6. A Guide to Preventing Hair Loss

There are several factors that contribute to hair loss, ranging from genetics to lifestyle choices, affecting both men and women. The most common type of hair loss is known as male pattern baldness (androgenetic alopecia), starting with a receding hairline and thinning at the crown of the head. This is believed to be related to one’s sensitivity to DHT.

For individuals who lost their hair at a young age, there isn’t much one can do, although alternatives like hair transplants exist and work relatively well. Naturally, our focus will be directed toward factors within our control.

If you are losing hope, look at the pictures below and take some inspiration from Matthew McConaughey. Most problems are solvable, with the limiting factor being our ability to become aware of such solutions or to afford them in the first place. He claimed that his success was the result of a ‘topical ointment’ applied daily for the past 20 years and that he never received a hair transplant.

When starting a hair loss protocol, this is often accompanied by a shedding phase, so do not be disheartened. Moreover, it would be wise to take pictures of your hair prior to starting, with your hair pulled back and including the crown area on your head.

You can then use those pictures as a reference point to gauge the effectiveness of the treatment and to understand if you are a good responder or not. Remember that gaining back lost ground is much more challenging than preventing hair loss, therefore, one should try and be as proactive as possible.

Minoxidil

Minoxidil, also known as Rogaine was initially used to treat hypertension, however, anecdotal reports were put forward by patients claiming they were growing hair across their body. While Minoxidil does not stop hair loss, it stimulates the growth of new hair follicles.

“Minoxidil slows hair loss by increasing blood flow to hair, extending the Anagen phase” - Andrew Huberman

This could be purchased in liquid form and applied using a dropper or through the use of foam, with the latter being a little less harsh on the scalp. This could involve the use of 0.5ml applied in the morning and at night. Avoid applying minoxidil in the morning if you intend to spend the day outside in the sun.

One can find several anecdotal reports and studies showing its efficacy. Naturally, people will respond differently to this topical application. However, this is not without side effects which include but are not limited to i) heart palpitations and chest pain ii) an increase in prolactin iii) hair growth in other parts of the body, etc…

These side effects are not that common, however, everyone’s body reacts differently thus, it is important to be mindful of them. It is recommended to do a blood test to check your prolactin levels before and after use.

Consumption of minoxidil orally i.e. tablet form is not recommended and is associated with a higher likelihood of the aforementioned side effects to arise. To increase the absorption of topical applications, one should ensure that a clean scalp is maintained. This can be achieved by exfoliating the scalp to prevent sebum or dandruff that may be present.

While Minoxidil seems to have higher efficacy compared to other alternatives, several people report that they start losing their gains once they stop applying it. Therefore, one must weigh the cost and potential side effects of prolonged use in exchange for delaying one’s hair from falling off.

Minoxidil for beard growth

In the event that you have a patchy beard and would like this to be filled in, minoxidil is a very good option. One of the main benefits of using minoxidil for beard growth is that unlike with hair, the gains achieved are much more likely to remain, even after use is stopped. Typically, one would need to keep applying this solution topically for at least around a year.

As a general rule, whether applying Minxodil for hair or beard growth, if no improvement is noticed after one year of consistent application, then it is likely you are a non-responder. In this case, one should consider seizing this treatment, as the risks begin exceeding the potential benefits.

Below I have included an extract from The New York Times where children were accidently prescribed minoxidil and developed ‘Werewolf Syndrome’… This gives you an idea of how well Minxodil can work.

Microneedling

One way to increase the effectiveness of minoxidil is to make use of a microneedling device that is to be applied over the scalp. It takes advantage of the skin’s self-repair process, triggering new collagen synthesis without causing new scar tissue formation. By contributing to low-level inflammation, this causes cells to be reactive again stimulating more hair growth.

In one study, a 1.5mm depth roller was used 1x per week for around 10/15 minutes in parallel with minoxidil. This group ended up achieving over 4x the results when compared to the minoxidil-only group! Based on these synergetic effects it would be wise to utilise a microneedling device should one pursue minoxidil application.

This was highlighted by Derek from More Plates More Dates (“MPMD”), whereby the pairing of minoxidil and micro-needling derived significant improvements. Feel free to check out his microneedling device, which handles the depth automatically at the speed you determine based on the settings.

It is important to note that one should wait 24 hours before applying minoxidil topically following microneedling. If not you will be more likely to experience the side effects described above, since the microneedling will allow a significantly higher amount of minoxidil to be absorbed into your bloodstream.

Shampoo

“The use of ketoconazole shampoo, when applied 2-4 times per week with a scalp contact time of 3-5 minutes generates an 80% response rate of maintaining hair that would otherwise be lost, increasing both hair number and diameter” - Andrew Huberman

Ketoconazole shampoo is an antifungal that prevents fungus resulting in a mild reduction in DHT. Ideally, one should find a concentration of at least 1% ketoconazole. In Malta, doctors typically prescribe Nizoral to prevent dandruff. This is probably one of the cheapest shampoos that you can buy from any pharmacy that contains Ketoconazole. The issue is that it dries your hair out.

As a result, I found Regenepure’s DR shampoo formula to be ideal in comparison, containing other useful ingredients such as caffeine, niacin, zinc oxide, and aloe. I also like to add a few drops of rosemary essential oil to it. This shampoo can be applied once every two days as a general rule, rubbing in thoroughly into the scalp, especially if one has long hair.

The inclusion of topical caffeine is likely to derive several benefits, by stimulating IGF One (known for increasing hair growth) while also entering the follicle and crowding out the androgen, with the latter found to be clinically significant.

Homemade Application

One paper found that rosemary essential oil was as effective as 2% minoxidil when applied topically to the scalp. Peppermint oil was also shown to stimulate hair growth due to vasodilation of the blood vessels, which can improve blood flow to hair follicles.

Make sure to NOT apply rosemary or peppermint oil directly to the scalp, rather mix this with a carrier agent such as coconut or castor oil. You can do this yourself at home, applying around twice per week, by placing the following ingredients in a small bottle.

• Rosemary essential oil → c. 10 drops
• Peppermint essential oil → c. 10 drops
• Castor oil → x2 tablespoons
• Coconut oil → x4 tablespoons (melt in the microwave during winter)

Shower filter

Tappwater Malta offers the independently lab-certified Tapp ShowerPro filter that utilises KDF-55, calcium sulfite, mineral beads (crystal quartz), and a limescale inhibitor. The best part is that if you go to their website, they provide lots of data. Alongside benefits to one’s hair, this shower filter is useful for dry skin, reducing eczema and dandruff.

Use the following link for €20 off your first purchase. Simply create an account using this LINK —> https://heroes.tappwater.mt/modernalchemy for a €20 voucher.

Consider that Malta is known for having ‘hard water’, with this post doing a good job explaining the topic given the lack of info available locally. Hard water is associated with dry, brittle, and frizzy hair. Malta also has the highest rates of ammonia and second highest rates of nitrates within the EU as a result of the use of fertilisers, negatively impacting humans’ thyroid, respiratory and reproductive systems.

This shower filter offers a relatively cheap solution, that only needs to be changed every 6 months depending on use. Chlorine often found in the water supply contributes to the thinning of the hair. The shower filter also removes most of the harmful iron and pesticides found in the water supply as highlighted in the table below.

Finasteride

This can be regarded as the elephant in the room. Does it work at reducing hair loss? For the most part, yes. But the risk profile is one that should put most people off and subsequently be avoided. While people report side effects for everything, in part driven by the nocebo effect (this will be covered in another newsletter), in this case, their prevalence is concerning.

Even if used for a short period of time, a number of people reported what is commonly referred to as Post Finasteride Syndrome. As a common rule of thumb, if someone felt the need to come up with a term for such a condition… and then it caught on… then there is typically truth to the matter.

What does post-finasteride syndrome encompass? Erectile dysfunction, low libido, depression, infertility… Basically, everything you wouldn’t want as a man. In certain cases, these side effects persist after cessation. Consider that this doesn’t impact most people to this extent, but even a remote possibility of such type of symptoms is very off-putting. Especially when the alternative is simply shaving your head and owning it, or going on a lads’ holiday to the land of the Turks.

These symptoms are mainly driven by finasteride due to the way in which it inhibits DHT conversion to stop miniaturisation, regrowing the hair follicles that have not fully closed up yet, resulting in chronically low DHT.

Michael Eisenberg from Stanford School of Medicine has published over 300 peer-reviewed articles on male sexual function. He emphasized that this is a real phenomenon, rather than fear-mongering circulating on Reddit. He notes that although the sexual health of most individuals rebounds within 3 to 6 months after stopping, a subset of individuals appear more susceptible, experiencing symptoms that may persist indefinitely.

Lifestyle factors that can be addressed

Hair loss can also be tied to living a relatively unhealthy lifestyle. Optimising your nutrition, going out in the sun, and exercising frequently are likely to indirectly positively impact your hair.

In the event that one is deficient in a particular micronutrient, this is likely to manifest itself in a variety of potential ailments, hair loss included. Micronutrient deficiencies typically associated with hair loss include Vitamin D, Biotin, Iron, Zinc, Vitamin B12, Folate, etc…

Consider that women who experience heavy periods are likely to be deficient in iron i.e. anemic. This is best addressed by eating foods high in iron such as red meat, rather than through supplementation. In the event that one is not deficient in the above vitamins, supplementation is unlikely to aid in hair loss.

Furthermore, hair loss is exacerbated through periods of intense stress, as seen in the picture of Barack Obama below. Other factors such as a lack of sleep, smoking, drinking, drug abuse, processed foods, inadequate sunlight, blue light toxicity, etc… all accelerate hair loss due to the heightened levels of inflammation they cause.

Other noticeable mentions

Below one can find some areas that you could carry out additional research on should you be interested:

• He Shou Wu (also referred to as ‘Fo-Ti’). One must be mindful of quality and sourcing as improper preparation can cause liver damage. It is often used as a kidney tonic, aligning with Chinese traditional medicine, whereby hair loss and premature greying of the hair are treated by targeting the kidneys.
• Saw Palmetto
• The pairing of minoxidil with tretinoin
• Red light exposure
• Topical cetirizine
• Topical peptides such as GHK-cu and Zn-Thymulin

Conclusion

What we know for certain is that it is much easier to prevent hair loss than it is to regrow hair i.e. recover lost ground. For this reason, should you have a family history of hair loss or begin noticing a reduction in hair quality, then it would be wise to adopt a proactive approach.

Given that this tends to be a sensitive topic for some, I wanted to share some insights that may be of value. Depending on one’s risk appetite, these methods range from simple lifestyle changes to medical treatments. In the end, it is about making an informed decision that aligns with your health and well-being.

DISCLAIMER

This is not medical, financial, or legal advice. Please consult a relevant professional prior to commencing anything outlined above, these are simply my own personal opinions.