prescribed to men or women.  Dutasteride works similarly to Propecia; however, it blocks an additional enzyme.  Spironolactone can be prescribed to women but isn’t recommended for men because it can cause breast enlargement.  Combination topical treatments are often a good choice because they conveniently combine multiple medications into one formula.  

Propecia is a well-tested medication proven to help people with androgenetic alopecia.  The medicine helps stop further hair loss and stimulates new growth in many patients with male and female pattern baldness.  If you have additional questions about Propecia, let us know.  Our board-certified dermatologists are available to review your case and recommend dosages, formulas, and other medications that work well with Propecia.

 

Resources:

(01) https://www.ncbi.nlm.nih.gov/books/NBK513329/#:~:text=2%5D%5B3%5D-,Finasteride%20is%20an%20FDA%2Dapproved%20pharmacologic%20agent%20for%20treating%20benign,a%20dose%20of%205%20mg.

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

(03) https://onlinelibrary.wiley.com/doi/full/10.1111/jdv.17738

(04) https://pubmed.ncbi.nlm.nih.gov/29464847/

 

REJUVENAGING® with Dr. Ron Kaiser Podcast Featuring Dr. Ben Behnam

 

Dr. Ben Behnam was recently invited to participate in the inspirational podcast Rejuvenaging, hosted by Dr. Ron Kaiser.  Dr. Kaiser is a psychologist, keynote and TEDx speaker, and author of the triple award-winning book Rejuvenating the Art and Science of Getting Older with Enthusiasm.  He likes to think of his podcast as a mental gym, a place for information about wellness, positive psychology, and, what he likes to call, goal-achieving psychology.  During the podcast, Dr. Ben and Dr. Kaiser discussed healthy ways to cope with hair loss, from both a physical and psychological perspective.  If you didn’t get a chance to tune in, here are some highlights that you won’t want to miss.  

The First Step in Coping with Hair Loss is Realizing that You’re Not Alone

Whether you’re male or female, if you’re in life’s second half-century, there’s a pretty good chance that you’re experiencing some type of hair loss.  According to American Hair Loss Association, 85 percent of men and 50 percent of women lose a significant amount of hair by the age of 50.  So when you look at the numbers, you’ll find that most people are experiencing some sort of hair loss by age 50. 

Dr. Ben defines hair loss in two ways:  thinning and balding.  When someone’s hair is thinning, you can see their scalp through the remaining hair.  When people are balding, hair is completely missing, and you can see their heads.  

Female Hair Loss No Longer Carries a Stigma

A couple of years ago, no one talked much about female hair loss. It was taboo. But now, over 50 percent of Dr. Ben’s patients are women with hair loss issues. Hair loss is becoming much more accepted in society.  When women talk about their hair loss, it’s good because putting the conversation out there benefits both men and women.  

It’s Important to Identify the Underlying Reason for Your Hair Loss

There are different reasons why people lose their hair.  Three common reasons include nutritional deficiencies, anxiety, and genetics.  Treating hair loss means understanding the cause.  

Common nutritional deficiencies Dr. Ben often finds in his patients are low Vitamin D, iron, and biotin.  Those vitamins are necessary for hair growth.  Vegetarians who don’t get enough protein in their diets also tend to experience issues with hair loss.  When Dr. Ben finds that patients are lacking vitamins or protein, he supplements their diets with additional proteins and collagen. He also adds Vitamin D and iron.  

Many times, Dr. Ben’s patients have already seen another doctor and are on medication for hair loss, but their hair still isn’t growing.  By the time they go to him, he doesn’t need to add another medication.  He’s just helping with lifestyle changes, so the medication works better.  Without the proper foundation, hair loss medication can’t work.  What you eat affects how you look.    

Hair Loss and Mental Health are Closely Intertwined

Anxiety can lead to hair loss in a few different ways.   One, when people are anxious, they are more likely to pull on their hair.  Physical manipulation will lead to more hair loss. Unfortunately, patients can also experience a lot of different stressful situations that can lead to hair loss.   One example is an 18-year-old patient with alopecia who did not go on birth control and could not use condoms for religious reasons.  She got pregnant and had to make difficult choices.  She hid her pregnancy from her parents and experienced great stress from the ordeal.  In situations like this, where stress is a hair loss trigger, Dr. Ben offers support by giving referrals to a therapist.  

Diagnosing Hair Loss Requires a Specialist

When someone experiences alopecia, Dr. Ben uses a holistic approach to treatment.  He looks at mental status, home life, stress levels, metabolic, and other health issues.  He believes that he should look at everything when he’s making a diagnosis and developing a treatment plan.  

Seventy to 80 percent of men are relatively easy to diagnose.  They don’t have nutritional deficiencies, mental issues, or any factors that would cause alopecia. They have clear-cut cases of male pattern hair loss.  But then there’s that 20 percent that doesn’t fall into that category.  Women are also a bit more challenging to diagnose.  Every case is different, and he believes that you have to evaluate each case individually.

People with Androgenetic Alopecia Can Regrow Their Hair

Depending upon the cause of your hair loss, treatment is available to help regrow your hair. People who experience male and female pattern hair loss tend to get good results with available medications.  Medications used include Finasteride, which is Propecia, a prostate medication that’s used to block testosterone.  Dr. Ben has seen excellent results with patients who use Finasteride.  Rogaine, which is a topical product sold over the counter, is also called Minoxidil.  Minoxidil is an oral medication used to control high blood pressure.  Since Minoxidil dilates the blood vessels, more oxygen reaches the scalp and causes hair growth.  

Finasteride, Minoxidil, and other hair loss treatments take about 6 months to start seeing results.

You Don’t Have to Experience Side Effects Associated with Oral Hair Loss Medications

One of the side effects of Propecia is erectile dysfunction.  So, a couple of years ago, Dr. Ben and Dr. Sean developed a Finasteride alternative.  It’s a topical Finasteride, meaning that you’re not ingesting it.  Clinical studies have proven that topical Finasteride has a lower risk of sexual side effects, yet it is still effective.  The dermatologists were quite excited about the discovery, so they developed Happy Head, their own formula of topical Finasteride combined with prescription-grade Minoxidil.  They tested Happy Head with patients and found that patients who experienced sexual side effects with oral Finasteride did not have the same side effects with the topical.  The product was researched for two years before being launched nationwide.  

It’s Time to Get Rid of the One Size Fits All Mentality When it Comes to Hair Loss

Dr. Ben and Dr. Sean set out to change the hair loss field.  After two years of launching Happy Head, it’s still the only company in the U.S. with a customizable prescription hair loss solution that’s available nationwide.  Most products on the market are mass-produced.  With Happy Head, however, patients can change the concentrations of ingredients, remove ingredients, and replace ingredients.  For example, the change can easily be made if you need .25 percent Finasteride rather than one percent.  A month later, if the .25 percent isn’t strong enough, the dose can be increased.  Traditional corporate thinking is to produce in large volumes to reduce cost.  With Happy Head, the needs of individuals are unique, so the product is customized to meet those individual needs. 

Fast, Easy Access to Prescription Hair Loss Treatments is Available

Happy Head is a telemedicine website with licensed doctors and pharmacies in every state.  It works by going on the Happy Head website to submit photos and complete a medical questionnaire.  The process takes about five minutes.  Within 24 hours, a doctor reviews the information you provided and writes a prescription.  You receive a bottle in three days.  There isn’t a charge for the consultation.  If the doctor who reviews your case determines that you’re not a candidate, your money is refunded.  

If you’re over 50 and experiencing hair loss, you’re not alone.  Eating well, managing stress, and living as healthy of a lifestyle as possible all contribute to the quality of your hair.  If you are experiencing male or female pattern hair loss (androgenetic alopecia), medications are available to help regrow your hair.  Simply visit happyhead.com and complete a brief survey.  A licensed dermatologist will review your case and determine whether you are a candidate for prescription hair loss medication.

5 Facts All Men Should Know About Hair Loss

A few weeks ago, my husband pointed out a Facebook meme that made us laugh.  It showed two photos of hair and body care products.  One photo included products that women use in the shower, and another photo showed the products that men use.   The women’s photo was loaded with products, including body wash, face wash, two different types of shampoos, and a couple of different types of conditioner.  The men’s photo only had one product, a lone all-in-one bottle of body wash, shampoo, conditioner, shaving cream, and toothpaste.  Not only was it funny, but it also depicted the scene in our shower pretty accurately. 

The truth is, though, although some men don’t give their hair a lot of thought, I don’t know of any who are thrilled about the idea of going bald.  It’s a super sensitive topic.  As nonchalant as my husband is about his hair, even a hint that his hairline is receding results in a very alarmed “What?” and a close scalp examination in the mirror that night.   

Hair loss in men is common, but that doesn’t mean you’re okay with it.  Nor does that mean that you have to accept your fate.  So, if you’re a guy with some recession, thinning, or balding, this one’s for you.  We’re here to fill you in on what you need to know about losing your hair and what you can do about it.  

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

According to the American Hair Loss Association, by age 50, 85 percent of all men will have significantly thinning hair. (01)  Yes, you read that correctly.  The majority of men will deal with some type of hair loss in their lifetime.  

Men lose their hair for a lot of different reasons.  Balding or thinning hair can be due to autoimmune conditions, Covid, or even stress.  The most common reason, though, is genetics. The vast majority of men with thinning or balding hair have androgenetic alopecia, male pattern baldness.  Yup, that’s right.  Your parents or grandparents may have passed along a baldness gene.  

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

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

2) Timing is Everything When it Comes to Hair Loss Treatments

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

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

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

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

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

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

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

Minoxidil 

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

Finasteride

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

Dutasteride

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

Cortisone

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

Retinol

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

Compounded Topical Formulas

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

Alternative Hair Loss Treatments for Men

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

Protein Rich Plasma

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

Laser Light Treatment

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

Hair Transplant Surgery

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

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

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

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

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

 

Resources:

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

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

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

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

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

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

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

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

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

 

The Real Story Behind Vitamins that Prevent Hair Loss

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

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

Get Diagnosed Before You Buy Vitamins to Treat Your Hair Loss

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

  • Telogen Effluvium

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

  • Androgenetic Alopecia

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

  • Alopecia Areata

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

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

Vitamins are Helpful When People with Alopecia Have Deficiencies

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

Vitamin D

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

Iron

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

Biotin

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

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

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

Prescription Medications Are Often Used With Vitamins to Get Better Results

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

Minoxidil (FDA Approved)

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

Finasteride, Proscar, Propecia (FDA Approved)

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

Dutasteride, Avodart (Not FDA Approved)

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

Spironolactone (Not FDA Approved)

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

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

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

Some Supplements Have Shown Moderate Improvement in Hair Loss

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

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

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

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

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

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

Resources:

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

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

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

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

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

 

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

What You Need to Know about Smoking and Hair Loss

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

Retinids 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/

 

The Surprising Connection Between Covid and Hair Loss

You’re in the shower, look down, and notice the drain is filled with hair.  Is that mine, or is it my partner’s?  Did the kids use my shower?  Where is all of that hair coming from?  Then, you notice something even worse.  The hair on the side of your head is so thin that it looks like you’re going bald.  What in the world is happening?  

As if dealing with constant fatigue, brain fog, and other Covid long-term effects isn’t enough, if you had Covid-19, you might be experiencing Covid related hair-loss.  Hair loss due to Covid can begin two to three months after having the virus and typically lasts about six months.  Although the CDC doesn’t talk about hair loss as an adverse effect, observational research conducted by leading dermatologists and hair specialists indicates that post-Covid hair loss is real. (01) Both men and women are affected.  

Covid-induced Hair Loss Can Be Significant

While thankful to be alive and regaining their health, many Covid long haulers are left trying to figure out why they’re shedding and how to stop it.  Dr. Ben Behnam, board-certified dermatologist, and owner of Dermatology and Hair Restoration located in Los Angeles, California, has seen many patients with Covid-induced hair loss in his office.  “I had a female patient in my office a few months ago who was 21 and lost 50 to 60 percent of her hair,” said Behnam.  “It was devastating for her.”  Some who have recovered from Covid report losses of as much as 70-80 percent of their hair. (02)

Covid’s Shocking Effects on Your Hair

According to the American Academy of Dermatology, the actual Covid virus doesn’t make your hair fall out.  The culprit is the fever that’s associated with the virus. (03)  A high fever can shock your system causing a condition called Telogen Effluvium.  Childbirth, major surgery, crash diets, and some medications also cause the condition.

Telogen Effluvium, the most common cause of diffuse hair loss, occurs when hair prematurely goes into a resting (telogen) phase.  Your hair sheds faster than normal when this happens, resulting in thinning hair or bald spots.  

Anything that puts stress on your body can cause Telogen Effluvium.  The condition is common after a significant health-related event.    

Losing your hair can be depressing, no matter what the reason.  There’s good news though.  Telogen Effluvium is temporary.  Typically, patients will find that their hair sheds for about six to nine months, then it stops.  While the wait may seem like forever, your hair will grow back.

How to Cope with Covid-induced Telogen Effluvium

It’s not unusual to feel powerless when you don’t have control over your hair loss and don’t feel like yourself. If you are experiencing Covid-related Telogen Effluvium, here are four tips to help you get your mojo back as you wait for your hair to grow:

1. Visit your dermatologist 

If you’re wondering whether you have Telogen Effluvium from Covid or another hair condition, a visit to your dermatologist will give you peace of mind.  Patients who get Telogen Effluvium as a result of Covid don’t typically experience itching, redness, scaling, or other side effects like patients who have other forms of alopecia (04) such as alopecia areata and lichen planopilaris.  If you have any of these symptoms, your dermatologist can give you a firm diagnosis to help you get on the right track and continue to recover.

2.  Try your best to relax

Getting Covid is scary.  Recovering from Covid is tough.  Losing your hair is upsetting and stressful.  You have been through a lot.  Although it’s not easy, do whatever you can to decompress, whether that’s yoga, meditation, listening to the Calm app, or even taking a brisk walk.  

Stress relief is crucial because stress triggers hair loss.  “When your scalp muscles tense, you constrict your blood vessels so that the blood doesn’t flow to your scalp,” said Benham.  So if you’re experiencing Telogen Effluvium from Covid and anxiety simultaneously, hair growth is going to be inhibited even more with both conditions.

3.  Eat for Nutritional Value

The cleaner you eat, the better, shinier… just more gorgeous hair you will have,” Benham explains.  In addition to minimizing processed foods, he recommends increasing the amount of protein in your diet since your hair is made up of protein.  Cashews, nuts, avocado, and organic, grass-fed chicken are all good choices.  He also recommends pure whey protein concentrate.  

You should always ensure that your vitamin levels are where they should be, but doing so is especially important after recovering from Covid.  Iron and vitamin D deficiencies are common contributors to hair loss.  

4.  Experiment with new hairstyles and make-up

Members of Facebook’s Covid-19 Long Hauler Group report feeling more confident after a make-over.  Some have shaved their heads, but others are sporting cute bobs and pixie cuts.  Perhaps it’s time to do some experimenting.  You may even fall in love with your new look.

If you had Covid and are currently experiencing hair loss, don’t despair.  Many Covid long haulers report that their hair grew back thicker and healthier than before (05).  Growth will be gradual, so don’t expect miracles right away.  You may not even realize that your hair is starting to grow.  Meanwhile, stay calm, make sure that you’re living the healthiest lifestyle you can, and do whatever it takes to make yourself feel confident.  Better hair days are right around the corner. 

Resources:

(01) https://pubmed.ncbi.nlm.nih.gov/34467470/

(02)  Facebook:  Covid-19 The Long Haulers Support Group – https://www.facebook.com/groups/373920943948661/

(03) https://www.aad.org/public/diseases/hair-loss/causes/covid-19

(04) https://consultqd.clevelandclinic.org/covid-19-related-hair-loss/

(05) Facebook:  Covid-19 The Long Haulers Support Group – https://www.facebook.com/groups/373920943948661/

 

Do you find Hair on Your Pillow or in the Drain?

It starts with a few hairs on your pillow. Then, while you’re in the shower, you notice a few more hairs than usual flowing into the drain. Once these incidents occur more often, you start to ask yourself the difficult question, “Am I going bald?” 

It’s a tough question to come to terms with, but one that many people eventually find themselves wondering. 

You may be going bald. Or you might not. Whatever the case, it’s better to face the question and find the answer now than to wait it out. Because if you are going bald, you need immediate attention to slow— or stop— the process. 

Four Signs of Hair Loss

About 25% of men have experienced hair loss by the age of 21. By age 50, about 50% of all the men have had some level of hair loss. Women are not immune to losing their hair, either, with about 40% of women experiencing hair loss within their lifetime. So, when it comes to going bald, you’re not alone. (01, 02)

Hair loss happens to many people and there are steps you can take to address the issue. But before you seek out treatments for possible balding, however, you should evaluate whether or not you’re losing hair. 

Here are four signs that may be going bald.

1. Gradual Loss of Hair

Sometimes, hair loss occurs suddenly. In rare instances, a physical or emotional trigger can loosen hair and cause large chunks of hair to fall out. Called telogen effluvium, this type of hair loss develops when scalp hair follicles lose their hair due to a shock (stress, illness, medication, or environmental factor). Hair follicles are most susceptible to this type of hair loss while in a resting state called telogen. 

Although the condition can still cause feelings of panic about losing hair, most instances of telogen effluvium are temporary. Gradual hair loss, however, is something to be concerned about as it can be a sign of going bald. According to the Mayo Clinic, hereditary hair loss is the most common cause of baldness, and it happens slowly over time. Unlike telogen effluvium, hereditary hair loss is permanent.  (03)

2. Developing a Receding Hairline

One of the most common types of hereditary hair loss is male pattern baldness, and the hallmark sign of male pattern baldness is a receding hairline. (04) Because a receding hairline occurs incrementally, it’s a sign that’s easy to ignore or overlook. The following are the most common signs of a receding hairline: 

  • You notice your forehead looks larger than usual. 
  • Your hairline begins to make an “M” shape. 
  • The temple area of your hairline appears thinner than before. 

A receding hairline can happen due to headwear. Tight-fitting headwear like baseball caps and headbands may encourage loss of hair at the hairline by restricting blood flow and through repeated motions (taking the hat on and off). In some cases, men with male pattern baldness may attribute a receding hairline to their hats rather than a hair condition. So, if you notice your hairline is receding, you may be experiencing hair loss. 

3. The Appearance of Random Bald Spots

Have you noticed bald spots or sparse areas that weren’t there before? Patchy, thinning hair and random bald spots may indicate the start of male pattern baldness or a condition called alopecia areata (03). With alopecia areata, an autoimmune disorder, hair falls out in round patchy areas or a band-like pattern around the head. Alopecia areata may also affect facial hair – creating small bald patches in the beard area or eyebrows. 

Another condition that begins with bald spots is hereditary baldness. Although hereditary baldness usually starts with a receding hairline, the condition can also begin with an expanding crown. Furthermore, women who experience female pattern baldness typically see different signs than men with male pattern baldness. (05)

A few of these signs are:

  • Thinning at the crown or hairline. 
  • Widening of the center part in a Christmas-tree pattern. 
  • Front hairline typically remains unaltered. 

Compared with male pattern baldness, hair loss associated with female pattern baldness doesn’t usually progress to full hair loss. Women typically keep most of their hair. Despite this, any hair loss can still be very distressing for women and may require treatment. 

4. Your Hair Isn’t Growing

According to the Academy of Dermatology, hair at the top of your head grows at an average rate of about six inches every year. This means that you can expect about a half-inch of growth every month. 

Your grows in three stages: (06)

  • Anagen Phase: Active growth lasting about 2 to 8 years. 
  • Catagen Phase: Hair halts its growth, lasting about 4 to 6 weeks. 
  • Telogen Phase: Resting phase, then hair falls out of the follicle, lasts about 2 to 3 months. 

Only about 5-10 percent of your hair is in the telogen phase at any given time. In contrast, most of your hair is in its growth phase. Your hair’s rate of growth depends on your age, health, genetics, and environmental factors. 

If your hair is thinning and you notice your hair’s growth is slowing, however, it may be because you have less hair than before. As you lose hair, you have less hair in the growth phase. The reduction in hair may make it appear as though your hair is growing more slowly. 

How Likely are You to Go Bald?

People who are experiencing hair loss often want to know when and if they’ll go bald. Unfortunately, there’s no way to predict exactly if and when you will lose all your hair. Genetics plays a significant role in determining how much hair you’ll lose over time. Other factors, like stress, nutrition, and your health also affect whether or not you might lose your hair. 

There’s no way to predict when you’ll go bald. You can, however, look at your family history. Genes are the primary factor that causes female and male pattern baldness. Also, women are much less likely to lose all of their hair when compared to men. 

While researchers still have much to learn when it comes to hereditary baldness, its cause is thought to be polygenic – involving two or more genes. A few genes for male pattern baldness are thought to exist in the “X” chromosome (07), the chromosome inherited through a male’s mother. A 2017 literature review, however, also found 63 genes for male pattern baldness that exists in the “Y” chromosome inherited from a father (08). 

These studies indicate that  interplay between genes may be what leads to inherited hair loss. If you’re wondering if you’ll go bald, look at your family. 

What You Should Do if You Think You’re Going Bald

There’s no timeline for how long it takes to lose all your hair. But if you really are going bald, it won’t happen overnight. Losing all your hair is a gradual process that  takes years or decades. In spite of this, you should intervene as soon as you suspect you’re losing your hair. Why? Because the sooner you start managing your hair loss the better the results will be. 
Think you’re going bald? Taking steps as quickly as possible to protect your hair and scalp can lead to improved hair retention. Whether managing hair loss means changing your lifestyle habits or taking a prescription-grade treatment for hair loss like Happy Head, quick intervention means keeping more of your hair.

Resources:

(01) https://health.clevelandclinic.org/why-do-men-go-bald-and-is-there-anything-you-can-really-do-about-it/

(02) https://www.medicalnewstoday.com/articles/292492

(03) https://www.mayoclinic.org/diseases-conditions/hair-loss/symptoms-causes/syc-20372926

(04) https://medlineplus.gov/ency/article/001177.htm

(05) https://www.mountsinai.org/health-library/diseases-conditions/female-pattern-baldness

(06) https://www.aad.org/public/kids/hair/how-hair-grows

(07) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5308812/(08) https://pubmed.ncbi.nlm.nih.gov/28272467/

 

Hair Therapy Podcast Featuring Hair Loss Specialist Dr. Ben Behnam

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

It’s No Longer Taboo to Talk About Hair Loss

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

Women are Seeking Hair Loss Treatment Too

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

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

Losing Your Hair Can be Devastating

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

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

Early Hair Loss Treatment Can Lead to a Better Outcome

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

Hair Loss in Men and Women Happens for Many Different Reasons

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

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

Other hair loss triggers include:

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

Stress Wreaks Havoc on Your Hair

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

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

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

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

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

Minoxidil is an Effective Hair Growth Treatment

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

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

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

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

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

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

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

There are Ways to Reduce Irritation from Topical Treatment

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

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

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

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

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

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

Clinical Studies Tell Us that Finasteride Promotes Hair Growth

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

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

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

Topical Hair Growth Treatments Like Happy Head Do Work

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

Focus on Being the Best Version of Yourself

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

About Dr. Ben Behnam

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

About Happy Head Prescription Grade Hair Loss Solutions

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

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