Hair Loss

[Michael Scally MD]

[Open Access] Hornfeldt CS, Holland M, Bucay VW, Roberts WE, Waldorf HA, et al. The Safety and Efficacy of a Sustainable Marine Extract for the Treatment of Thinning Hair: A Summary of New Clinical Research and Results from a Panel Discussion on the Problem of Thinning Hair and Current Treatments. J Drugs Dermatol. 201514(9):s15-22. http://jddonline.com/articles/dermatology/S1545961615S0015X

Alopecia and thinning hair are highly prevalent conditions affecting a large proportion of men and women.

Diffused hair loss is often more difficult to diagnose in women, mostly due to over-reliance on the assumption of hormonal influences, and it is commonly treated with a multi-therapy approach.

Clinical studies have demonstrated the effectiveness of a nutraceutical supplement to provide essential nutrients that aid in stimulating existing hair growth and reducing hair shedding.

The supplement Viviscal®; contains a proprietary blend of proteins, lipids, and glycosaminoglycans derived from sustainable marine sources.

We present here a summary of studies that have examined the safety and efficacy of this nutraceutical; as well as discussions on hair loss and current therapies from a recently convened expert panel in dermatology and plastic surgery.

 

[Reporich]

Interesting, has anyone tried this stuff?

 

[Dr JIM]

View attachment 29354

[Open Access] Hornfeldt CS, Holland M, Bucay VW, Roberts WE, Waldorf HA, et al. The Safety and Efficacy of a Sustainable Marine Extract for the Treatment of Thinning Hair: A Summary of New Clinical Research and Results from a Panel Discussion on the Problem of Thinning Hair and Current Treatments. J Drugs Dermatol. 201514(9):s15-22. http://jddonline.com/articles/dermatology/S1545961615S0015X

Alopecia and thinning hair are highly prevalent conditions affecting a large proportion of men and women.

Diffused hair loss is often more difficult to diagnose in women, mostly due to over-reliance on the assumption of hormonal influences, and it is commonly treated with a multi-therapy approach.

Clinical studies have demonstrated the effectiveness of a nutraceutical supplement to provide essential nutrients that aid in stimulating existing hair growth and reducing hair shedding.

The supplement Viviscal®; contains a proprietary blend of proteins, lipids, and glycosaminoglycans derived from sustainable marine sources.

We present here a summary of studies that have examined the safety and efficacy of this nutraceutical; as well as discussions on hair loss and current therapies from a recently convened expert panel in dermatology and plastic surgery.

Exclusive of the historical fact the overwhelming majority of OTC "cures"
for baldness a just short of vodoo medicine, I wouldn't hold your breath primarily bc MPB is an ailment that is multi-factorial in its causation from genetics to DHT and follicular obstruction.

 

[Michael Scally MD]

[Open Access] Topical Minoxidil: Systematic Review and Meta-Analysis of Its Efficacy in Androgenetic Alopecia

Topical minoxidil has become a mainstay in the treatment of androgenetic alopecia (AGA). Despite being a longstanding treatment for AGA, relatively few reviews of its efficacy have been published.

The current study sought to synthesize the available efficacy data by performing a systematic review of the literature and conducting random-effects pairwise meta-analyses for the outcomes percent increase in hair count from baseline, investigator assessment, and patient self-assessment.

Results showed that minoxidil is more effective than placebo in promoting total and nonvellus hair growth (mean difference [MD], 16.68; 95% confidence interval [CI], 9.34-24.03 and MD, 20.90; 95% CI, 9.07-32.74).

A significantly higher proportion of participants in the minoxidil group had greater hair growth than participants in the placebo group as judged by both investigators and self-reports (relative risk [RR], 2.28; 95% CI, 1.58-3.31 and RR, 1.56; 95% CI, 1.34-1.80).

Despite significant clinical efficacy, cosmetically acceptable results are present in only a subset of patients. Compliance is thought to be a major limiting factor and is being addressed by novel formulations and combinations.

Gupta AK, Charrette A. Topical Minoxidil: Systematic Review and Meta-Analysis of Its Efficacy in Androgenetic Alopecia. Skinmed. 2015;13(3):185-9. http://issuu.com/pulsemarketing/docs/skinmed_v13_i3?e=5397957/14071318

 

[Michael Scally MD]

Kanti V, Hillmann K, Kottner J, Stroux A, Canfield D, et al. Effect of minoxidil topical foam on frontotemporal and vertex androgenetic alopecia in men: a 104-week open-label clinical trial. J Eur Acad Dermatol Venereol. http://onlinelibrary.wiley.com/doi/10.1111/jdv.13324/abstract

BACKGROUND: Topical minoxidil formulations have been shown to be effective in treating androgenetic alopecia (AGA) for 12 months. Efficacy and safety in both frontotemporal and vertex regions over longer application periods have not been studied so far.

OBJECTIVES: To evaluate the effect of 5% minoxidil topical foam (5% MTF) in the frontotemporal and vertex areas in patients with moderate AGA over 104 weeks.

METHODS: An 80-week, open-label extension phase was performed, following a 24-week randomized, double-blind, placebo-controlled study in men with AGA grade III vertex to VI. Group 1 (n = 22) received ongoing 5% MTF for 104 weeks, Group 2 (n = 23) received placebo topical foam (plaTF) until week 24, followed by 5% MTF until week 104 during the extension phase. Frontotemporal and vertex target area non-vellus hair counts (f-TAHC, v-TAHC) and cumulative hair width (f-TAHW, v-TAHW) were assessed at baseline and at weeks 24, 52, 76 and 104.

RESULTS: In Group 1, f-TAHW and f-TAHC showed a statistically significant increase from baseline to week 52 and week 76, respectively, returning to values comparable to baseline at week 104. No significant differences were found between baseline and week 104 in v-TAHC in Group 1 as well as f-TAHC, v-TAHC, f-TAHW and v-TAHW values in Group 2.

CONCLUSIONS: 5% MTF is effective in stabilizing hair density, hair width and scalp coverage in both frontotemporal and vertex areas over an application period of 104 weeks, while showing a good safety and tolerability profile with a low rate of irritant contact dermatitis.

 

[Michael Scally MD]

Gentile P, Garcovich S, Bielli A, Giovanna Scioli M, Orlandi A, et al. The Effect of Platelet-Rich Plasma in Hair Regrowth: A Randomized Placebo-Controlled Trial. Stem Cells Transl Med. http://stemcellstm.alphamedpress.org/content/early/2015/09/23/sctm.2015-0107.abstract

Platelet-rich plasma (PRP) has emerged as a new treatment modality in regenerative plastic surgery, and preliminary evidence suggests that it might have a beneficial role in hair regrowth. Here, we report the results of a randomized, evaluator-blinded, placebo-controlled, half-head group study to compare, with the aid of computerized trichograms, hair regrowth with PRP versus placebo. The safety and clinical efficacy of autologous PRP injections for pattern hair loss were investigated. PRP, prepared from a small volume of blood, was injected on half of the selected patients’ scalps with pattern hair loss. The other half was treated with placebo. Three treatments were administered to each patient at 30-day intervals. The endpoints were hair regrowth, hair dystrophy as measured by dermoscopy, burning or itching sensation, and cell proliferation as measured by Ki67 evaluation. Patients were followed for 2 years. Of the 23 patients were enrolled, 3 were excluded. At the end of the 3 treatment cycles, the patients presented clinical improvement in the mean number of hairs, with a mean increase of 33.6 hairs in the target area, and a mean increase in total hair density of 45.9 hairs per cm2 compared with baseline values. No side effects were noted during treatment. Microscopic evaluation showed the increase of epidermis thickness and of the number of hair follicles 2 weeks after the last PRP treatment compared with baseline value (p < .05). We also observed an increase of Ki67+ keratinocytes in the epidermis and of hair follicular bulge cells, and a slight increase of small blood vessels around hair follicles in the treated skin compared with baseline (p < .05). Relapse of androgenic alopecia was not evaluated in all patients until 12 months after the last treatment. After 12 months, 4 patients reported progressive hair loss; this was more evident 16 months after the last treatment. Those four patients were re-treated. Our data clearly highlight the positive effects of PRP injections on male pattern hair loss and absence of major side effects. PRP may serve as a safe and effective treatment option against hair loss; more extensive controlled studies are needed.

Significance - Platelet-rich plasma (PRP) has emerged as a new treatment modality in regenerative plastic surgery, and preliminary evidence suggests that it might have a beneficial role in hair regrowth. Here, the results of a randomized, placebo-controlled, half-head group study to compare the hair regrowth with PRP versus placebo are reported. Hair regrowth was quantified by a blinded evaluator using computerized trichograms. The safety and clinical efficacy of autologous PRP injections for pattern hair loss were investigated. Of the 23 patients enrolled, 3 were excluded. At the end of the 3 treatment cycles, the patients presented clinical improvement in the mean number of hairs, with a mean increase of 33.6 hairs in the target area and a mean increase in total hair density of 45.9 hairs per cm2 compared with baseline values. No side effects were noted during treatment. The data clearly highlight the positive effects of PRP injections on male pattern hair loss and absence of major side effects.

 

[Michael Scally MD]

Macrophages Contribute to the Cyclic Activation of Adult Hair Follicle Stem Cells

The cyclic life of hair follicles consists of recurring phases of growth, decay, and rest. Previous studies have identified signals that prompt a new phase of hair growth through the activation of resting hair follicle stem cells (HF-SCs).

In addition to these signals, recent findings have shown that cues arising from the neighboring skin environment, in which hair follicles dwell, also participate in controlling hair follicle growth.

Here we show that skin resident macrophages surround and signal to resting HF-SCs, regulating their entry into a new phase of hair follicle growth. This process involves the death and activation of a fraction of resident macrophages— resulting in Wnt ligand release —that in turn activate HF-SCs.

These findings reveal additional mechanisms controlling endogenous stem cell pools that are likely to be relevant for modulating stem cell regenerative capabilities. The results provide new insights that may have implications for the development of technologies with potential applications in regeneration, aging, and cancer.

Castellana D, Paus R, Perez-Moreno M. Macrophages Contribute to the Cyclic Activation of Adult Hair Follicle Stem Cells. PLoS Biol. 2014;12(12):e1002002. http://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.1002002

Skin epithelial stem cells operate within a complex signaling milieu that orchestrates their lifetime regenerative properties. The question of whether and how immune cells impact on these stem cells within their niche is not well understood.

Here we show that skin-resident macrophages decrease in number because of apoptosis before the onset of epithelial hair follicle stem cell activation during the murine hair cycle. This process is linked to distinct gene expression, including Wnt transcription.

Interestingly, by mimicking this event through the selective induction of macrophage apoptosis in early telogen, we identify a novel involvement of macrophages in stem cell activation in vivo. Importantly, the macrophage-specific pharmacological inhibition of Wnt production delays hair follicle growth.

Thus, perifollicular macrophages contribute to the activation of skin epithelial stem cells as a novel, additional cue that regulates their regenerative activity. This finding may have translational implications for skin repair, inflammatory skin diseases and cancer.

 

[Michael Scally MD]

PLOS Science Wednesday: Hi Reddit, I'm Zhengquan Yu, here to talk about my recent PLOS Genetics paper that has identified the key role of a microRNA in hair loss. I'm joined by Maksim Plikus, who studies stem cell regulation using hair follicles — Ask Us Anything!
https://www.reddit.com/r/science/comments/3myf47/plos_science_wednesday_hi_reddit_im_zhengquan_yu/

My name is Zhengquan Yu and I am an associate professor at the China Agricultural University. Joining me in this AMA is my colleague, Maksim Plikus from the University of California, Irvine, who studies the principles and mechanisms of adult stem cell regulation using hair follicle as the primary model system.

My research focuses on regulatory network of somatic stem cells in hair follicle and mammary gland.

We recently published a research article titled Post-transcriptional Regulation of Keratinocyte Progenitor Cell Expansion, Differentiation and Hair Follicle Regression by miR-22 in PLOS Genetics. http://journals.plos.org/plosgenetics/article?id=10.1371/journal.pgen.1005253

We describe an essential role for a highly conserved microRNA, miR-22, in regulating the regression of mouse hair follicles.

We found that increasing miR-22 results in hair loss in mice due to the premature regression of follicles, and that silencing of keratin-mediated hair shaft assembly by miR-22 is a prerequisite for follicle regression. There are hundreds of microRNAs expressed in hair follicles, but most of them are not well studied.

This paper highlights the importance of determining the combinatorial effects of the microRNA regulatory network in hair cycling and provides new insights into the mechanism of premature hair follicle regression in understanding the pathology of hair loss.

 

[Michael Scally MD]

[Editorial] Platelet-Rich Plasma Therapy: A Novel Application In Regenerative Medicine [Caveat Emptor]

Plasma samples with platelet concentration above base line values are referred to as platelet-rich plasma (PRP).

The clinical efficacy of the PRP was discovered in early 1990s when new “biological glues” were being discovered. They are at present being extensively used in many clinical and surgical fields requiring tissue regeneration such as orthopedics, dentistry, wound healing, and maxillofacial surgeries.

The therapeutic effect of PRP is attributed to the abundance of various growth factors such as platelet-derived growth factor (PDGF), transforming growth factor-β, fibroblast growth factor, insulin-like growth factor-1 (IGF-1), IGF-2, vascular endothelial growth factor, epidermal growth factor, and also some cytokines primarily stored in alpha granules [& Frosted Flakes].

Cont. at link …

Jain A, Bedi RK, Mittal K. Platelet-rich plasma therapy: A novel application in regenerative medicine. Asian J Transfus Sci 2015;9(2):113-4. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4562126/

 

[Michael Scally MD]

Singhal P, Agarwal S, Dhot PS, Sayal SK. Efficacy of platelet-rich plasma in treatment of androgenic alopecia. Asian J Transfus Sci 2015;9(2):159-62. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4562137/

BACKGROUND: Platelet-rich plasma (PRP) has shown remarkable beneficial effects without any major adverse reactions in the treatment of androgenic alopecia. The growth factors in activated autologous PRP induce the proliferation of dermal papilla cells.

OBJECTIVES: The objective was to investigate the clinical efficacy of PRP in treatment of androgenic alopecia.

MATERIALS AND METHODS: Ten patients were given autologous PRP injections on the affected area of alopecia over a period of 3 months at interval of 2-3 weeks and results were assessed.

RESULTS: Three months after the treatment, the patients presented clinical improvement in the hair counts, hair thickness, hair root strength, and overall alopecia.

CONCLUSION: PRP appears to be a cheap, effective, and promising therapy for androgenic alopecia with no major adverse effects.

 

[Michael Scally MD]

Arthritis Drug Doubles As Hair-Fertilizer

A class of drugs already approved by the U.S. Food and Drug Administration for treating rheumatoid arthritis is raising hairs in the research community—literally. Previous studies had shown that Janus kinase inhibitors, including tofacitinib and ruxolitinib, can treat alopecia areata, an autoimmune disease that causes bald patches when immune cells attack hair follicles. The researchers noticed that, when applied topically, the treatment seemed to be directly spurring robust hair growth.

New research suggests that the drugs can do the same even in mice without the autoimmune disease. When researchers applied the drugs topically to the right side of mice whose hair follicles were in a resting phase, the difference was clear: 90% of the treated mice had hair growth within 10 days. And after 3 weeks, untreated mice in a control group (left) remained bald, while those given tofacitinib or ruxolitinib (right) had hair-covered right sides.

The drugs, it turned out, had kick-started their hair cycles, putting follicles into an active growth phase. Results were similar when the scientists grafted healthy human scalp skin onto mice, and further experiments showed that the new hair growth was normal at a molecular level, the team reported online today in Science Advances.

But it might be some time before you can use the drugs to treat your own bald patches: Scientists still have some ways to go before knowing whether the drugs work on male or female pattern baldness.

Harel S, Higgins CA, Cerise JE, et al. Pharmacologic inhibition of JAK-STAT signaling promotes hair growth. Science Advances. http://advances.sciencemag.org/content/1/9/e1500973 ]

Several forms of hair loss in humans are characterized by the inability of hair follicles to enter the growth phase (anagen) of the hair cycle after being arrested in the resting phase (telogen).

Current pharmacologic therapies have been largely unsuccessful in targeting pathways that can be selectively modulated to induce entry into anagen.

We show that topical treatment of mouse and human skin with small-molecule inhibitors of the Janus kinase (JAK)–signal transducer and activator of transcription (STAT) pathway results in rapid onset of anagen and subsequent hair growth.

We show that JAK inhibition regulates the activation of key hair follicle populations such as the hair germ and improves the inductivity of cultured human dermal papilla cells by controlling a molecular signature enriched in intact, fully inductive dermal papillae.

Our findings open new avenues for exploration of JAK-STAT inhibition for promotion of hair growth and highlight the role of this pathway in regulating the activation of hair follicle stem cells.

Inhibition of JAK-STAT signaling restarts anagen in wild-type mice. (A) Seven-week-old wild-type mice were shaved and treated daily with either a topical application of vehicle control, sonic hedgehog agonist (SAG), 3% ruxolitinib (JAK1/2 inhibitor), or tofacitinib (JAK3 inhibitor). Skin was harvested at the indicated time points and stained with hematoxylin and eosin (H&E). Images of mice were taken at D21 of treatment.

 

[Michael Scally MD]

Behind the Scenes of Turkey’s $1B Hair Transplant Industry
http://www.wired.com/2015/11/emanuele-satolli-turkish-hair-farmers/

HAIR TRANSPLANTS ARE a $1 billion big business in Turkey, where there are around 350 clinics in Istanbul alone and some 5,000 people descend on the country each month to get a more luxurious head of hair.

It’s a strange world, one that photographer Emanuele Satolli reveals in his riveting series Turkish Hair Farmers. He goes into operating rooms where bright lights illuminate scalps prepped for surgery, and into the streets where patients play tourist with their families afterward. “It’s very common to see men with bandages visiting museums, walking on the streets or eating in the restaurants,” Satolli says. “They are alone, with their wife and children, or with other friends all who underwent the operation. It’s very strange and interesting at the same time.”

The procedure, called follicular unit extraction, costs between $1,700 and $2,000 in Turkey—an absolute steal compared to the $15,000 to $25,000 you’d pay in the US. It’s relatively straightforward: a surgeon harvests roughly 4,000 hair follicles from the back of the head, where hair is thicker, and inserts them into tiny incisions elsewhere in the scalp.

Satolli learned about the surgery earlier while visiting Istanbul earlier this year. He frequently saw men with gauze around their heads and wondered what had happened to them all. A friend told him they were simply getting a good deal on a head of hair. Turkish clinics, he explained, can provide the surgery cheaply because overhead like rent and salaries are so low. They draw thousands of patients each month, many of them from the Gulf region.

“When I realized that Turkey is the top country in the world for hair transplants and most of the patients arrive from Arab countries, I wanted to go deeper and meet these people to understand why so many really care about their physical appearance and in particular their baldness,” Satolli says.

The photographer met with several doctors. Most saw his project as a way to advertise their work, and some even asked patients if they’d be willing to be photographed. Of course, many refused. “It’s not easy to show, especially to the people who know you, that you are not happy about your personal appearance and you want to change it with an operation,” he says.

Satolli worked with four clinics early this summer. He used a Nikon D800 camera with a 35 mm lens, switching to a 24mm for wider shots. His photos are surprisingly intimate, capturing men as they wait to see a doctor, have their hair shampooed by a nurse, and lie sedated on the operating table. Many even take the opportunity to see the city, like the friends Satolli captured taking a night ferry tour of the Bosphorus strait.

For the most part, the operations seem to work. Many of the men return a second, third, or fourth time if their bald area is too large to cover all at once.

 

[Outlier]

Allegedly the Japanese have discovered a cure for hair loss. RepliCel Hair-01 (RCH-01) will go onto the market in 2018. I wouldn't advise anyone to hold their breath per se. It seems that a few times a year there is a "breakthrough" and typically it involves mice, some time passes and we never hear of the "breakthrough" again. As of right now, A number 1" all the way around works for me.

 

[BigTurk]

Food for thought:

I have always believed that hairloss in males was from overproducing DHT in the hair follicle, which is what I kept reading...I bought some DHT removing shampoo and noticed it worked pretty good, although every so often I had the clump of hair in the shower...taking Test at high doses at the time and after in TRT(where I am now), I figured it was due to the higher levels of test converting to DHT...

Well, apparently they/I was wrong...in fact the reason I was losing my hair was related to same reason I was stiff as a board....soft tissue

When you become calcified, it doesn't just happen in one area...it happens all over your body and although you may not have any outward symptoms in some places, it is occurring none the less....I likely was heading towards having a heart attack from arterial calcification if I didn't start this program/research(thanks psoriasis, for once!) as I had been having tightness in my chest and feeling strange for a while back every so often...not any more, haven't had anything like that for months now...

The loss of hair in many cases, and my case, is caused by the calcification of the capillaries that feed the hair follicles on the top of your head. When these become calcified, they can no longer supply blood to those follicles and the follicle dies from malnutrition. When you decalcify them, you reintroduce the blood flow to those dormant follicles, spurring them back to life...my bald spot has AT LEAST shrunk in half over the past few months. I have proof positive of that because in my office I sit in, there is a video camera up on the ceiling that points directly at the back of my head. Directly to my right, as I'm sitting down is the security monitor showing the video...I look at it every day and am getting closer and closer to having a full head of hair again.

Extrapolating this thought to steroids, I realized that atherosclerosis, or calcification of the arteries is one of the dangers of taking testosterone and other steroids at high levels, as it seems to lead to greatly increased activity there. Looking into this further, I found several studies such as this one below showing that calcification is greatly increased, much above expected values in steroid users.

http://www.ncbi.nlm.nih.gov/pubmed/17085981

So, perhaps like testosterone's effects on increased Red Blood Cell production, it also increases bone mineral density by attempting to add calcium to the bones to help the body prepare for the added muscle it is adding, which I looked into and was correct again based on this study, showing that it stimulates bone formation.

http://www.ncbi.nlm.nih.gov/pubmed/8256453

So now that brings us back to the original point. If the body is already having calcification issues without steroids, then the addition of steroids will only serve to greatly accelerate this calcification problem...meaning more rapid hairloss and more rapid atherosclerosis formation as well as more rapid soft tissue calcification all over the body...

However, like any other calcification issue, its not a problem so much with what is going on with the calcium, rather that the body does not have the necessary tools in its arsenal to deal with the excess calcium to make sure it stays away from where you don't want it(blood vessels, soft tissue and skin) and make it goes to where it should be(bones and teeth)...namely Vitamin D3, Vitamin A, Vitamin K2 and Magnesium Oil...and if on steroids you will need to greatly increase your dosages since these are being used up rapidly by the body. I'm pretty confident will virtually shut down the hairloss side effect and keep your arteries squeaky clean and supple even if using steroids...


Suggested usage for those experiencing hair loss/on steroids:

Fermented Cod Liver Oil/Skate Liver Oil(1-2 TBSP per day) great source of Vitamin A and D in a natural form with cofactors to help utilization--Skate Liver Oil also contains K2, AKG's and Squalene(shark liver oil anti-cancer properties)

Vitamin D3---25,000-35,000 IU per day

Vitamin K2---minimum of 600-800 mcg of K2 per day(MK-7 form). Alternatively you can get High Vitamin Butter Oil or Organic Pasture Fed Cultured Ghee, but I prefer use LEF's Super K with Advanced K2 Complex and some MK-7 capsules to add to the dosage as well as 1/2 teaspoon of natto powder(contains nattokinase and MK-7)

Magnesium Oil---I spray myself all over my entire body at least once a day, sometimes also doing a warm foot bath at night as well. Easy and cheap to make your own magnesium oil--buy magnesium chloride flakes and then use 1 cup of boiled, distilled water added to a bowl containing 1 cup of magnesium chloride flakes and stir until fully dissolved. Let it cool and pour into a spray bottle...you can further dilute it if its too strong and causes skin irritation

After a few weeks you should notice your hairloss stops, then starts reversing, you will have more energy and basically feel better then you have in a long long time...

 

[Outlier]

BigTurk,

That was an interesting read. I used AAS on and off for appoximately four years and experienced hairloss. I then had an eight year hiatus...but my hair loss did not. But you bring up a good point. When a real cure is found for hairloss, it's likely going to be something out of left field, yet something very simple.

 

[jnsm2842]

My hairline has slowly but surely been creeping back(have a beauty mark for reference lol). However I have only done two test cycle and no one in my family has baldness other than an uncle... I've used Nizoral fairly religiously too.

If my hairline has crept back minimally with a little thinning on the crown, what should I expect from future cycles considering I am two cycles in and 24. I can't really afford to go bald(lots of income based on appearance) and I could afford a transplant if I ever needed it but would definitely prefer not to need to.

And a question no one has been able to answer of mine: If you are receding does that mean you will KEEP receding/thinning guaranteed? Or can you hit a point where the loss will stop? My hairline has always been high, so my loss could be mostly chocked up to maturing sped up by test, but if it keeps going obviously thats a problem.

 

[jnsm2842]

My hairline has slowly but surely been creeping back(have a beauty mark for reference lol). However I have only done two test cycle and no one in my family has baldness other than an uncle... I've used Nizoral fairly religiously too.

If my hairline has crept back minimally with a little thinning on the crown, what should I expect from future cycles considering I am two cycles in and 24. I can't really afford to go bald(lots of income based on appearance) and I could afford a transplant if I ever needed it but would definitely prefer not to need to.

And a question no one has been able to answer of mine: If you are receding does that mean you will KEEP receding/thinning guaranteed? Or can you hit a point where the loss will stop? My hairline has always been high, so my loss could be mostly chocked up to maturing sped up by test, but if it keeps going obviously thats a problem.

My hair started receding at a young age, however it seemed to have stopped. and has been at the same spot for the last 10 yrs or so

 

[Bruce St. Pierre]

Some of you bros dont care about hair loss, but it can be a big concern for most of us other bros. I'm 35 and I still have a thick and full head of hair. I am not one of those guys who would look good bald or balding. In some of my cycles years ago, I noticed large volumes of hair falling out in the shower during a cycle. This brought me to the point where I would look in the mirror and say, "What good is there in having huge muscles if my hair looks like crap?" So my search began to find the best possible hair solution, which involves stopping hair loss and even reversing it!

Let me just show you the final results (IN ORDER OF IMPORTANCE), and I will comment on each:

1. AVODART® (Dutasteride) - Dutasteride was developed to help shrink the prostate and was found to have an even more profound effect on regrowing hair than Finasteride! Not only that, it can take care of more of your DHT, it starts working faster, and stays in your system for much longer. 1 to 5 mg ED is all you need, and it also keeps that prostate down during your cycles. In my book, this is a win/win situation.
   
2. PROPECIA® (Finasteride) - Next to Viagra, this drug may have had one of the all time record advertising budgets. Finasteride is a hair loss prevention / regrowth drug. Recommended dose is 1 mg ED and after 6 to 12 months the user may achieve positive results. The reason I write "big 4" in the title of this thread is that it may not be necessary to use both Dutasteride and Finasteride, although there are no known drug interactions. I say roll with Dutasteride if you can and if not then use Finasteride.
   
3. ROGAINE® (Minoxidil) - Cheap to buy generic at target in three month supply, Minoxidil blocks DHT on the scalp. After handling DHT within the body via Dutasteride or Finasteride, you can also stop the damage of DHT on the scalp. Use twice a day. I use it after my morning shower and after my workout shower.
   
4. NIOXIN® (Cleanser, Conditioner, and Treatment) - Use these Nioxin products as your daily shampoo and conditioner. They work on the scalp to ensure that your skin is healthy. Shampoo removes impurities that clog follicles, including DHT. The conditioner keeps the scalp moisturized. The treatment adds botanicals and nutrients to the scalp skin.
   
5. NIZORAL® (A-D Shampoo) - Ketoconazole, the main ingredient in Nizoral, acts as a relatively mild anti-androgen. (Androgen binds to hair follicles and over time shrinks them down, causing thinner and thinner hair.) Use this shampoo once a week for help with DHT.

​

This hair regiment is not difficult to maintain, and can provide great results. I went from losing my hair to growing it back! It takes a few months to start working, so for the first 6 months have patience. Passing the 1 to 2 year markers using the "Big 4" regiment should yield significant hair gains, or at the very least put an end to your loss.

This article assumes appropriate nutrition, hydration, and sleep.

Peace,

-bj

Great post man! Thank you for this!

 

[Michael Scally MD]

Ertas R, Orscelik O, Kartal D, et al. Androgenetic alopecia as an indicator of metabolic syndrome and cardiovascular risk. Blood Press. http://www.tandfonline.com/doi/full/10.3109/08037051.2015.1111021

Numerous studies have investigated a probable association between androgenetic alopecia (AGA) and cardiovascular disease (CVD) by researching limited and dispersed parameters.

We aimed to evaluate both traditional and non-traditional cardiovascular risk factors in male patients with early-onset AGA.

This case-control study included 68 participants: 51 male patients with early-onset AGA and 17 healthy male controls.

Patients with AGA were classified into three groups according to the Hamilton-Norwood scale and the presence of vertex hair loss.

Traditional and non-traditional cardiovascular risk factors were examined in all study subjects.

Metabolic syndrome was diagnosed in 25 patients with AGA and in two control subjects (p < 0.05).

The carotid intima-media thickness values were found to be significantly higher in patients with vertex pattern AGA than in patients without vertex baldness and controls (p < 0.05).

The pulse-wave velocity values were also found to be significantly higher in patients (p < 0.001).

A limitation of this study was the small study population. In conclusion, vertex pattern AGA appears to be a marker for early atherosclerosis.

This finding supports the hypothesis that early-onset AGA alone could be an independent risk factor for CVD and metabolic syndrome.

 

[Michael Scally MD]

Caserini M, Radicioni M, Leuratti C, Terragni E, Iorizzo M, Palmieri R. Effects of a novel finasteride 0.25% topical solution on scalp and serum dihydrotestosterone in healthy men with androgenetic alopecia. Int J Clin Pharmacol Ther. http://www.dustri.com/nc/article-response-page.html?artId=13950&doi=10.5414/CP202467

OBJECTIVE: The effects on scalp and serum dihydrotestosterone (DHT) of different doses of a novel topical solution of 0.25% finasteride (P-3074), a type 2 5alpha-reductase, were investigated in men with androgenetic alopecia.

METHODS: Two randomized, parallel-group studies were conducted.

Study I: 18 men received 1 mL (2.275 mg) P-3074, applied to the scalp once a day (o.d.) or twice a day (b.i.d), or 1 mg oral tablet o.d. for 1 week.

Study II: 32 men received P-3074 at the dose of 100 (0.2275 mg), 200 (0.455 mg), 300 (0.6285 mg), or 400 (0.91 mg) muL or the vehicle o.d. for 1 week.

Scalp and serum DHT and serum testosterone were evaluated at baseline and treatment end.

RESULTS: Change from baseline in scalp DHT was -70% for P-3074 o.d. and approx. -50% for P-3074 b.i.d. and the tablet. Serum DHT decreased by 60 - 70%. The doses of 100 and 200 muL P-3074 resulted in a -47/-52% scalp DHT reduction, similar to the 300 and 400 muL doses (i.e., -37/-54%). A -5.6% inhibition was observed for the vehicle. Serum DHT was reduced by only -24/-26% with 100 and 200 muL P-3074 and by -44/-48% with 300 and 400 muL P-3074. No relevant changes occurred for serum testosterone.

CONCLUSIONS: The novel finasteride 0.25% solution applied o.d. at the doses of 100 and 200 muL results in an appropriate inhibition of scalp DHT potentially minimizing the untoward sexual side-effects linked to a systemic DHT reduction.