Hair originates in the dermis, the skin layer just below the surface layer
Baldness (alopecia), or severe hair loss, is much more common in men than in women.
result from genetic factors, aging, local skin conditions, and diseases that affect the
body generally (systemic diseases). Some medications, such as those used to treat cancer,
also cause hair loss. Perhaps a poor diet with lots of junk food over a period
of years and decades is involved, but scientists still don't
have a good understanding regarding the relationship of food, diet and hair
loss. A broad range of lifestyle factors, including stress (such as from
divorce, marriage, childbirth, and surgery), smoking, heavy drinking,
and sun exposure of the head (wearing hats while in the sun could be of
help), may also foil the follicles. High testosterone levels are
associated with hair loss.
Medical hair loss treatment
Most types of hair loss have no cure at the present time. A person with male-pattern or female-pattern baldness may undergo hair transplantation, in which hair follicles are removed from one part of the body and transplanted. Medications are another option.
This medication works well to promote hair growth. Finsateride is available as the product name Propecia 1 mg, or as Proscar 5 mg (used for enlarged prostate). It is cheaper to buy Proscar 5 mg and bite off about a fifth every other day or every third day instead of buying Propecia since Proscar is only slightly more expensive than Propecia but it has 5 times as much finasteride (see list of side effects). It was originally approved in 1992 for the treatment of benign prostatic hypertrophy. Its approval was expanded in 1997 to include the treatment of androgenetic alopecia in men at a dose of 1 mg/day. Finasteride inhibits 5alpha-reductase, thereby prohibiting the conversion of testosterone to dihydrotestosterone (DHT), a hormone that in high amounts accelerates hair loss in some men. Reduction in DHT results in a significant improvement in hair growth and density. The most common side effects are reduced libido, decreased ejaculate volume and gynaecomastia (enlargement of breast tissue). For those who feel they need to rely on finasteride for hair regrowth or to prevent further hair loss, but wish to minimize the side effects, 0.5 or 1 mg pill every three or four days rather than daily.
Can a person take Passion Rx if they are taking Propecia
for hair loss? I find Propecia reduces sensation and makes me lose
interest in sex.
Yes, we have found that Passion Rx often reverses the sexual side effects from Propecia and you may take it if your doctor approves. Avodart is also known to reduce libido and sexual drive.
This medication was originally used to lower blood pressure. It used topically as minoxidil 2% for women and minoxidil 5% for men. It may promote hair growth in a small percentage of people.
Prostaglandin D2 blockers?
Future drugs that inhibit the action of prostaglandin D2 should delay male pattern baldness.
Natural hair loss remedy?
The role of diet in hair loss is not well understood, but it is possible that a diet with lots of junk food could promote inflammation and be harmful, whereas a very healthy diet, over many years, may reduce hair loss. I'm not sure whether eating soy products, lots of vegetables, fish or taking fish oils pills can be of benefit, but they certainly have other health promoting effects. Fish oils thin the blood and improve circulation. I'm not aware of a hair loss vitamin that would be useful since most Americans are not severely deficient in any particular vitamin.
High doses of vitamin A can cause hair thinning. The over the counter hormones DHEA and pregnenolone can cause hair loss.
Tocotrienol supplementation should be considered.
A randomized, double-blind, placebo-controlled trial to
determine the effectiveness of botanically derived inhibitors of
5-alpha-reductase in the treatment of androgenetic alopecia.
J Altern Complement Med. 2002.
One contributing factor to androgenic alopecia is the conversion of testosterone (T) to dihydrotestosterone (DHT) via the enzyme 5-alpha reductase (5AR). This metabolism is also key to the onset and progression of benign prostatic hyperplasia (BPH). Here, we report the first example of a placebo-controlled, double-blind study undertaken in order to examine the benefit of these botanical substances in the treatment of androgenetic alopecia. The goal of this study was to test botanically derived 5AR inhibitors, specifically the liposterolic extract of saw palmetto and Beta-Sitosterol, in the treatment of androgenic alopecia. Included in this study were males between the ages of 23 and 64 years of age, in good health, with mild to moderate androgenetic alopecia. The results of this pilot study showed a highly positive response to treatment. The blinded investigative staff assessment report showed that 60% of (6/10) study subjects dosed with the active study formulation of beta sitosterol and Saw-Palmetto were rated as improved at the final visit.
A molecule produced in the intestine when soy is digested stops a hormone which
can fuel prostate growth or cause hair loss. Writing in the journal Biology of
Reproduction, researchers said the finding could explain why Japanese men, who eat more
soy, rarely have prostate cancer. They said the molecule could be used as a
treatment for cancer and hair loss. The team found that the molecule, an isoflavone called
"handcuffs" the male hormone DHT - a by-product of testosterone. Equol
is a metabolic product of the flavonoid daidzein. The researchers
say this could be particularly important for men who have been diagnosed with
either an enlarged prostate (benign prostatic hyperplasia), or cancer of the
prostate. DHT has also been implicated in research into the causes of male
pattern hair loss.
Saw palmetto extract is also involved blocking DHT in prostate tissue, whether it does so in hair tissue is not clear. One small study indicates the combination of saw palmetto and beta sitosterol could be helpful (see below). Hopefully, over the next few years we will have a clearer understanding of the role of long term dietary intake or supplement use and hair health.
Dietary isoflavone increases
insulin-like growth factor-I production, thereby promoting hair growth in mice.
J Nutr Biochem. 2010. Department of Translational Medical Science Research, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan.
Sensory neurons release calcitonin gene-related peptide (CGRP) upon activation. We previously demonstrated that CGRP increases insulin-like growth factor-I (IGF-I) production in various tissues of mice including the skin. Our observations strongly suggest that might increase IGF-I production in the hair follicle dermal papilla cells in mice through increasing CGRP production in the sensory neurons, thereby promoting hair growth associated with melanogenesis in mice.
Prostate Power Rx - I have formulated a product for prostate tissue health which contains saw palmetto, isoflavones such as genistein and daidzein, along with beta sitosterol. Whether this product helps those with hair loss has not been evaluated. Interestingly, Prostate Power Rx users report sexual enhancement.
extract (standardized to contain 45% fatty acids - serenoa repens fruit)
Stinging nettle 4:1 extract (urtica diocia root)
Quercetin which is a flavonoid
Rosemary 4:1 extract (Rosemarinus officinales leaf)
Beta sitosterol which is a phytoestrogen
Pygeum 4:1 bark extract (Pygeum Africanum)
Daidzein (standardized to contain 40% isoflavones)
Genistein (standardized to contain 40% isoflavones)
Lycopene (Lycoperscion escatatum fruit)
Buy Prostate Power Rx, Passion Rx for enhanced sexual pleasure
This is the most common type of hair loss affecting men. It's rare in women and children because it depends on the presence of male hormones (androgens), and levels of these hormones are high in males after puberty. Hair loss runs in families. Hair loss usually begins on the sides, near the front, or on the top of the head toward the back. Hair loss can begin at any age, even in the middle teen years. Some people lose only some hair and develop a bald spot in the back or a receding hairline; others, especially people whose hair loss begins at a young age, may go completely bald.
Researchers have found that variations in a gene related to male sex hormones may be at the root of male-pattern baldness, the most common form of hair loss. The culprit is the androgen receptor gene, and it dwells on the X chromosome, which all men inherit from their mothers. Other, yet-unidentified genes are likely involved in male-pattern baldness, possibly including ones handed down by fathers. But the new findings highlight the importance of mom's side of the family when it comes to a man's hairline.
A cellular malfunction short-circuits the process by
which hair follicle stem cells turn into hair-producing progenitor cells. That
defect, rather than any loss of stem cells themselves, sparks the onset of
androgenetic alopecia, the medical term for a type of genetic hair loss that
affects both men and women, according to Dr. George Cotsarelis, chairman of the
dermatology department at the University of Pennsylvania School of Medicine
Female hair loss is less common than male-pattern baldness. Usually, this condition causes the hair to thin in the front, on the sides, or on the crown. It rarely progresses to total hair loss.
Genetics aside, the next strongest predictor of midline (central) hair loss among women is their marital status, with the loss of a spouse (through either divorce or death) raising the risk for thinning hair above that of married or single women.
Hair goes gray when melanocytes become depleted. The scalp contains a reservoir of adult stem cells that provide a continuous supply of these color-making cells. But as the body ages these cells become depleted and sometimes begin to develop in the wrong part of the hair follicle. I have not yet come across any credible research regarding the reversal of gray hair with vitamins or supplements.
Common causes of hair loss
The most common is male pattern baldness due to genetics, or hereditary factors.
Telogen effluvium may follow emotional distress, such as a death in the family or a physiological stress, such as a high fever, sudden or excessive weight loss, extreme diets, nutritional deficiencies, surgery, or metabolic disturbances. Hair typically grows back once the condition that caused it corrects itself, but it usually take months.
Hormonal problems, the thyroid gland can be overactive or underactive.
When androgen hormones in the body are out of balance or people are prescribed testosterone or other androgens. Bodybuilders who take steroids could lose their hair.
Some women notice hair loss a few months after they've had a baby. During pregnancy, high levels of certain hormones cause the body to keep hair that would normally fall out. When the hormones return to pre-pregnancy levels, that hair falls out and the normal cycle of growth and loss starts again.
Excessive vitamin A intake.
Certain infections such as fungal infections of the scalp.
Certain medical conditions such as lupus or diabetes.
Alopecia areata. This is classified as an autoimmune disease, but the cause is unknown.
Traction alopecia. Excessive hairstyling or hairstyles that pull your hair too tightly cause traction alopecia.
Undergoing chemotherapy or radiation therapy may cause you to develop alopecia.
Trichotillomania is a type of mental illness in which people have an irresistible urge to pull out their hair, whether it's from the scalp, their eyebrows or other areas of the body.
Many different types of
medications are thought to cause hair loss, including certain::
Acne medications containing vitamin A (retinoids)
Antibiotics and antifungal drugs
Birth control pills
Anticlotting drugs, blood thinners, anticoagulants.
Gout treating medications
Medications that suppress the immune system
Drugs that treat breast cancer
Epilepsy drugs (anticonvulsants)
High blood pressure medications (anti-hypertensives), such as beta-blockers, ACE inhibitors, and diuretics
Hormone replacement therapy
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Parkinson's disease drugs
Weight loss drugs
Does having sex cause
hair to fall out?
I seriously doubt there is any relation between sexual activity and balding. We do lose some omega-3 fatty acids and other beneficial substances in semen and sperm, but I doubt this would influence balding.
Natural hair growth research studies
Melatonin topical application and hair growth
Melatonin increases anagen hair rate in women with androgenetic alopecia or diffuse alopecia: results of a pilot randomized controlled trial.
Br J Dermatol. 2004.
In addition to the well-known hormonal influences of testosterone and dihydrotestosterone on the hair cycle, melatonin has been reported to have a beneficial effect on hair growth in animals. The effect of melatonin on hair growth in humans has not been investigated so far. To examine whether topically applied melatonin influences anagen and telogen hair rate in women with androgenetic or diffuse hair loss. A double-blind, randomized, placebo-controlled study was conducted in 40 women suffering from diffuse alopecia or androgenetic alopecia. A 0.1% melatonin or a placebo solution was applied on the scalp once daily for 6 months and trichograms were performed to assess anagen and telogen hair rate. To monitor effects of treatment on physiological melatonin levels, blood samples were taken over the whole study period. Melatonin led to a significantly increased anagen hair rate in occipital hair in women with androgenetic hair loss compared with placebo. For frontal hair, melatonin gave a significant increase in the group with diffuse alopecia. The occipital hair samples of patients with diffuse alopecia and the frontal hair counts of those with androgenetic alopecia also showed an increase of anagen hair, but differences were not significant. Plasma melatonin levels increased under treatment with melatonin, but did not exceed the physiological night peak. To the authors' knowledge, this pilot study is the first to show that topically applied melatonin might influence hair growth in humans in vivo. The mode of action is not known, but the effect might result from an induction of anagen phase.
Q. I just read your article about the study done on
woman using melatonin solution on their hair. I am a woman in her 50s and have
already lost hair in the front and upper sides. I was wondering where I can get
this melatonin solution for hair loss. Can you direct me to someone who can help
Q. I understand 0.1% melatonin hair formula can help with growing hair back for women. Where can I purchase this and would I need a prescription? I saw a website that said, "ASATEX Swiss Melatonin Hair Formula is the first topical hair product with Melatonin in a special carrier system protected by world wide patents. It is recommended for men and women experiencing short-term hair loss caused by various factors such as stress, nutritional problems and seasonal influences.
ASATEX improves the texture and appearance of hair in long-term hair loss mainly due to hereditary factors. The product has been developed for use in early stages of hair loss and hair thinning.
A. I am not familiar with this company and do not know if their product works or whether there is an adequate amount of melatonin in the hair formula.
Emails regarding hair loss
Q. I read you article on Serenoa repens ( saw palmetto ) and hair loss.... What is your opinion ( I know research is lacking ) on combining finasteride with Serenoa repens ( saw palmetto ) ---given the former is a type 2 inhibitor whereas the saw palmetto is a dual inhibitor would you speculate there may be a beneficial effect on hair loss or an adverse one involving hormonal feedback loops ?
A. You ask a good question. i don't see any obvious harm adding saw palmetto to finasteride, but I honestly don't know whether there would be a synergistic effect. I still am not convinced daily use of finasteride for hair loss or prostate enlargement is safe in the long run. Finasteride may blunt sexuality, but more research is needed.
Q. I am a 43 year old woman and
took a 25 mg. DHEA supplement recommended by my doctor. He was not really clear
about how long I should take it, nor did he give me any warnings about possible
side effects. Unfortunately I took it for 6 months and now am experiencing
pretty severe hair loss.
I have lost 50% of my hair in the last 2 months. I really had NO IDEA what I was taking and feel very stupid for not researching this before I took it. My levels were tested on June 23rd and were high (260 in a scale of 14-244). I have stopped the supplement as of 3 weeks ago. Can you give me any hope (at all!) about regaining my hair once the DHEA level drops? I know you won't recommend treatments but if you could direct me to some information I would be grateful. This is causing me unbelievable anxiety.
A. Unfortunately we have had many emails regarding hair loss associated with misuse of DHEA. There is hope that some of the hair, maybe most or all could grow back, but it is impossible to predict. Perhaps some of the herbs as mentioned above could be tried or your doctor could prescribe finasteride for hair regrowth, at least for a few weeks or months.
Q. Is there a way to test if you are an equol producer? I'm
an average joe taking red clover twice a day (for hair loss) but also for
prostate health. I would like to know if it's beneficial to me to keep
taking this. Also, after reading a couple of the daizden articles, I
believe I have experienced my first "hot flash" the other night. It felt
as though I was going to be sick, I got real hot then sweat on my
forehead. I just thought I had caught a touch of the flu. Anyhow, I'm now
thinking that I had a hot flash, becasue I'm taking too much daizden? hard
to say, there aren't any guidelines for how much to take. Are the "herbal"
drug companies any closer to creating an over the counter equol supplement
so us thinning hair people can combad male pattern baldness?
A. You ask good questions and we just don't have enough knowledge at this time to make any firm recommendations.
Q. I receive your
Research Update. Another drug to add to
the list of harmful pharmaceuticals is Propecia (Merck) for hair loss. More and
more people, myself included, are suffering from the long-term, potentially
permanent side-effects of this hair restoring drug. The finasteride side-effects
include impotence, loss of libido, hormonal imbalance, and problems with mental
clarity. In my opinion, this is the next drug that the public will "blow the lid
off of." I hope that Dr. Sahelian would comment on this further in upcoming
newsletters. Furthermore, I was wondering if Dr. Sahelian has any
recommendations for people who've been affected by Propecia. Is there a way to
correct the hormonal imbalance that this drug has caused? Has he helped others
with this issue? Is there hope? I belong to a web forum called
finasteride-side-effects.com. A brief look at the messages posted here show that
hundreds of people (on this site alone) have been affected.
A. Even though long term ( 5 year ) studies thus far do not clearly indicate significant side effects from finasteride, I suspect that we will encounter some problems as you mention. A couple of options for improving libido include Passion Rx or Tongkat Ali. For mental clarity, Mind Power Rx is an option.
Q. I am a 56 year old
woman. I have come through menopause but lately noticed that my hair is thinning
in the front crown area of my head. Do you sell anything that might help it to
thicken my hair again?
A. I have been looking into a good hair raising formula and thus far I have not yet found a product that I feel works effectively. But I actively looking, and if I do come across a hair raising formula, I will mention it in the newsletter.
Q. I read your newsletter with great interest.
Something puzzles me: you do not mention the effect of biotin on hair growth. I
am seventy, a woman, and afflicted with male pattern baldness. A dermatologist
recommended 5mg (milligrams) of biotin three times a day. I confirmed this with
my internist, was told it was all right, but am still a bit uncomfortable with
such a high dose. I would appreciate your thought.
A. We have not come across any reliable research regarding biotin supplementation leading to hair growth for those with age related hair loss. If your doctors have such information, we would be glad to review it.
Q. I have some personal experience
with taking DHEA in 25 mg doses and also later taking finasteride (Propecia 1mg)
for hair loss. There are pros and cons to each. I am a normal 44 year old
Caucasian male Navy carrier pilot.
DHEA: I took this at three different times over a few years as part of a workout supplementation program. I found that it increased my energy, libido, ability to lift heavy weight in the gym, and my overall feeling of strength and well being. It also significantly increased the volume and fluidity of my ejaculate and reduced sexual recovery time, letting me "stud out." It reduced joint pain due to lifting weights and trimmed me down somewhat by reducing belly fat. But it very definitely increased the rate of my male-pattern baldness and hair thinning, so I stopped taking it. It also made me irritable, impatient, intolerant, and aggressive as you would imagine with increased testosterone.
Finasteride / Propecia: I just stopped taking this after only 13 days because it made me feel as though my prostate was drying up. It was already visibly changing my hair by increasing the area of growth, but this is not worth the negative side effects. I found it reduced my libido (which I thought would be good but felt unnatural, almost like being neutered), greatly reduced the volume of my ejaculate, induced low back pain and a sense of dryness/pain in my whole prostrate / genital region, increased my belly fat, and made me a bit lethargic.
I never took these two hormones / drugs together. They have opposite effects in my body. DHEA was better except for the hair loss and increased aggression, as well as possible long-term contribution to prostate cancer. The only benefit to finasteride was hair improvement - everything else was very negative. I have normal to high levels of DHEA and testosterone naturally in my body. I plan to take a little DHEA to get back to neutral after quitting finasteride, then not take either one and letting my body do its own natural thing.
A. We're impressed on how observant you are about the effects of dhea and finasteride. Our own experiences confirm your findings. One option is to take a sexual enhancement product without dhea, and thus get the sexual benefits without the hair loss effects of dhea. We have found in many propecia users that Passion-Rx reverses the sexual side effects.
Q. I have been suffering from extreme hair loss ever
since puberty. I am 30 years old and I recently got a saliva test for my
hormones. My progesterone
was very low(46 pg/ml) during the luteal phase, and my DHEAS was very high (15.7
ng/ml). I have been also suffering from
acne, itchy scalp, horizontal
ridges on my nails. I hardly have any hair left on my scalp. My doctor told me
to use natural progesterone cream because my body is unable to make
progesterone. I have been using the cream for 12 days a month (30 mg/day) for 3
months now and still there is no improvement.
A. We cannot make individual recommendations, but the information on this hair web page and the page on acne should be helpful to you. The prescription of hormones bases on saliva tests is no always reliable.
Q. I saw an advertisement on the internet for a product
called Advecia which is supposed to help with hair loss. Do you have an Advecia
review? Does Advecia really work for hair loss?
A. We don't have an Advecia review but can comment on the ingredients in Advecia as mentioned on their website. The Advecia website claims this product is a restorative formula for bald or thinning hair. There is a question on the website that asks, "Can Advecia assist in your individual pursuit for slowing hair loss? And they answer, "Yes." I cannot find any clinical trials with Advecia mentioned on their website. The ingredients in Advecia are saw palmetto, beta sitosterol, green tea extract, lysine, arginine, and grape seed extract. These are good nutrients and herbs, but I seriously doubt whether Advecia has a significant impact on hair loss or hair growth. The burden of proof lies with the advecia sellers and they have not provided this proof before making these claims. There is not good evdience that saw palmetto can block 5 alpha reductase is a sufficient manner in hair follicles to prevent hair loss or restore hair loss. Therefore, at this time, Advecia appears like another one of those "me too" natural hair loss product heavily advertised with no proof of effectiveness. You can find the invidivual herbs sold separately for much cheaper. There seems to be a negligible amount of saw palmetto in Advecia and a high amount of green tea extract. Until Advecia sellers present a couple of human studies proving that Advecia administration reversed hair loss, your money is better spent somewhere else. There is also a possibility of Advecia side effects with too much green tea, especially when the Advecia web site recommends taking two Advecia capsules in the evening. This could cause an Advecia side effect of insomnia.
Q. I am writing an article for a health magazine on a
natural approach to prevent hair loss. Are there any natural supplements you
recommend to stop hair loss?
A. Hair loss in men is mostly due to genetics. We all know people who eat a terrible diet with tons of fast foods and soft drinks, yet they have a full head of hair while others watch their meal selection carefully and choose healthy foods on a regular basis but still can's stop their hair loss. Although genetics has most of the influence, it is possible that a low inflammatory diet over the long run could be of benefit. This low inflammatory diet would have a high intake of fish and fish oils, a high intake of all sorts of vegetables and whole grains, and a low intake of sugar and simple carbohydrates. By reducing inflammation, there would be less damage to the microcirculation that supplies nutrients to hair follicles. Furthermore, flavonoids in vegetables dilate blood vessels, and the fish oil thin the blood. As to herbs or nutrients that may help hair growth, there has been very little study in this area. I have seen one study where the combination of saw palmetto and beta-sitosterol was helpful, but many more are needed before we determine the appropriate dosage and long term benefits and risks.
Q. I took
Pregnenolone hormone for several years,
one 50 mg capsule each day. For the last couple of years, I have noticed that my
hair is much thinner than it used to be and I was puzzled until I read that
pregnenolone could have that effect on hair. Immediately I discontinued taking
pregnenolone. That was about six months ago but I have not seen any difference
in my hair. If this hormone is responsible for my hair thinning, can its effect
be reversed by discontinuing the use of this hormone? While, I am female, have
always had thick hair, and am now 70 years old ... my family history shows no
sign of hair thinning or balding in either sex ... quite the reverse ... a good
head of hair into old age.
A. The use of pregnenolone hormone or DHEA is associated with hair thinning or hair loss. In some cases the hair regrowth occurs after discontinuation of the hormones, and in other cases it may not. We are not sure if finasteride use for a few weeks would be helpful or not but that is something you could discuss with your doctor.
Q. I am a man, I have thinning hair and would like to
do something to prevent it. I don't really want to use something like minoxidil
because of the side effects. In the searching I have done on the internet I was
thinking about trying saw palmetto but then I came across something called beta
sitosterol. I was wondering if Dr. Sahelian had a preference between the two and
why. I was also going to try saw palmetto shampoo as I've heard the shampoo can
remove DHT from the scalp. Is this true and is there a particular brand of
shampoo that he recommends?
A. I have not seen any research that saw palmetto shampoo can remove DHT from scalp hair follicles or reverse hair loss. Research with beta sitosterol and saw palmetto regarding hair growth is quite limited and at this time, November 2008, I have only come across one small study that showed a potential benefit with the combination of saw palmetto and beta sitosterol.
I am a 48 year old women who is going through surgical
menopause. Would it be
safe for a women to take Prostate Power Rx to see if would help stop hair loss?
Thus far we have not had any negative feedback from women who have used this natural supplement, but it is not possible for us to predict the safety of use in any one individual woman.
I have. I have cystic fibrosis,
and would like to start taking oral glutathione in hope that it may raise my
bodies glutathione levels and because some cystic fibrosis patients mention it
seems to increase their appetite. But the problem is i take whey protein powder
which contains tyrosine. I have read on the internet on so many different
websites that if you take Glutathione and l-tyrosine together that your hair can
turn white. I dont want my hair to grey before its time.
I have not seen any reliable studies that indicate this problem would occur.
Dry hair cause
These are the primary external causes
Shampooing too often
Chlorine in swimming pools and hot tubs
Overuse of the blow dryer or curling iron
Too much exposure to sun and wind
High mineral content in local water supplies
Too much brushing
Use a high quality conditioner
Try a few drops of lavender and sandalwood essential oils mixed with a few ounces of warm sesame or soy oils then rub the oil to the hair, wrap in a towel for 10 minutes, then rinse.
Perhaps eating more fish and flaxseed, or taking the oils could help.