Thinning/thin hair, short/shortening terminal length ("hair won't grow")? Check here!

[Reyesuela]

My background:

I started lurking here...some time before 2008. I'd always had what lay people call "long hair" (hips to APL, depending on what I felt like) and decided to actually grow it out. I got it to pinkie length before I got bored and chopped it to pixie. After that, I had it various lengths and various styles--lots of conventional dye, highlights, etc. Had more kids and less time, so decided to go long again (sooo much less work than anything but pixie). But then my hair started to fall out. A lot. I had never measured my ponytail width officially before, but I lost between 33% and 75% of my hair at the base of my neck. At BSL, my hair was the same density it had been at my thighs!

Thinning hair runs in my family. It's probably not classic androgenic alopecia because even my father, who has it the way my grandmother did, just has very diffuse but profound thinning across all of the top and sides of his head. Nevertheless, I felt that proven balding methods would work for me. It takes months for definite results, of course, but the evidence is now all over my head--and NOT IN MY BRUSH!!! I look like a dandelion, with hair sprouting everywhere, and I am losing 0-5 hairs daily. That's right. Some days I don't lose a single hair. Most days I now lose 1-3.

I remembered this community, which gave me hairstyling ideas back when I had really long hair, and I wanted to see if others were dealing with or had overcome similar issues. I see that a lot of people are struggling with hair loss and even defining hair loss (is it "thinning"? is it hormones? is it "shortening"? is it breaking?), and I thought that I actually had something to contribute now. So I signed up!

I also found out that, while hair thinness (in terms of ponytail diameter) and terminal length are somewhat genetic, there are things that anyone can do that are very likely to increase both. Whether you want to call this restoring you to your genetic potential or manipulating growth is up to you. :) NO, I'm not claiming that you can start cranking out 2" of hair a month. But you can likely increase your growth rate and terminal length on the order of 5% to 30% if you don't have anything wrong, depending on how stunted your normal growth is compared to your potential--and if you do have something wrong (and contrary to what people think, virtually all women who make it past 60 will have SUBSTANTIAL hair loss), you can likely do far more than that...if and only if catch it early enough, before the hair follicles have actually died. (Once they're dead, they're probably dead.)

Hair Quantity vs. Ponytail Diameter

Lots of people drastically underestimate how much hair they've lost (or how thin their hair is). They go from a 4" pony to a 2" pony, and they think they've lost half their hair. Really, they've lost 75% of their hair! That's because the area of a circle grows much faster than the circumference. So as my initial post, here's a circumference-change-to-hair-loss guide. Most women with longer hair will notice their thinner ends long before they notice a thinner ponytail or scalp. That's because the longest hairs often fall out first. Other first targets are the hair around the face, especially at the temples, getting thinner and shorter.

If your ponytail is one eighth smaller around, you've lost one quarter of your hair.

If your ponytail is one quarter smaller around, you've lost 46% of your hair.

If your ponytails is 3/8 smaller around, you've lost 51% of your hair.

If your ponytail is one half smaller around, you've lost three quarters of your hair.

If your ponytail is 2/3 smaller around, you've lost 89% of your hair.

If your ponytail is 3/4 smaller around, you've lost 94% of your hair.

[Reyesuela]

One more post today... If you have any questions about this, I'll answer below! Plan for tomorrow is to talk about some lifestyle/drug/food/etc. factors that can lead to hair thinning.

Sometimes, it's easy to tell something is wrong. If your ponytail is getting smaller, you're losing hair. If your part is getting wider, you're losing hair. If your hair is getting really thin at the ends or your maximum length is creeping up your back, you're losing hair. If your temple area is getting much shorter and more feathery, you're losing hair. If you can see the scalp at your crown, you're losing hair.

Sometimes, it's not so obvious. Are these wads of hair normal or not?

Plus, you can lose hair due to true hair loss or due to breakage or ripping out your hair. Fortunately, this last issue is easy and very fast to sort out!

But if it's due to true hair loss, remember that absolutely nothing you do to the length of your hair can convince it to stay in your head. You have to address the scalp.

Shedding. What's normal and what's not?

Everyone sheds. I said above I'm barely shedding now--that's because I lost a massive amount of hair prematurely. This is a really abnormal state, and it's medication-induced and will stop when my new hair lifespan is reached.

Three types of hairs end up in your hairbrush. Broken hairs don't have a root (thick bit) on either end. True hair loss doesn't directly cause breakage, but when your hair is thinning it can be more fragile because individual strands also thinner. Breakage is caused by damage, hair style, trauma, or all of the above. Anagen (growing)-phase hairs that get ripped from your head have a thick sheath at the root. That's an issue with you catching your hair or VERY rough handling. Telogen (resting) hairs that are shed the normal way have a little keratin bulb at the root. Extra telogen hairs being shed are what you get from normal kinds of true hair loss. (You can also get anagen effluvium from chemotherapy and severe poisoning, but I hope you'd know if you were on chemo or ate a bunch of rat poison!)

Normal telogen shedding occurs because all follicles cycle through growing and resting phases, and when they enter the resting phase, the end of the hair is cut off and falls out before new hair can grow. The terminal length of any hair is determined by how fast it grows (on average about .5" a month for vigorous terminal hairs) and how long it stays attached to your head. We're not really concerned about the smaller, finer hairs on people's head that often doesn't grow for this but rather the hair that you can put in a ponytail. :) Based on that, a person who can achieve 50% thickness around the midback--which most young women can--would shed just under 50 hairs a day, while a typical man (men's hair grows less vigorously from puberty--sorry guys) would shed about 75. These are Caucasian figures. Asians have 20% fewer hairs. People of African ancestry have 30% fewer hairs, but they may also possible have either a higher turnover or a slower growth rate. (Sorry--info on African hair stinks.)

Abnormal levels of shedding occur with hair loss/hair thinning/baldness. Women tend to have either classic female-pattern androgenic alopecia or diffuse thinning...or both. The advanced appearance of these types of thinning can be found in online searches. :) What you want to do is to catch it early! But to do that, you have to know if you're really shedding extra. So if you're a Caucasian woman losing more than 50 hairs a day or and Asian woman losing more than 40, that can be a warning sign.

Averages are just that, though. Humans shed more hair in the fall than in other seasons. No one knows why. (I guess we suck at putting on winter coats or something.) Women often vary in their shedding rates by the time of month. And we go through heavier shedding phases due to extreme stress or after childbirth (if your hear got thicker while you were pregnant) or for no particular reason at all. Stress should not KEEP your hair thin, though. So your average shed over months should still average out below the numbers above for the vast majority of people. If your hair can reach impressive lengths with less taper than normal, then either your shedding rate is lower or your hair's growing rate is faster than normal. If you're losing an abnormally high number of hairs for three months in a row, there's good high chance that you're experiencing true hair loss. Progressive hair loss often has periods of partial recovery, especially with women, but over several years, you'll keep thinning without intervention.

The size of your hairball is a terrible measure if your hair is getting longer! If you go from chin to waist-length hair, one hair is 4-5 times as big as it used to be. You can also shed a lot of unnoticed hairs if you wear your hair down. If you want to find out how much you're shedding and what other kinds of hairs you're losing, wear your hair up or in a braid and then brush it at the end of the day before immediately containing it again for bed. Brush before your shower, too, and try to catch any hairs that come out. And COUNT them. If you're a smart, prepared person (and I'm not), you'll do this before you're worried about hair loss to get a baseline. But chances are, you won't pay attention until you're really worried. :)

If you have already lost a lot of hair, you may eventually no longer have lots of shedding because you have so much less hair left. Go with the warning signs of a smaller ponytail, wide part or thin patch, thinning temples, shortening hair, or thin hair in the last 6" above the early warning signs of excessive loss.

Here's something most people don't know: Thinning is as normal as gray hair, but a lot less desirable! About 1 in 5 women will notice thinning before 50, and by 60, it's up to half, and by 80, it's more than 80% (and most of the rest are blind or in denial--80-year-olds with youthfully full heads of hair are really rare). Many women don't notice thinning hair until after major hair loss, especially if their hair is pretty short. Or they don't link female-pattern thinning to male-pattern baldness and just cut their hair shorter and curl it on top of their heads for volume and move on. (This is the real reason most old women have very short hair--short styles makes it easier, for quite a while, to hide the scalp.)

When you find lots of extra shed hairs in your brush, this means that A) you got some kind of shock (like the hormone change post-childbirth or a sudden stress)--in this case, the excess shedding should last less than 6 months and all your hair returned to its normal level by a year, with no more bouts, B) more hairs are going and staying dormant, or C) your hair is short-cycling, and with each cycle, the hair comes in thinner and stays less time until many follicles die.

With case A, a shock, the hair loss is always diffuse. If you start noticing thinning at your temples, hairline, crown, or across the top (seen at your part) rather than evenly all over, it's not A. With B and C (high dormancy and short-cycling), the hair loss is often heavily concentrated in the temples, hairline, part, and/or crown, but not always. So (to be clear) diffuse thinning can be A, B, or C, but concentrated thinning is always B or C. If you want to take a wait-and-see approach, if you can't tell that the hair loss is concentrated in any area, you can wait six months. If you see thinning in certain regions or the hair loss continues, though, progressive hair loss is occurring! In the case of a shock, there's no intervention that needs to be done. So you can just move on with your life. :)

I won't be addressing breakage-related hair thinning for quite a while, just cases B and C.

[lapushka]

What is maybe important to add is, that thinning is normal after having had a baby: see, post-partum hairloss.

Also, if you notice thinning, just don't go to the store and start smearing all sorts of things on your head, go to your doctor first and have a basic bloodtest done to look for deficiencies or potential health risks.

[Reyesuela]

I noted post-partum hair loss above twice. :)

Getting to the health issues that can cause hair loss today!

I forgot about alopecia areata, which is a non-toxicity-based anagen effluvium! Other autoimmune disorders like lupus can cause this type of hair loss, too--sometimes lupus (but not thyroid disease; that causes telogen hair loss). Some of these diseases can be treated and the hair loss will then resolve. Alopecia areata doesn't have great direct treatments, but certain treatments that work on age-related thinning also help this condition. I don't know much about alopecia areata or other immune conditions directly, but a lot of the hair loss studies I've looked at have examined remedies in the context of alopecia areata as well as classic androgenic alopecia and diffuse thinning.

EDIT: YAY! I can edit!

I have left out local infections like ringworm entirely or localized plaque psoriasis. I figure that you will know if you have these conditions and are working with your doctor to treat them!

[Reyesuela]

Lifestyle/Health Factors that Cause/Worsen Thinning

The bad news: Much thinning is going to have underlying general age-related hair loss. That's because the vast, vast majority of people, women and men, lose hair with age. Women just lose less, on average, and in a more diffuse way.

The good news: Sometimes, thinning is partially or entirely because of other issues that can be treated. Yay!

Underweight
Effect size: Mild to moderate.

Something that will cause heavy hair loss in most people is being more than mildly underweight. Your body will ditch a lot of nonessential functions to try to lower its basal metabolic rate. That alone will eventually cause hair to fall out. For some people, even with a perfect diet, this can happen while still in the mildly underweight range. For others who maintain very good diets, hair loss does not occur until they are severely underweight.

But most people have not-fabulous diets at the best of times. With normal quantities of food, frank deficiency is rare, but people who are eating very little food tend to have an even worse diet because they are living an irregular lifestyle, they have serious food aversion issues, they have an eating disorder, or they have gastrointestinal/medical issues that cause them to avoid and restrict certain foods. Therefore, most people who are more than mildly underweight have really poor diets, which adds to the hair loss.

Hyperthyroidism
Effect size: Mild.

Hyperthyroidism is a common cause of being underweight, and it is associated with hair loss. A normal thyroid runs at extremely high efficiency. An over-active thyroid is inefficient, which means that it is wasting fuel (calories). This has many different symptoms, and thinning, brittle hair can be one. This is usually caused by a tumor on the thyroid gland.


Malabsorption
Effect size: Mild to moderate.

If you have a malabsorption issue due to Crohn's disease, ulcerative colitis, untreated severe celiac disease, or something similar, hair loss is frequent. It is not, however, your main symptom--other problems will be far more severe. Frank vitamin deficiencies manifest in many ways. Your hair is just one of them. Many malabsorption disorders are general and so present with severe weight loss and underweight. Some, though, are selective, so you can be a normal weight but not be absorbing certain nutrients. I put it in this here not because everyone with poor absorption is underweight but because most who have hair loss are.

Frank Vitamin Deficiency

Effect size: Mild to moderate-severe, but you'll be VERY sick.

You rarely get frank vitamin deficiencies in the first world, but many will cause hair loss at some point before death. They are most commonly the result of malabsorption or an extremely variety-restricted or quantity-restricted diet. You can fast for a week and not lose any extra hair, and a typical moderately bad Western diet doesn't cause vitamin-deficient thinning hair.

Vitamin A Excess
Effect size: Mild to moderate.

This only occurs with non-natural sources unless you love liver. :) Vitamin A toxicity can occur due to diet only by eating a lot of organ meats because the levels in other meats are low and the plant forms are rejected if your blood levels are too high. But if you take a vitamin A supplement with the retinol form of vitamin A or take Accutane or similar vitamin-A based prescriptions, you can have hair loss from vitamin A toxicity. Topical retinoids and tretinoin don't cause this, and getting these things in/on your scalp is no problem.

Hypothyroidism
Effect size: Mild to moderate-severe.

Hypothyroidism is linked to overweight, but not for the reason most people think. While some normal-weight women develop low thyroid function (usually due to an autoimmune disease), most women with low thyroids have thyroids that are impaired by fat accumulation around the gland. While low thyroid does cause bloating, it causes very little fat gain. Hypothyroidism is not a cause of overweight and obesity because it can only down-regulate your metabolic rate a little bit. (Otherwise, you die!) Your body already runs at max efficiency without ditching functions--getting a disease doesn't make it run better! Hair is one of the few functions your body can ditch without you dying as a result, so that's something that goes up on the chopping block pretty quickly. Low thyroid does, though, encourage you to move a lot less by making you tired all of the time! That can push down your overall energy expenditure, especially if you're trying to exercise--you just really, really won't want to. Hypothyroidism is entirely treatable with drugs, weight loss, or both, depending on what is needed. Many people find that they do much better on either a natural thyroid supplement or the right combination of natural and synthetic because Synthroid has conversion issues between the different types of thyroid hormone, so if some of your numbers look normal but you're not feeling better and getting your hair back, you might want to change the drug mix.

Higher Androgen Levels
Effect size: Mild to severe.

Some women over-produce androgens no matter what their weight. Because women's bodies are so sensitive to androgens, this can produce major hair thinning. Sometimes this is a birth defect. Sometimes this is acquired. Congenital adrenal hyperplasia is something that gets diagnosed usually soon after birth or in childhood. Nonclassic congenital hyperplasia is usually diagnosed in childhood but is sometimes diagnosed later. These are weight-independent. Rarely, an adrenal tumor or an androgen-producing ovarian tumor can cause this. So see your doctor! Normal weight women can also have the most common type of androgen excess, but is it much rarer than in heavier women, because it is closely linked to insulin resistance/type 2 diabetes or type 1 diabetes, which results in PCOS or HAIR-AN syndrome. It appears that insulin resistance and type 1 diabetes both encourage the ovaries to make more androgens. No one is fully sure why yet. But this means that if your body has poorer blood sugar management (meaning your body does, not that you make bad decisions), you're much more likely to develop androgen excess resulting in more body hair and thinning head hair.

So what's the link to fat? Fat, especially abdominal fat, secretes both male and female hormones, which tips women into an androgenic state, AND it increases insulin resistance, which tells the ovaries to go androgen crazy--a double-whammy on the PCOS/HAIR-AN hair loss scale. We are all walking around with different levels of susceptibility to fat's ability to induce insulin resistance and to androgens. If you're very sensitive, as above, and your body is insulin resistant at any weight, you can have androgen excess even at a very lean weight. If your body isn't hardly susceptible to insulin resistance at all, you could reach 400 pounds and have a gorgeous head of hair, no excess facial hair, and totally regular periods. The vast majority of women are at least moderately susceptible to insulin resistance and excess androgens, which means that the more overweight you are and the longer you stay overweight, the higher your risk goes up for everything that goes along with it, including hair thinning. The crazy thing is that intra-abdominal fat is the first fat that gets lost when you lose weight, so a mere 20% of body weight loss can drastically reduce the symptoms of androgen excess, even in people who need to lose 50% of their body weight or more.

Spironolactone is the frontline anti-androgen that is used for women with androgen excess. You can have androgenic alopecia without high androgens, though--and many older women do. In this case, your hair follicles use completely normal amounts of androgens to convert to extra DHT and destroy your hair. MOST women with androgenic alopecia don't have excess androgens. They just have mean hair follicles.

[Reyesuela]

Birth Control Pills
Effect size: Mild.

In women who are really androgen sensitive, birth control can cause hair thinning (and often acne and hair where you don't want it). Changing types of hormonal birth control can really blunt the effects, but because the pills with the highest androgenic effects have the lowest level of blood clots, responsible OB/GYNs start with the more androgenic ones. High-dose hormonal birth control, like implants and the shot, have more androgenic side effects than pills with the same types of synthetic hormone.

Anemia
Effect size: Mild.

Anemia (low iron) can commonly cause hair loss. This is best measured through serum ferritin rather than a hemoglobin count. 15-200 ng/mol are typical amounts for a woman. HOWEVER, there is evidence than below 25 ng/mol can cause negative health effects, like hair loss, but above 100 ng/mol is associated with much high rates of cardiovascular disease and death. The ideal range is considered to be 25-75 ng/mol. I know some people want to get above 50 ng/mol--but PLEASE be cautious and do not go higher!!!!

Skin Conditions
Effect size: Mild.

Seborrheic dermatitis (AKA dandruff--the patchy, greasy, scaly kind) can cause hair loss. Plaque psoriasis on the head causes hair loss. So can other inflammatory skin conditions. Treating the condition resolves thinning caused by these conditions. Even more fun--if you have one inflammatory condition, you're more likely to have others.

Autoimmune Diseases
Effect size: Mild to extremely severe, depending on disease.

Some autoimmune diseases cause hair loss. This is usually mild unless it's alopecia areata/totalis--a hair-specific condition. The hair loss caused by these conditions can be addressed ideally by treating the underlying disease. When no complete treatment exists, then there are a number of other things that can be used to encourage hair to regrow, which I'll cover later.

Shock Loss
Effect size: Mild to moderate.

I guess I'm covering that again. :) Birth is the most common shock loss that women have. Extreme periods of emotional upset (losing a loved one) can also cause shock loss. So can a major surgery or major trauma, like a severe car crash, heart attack, or even a really bad infection. Even certain immunizations have been documented to cause shock loss in some people. The important thing to remember about shock loss is that it's temporary and resolves on its own.

Chronic Extremely High Stress
Effect size: Mild to moderate.

Extremely high stress can contribute to hair loss. This level of stress will also manifest in OCD-type behaviors, panic attacks, constant nightmares, extreme over/under eating, and/or other maladaptive behaviors. This isn't the kind of thing that happens in isolation. Hair loss is one of a number of sequelae you can expect with very severe stress.

Other Drugs
Effect size: Mild, unless chemo, then very extreme.

Certain other drugs, such as some common antidepressants, can cause hair loss. You may be able to change drug therapy. Obviously, sometimes, taking the drugs is far more important than preserving your hair, such as chemotherapy for cancer! If you're taking something that thins but does not destroy hair and can't get off it, there are a number of therapies that can help. For chemotherapy, there is literally nothing that has been tried that makes a difference.

EDIT TO ADD--I'm editing to add up here for organization!

Vitamin D
Effect size: Mild.

Low vitamin D levels can impact hair. However, almost all people in first-world countries have low vitamin D levels! (You are supplementing, right?) I recommend the Vitamin D Council's recommendations for vitamin D blood levels. But talk to your doctor about what's right for you. Remember that vitamin D3 is the only form that can be absorbed, and you can't get it through food--sunlight or supplements are it!

Smoking
Effect size: Mild to moderate.

Smoking kills hair follicles over time and also turns your hair gray. As if you need another reason to quit! QUIT!

Coronary Artery Disease
Effect size: Mild, probably--lots of cause/effect questions here.

Hair loss has been seen as a warning sign for a higher risk of coronary artery disease, but it turns out, it also works the other way around. Your body can manufacture hair-killing DHT in the skin using cholesterol. High cholesterol means, on average, less hair.

[Alissalocks]

This is very informative, thank you for sharing! (Although I'm kinda worried now that I'm shedding too much, but im trying to not freak out). :p

[Reyesuela]

The vast, vast majority of women have hair that significantly thins between age 18 and 80. Thinning is like gray hair. Not everyone gets it, but most do, and some more than others! I know I'm not being helpful YET on what to do about it, but that will come, I promise!

Extreme Diets
Effect size: Mild to moderate, unless you're super ill.

Very low calorie diets--less than 800 cal/day--cause thinning over a prolonged period of time. At this kind of deficit, already very slender women will be losing a pound a week, normal-weight women lose two pounds a week, overweight women three, and obese women would be losing 3.5-10 pounds a week, depending on their starting weights. A healthy minimum calorie count for non-doctor-supervised and supplemented diets is 1000-1200 calories a day for women and 1200-1500 calories a day for men, depending on height and activity level. Most people wildly underestimate how much they are eating, so that's why I put in the weight loss that comes with VLC diets. No one has a "slow metabolism" that can keep you from losing weight when calories are reduced. That's like saying that your car is now more fuel efficient because it's broken. Your body would have to do the equivalent of throwing all the seats out and cutting off the top to keep going just as far on less gas!

Gastric Bypass Weight Loss Surgery
Effect size: Mild to moderate, unless you're super ill.

Gastric bypass, specifically, removes part of the digestive system, so you absorb nutrients less well. You will be told to take particular supplements to avoid vitamin deficiencies for the rest of your life. Many people stop taking these supplements. Deficiency and hair loss can result.

Insulin Resistance/Type 2 Diabetes OR Type 1 Diabetes
Effect size: Mild to severe.

Your hair follicles need to be able to process insulin to grow. We don't know why. But if they can't take up insulin (insulin resistance/type 2 diabetes) or if there is often not enough insulin present (poorly managed type 1 diabetes), hair loss results. Diabetes-managing medication is helpful in both cases. In inEffect size: Mild to moderatesulin resistance/type 2 diabetes, maintaining a normal body weight and changing to a diet low in refined sugars and grains and high in unprocessed fruit and plenty of veg and whole grains will help or even reverse insulin resistance in most cases.

Vegetarian, Especially Vegan Diets When not Supplemented
Effect size: Mild, unless also ultra low fat or something really unsound like raw vegan, then up to moderate.

Without supplementation, vegetarian and especially vegan diets are likely to lack some crucial B vitamins and be unhealthily low in some hair-building amino acids. Very low fat diets can also cause hair loss!

Low Carb or "Paleo" Diets, Especially Ketogenic Diets
Effect size: Mild to moderate.

Paleo diets aren't actually based on how people ever lived, and ketogenic diets can be healthy in the short term but induce insulin resistance that is VERY hard to reverse and creates many vitamin and mineral deficiencies over the long run. Slow carb is great--very low carb, not going to be your friend in 1-5 years.

Aging
Effect size: Mild to severe.

This is one that gets almost everyone to some extent. Estrogen tends to make your hair thicker because it binds to the precursor to follicle-destroying DHT. As you get older, you might start to see some dark hairs here and there on your lip and chin, and your braid isn't as thick as it was. Menopause, especially, accelerates hair loss in women. Men get much more dramatic hair loss, especially at younger ages. Just because you have hair loss doesn't mean your androgens are high. Men who are bald have no more testosterone, on average, than men with hair. Their follicles are just more sensitive to it. It's the same with women--our overall lower levels of androgens help keep most of us from losing as much hair, even spread out across our heads in the female pattern, as men do. It also isn't linked to low fertility, if you thin early!

Fact or Myth Quickie: Your Hair Comes From Your Father's Mother

Complete myth in a general sense, I'm afraid. Your genetic hair destiny comes from both sides of the family. My father got this extreme diffuse thinning from his mother--I got it from him, but it's not because she was my father's mother. It's just bad luck. Her older sister had hair that went gray and stayed thicker. She got hair that stayed black and fell out.

That's it for causes! Next on to solutions.

[Reyesuela]

How to Give You Hair the Best Chance: Basic Lifestyle Factors

These aren't things that can totally prevent hair loss in everyone. I'm in the ideal weight range for healthy hair and hormones, I work out regularly, and I have a nearly perfect diet according to food diet logs that I used to make sure I was getting the right macronutrients, micronutrients, and servings, following the Mediterranean diet. And....my hair was falling out in handfuls. :) But there's good research that indicates that without these things, my hair would have been falling out in BIGGER handfuls! For some people, this big-picture lifestyle things will be enough to maintain a good head of hair for a long time.

Cardiovascular Exercise, or Cardio with Weights

Regular cardiovascular exercise, especially regular cardiovascular exercise plus some weightlifting, is great for both general health and hair thickness. Weightlifting alone does not have most of these benefits. :) Because I'm lazy, I'll just call this "exercise" from now on.

First, exercise causes decreased blood pressure and increased circulation, not just during exercise but all the time. Increased circulation has been show to be very good for hair, and softer, more flexible blood vessels are much better at delivering nutrients and oxygen where needed.

Second, exercise triggers a flood of reactive oxygen species (ROS)--basically, oxidants. You might think this is bad, but it's really great! In an extremely simplified form, your body notices the sudden flood of ROS, and in response, it sends an army of antioxidants and the repair patrol to cancel out all the oxidants that it can find and to send repairs anywhere they were. Without this chain reaction, your body accumulates a lot more damage. We used to think that the brain couldn't generate neurons after birth, but guess what? Cardio exercise that lasts for more than 30 minutes, continuously, causes neurogenesis, and it is the ONLY thing that does, as far as we know. Oxidative stress is a major factor in many kinds of hair thinning for reasons not fully understood, and exercise is how you healthily release your antioxidant army.

Third, exercise increases insulin sensitivity. While the normal blood sugar range is fine, the farther you can get into the bottom of the normal range, the better it is. Ketogenic diets will initially slash your blood sugar, but over time (6 months or more), your body tissues become increasingly insulin resistant to allow your brain to make use of the little natural glucose available to it, and blood sugar creeps back up, so there are no long term shortcuts to this. Hair follicles need to be able to make use of insulin to make thick hair, and the more insulin sensitive your body is, the better it can do that. Weightlifting plus cardio does this even better than just cardio alone because you increase your muscle mass, which is naturally much more insulin sensitive than fat is.

Fourth, this kind of exercise reduces free testosterone--the kind that's in your bloodstream that can then go to your follicles and gent converted into DHT.


Fifth, it reduces inflammation. Inflammation is a contributor in hair thinning, too, and anti-inflammatories administered at the scalp have been proven to increase hair thickness. Cardio exercise is one of the best ways to decrease overall inflammation because of the repair army that gets released after, as mentioned above.

Sixth, exercise helps manage weight, combined with a sensible diet, and being overweight is bad for your hair because fat is an inflammatory endocrine tissue, it secretes androgens, it increases insulin insensitivity and oxidative damage, and it impairs circulation. :(

This leads to the second major lifestyle factor...

[Reyesuela]

Maintain a Healthy Body Fat Percentage and Lean Mass

If you have an average lean mass, you should have a body fat percentage between 20 and 25%, as a woman, or 10 to 15%, as a man, for good hair health. Fat is an endocrine tissue. With too much, you end up with high inflammation and all the things mentioned above: poorer circulation, higher blood lipids, higher blood pressure, greater insulin sensitivity, higher oxidative damage, higher androgens in women, etc. With too little, you leptin levels plummet and other ugly things happen--including hair loss!

If you have a very large muscle mass due to weight-bearing exercise, then as low as 15-18% can be healthy for a woman because she would not have low fat, in pounds, but a healthy total quantity of fat plus extra muscle. Muscular men can go down to 8-9% and still be very healthy--men who don't much exercise already have a much larger muscle mass than women do, so their percentages don't change as much.

Realistically, a healthy body fat mass and muscle mass will only occur with a BMI (body mass index) between 18.5 and 23 for women, including muscular women, and up to 25 for muscular men. If you are a professional male bodybuilder at the absolute limits of natural human genetic potential and you are very tall, you can have a BMI up to 29 with 15% body fat if you are very, very hydrated. Any more than that, any you're going to have high body fat or be on some performance-enhancing drugs. In the same situation, women will very rarely be able to hit a BMI of 26 and still have a body fat at 25% or under.

The most accurate way of getting your body fat percentage and fat-free mass index is through a DEXA scan, which costs about $75. But the Navy body fat calculator is quite accurate, too: http://fitness.bizcalcs.com/Calculator.asp?Calc=Body-Fat-Navy . It can be off by up to 10%, which means that if it says that you have 30% body fat, you really have 27% to 33% (not 20% to 40%!!!!). Note that your body fat doesn't decrease as fast as you might think with weight loss. That's because fat requires structural tissue to hold it to your body, mostly collagen, as well as additional blood supply, blood vessels, and water, all of which are lean. So between 15% and 33% of every pound loss is fat-associated lean tissue.

And now on to the third major lifestyle factor...

[Reyesuela]

A Healthy Diet

A healthy diet has enough "good" carbs, fat, and protein and limits the "bad." It also has plenty of all the needed micronutrients. You can evaluate your macronutrients (carbs, fat, and protein) on MyFitnessPal for free, or your micronutriens on Cronometer for free--it's slightly more of a pain to use. Weight your food, or it's completely worthless. Even packaged food. I'm serious! Otherwise, your estimates will be wildly wrong.

Good Carbs: 50-70% of Calories

Vegetables: 5-10 servings a day

The largest source of high-quality carbs in your diet should be culinary vegetables. Five a day is good. Ten a day is better. Eat "across the rainbow" for the best health. I've spent a long time with nutrition tables, and I've got a simple formula that I try to get every day to hit all the micronutrients without weighing my food every single day.

-Dark leafy greens and cabbage family. Salad or cooked, doesn't matter. At least one serving. Also includes broccoli.
-Orange, dark yellow, or red vegetable. I try to get a serving of these, whether tomatoes, sweet potatoes, squash, red peppers, or carrots.
-Onion family. Some onions/leeks/garlic every day. I eat less than a full serving, almost always, but I put a decent amount inside one or more dishes!
-Starchy vegetable. Yes, potatoes are healthy! Just don't fry them or drown them in butter. I usually get one serving of some kind of starchy veg. These have lots of soluble fiber.
-Beans and Peas. Together with whole grains, these are lower-methionine sources of protein as well as high-quality carbs.
-Other Veg to Watch: While not daily, necessarily, it's very good to have peppers, seaweed, and cooked mushrooms. (Raw mushrooms are not very healthy at all, though.)

Whole Grains: 2-5 servings a day

I love whole grains, but I try to limit myself to make more room for veg! 2-5 servings a day is ideal, with higher numbers mostly for active men who are eating more calories.

Whole grains include oats, rye, wheat, and barley, among others. Sweet corn, not so much, but cornmeal, especially masa, yes. They have very high protein for plant-based foods. Unless you have an allergy or celiac disease, there is no reason to avoid wheat. Gluten today is the same as gluten 150 years ago. The "wheat belly" author flatly lied. People have been eating high-starch foods from the beginning of time. Where grass seeds weren't a staple, starchy roots were. Whole grains are closely associated with good insulin sensitivity and low levels of heart disease, especially those types affected by atherosclerosis.

Oats are especially good for hair, and whole wheat and barley have high silica content--also hair-boosters.

Fruit: 3-5 servings a day

Eating across the rainbow also applies to fruit! Culinary fruit can be divided largely by color. I try to eat an orange/yellow citrus fruit, a red or purple berry serving, and one other fruit, often apples, each day, minimum. Fruit is high sugar, but in the whole form, it has enough fiber that it doesn't have a negative impact on a healthy person's blood sugar, and fruit has many micronutrients that are either unique to fruit or not really found elsewhere. Whole fruits are always better than juice. Juice is more like sugar water with vitamins thrown in!

As far as hair goes, these carbs are going to be the major source of antioxidants for your body, including vitamins A, C, and E, as well as some trace minerals like silica.

Fermentation: Healthy Booster

A number of fermented foods have been shown to have really positive health effects that are unique to fermentation.

Bad Carbs

Added sugars, including natural sugars like agave nectar and honey, fruit juice, and refined grains do not have the health benefits of good carbs and are implicated in atherosclerosis and insulin insensitivity. Keep under 2 servings of refined grains of any type and under and under 6 teaspoons--preferably half that--of added sugars.

[Reyesuela]

Fats: 15-30%

Low fat diets destroy hair, but the wrong kinds of fats won't do you any favors, either.

True olive oil is the single best-documented fat for beneficial health effects. As much as possible, added oils and fats should come from olive oil. You can cook with it and garnish with it. Sadly, almost all the oil that is imported is adulterated due to the massive influence of organized crime in Europe. Buy certified California-grown olive oil instead. I buy a big bottle right after harvest and stash it in my deep freeze, unfreezing it to refill a smaller bottle so it doesn't oxidize much throughout the year. Other decent fats include naturally-occurring fats in fruits like avocado and also peanut and canola oils.

Fatty fish are the main source for healthy dietary omega-3 fats that the body can use. While flaxseed is great for other reasons, you can't actually use the ALA omega-3 from plant sources with any efficiency. Fish are where it's at. If you don't want to eat animal-derived products for ethical reasons, try algal oil that contains DHA and EPA.

Nuts are an excellent source of healthy fats. Many studies have specifically linked the consumption of 1-2 servings (moderate handfuls) of nuts a day to good heart health.

Monounsaturated animal fats are also fine in moderation.

Bad Fats

Saturated fats are not fine! Despite the recent hype, yes, saturated fats are clearly bad for you, even when they come from grassfed beef or butter. Limit these severely--red meats to 2 servings or less a week, and butter the same. Dairy products that are part skim are better than full fat, and cheese with fat should be limited also because of high levels of advance glycation end products (AGEs).

Palm oil is possibly even worse than red meat fat. The benefits of eating, not spreading on hair/skin, of coconut oil is primarily documented in contrast to palm oil. Coconut oil versus olive, peanut, or canola oil does not yet have any documented benefit, but it's definitely a smart choice over butter or palm oil!

Frying, including deep frying or pan frying, makes even healthy oils far less healthy and causes AGEs to form at extremely high rates.

Protein: 10-20% of calories

Adequate protein is crucial for hair growth, as hair is made of protein, and protein sources are also the best sources for most B vitamins and many trace minerals. A diet should be lower in protein if you are younger and less active. If you are highly active and young, 15% is good. If you are over 65, 15-20% is best because people stop absorbing protein as well, regardless of activity level.

Protein from plant sources should ideally be at least half of all your protein. Many meats are pro-inflammatory, and the amino acid mix from plant sources are less aging than animal sources. Aging is bad for hair! The remainder of protein can come from animal sources, ideally the following:

Seafood, Especially Fatty Fish: 2+ servings per week

Fatty fish twice a week and as much other seafood as fits your diets are good for the body and hair. Don't eat high-PCB and mercury fish more than once a week, though.

Dairy: 1-3 servings a day

Dairy is still the best dietary source for bio-available calcium--and calcium supplements have all kinds of health issues associated with them, so dietary sources are far, far better. Low-sugar dairy, such as kefir, unsweetened yogurt, and fresh cheeses are best, especially if they are also skim or part-skim. At least one serving a day is needed even with lots of calcium-rich other foods, unless you are eating lots of fish with bones (as some people do with anchovies canned sardines and salmon).

Lean White Meats

Poultry is a healthy source of many amino acids and trace elements.

Eggs: Up to 5 a week

Up to five eggs a week is still shown to be healthy! Eggland's Best or pastured eggs are healthier than conventional. Organic doesn't matter.

Gelatin

Gelatin and broth/stock made with animal skin are an important source of amino acids that tend to be in short supply in modern diets that are incredibly important for hair-building. You can take these however, but I stick with caplets because I just don't like gelatin all that much, and I don't eat yogurt fast enough to keep it from gelling unpleasantly with pure gelatin. 3g a day is a great goal. This has been shown in numerous studies to increase hair.

Bad Protein

Preserved Sausage and Deli Meats

These are class 1 carcinogens. They have a weak effect, but limit them to once a week! They are very pro-inflammatory. Not good for hair.

Red Meat

Eat lean cuts of red meat no more than twice a week. Even grassfed beef and wild game has unhealthy fats. The added amounts of omega-3, monounsaturated, and CLA are very, very negligible, unfortunately, and don't offset the effect of the saturated fat.

[*Wednesday*]

What is maybe important to add is, that thinning is normal after having had a baby: see, post-partum hairloss.

Also, if you notice thinning, just don't go to the store and start smearing all sorts of things on your head, go to your doctor first and have a basic bloodtest done to look for deficiencies or potential health risks.

That is a good mention. If all is okay, then we can smear :p

[Reyesuela]

That is a good mention. If all is okay, then we can smear :p

LOL! If you have hair loss that is really dramatic or is part of other symptoms, you should definitely see a doctor! Hair loss plus hair where you don't want it, hair loss plus fatigue, hair loss plus aching gums, hair loss plus dramatic weight loss--those might be signs of something serious.

Plus, everyone should ALREADY KNOW their vitamin D and fasting/postprandial blood sugar levels. Right? Right? ;)

[lapushka]

Smoking

Smoking kills hair follicles over time and also turns your hair gray. As if you need another reason to quit! QUIT!


Smoking might not be as "hip" ;) as it was in the 50s, and 60s and 70s, but my mom and dad have both smoked their entire lives (they are both in their 70s now), and my dad has gone gray very gradually (still isn't fully gray), and my mom was gray by age 40-45. Is there any proof (study) out there that confirms this?

[Reyesuela]

Your Hair is Thinning! What Will the Doctor Do?

What the doctor does depends on finding other than hair thinning. In general, he will probably order a basic metabolic panel.

Poor fasting glucose levels indicate insulin resistance. Most people's fasting glucose gets worse with time. This is partly aging but heavily accumulated damage due to sedentary lifestyle, poor diet, and increasing fat mass with decreasing muscle mass due mostly to the two things before. 70-99 mg/dl is considered normal. (If you're in a country that reports in mmol/L, divide everything by 18.) But below 85 is best--this "high normal" includes 85-year-olds, and unless you're 85, you shouldn't be getting these numbers. High-normal to low-high fasting glucose isn't treated medically, but exercise and diet changes should do the trick. Metformin is usually the frontline treatment for higher levels--but lifestyle changes are still important. Start with a microdose with a pill cutter to avoid extreme nausea, if your doctor lets you. If you ramp up slowly, it's very well tolerated. The initial nausea stage makes most people stop taking it.

A high BUN/creatine ratio is also associated with hair loss since it can indicate blood flow issues that come with heart disease. (Don't freak out--it also comes with dehydration!)

You may also get a lipid panel. High cholesterol is associated with hair loss because your skin can manufacture androgens locally from cholesterol.

You should get a serum ferritin test. Low ferritin causes hair loss. Typical results are 15-200 ng/ml for women and 20-300 ng/ml for men. Above 100 ng/ml has been shown to be highly associated with heart disease and is believed to CAUSE it. Therefore, the ideal range is considered to be 25-75 ng/ml for both men and women. Some people really want their serum ferritin above 50 ng/ml because they think it improves hair. Fine, but keep it BELOW 75 ng/ml. If your iron is low, you'll be prescribed iron. If it's high, donate blood! Many doctors don't know about the ferritin/hair loss link, so you may need to push for this, but you should be getting this anyway because of the extremely damaging effects of high ferritin!!!!

You should already be getting vitamin D tests regularly and should be on a supplement. Vitamin D is manufactured in the skin with exposure to UV radiation and can't be gotten through food. Almost no one with an indoor job gets enough sun exposure to get enough vitamin D, and no one does in the winter in moderate to cold climates. People with darker skin are especially prone to get deficiencies. So basically practically everyone is deficient at least part of the year. The Vitamin D Council recommends that adults take 5000 UI of Vitamin D daily so that you have a low chance of being deficient or having too much. The healthiest range is 40-80 ng/ml or 100-200 nmol/l. Vitamin D3 is the only usable form of vitamin D.

If you present with fatigue or with sudden weight loss or you are quite slim, your doctor is likely to order a check of your thyroid hormone levels. There is some debate as to what the low cutoff should be because some people with low-normal thyroid hormone levels feel better with higher levels. There are very long articles written on this. I'm staying out!

If you are a woman presenting with hirsutism and/or disturbed menstrual cycles, your doctor will likely order a hormone panel and look carefully at your androgens, FSH, and LH levels, plus take a history to see if you might have PCOS or (very unlikely) an ovarian or adrenal tumor. The frontline medication for excess androgens (assuming no cancer) is spironolactone. This is so effective that male-to-female transexuals use it to knock out testosterone almost completely. It is NOT SAFE in pregnancy.

Your doctor might also see other symptoms or might want to check the boxes and look at other vitamin and mineral levels, including B12, folate, vitamin A, vitamin C, selenium, and zinc. These are more long-shot.

Your doctor is likely to ask about any prescription medications you're taking, in case those are the culprit, and might change your prescription.

Your hair loss is most likely to resolve if you had severe thyroid issues or androgen excess that are successfully treated or if it was medication-induced. Because hair loss is a normal part of aging, if it is one of these other issues, you are likely to see only minor improvements.

What hair loss-specific treatments can the doctor prescribe?

For women, there are no prescription hair loss treatments. Minoxidil, which is over-the-counter, is the only FDA-approved medicine for women. That does not, however, mean it's the only thing that works! Minodixil does not depend on androgen knockdown for its effect, so it works in cases even where DHT isn't the culprit. Hair loss can improve in post-menopausal women with the use of estrogen in hormone therapy, but there are important risks to consider before taking this step. Your doctor should discuss these with you.

For men, there are finasteride and the more-powerful dutasteride prescription medications for androgenic hair loss. Finasteride is anti-androgenic and has a 2-4% risk of erectile dysfunction, ejaculatory dysfunction, and loss of libido, which is long lasting or even permanent in rare cases. It also decreases sperm count down to between half and 1/12th, with an average of 1/4th the normal sperm count being recorded. This would push a number of men into the infertility range, so if you're hoping to conceive and don't do so within six months, there's a high likelihood that the finasteride is to blame. The other FDA-approved medicine option is minoxidil, which doesn't work as well on men as it does on women but is very effective in greatly slowing hair loss in many men. Other things that aren't FDA approved also work.

Note that some doctors prescribe finasteride off-label for post-menopausal women, believing that the negative study was "fixed" to avoid lawsuits that might come about if a woman wasn't post-menopausal and got pregnant and her child had birth defects of the genitalia (highly likely for a male baby). Whether this works at all is debatable.

[Reyesuela]

Thinning Hair: How It Works (We Think!)

Say you aren't losing hair because of some underlying medical problem. What, then, is the cause, and how common is it?

Objective measurements find a lot more hair loss than women admit to. In one study of more than 400 randomly selected 63-year-old women, a third had Ludwig stage II or III hair loss--this is very severe hair loss, as women with stage I have already lost well over 75% of their crown hair! What stage 1 and 2 look like: https://www.youtube.com/watch?v=pMXqac025Zo For comparison, on the Savin scale, I was a Savin I-2 (I-1 is no hair loss) with at least 1/3 total hair loss at ponytail level--and a Savin II is a Ludwig I!

There are a number of factors that cause progressive hair loss in both men and women. The classical explanation is that circulating testosterone is turned into dihydrotestosterone (DHT) in the scalp through the androgen 5-alpha reductase, which occurs in sweat glands, oil glands, and hair follicles, Type 1 5α-reductase is expressed predominantly within the sebaceous gland, and type 2 5α-reductase, most commonly attributed to much if not all of the DHT manufacturing, is mostly located in hair follicles The DHT causes the hair to thin because it downregulates β-catenin/Wnt signaling, which in turn is what "turns on" hair follicles, sending them into the growing anagen phase and telling them to stay there. This also enlarges the sebaceous glands. In addition, VERY high levels of oxidative stress is usually demonstrated in the scalp of someone with high local DHT levels. In older women, lower estrogen seems to be implicated as aromatase binds androgens locally in the female scalp in the pre-menopausal woman.

All of this means that your hair grows for a shorter period of time, falls out sooner, becomes thinner and shorter each time (a process called miniaturization), until the hair follicle switches from terminal-type hair production (head hair) to vellus-type hair production (microscopic body hairs, like on your inner forearms) and then is eventually killed off.

The earlier in the miniaturization process we can get, the thicker your hair can be.

You might notice that we already know that there are a lot of moving pieces to this hair loss issue. Even completely blocking all DHT at the follicle level does not thicken hair or slow hair loss in everyone because β-catenin/Wnt signaling might be inhibited for other reasons completely unrelated to androgens or any other health issue--but non-androgen-based treatments can still work on these individuals. Which leads us to.....

Naturally Thin Hair that is NOT Thinning

If you have thin hair for your race, then most likely, you have the same number of follicles as everyone else, but your personal hormonal balance/sensitivity and your body's genetic hair growth clock tells it to have shorter default hair cycles, longer or more frequent telogen (resting) phases, and to make thinner hairs.

You would be nuts to try finasteride (as a man--women aren't prescribed this) in such a case. But the rest of the treatments do things other than knock down androgens on a body-wide level, and many have been shown to thicken individual hairs, increase hair density, and lengthen the anagen phase in a way that does or should work for people with non-thinning hair, too. Consistent use of minoxidil is also shown to prevent future hair loss, since it prevents hair loss better than it restores hair. I will note any side effects with these various approaches as they come up!

What I strongly discourage is sticking untested traditional remedies on your head or untested essential oils. While some work (most likely to do with their antioxidant properties), some have been shown to actually permanently destroy hair follicles. We don't want that!!!!

[Reyesuela]

Smoking might not be as "hip" ;) as it was in the 50s, and 60s and 70s, but my mom and dad have both smoked their entire lives (they are both in their 70s now), and my dad has gone gray very gradually (still isn't fully gray), and my mom was gray by age 40-45. Is there any proof (study) out there that confirms this?

YES! Everything I have here is based on actual studies, but it's too much work to link them all.

Smokers had earlier onset of hair graying (smokers: 31 (7.4) vs. nonsmokers: 34 (8.6), P = 0.034). Using multiple logistic regression with conditional likelihood, smokers were two and half times (95% CI: 1.5-4.6) more prone to develop PHG. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3673399/

(Edit: This best understood as smoking gives nearly everyone MORE gray hair EARLIER, which means that you have a much greater risk of premature graying, in the medical definition, and a nearly 100% chance of having significantly more gray hair earlier than you otherwise would.)


The mechanisms by which smoking causes hair loss are multifactorial and are probably related to effects of cigarette smoke on the microvasculature of the dermal hair papilla, smoke genotoxicants causing damage to DNA of the hair follicle, smoke-induced imbalance in the follicular protease/antiprotease systems controlling tissue remodeling during the hair growth cycle, pro-oxidant effects of smoking leading to the release of pro-inflammatory cytokines resulting in follicular micro-inflammation and fibrosis and finally increased hydroxylation of oestradiol as well as inhibition of the enzyme aromatase creating a relative hypo-oestrogenic state. https://www.ncbi.nlm.nih.gov/pubmed/12673073

(It will kill your hair. How much and how fast depends on a lot of things.)

There are approximately a bazillion studies on this. :) I just linked the first two. I don't state that "X totally causes Y" with just one study--I prefer 5 or more good ones.

[Reyesuela]

Active Treatment: Minoxidil
Quality of treatment: Front line
Level of evidence: Excellent. This is a gold-standard treatment.
Level of effectiveness: Mild to moderate improvement over baseline in 60% of men, more in women.
FDA approved: Yes.
Method of action: beta-catenin/Wnt signaling
Common side effects: Scalp irritation
Application: 2% twice a day, or 5% liquid/foam once or twice a day, following doctor's recommendations

Minoxidil is incredibly effective at slowing hair loss, moderately effective at stopping hair loss and increasing the diameter of hair, and mildly to moderately effective at regrowing hair from follicles that were not making hair but weren't dead yet. Because of women's pattern of hair loss, it is more effective on women than men.

Men have used minoxidil to thicken their beards with great success. You don't need to be balding for it to make your hair thicker!

Minoxidil was originally a vasodilator and blood pressure medication, but it wasn't a very good one because it had to be taken orally every four hours! But it did thicken people's hair. So it was repackaged as a topical solution that doesn't absorb well beyond the skin and FDA approved for hair growth. The vasodilator effect means that if it DOES absorb too well in the body, you can get a flushed feeling and your heart rate can increase as your blood pressure drops, and you can retain a lot of water, causing abrupt weight gain or swelling. This isn't a sign that it's working better! You should stop using it if you have these symptoms. Your doctor may recommend that you decrease your dosage or stop using it completely.

According to the FDA, women are recommended to use either 2% liquid twice a day or a 5% foam once a day. Men can use a 5% foam or liquid twice a day. The vehicle that delivers the medication is usually alcohol and propylene glycol. Minoxidil causes no irritation, but the vehicles frequently do. The foam is less irritating than the liquid, but I found it impossible to get on my scalp once my hair started really growing back, and some studies have shown it to be slightly less effective.

Women are more likely to get (or, more likely, NOTICE) extra hair on the forehead, cheeks, or "sacral region" (butt crack).
I have been using 5% minoxidil twice a day for months, and my eyebrows are bushier, with more eyebrow hairs, I've found two stray longer but fine white hairs ever on my cheeks. I do regular at-home laser treatment of my backside already, so I haven't noticed any difference there, but if I did, I would not care--depilatories work. I really don't care about any of these. I actually love the my eyebrows are going back to my youthful thickness. Thinning eyebrows are so aging!

Because 2% minoxidil works as well or better than 5% in men, women are recommended to start with less. For minimal irritation, I recommend starting with 5% foam once a day. If you get none of the more serious side effects (which are extremely rare), can choose, with consultation with your doctor, to ramp up to 5% liquid twice a day. If you start having serious irritation, let your scalp rest for a day. All your hair won't fall out from missing a few doses, and you're much more likely to develop tolerance if you're easy on your skin. If you can't tolerate either alcohol or propylene gycol, there are formulations without one or the other. There are some formulations without both, but they don't work as well.

How It Works--And What Stops It From Working

There was a lot of speculation that minoxidil vaguely "increases blood circulation," because of its effects as a vasodilator, but we now know it doesn't grow hair that way, mainly because we've discovered two things that keep it from working!

Minoxidil doesn't work at all ex vivo--that is, outside the body. Researchers discovered that the reason is that minodixil needs insulin-reactive scalp tissue and insulin to work. If you are a poorly controlled type-1 diabetic or you have type 2 diabetes/insulin resistance that is not rectified with medication, minodixil won't work for you well at all.

Minoxidil needs COX-1 enzymes to work. Taking daily doses of aspirin, ibuprofen, or naproxen will stop it from working. That's right: no aspirin therapy with minoxidil. You have to pick one. I start bleeding into the skin on baby aspirin (because my blood is already in such great shape!), sot this is a no-brainer for me. It might not be for you! I do now have to make harder choices about pain control, since Tylenol doesn't work nearly so well.

These have never been controlled for in minoxidil studies, so likely a pretty good hunk of weak responders were either on aspirin or insulin resistant, since both of these are very common in older adults likely to have balding.

NSAIDs (aspirin, etc.) by themselves haven't been shown to cause hair thinning when used chronically. But I don't think this has been studied. Insulin resistance does cause thinning on its own.

What It Does

Minoxidil tells your hair follicles to go into the anagen (growing) stage. Many people with thinning hair have an unusual proportion of follicles in the telogen (resting) phase. If they are already in the telogen phase but the hair has not yet fallen from the follicle, the hair must fall out before new hair can grow. Minoxidil also apparently can't keep hair that is fast approaching the telogen stage but not quite there from entering it. It actually tells these hairs to go into telogen faster so they can start with a fresh anagen stage. This increases the number of growing hairs.

Minoxidil also tells your hair follicles to thicken the individual hair shafts. This increases the number of terminal (vs. vellus) hairs, decreases hair miniaturization ("baby hairs" or ultrafine hairs), and thickens up even "regular" terminal hairs. This makes hair thicker around.

Minoxidil also increases the total number of hairs per follicle, mainly in non-Asians. This also increases the number of growing hairs.

Finally, minoxidil keeps hair in the anagen state for longer. This increases the total maximum length of your hair.

What to Expect

For anagen hair to grow, telogen hair must fall out. Therefore, for one to three months, people starting minoxidil experience increased telogen effluvium--AKA, more of your hair falls out! This doesn't mean that minoxidil is accelerating your hair loss. It can't do that. The only reason the hairs are falling out is because new hairs are coming in behind them. These hairs should be thicker and last longer than the old ones were going to do.

By month 6, you should know whether your hair will respond well to minoxidil based on the density at the scalp. If it is the same or slightly better than it was six months ago, you're a mild responder. If it's remarkably better, you're a strong responder. If it's slightly worse, you're a very weak responder. Very few people are complete non-responders. It should at least slow hair loss in almost everyone. It cannot accelerate hair loss, despite its hair syncing ability.

Among men who are suffering from hair loss, minoxidil, on average, gives 20 (at six months) and 50 (at one year) more terminal hairs per square centimeter. (The average healthy scalp has ~200 total.) Women respond better. The total hair thickness (ponytail thickness, basically) isn't studied. :)

Your peak hair density at the scalp will be reached between 1 and 5 years of treatment. After than, your hair desyncs and progressive aging-relating hair loss begins to take hold, but at a much reduced rate. In perspective: people general have better hair 15 years after starting minoxidil than at baseline. That means it turns back/slows the clock at least 15 years in most people.

[Reyesuela]

Active Treatment: Ketoconazole/Nizoral shampoo, AKA QUIT PUTTING MONISTAT ON YOUR HEAD
Quality of treatment: Adjunct
Level of evidence: Excellent.
Level of effectiveness: Roughly the same as minoxidil
FDA approved: No.
Method of action: No one knows!
Common side effects: Scalp irritation with overuse
Application: 1% 1-7 times weekly, 2% 1-3 times weekly, following doctor's advice

Ketoconazole comes in a 1% shampoo over the counter in the US and some countries and 2% either over the counter or by prescription (US) depending on the country. It is an antifungal shampoo for dandruff. It is supposed to be used for dandruff twice a week, due to the risk of scalp irritation. Some people can tolerate the 1% shampoo up to daily and the 2% up to three times a week. It needs to be applied to the scalp only for it to work.

I personally do conditioner (full head), shampoo (just scalp), conditioner (full head) with this shampoo.

People using ketoconazole noticed thicker hair, and so a number of studies were done on its effect on hair growth. The results were generally about the same as minoxidil, but it uses a different pathway, so it can be combined with minoxidil and other therapies for better effect. What pathway is that? you must want to know. No one knows! Some people thought that maybe fungal infections were causing hair loss in some people. That was disproven. Some people thought that it has an anti-androgenic effect on the scalp. It might do that, but mouse studies revealed that it wakes up hair in the telogen phase just fine when no androgens are involved in the condition at all! So what it comes down it is...we don't know. It works on people with thinning hair and people without thinning hair, to various degrees.

Unlike minoxidil, it doesn't seem to create much telogen effluvium at first. Like minoxidil, it takes about six months for most people to see clear results. At six months, most studies show about 20 extra hairs per square centimeter on average (in Caucasian men). It works for men and women.

What to Expect

Greater hair thickness or at least significantly slowed hair loss after six months. Fine tune your frequency to prevent scalp irritation, especially if you're adding it to minoxidil, which you should be if you've got hair loss.

[Rebel Rebel]

Reyesuela,
My main question is...Can you have normal iron and low ferritin?

I know I've read 70 is optimal for ferritin. I had a simple iron test last Oct and was told it was normal. At the time I was shedding a lot and thought for sure I was anemic ( history of anemia, heavy periods.) I then thought, well maybe it was a seasonal shed. As of right now it's slowed down but feel like it lasted a good 4 or 5 months. I'm really going to pay better attention this year. I'm also supplementing vitamin D, as I have had a deficiency. I've got a few more questions but I'll leave it here for the moment. I'll also add the my hair is superfine and thin, so extra hair loss is incredibly alarming but it might really be normal. Thanks for any thoughts here and thank you for compiling all of your exhaustive research in one convenient spot.

[Reyesuela]

Reyesuela,
My main question is...Can you have normal iron and low ferritin?

I know I've read 70 is optimal for ferritin. I had a simple iron test last Oct and was told it was normal. At the time I was shedding a lot and thought for sure I was anemic ( history of anemia, heavy periods.) I then thought, well maybe it was a seasonal shed. As of right now it's slowed down but feel like it lasted a good 4 or 5 months. I'm really going to pay better attention this year. I'm also supplementing vitamin D, as I have had a deficiency. I've got a few more questions but I'll leave it here for the moment. I'll also add the my hair is superfine and thin, so extra hair loss is incredibly alarming but it might really be normal. Thanks for any thoughts here and thank you for compiling all of your exhaustive research in one convenient spot.

You can have normal hemoglobin and low ferritin, yes. I would not make 70 ng/ml a goal. It is awfully close to the danger zone for cardiovascular disease. I recommend 50 ng/dl only with caution.

There is only mild to moderate evidence that ferritin levels below 25 ng/dl can cause hair loss. And even then, you would present with other symptoms, almost certainly, in addition to hair loss.

Everyone pretty much is deficient in vitamin D. The chances that this is substantially impacting your hair without a really, really severe deficiency is pretty low. But it can mildly impact your hair loss! :)

[Reyesuela]

Active Treatment: Finasteride and Dutasteride
Quality of treatment: Front line
Level of evidence: Excellent.
Level of effectiveness: Twice as effective as minoxidil--two thirds regain hair from baseline, and hair loss is slowed in almost everyone.
FDA approved: Yes
Method of action: 5 alpha reductase inhibitors
Common side effects: Reversible dramatically reduced sperm count; less common, impotence/libido loss (in men and women)/etc., almost always reversible
Application: 1 pill daily, ORAL, 1-1.25mg

Danger! For men and postmenopasual (off-label) women only.

Finasteride/dutasteride treats androgenic alopecia in men. It is fairly frequently prescribed off label for post-menopausal women (at higher doses, because it has weaker effects in any age of woman) but should never be used by pre-menopausal women due to extreme teratogenic effects (birth-defect-causing) and the uncertainty about the reversibility of all of its effects. Pre-menopausal women are not to even handle the pills without gloves! However, it does not effect the child of a man on these drugs.

How it Works

The first 5 alpha reductase inhibitor, finasteride was originally marketed as Proscar for benign prostate hyperplasia. Its effects on hair were soon noticed, and at a reduce dose (1mg down from 5mg), it was marketed for hair loss. It selectively reduces the isoforms II and III--and if you remember, it's mostly the isoform II that is needed to transform testosterone to hair-follicle-killing DHT. Dutasteride suppresses all three isoforms, I-III, but it's believed that it's additional effectiveness might come from suppressing isoform II better rather than suppressing I in addition to II. But it is known that reducing sebum alone mildly improves hair growth on an oily scalp, and sebaceous glands mostly produce isoform I, so there's some debate about that, still. Dutasteride has greater side effects than finasteride, so most men start on finasteride. Finasteride is either prescribed as a 1mg hair-loss drug or the cheaper 2.5 or 5mg prostate drug and then cut with a pill cutter.

Finasteride and dutasteride are the most effective hair loss treatment for men currently on the market. There is literally nothing that does better. Some men choose to do only these drugs. I think that's a bit silly. If you're desperate enough to take finasteride, wouldn't you want the considerably better result of finasteride plus things that have very rare or mild side effects, like minoxidil and ketoconazole shampoo???? Sure, they may only boost your results by 20-30% over finasteride alone...but priorities, man.

Side Effects

Because these drugs affect certain androgens, they can also have an effect on sexual performance and fertility. They always cut sperm counts drastically in men, from half to one twelfth of baseline just for finasteride, one fourth on average. This is almost always reversible, and in most cases, they do not cut sperm counts to the subfertile level. But a certain percent of men who were very fertile and many men who were only somewhat fertile will become infertile on these drugs and will need to stop to achieve pregnancy with a partner.

In 2-4% of men on finasteride, there is a loss of erectile function, ejaculation, and/or libido (the last in both men and women). In a certain percentage of those men, the loss is long-lasting, perhaps even permanent.

This is not to say that there are not millions of men extremely happy on finasteride or dutasteride! Once again, only 2-4% experience extreme side-effects. This is just to say that you should never let your wishful thinking override noticing real and emerging side effects, and you should get off the drug immediately if you have erectile or ejaculatory dysfunction or a loss of libido, before it has a chance to become permanent. And if you're trying to have a baby, have your sperm checked out if you don't get pregnant in less than 6 months.

[Reyesuela]

Active Treatment: Spironolactone Oral
Quality of treatment: Front line
Level of evidence: Excellent.
Level of effectiveness: Far more effective than minoxidil when used to treat androgen excess in women.
FDA approved: Yes
Method of action: Androgen inhibitor
Common side effects: Vomiting, diarrhea, and stomach pain or cramps. Dry mouth and thirst. Dizziness, unsteadiness, and headache.
Application: 1 pill daily, ORAL.

How It Works


Danger! For women with documented androgen excess and postmenopasual (off-label) women only.

Oral spironolactone is a powerful anti-androgen treatment for women with documented adrogen excess, usually with PCOS or adrenal hyperplasia. Many women get off it quickly because starting with a high or even the lowest normal dose can have serious nausea as a side effect. However, if your doctor allows you to cut the pills, you can start on a very low dose and ramp up, which is usually extremely well tolerated. If you have PCOS, you'll likely get metformin prescribed, too, to deal with insulin insensitivity.

Spironolactone is very dangerous in pregnancy and should only be used by women using TWO forms of reliable contraceptive. It treats androgen excess very effectively, and female-pattern androgenic balding due to androgen excess tends to be incredibly treatable, so there is a high chance that on this drug, caught early, you will get back a full head of hair. If obesity contributes to your androgen excess, it is crucial to get your weight down to control the long term outfall of all the comorbid conditions! Androgen excess never contributes to obesity, but obesity frequently contributes to adrogen excess.

For women with classic pattern baldness and no androgen excess, it is more effective (off label) than finasteride, with regrowth in 44% and stopped loss in another 44%, but it was less effective than finasteride in men (about 66% hair regrowth). This is because a lack of estrogen in the scalp of women appears to also be a major factor in female pattern baldness. Spironolactone is most commonly prescribed to postmenopausal women.

[Reyesuela]

Active Treatment: Spironolactone Topical
Quality of treatment: Adjunct
Level of evidence: Moderate
Level of effectiveness: Unknown.
FDA approved: No
Method of action: Androgen inhibitor
Common side effects: None
Application: Once or twice a day topical

Spironolactone has been used in professionally manufactured preparations, usually a nanostructured carrier gel, tone tested for treatment of acne and, in women, hirsutism. It has been quite successful in this because of its anti-androgenic effects,which means that it should regrow hair and de-miniaturize hair on the scalp. This hasn't been studied in head hair but based on facial application, it should work.

It isn't absorbed beyond the skin hardly at all--in fact, it needs a special carrier just to get it beyond the stratum corneum--which means that it's very safe as anti-androgens go, and men and women can both use it. But this means that you need to trust the company that manufacturers it to actually have a successful carrier, because there's no standard procedure for delivery. Many spironolactone creams also stink. There is at least one deodorized cream. I can't speak to its efficacy.

[Reyesuela]

Active Treatment: Estrogen replacement therapy
Quality of treatment: Adjunct
Level of evidence: Moderate
Level of effectiveness: Possibly more effective than minoxidil on postmenopausal women
FDA approved: Not for this
Method of action: Anti-androgen.
Common side effects: None, but contributes to breast and ovarian cancer risk
Application: Oral


Danger! For postmenopasual women only.

Estrogen's loss is thought to heavily contribute to postmenopausal hair loss in women, and estrogen therapy has been shown to reverse it in women with low estrogen. However, it doesn't reverse hair loss very well when progesterone is also used. And it contributes to breast cancer and ovarian cancer risks, especially when used for more than five years. Therefore, its use is limited for hair loss. It's usually aside benefit to estrogen used in cases of severe menopause symptoms.

This is obviously only for post-menopausal women!

[Reyesuela]

Active Treatment: Topical Botanical Estrogen (Soy, Red Clover, etc)
Quality of treatment: Adjunct.
Level of evidence: Moderate
Level of effectiveness: Likely around that of 5% minoxidil or slightly less--for women only
FDA approved: No
Method of action: Anti-androgen
Application: Topical on scalp once or twice a day
Common side effects: None, unless the particular formula is irritating

Isoflavones are common phytoestrogens that can penetrate into the lower outer layers, and with enough time and applications, into the upper epidermis under the stratum corneum. Liposomal delivery is necessary, so commercial applications are required. There, they bind locally with androgens and promote hair growth by reducing DHT formation. There haven't been a lot of in vivid human studies, but the ones that exist show good results.

Because the effects are local, cancer isn't a fear.

There is conflicting data on whether this will work well in men.

[Reyesuela]

Active Treatment: Oral Saw Palmetto
Quality of treatment: Adjunct.
Level of evidence: Moderate
Level of effectiveness: Half that of finasteride in men, less effective in postmenopausal women
FDA approved: No
Method of action: 5 alpha reductase inhibitor
Common side effects: same as finasteride, but less insofar as it's less effective.
Application: oral


Danger! For men and postmenopasual women only.

Saw palmetto extract and saw palmetto powdered berries have 5 alpha reductase inhibition properties. Taking these tablets is like taking a less regulated, less standardized, less safe and yet weaker version of finasteride. If you want to go the route of an oral 5 alpha reductase inhibitor, take the safer type with the known dosage and better manufacturing controls! Just because it is natural does not make it safer. If it wasn't natural, it would never, ever be allowed to be bought over the counter.

Pre-menopausal women should not take this at all. It might have some effect in post-menopausal women, but really, spironolactone is the first choice for anti-androgens for women. Women have so much less androgens already that they seem to need much more aggressive treatment.

[Reyesuela]

Active Treatment: Topical Saw Palmetto Extract (Oil)
Quality of treatment: Adjunct.
Level of evidence: Moderate
Level of effectiveness: Unknown, should be reasonably effective, more in men than women
FDA approved: No
Method of action: 5 alpha reductase inhibitor
Common side effects: Haven't found any, but you may find it irritating
Application: topical

Unlike botanical estrogens and spironolactone, saw palmetto extract (the plant sterols, which come in the gel caplets or in a pre-prepared cream) evidently don't need a carrier to deliver it into the upper levels of the skin when used topically, but it also does not have a systemic action--double win! If you are already on finasteride/dutasteride, this isn't likely to do much more (though this hasn't been studied), but if you want a more thorough 5 alpha reductase knockdown, this might have some additive effect, and it should definitely reduce 5 alpha reductase if you don't want to use an oral drug. (Neither finasteride nor dutasteride are able to be used for local topical use.)

It will likely be less effective for women than for men, as women seem to depend on estrogen's androgen-binding effect more than men do.

[Reyesuela]

Active Treatment: Oral Pumpkin Seed Oil
Quality of treatment: Adjunct.
Level of evidence: Low
Level of effectiveness: Unknown, should be at least partially effective, more in men than women
FDA approved: No
Method of action: 5 alpha reductase inhibitor
Common side effects: Like finasteride, but less so
Application: oral

Danger! For men and postmenopasual women only.

Pumpkin seed oil is even less well researched than saw palmetto, but orally, it inhibits 5 alpha reductase, and it has been shown to regrow hair in some studies. It will have the same side effects of all oral 5 alpha reductase inhibitors. If you're going to take an oral inhibitor, again, I recommend taking finasteride.

It is unknown whether the responsible sterols are able to penetrate the skin at all or whether or not they have a systemic effect, though it's been a cosmetic ingredient for some time. I wouldn't use it on my scalp for hair loss. There is no evidence that it works.

[Reyesuela]

Active Treatment: Alfatradiol (Topical)
Quality of treatment: Adjunct.
Level of evidence: High
Level of effectiveness: Less effective than minoxidil in women--likely more effective in men
FDA approved: No, but it should be--prescription medication available in many other countries, such as Germany
Method of action: 5 alpha reductase inhibitor
Common side effects: Unknown
Application: topical

This is a potent topical 5 alpha reductase inhibitor that really should be FDA approved! It's less effective than minoxidil, but as an adjunct therapy, it should regrow hair better with minoxidil than minoxidil alone. It's a fully controlled and standardized 5 alpha reductase inhibitor with great local action in the skin and little to no systemic action. It has a completely different mechanism of action than minoxidil does, which is why it would be a good combination.

I certainly would not recommend trying this through a reputable online international pharmacy, because that would be illegal.

[Reyesuela]

Active Treatment: Polygonum multiflorum/He Shou Wu/Fo-ti (Topical)
Quality of treatment: Adjunct.
Level of evidence: Low
Level of effectiveness: More effective than minoxidil in men. Will be less effective in women. Very few studies!!!!
FDA approved: No
Method of action: Anti-adrogen
Common side effects: Liver failure if you take it orally. Seriously. Don't eat this. Unknown how well it absorbs--maybe has systemic effects.
Application: Topical. I mean it. And only if you insist.

Danger! Not well researched. Possible serious side effects.

Polygonum multiflorum is used for many things in traditional Chinese medicine, including to prevent hair from turning white (doesn't work) and all kinds of internal diseases. It has been shown to be a powerful anti-androgen, but taken internally, it can lead with disconcerting frequency to liver damage and even failure. It seems to work just as well topically, but I have heard sporadic reports of breast development in men. I think this one is a good idea to LEAVE ALONE until there is better quality research on the topical form--and under no circumstances should you take it orally.

[Reyesuela]

Afterword: Because I Forgot the Introduction

Everything on this list from finasteride through polygonum multiflorum interferes with the ability of DHT to down-regulate beta-catechin/Wnt signalling which triggers and sustains the anagen phase in hair. The 5 alpha reductase inhibitors try to prevent the creation or circulation of those specific androgens, which are enzymes necessary for converting testosterone to DHT. They work best in men, and oral versions are incredibly dangerous in pregnancy. Topical 5 alpha reductase inhibitors seem to be two thirds to half as effective in women, pre- or postmenopausal.

A lack of estrogen seems to be hair-thinning in women only--young men who are balding often have too much estrogen. And oral spironolactone is a more broad-spectrum anti-androgen which is used mostly in women with androgen excess but occasionally in post-menopausal women. These should be used by women only.

Once you suppress once cause as much as is practical, there is little point in adding on more things with the same mechanism. From this list, then, only a few things would realistically be chosen for any one person, depending on age, gender, and hormonal status.

[Reyesuela]

Introduction to Weird Things that Increase Hair Growth

Following will be a list of peculiar things that have been shown to increase hair growth in people with hair loss. We don't know why these work. In some cases, we have no idea why anyone ever tried it. (Ketoconazole is one of those things that has a mysterious but well documented method of action, but at least we know why people were putting it on their heads!) A few of them work as well or better, in the limited trials that have been done, as minoxidil. None of them have as many studies as minoxidil, though, and that's important to remember! The quality of evidence on minoxidil is very high. Some of these look incredibly promising but don't have a lot of evidence behind them (usually because there's really not a way to patent them and make a ton of money off them, to be honest).

Ready for some weirdness? Let's go!

[Reyesuela]

Active Treatment: Topical Melatonin, 0.0033%
Quality of treatment: Adjunct.
Level of evidence: Moderate (five, but all funded by th same company)
Level of effectiveness: As or more effective than monoxidil--unless they're lying!
FDA approved: No
Method of action: Melatonin receptor -> ??? -> Success!
Common side effects: Temporary reddening or sensitivity
Application: Topical.

This is an approach I suggest, along with ketoconazole shampoo, for women experiencing temporary shock loss, like post-partum, who want to recover quickly.

There are melatonin receptors in the scalp. When you take melatonin orally, the body quickly down regulates its own production and metabolizes the rest--you adjust very quickly. When you apply it to the skin, no such down-regulation occurs, so the receptors are consistently more stimulated. Even better, very little, at this concentration, is absorbed into the bloodstream.

As a result, you grow more hair--in cases of hair loss, with most of the difference new growth showing up in 30 days. Hair counts were up an average of 43% in one study in six months. Hair-pull tests (a common test for severity of telogen effluvium) went from 12% negative to 62% negative in 90 days, while severe/moderately severe outcomes dropped from 62% to 8% over the same period. Nearly a quarter were growing new hair at 90 days, too.

So, what is the role of these melatonin receptors? No one knows! I'll take my guess, though. Human grown hormone surges at night, especially in growing children. Hair is supposed to grow independently of HGH. So my guess is that it grows more in response to surges of melatonin that tell it that the body isn't needing energy for moving around, so more can be spent on stuff like repairs and, well, hair. Apparently, the solution also has an effect on dandruff--but we already know that as beta-catechin/Wnt signaling goes down, sebum increases, so increasing hair growth should normally decrease dandruff.

The design of the studies are good. Unless the principal investigator just hijacked the data and fabricated the results, this looks really good. You can get melatonin drops easily. I would dilute it carefully to the proper percentage--only enough for a week at a time--and give it a shot. Make sure to put it in an opaque bottle and use distilled water. (The drops should already be in an easily water-soluble form.)

[Reyesuela]

Active Treatment: Topical Caffeine
Quality of treatment: Adjunct.
Level of evidence: Low (it definitely counteracts testosterone, but no long-term studies to show this results in growth)
Level of effectiveness: Unknown
FDA approved: No
Method of action: Phosphodiesterase inhibitor?
Common side effects: Temporary sensitivity???? Just guessing--probably not anything, really.
Application: Topical.

Will almost certainly work better on men.

Drinking caffeine will not get the same results.

The study of caffeine began with some in vitro studies that showed that it counteracted the effects of testosterone at .001% and .005%. In vitro means that A) the caffeine doesn't have to deal with the skin barrier, and B) it's sitting in the caffeine solution. Therefore, it's been tested at 2% in shampoo formulations, and most shampoo formulations keep their levels at 2-4%. For any wash-off product, I would also keep it at 2%. Leave-on gel products have been formulated at .5%. You can also add caffeine tablets to your shampoo--it's easily dissolved by water.

The question is, how did it counteract the effects of testosterone? They think that as a phosphodiesterase inhibitor, it up-regulated the cAMP-dependent pathway, which testosterone is known to down-regulate (independently of the DHT production issue, and independently of any 5 alpha reductase action), which can decrease hair growth.

Will hair that is not testosterone-blunted also grow more? Who knows! The study designers were crappy researchers, so they didn't get a baseline with caffeine and no added testosterone. Shame on you, crappy researchers.

It's cheap, it's easy, it's interesting, and it has potential. You'd chuck in a 200 mg caffeine pill for every gram/ml of shampoo, or create a pre-shower solution with water. Boom.

[Reyesuela]

Active Treatment: Salicylic Acid Shampoo
Quality of treatment: Adjunct.
Level of evidence: Low
Level of effectiveness: Low
FDA approved: No
Method of action: Reduces sebum, better penetration of other topicals, healthier/younger-type skin growth, anti-inflammatory
Common side effects: Can cause some scalp irritation.
Application: Topical.

As part of a larger regimen, this is more effective than minoxidil for restoring hair lost to alopecia arreata, a condition that minoxidil doesn't treat well at all. (Topical steriods are front-line for AA, by the way.) But really, it's most helpful in addition to other, better therapies. If you're using products on your scalp daily, there's a good chance you'll be washing your scalp more frequently. If you're washing your hair more than twice a week, there's a good chance you can't use the proven ketoconazole shampoo on your scalp every time you wash it. On the off-days, a salicylic acid shampoo is a really good idea, unless your scalp is extremely dry from the washing. Reducing sebum production will reduce 5 alpha reductase production, which is probably pulled from the hair follicle by salicylic acid, too, too some extent; the thicker layers of outer skin will be shed for more even penetration of topicals; and the outer layers of the skin will have a younger-type histology, all of which is good for hair growth.

Will it do anything on its own? Likely little to none. But it will probably increase the effectiveness of other interventions.

[Reyesuela]

Active Treatment: Topical Peppermint Oil
Quality of treatment: Adjunct.
Level of evidence: Low--few studies
Level of effectiveness: As high as minoxidil
FDA approved: No
Method of action: Anti-androgenic, but it shows action on regular telogenic hair, too, that isn't affected by androgens, by increasing IGF-1 locally
Common side effects: Can cause some scalp irritation.
Application: Topical, usually wash-off--when I say topical, I really mean topical, please!

This might be good for people unwilling to try minoxidil because it's not "natural" enough--or as an additional therapy for those already on it.

Use this in low concentrations in a carrier oil or shampoo--3% or less. Don't say I didn't warn you! They used jojoba oil in the study. Normal concentrations for leave-on formulas are >=.2% and >=3% in rinse-off due to tingle and smell.

In a study on mice, 3% peppermint oil caused hair growth on telogenic (resting-phase) hair and new follicle growth better than minoxidil. Mice are easier to grow hair on than people, but this is a very, very promising study. Peppermint oil isn't patentable, so any follow up will take forever due to funding issues. There are no signs of toxicity or phototoxicity with peppermint oil. However, you will smell like peppermint! Be aware that using 3% peppermint oil in a carrier oil as a leave on probably isn't practical.

Menthol is the largest component of peppermint oil, and it is included in some shampoos for the "tingle". It's unknown if this has the same effect, but for the heck of it, I picked a salicylic acid shampoo with menthol.

I would buy peppermint from a big company that is going to adhere to safety guidelines on the maximum acceptable content of pulegone. :) A backyard herbalist isn't going to even have the testing capacity for this.

[Reyesuela]

Active Treatment: Rosemary Oil
Quality of treatment: Adjunct.
Level of evidence: Low to moderate--few studies, but there is one in vivo on women
Level of effectiveness: As high as minoxidil 2%
FDA approved: No
Method of action: Not known, but it does increase microcapillary perfusion, so maybe that's a cause--also implicated as an anti-androgen
Common side effects: Can cause some scalp itching.
Application: Topical, usually not wash-off--when I say topical, I really mean topical, please!

Note: Rosemary oil has a very, very powerful odor. There were no concentrations published in these abstracts, but realistically, you're looking at >=15, likely .2%, on a leave-on product and 3% on a wash-off product, just like peppermint.

Rosemary oil, applied topically in a leave-on, was used in a trial with women who had pattern baldness. After three months, it had done nothing, just like minoxidil--but after six, it had regrown a significant amount of hair--just like minoxidil.

This can be added to a leave-on scalp oil in whatever concentration you find acceptable. I recommend starting LOW, and don't go above 1% for a leave-on.

Never, ever, ever take rosemary oil internally. Rosemary herbs whole on food--perfectly fine! But not the oil.

[Reyesuela]

Active Treatment: Green Tea Catechins
Quality of treatment: Adjunct.
Level of evidence: Low to moderate--few studies, but there is one in vivo on women
Level of effectiveness: Unknown
FDA approved: No
Method of action: 5 apha reductase inhibitor, but also upregulates phosphorylated Erk and Akt and by increases the Bcl-2/Bax ratio.
Common side effects: Depends on carrier, most likely.
Application: Topical or oral or both.

Green tea epigallocatechin-3-gallate (EGCG) is the primary green tea polyphenol, and it shows great promise in stimulating hair growth. However, washing your head in tea isn't going to do anything but leave your hair a funny color--aside fromt he caffeine, which could do something. It's the isolated EGCG that you want. It is moderately soluble in hot water(up to 5%) and very soluble in ethanol. Hot water doesn't denature it.

Green tea EGCG has been shown to prevent DHT from damaging the hair and to also grow telogen-stage hair that is undamaged by androgens.

We have epidemiological studies on drinking green tea and average hair loss, specific studies on EGCG and hair growth in telogenic rodents, and studies on androgenic and non-androgenic human scalp ex vivo. So it works...but how much? We don't know.

You can add enough to your minoxidil liquid to make it 5% EGCG, if you want to try it. If you're not already putting ethanol on your head, I'd recommend dissolving it in hot water and then cooling it.

[Reyesuela]

Active Treatment: Retinol or Tretinoin
Quality of treatment: Adjunct.
Level of evidence: Moderate
Level of effectiveness: This has been tested insofar as its effect on helping minoxidil; can make it 10-100% more effective, depending on study--it's also been tested as a stand-alone, but with only a negative control (not head-to-head with minoxidil)
FDA approved: No
Method of action: reduces horny layer of skin while increasing vascularization and skin quality
Common side effects: Itching, redness, peeling
Application: Topical only, ONCE daily, very small amounts

While too much internal vitamin A can cause hair loss and even follicle death, external tretinoin has been shown to make minoxidil more effective. If you have thick/thickening hair, it will be completely impossible to apply tretinoin in the small quantities that it should be applied at to the scalp. I could have done it three months ago--now, my hair would laugh at me. So keep this in mind. It's best, then, on very thin places or the edge of the hairline.

These interventions have been shown to make minoxidil anywhere from between 10 to 100% more effective, depending on the study.

Retinol can be obtained in a thinner serum that's easier to apply to the scalp and has been tested with a number of other lesser hair-growth formulas and has been shown to be effective.

[Reyesuela]

We're done with the weirder and more mysterious hair loss leads. Now on to some that directly stimulate various growth factors. Most do this by convincing the body to go into repair mode, with a few twists along the way. We'll start with the most effective.

[Reyesuela]

Active Treatment: Microneedling/Dermarolling
Quality of treatment: Adjunct.
Level of evidence: Moderate
Level of effectiveness: Incredibly effective with minoxidil and topical PGE2 and PGD2 inhibitors--more effective than any other combination of therapy
FDA approved: No
Method of action: greatly increases PGE2 expression; wounding causes IGF-1 flooding; dermal thickness and vascularity improved
Common side effects: It can hurt!
Application: Once per week. NO MORE than once ever 5 days. The key is the healing, not the wounding.

Microneedling is an incredibly effective method of inducing skin remodeling. It turns out that it works wonderfully on the scalp, too, especially with minoxidil, which works through the COX 1/PGDE2 pathway to stimulate hair growth. A trial study showed that it quadrupled the number of new hairs grown in six months per square centimeter, and other trials are continuing to see more results.

Many people assume this is because it helps topicals to "sink in" better. This is not true. Most studies do not allow minoxidil on the days that microneedling it performed to prevent possible side effects. It is the healing, not the wounding, that creates hair growth, and it seems to be able to either wake up or generate follicles on parts of the head that were slick-bald before.

You should, of course, sterilize your device every time you use it.

Personal note:

After my minoxidil/ketoconazole/salicylic acid menthol shampoo combo worked so well, this is what I added next. About five days after, I got a wave of stubble on my head that I could feel, so my own results were quite enthusiastic. I do it just hard enough to "pop" the stratum corneum and barely wound the layer underneath. Others are much more aggressive, but I had good luck with this level of wounding on my face, so I just transferred it to my scalp, too. It's easiest with damp hair that can easily be pulled flat against the scalp.

[Reyesuela]

Active Treatment: Plasma Rich Platelets/PRP + ACell
Quality of treatment: Adjunct.
Level of evidence: Moderate
Level of effectiveness: Around that of minoxidil
FDA approved: No
Method of action: induces skin remodeling
Common side effects: It hurts!
Application: In a doctor's office--usually trichologists and dermatologists use this; once every 6-8 weeks at first, then down to 4-6 months

Your blood is drawn out, separated, and the plasma with platelets and sometimes mixed with a powder called ACell is injected into your scalp.

Does it work? Yes, but like everything else, it's not a miracle cure. It helps in most studies about as much as minoxidil, but it uses a different pathway. ACell is supposed to make it work better.

The biggest drawbacks are the expense and the pain. This is also not a fully standardized procedure yet, so YMMV.

[Reyesuela]

Active Treatment: Low Laser Light/Red Light LED Therapies
Quality of treatment: Potentially primary.
Level of evidence: Strong, with outstanding questions
Level of effectiveness: A bit less than minoxidil to much better than minoxidil
FDA approved: Yes.
Method of action: induces skin remodeling
Common side effects: None known
Application: Once a month to daily--not standardized

Though this sounds like complete hokum, the hair-stimulating ability of infrared and near-infrared light was discovered by a scientist who was trying to see if low-level laser light caused cancer. He shaved the mice for the test, and to his surprise, they grew back telogenic hair. This was back in the 1960s.

Does it look absolutely absurd? Yes! Does it work? Also yes, provided you get enough of a dose. The first FDA approved device was a laser comb, but the helmets are much less of a pain to use. They are very expensive at hundreds of dollars per device, but they are a one-time expense, unlike drugs that have to be bought continuously.

Many hair replacement specialists have in-office laser devices that are on the more powerful side that you can make appointments to use. There are also home LED devices that are FDA approved/certified. The effectiveness depends on the strength of the light and how long it's used.

[Reyesuela]

Active Treatment: Mesotherapy
Quality of treatment: Adjunct.
Level of evidence: Low
Level of effectiveness: Unknown
FDA approved: No
Method of action: depends on medications used
Common side effects: Pain, unknown
Application: Once a month to twice a year--really, not standardized

"Mesotherapy" just means the cutaneous injection of herbal or drug cocktails. It is poorly studied with little evidence to support it. If the right substances were used, it could work quite well (for example, a standard treatment of alopecia areata is the intralesional injection of corticosteriods, which is quite effective, which could be called "mesotherapy"). If the wrong substances are used, it's not effective at all.

Right now, I would give this a big miss. It will be expensive, there's no documented good outcomes, and there are high risks.

[duchess67]

This is so informative, you seem to have put in a lot of work on this subject. It was quite intresting to read through the whole thread and all the research papers.

My hair has thinned over the years, all age related and hereditary of course. Unfortunately I had a terrible reaction to Minoxidil and so had to stop using it. My mom on the other hand grew a lot of hair being on Minoxidil and got almost all her lost hair back.

[Reyesuela]

I've gotten all my lost hair back...and more than I had when I was a teenager. But now I'm using a lot more than minoxidil because I got high on all that hair growth!!!!

We'll see when it grows out how it affects my actual hair length's circumference! (Who knew that the wispies around my face didn't have to be wispy? Who knew that my sideburn fluff could reach my bun and not stick up straight without carefully checking it?)

I need to continue this and then have actual recommendations at the end for people who can or can't use minoxidil or don't want to. :D

[lizardspots]

Just wanted to say a massive THANK YOU Reyesuela for this huge amount of quality information on hair loss treatments.

Could you describe your hair care & hair loss treatment regime, day to day? And with minoxidil foam, does it leave a residue/greasiness in the hair?

[Faustine]

Oh wow, what a great topic ! So much interesting and useful information here.
Thank you so much for taking the time to share all this knowledge with us, I'm definitely saving this page on my browser :thumbsup:

[Reyesuela]

Just wanted to say a massive THANK YOU Reyesuela for this huge amount of quality information on hair loss treatments.

Could you describe your hair care & hair loss treatment regime, day to day? And with minoxidil foam, does it leave a residue/greasiness in the hair?

Mine is changing constantly as I'm phasing things out and in. Hair loss increases? I toss it. Hair loss decreases or stays the same and hair growth velocity is good? I keep it. ;)

With the minoxidil foam, I could not use it now because my hair has gotten too thick. In fact, I've just ordered another shampoo brush because I'm having such a hard time getting to my scalp now. (YAY!!!) If your hair is thin enough for it, though, it is less IRRITATING and greasy than the bottled stuff, BUT the greasiness of the liquid is so minimal and only lasts a short time. The propylene glycol is greasy to some people, but with the liquid stuff, I can apply it RIGHT to my scalp and get almost none on my hair. I don't massage it in because I don't want my hair to pull it all off my scalp and it doesn't really impact my hair styling at all. Brush hair. Apply minoxidil. Put it up--brushing as needed with a non-BBB, or with a BBB, not to the scalp. So it just stays on the scalp. The foam, though, acts a little like mousse in terms of sticking hair strands together, and it flakes. All that said, some people swear by it, and if the propylene glycol is irritating to you, foam really is your best (inexpensive) alternative.

All that said, my routine looks like this. I'm always an evening shower-er, partly because I work out in the evenings.

Mornings:
-Get dressed. Remove cap. Brush hair with wide-spaced brush.
-Brush teeth.
-Apply minoxidil, which is infused with all kinds of other stuff that's alcohol, water, or propylene glycol soluble.
-Wash face. Homemade face cream. Neutrogena SPF 100 grease-free sunblock. Put on daily make up: Eyebrow powder, a little concealer/highlight under -the eyes, anti-redness BB cream just around the nose/mouth, neutral lip liner, either lipstick or gloss/Carmex depending on mood, mascara.
-Style hair in updo.
-Apply coconut oil as needed to hold the style/control any wispies. :)
-Grab morning supplement pack to take with my morning cup of tea--I drink 2 black and 2-4 cups of green tea throughout the day, with nothing added except soluble fiber. In the evenings, I used to have herbal teas, but I'm off BC now, and MANY ingredients, including chamomile and hibiscus, can do ugly things in pregnancy. (I have actually analyzed my diet, and I take supplements where I fall short, plus things that are either inconvenient or unrealistic for me to try eat all the time, like capsaicin and EGCg and curcumin in higher concentrations--I ruined about 5 shirts with herbal tea before I gave up on turmeric in tea!)
Total time: Depends on the complexity of the hairstyle. Usually 15-30 minutes, moving at glacial morning speeds. I hate mornings.

I usually restyle my hair into a secure updo for vigorous exercise.

Evenings:
-Brush hair with wide-spaced plastic brush for minimal friction as the bathtub fills.
-Apply more coconut oil along the whole length. Clip hair up again.
-Brush teeth.
-Do a peel if my face needs it. Otherwise, chill with a book until the bathtub is full.
-Let the coconut oil soak in as I cook myself for about 10 minutes in the tub, partly because it feels good, partly for the anti-cancer effects. :D Shave as needed. Wash face with face wash of I didn't do it with the peel.
-Dip head under. Apply conditioner to whole head. Rinse immediately.
-Apply medicated shampoo. M/W/F/Sa I use Denorex, which has menthol and salicylic acid. Tu/Th/Su I use Nizoral, with ketoconazole.
-Comb into scalp with shampoo brush. Leave on head for maybe 2 minutes. Rinse.
-Condition whole head again. Rinse immediately.
-Squeeze hair into tub and put up immediately if I want to hang more. Otherwise, squeeze hair and get out.
-PAT/SQUEEZE hair dry with towel.
-Brush out with the same brush. This causes less friction than combs I've had. I would not do this with a BBB!!!!!
-Pat and squeeze more with towel as needed. By now, it's very damp, definitely not soaking.
-Apply coconut oil mainly to ends. A leeettle to the length and to the "edges."
-Spray with silicone slip agent, length only, lightly. I do it after brushing, but I have to for distribution. :P
-Get dressed in PJs. Do evening stuff with hair down for a little while.
-Retin-A on face. It's REALLY sensitive to oxidation, so I don't bother on my head.
-ONLY ON SATURDAY NIGHT: Dermaroll face and head!
-Apply minoxidil concoction again.
-Put up hair when it feels dry enough.
-Apply scalp oil concoction and then phytoestrogen cream right before bed.
-Do my evening face cream, with an occlusive on top.
-I'm thinking of moving the scalp oil to the middle of the day, though, as I can use a dropper right through my hairstyle fine. :)
-Either stick in a U-pin or two or just pull out the claw clip and let my hair slowly undo itself in its sleep cap. I sleep on a silk pillowcase. If anything feels not quite coconut-oily enough, I add a little more, but no more than will absolutely soak in by morning.
-Take my evening supplement pack--gelatin has glycine in it, which will make you sleepy, and I take my NAC then just because and my curcumin then because it's a COX2 inhibitor and I have chronic pain which is worse at night, so I'm able to avoid 90% of pain pill taking with just the curcumin. That stuff's amazing.
-On Friday nights, I really slather my hair in coconut oil to get the maximum amount soaked in over the day. It doesn't look greasy because I wear it up, but it feels a bit funny the next day!
-Once every 6 weeks, I do an Aphogee 2-step keratin treatment to patch up any holes in my hair. ;)
-I henna once every three months or so because my hair is so dark the roots don't look weird, and I'm lazy.

Evening hair bits take...15 minutes, except Friday, which takes 3 minutes more, and Saturday? Maybe considerably less. Of course, the henna takes for-freaking-ever.

I wash my silk pillowcase and sleep cap once a week with everything else.

I trim as needed. It's been once every 8 months since I started wearing my hair up, but that wasn't from the ends being crispy but rather because of my overall thinning. I think I'll be able to get away with an inch total per year or less, for hair health, but I will have to deal with my hair racers over time--different parts of the hair on your head grow at different rates normally, which will always thin out your hemline beyond normal taper.

I really want a red laser LLLT helmet for face as well as hair. LOL. I'd just use it at work (I work from home) when I'm not at my treadmill desk. No added time. The comb is just too time-intensive. I already don't zap my legs as much as I really should (with Silk'n). Maybe next year. They are hideously expensive.

And that's it, really. It sounds a ton more complicated than it is.

[Reyesuela]

Oh, and I remake all my pill packs and my infusions and everything else once a month. It does take a while--a couple of hours. So I watch a TV show and do it on a Friday night, because that's usually my rest day for workouts.

I also want a candle warmer for my coconut oil. My hands are sometimes too cold for them to melt the stupid stuff in a timely fashion.

[lizardspots]

WOW thanks for the detailed info, Reyesuela! Your regime sounds really intense and time consuming D: I'm sure you're well practiced at it and have no trouble getting it done in a few mins, but I am way too lazy for this amount of intense treatment xD

I think I would be most interested in trying the Minoxidil alone, rather than the scalp oil or shampoos. I have found oil on my scalp increases shedding and makes my head itch, and I am happy with my shampoo choices at the mo. I guess I could experiment more with oils - I've tried coconut, jojoba, castor & olive oil. The liquid Minoxidil sounds like the best option - I don't wash my hair every day, so I don't want something in there that will leave flakes.

It's wonderful to hear your scalp hair is so thick you can't get the treatment to it - success! My scalp is rather spare and I can access it with ease, LOL. My fringe/top of head/crown area is the thinnest, and if I don't smoothly brush my hair just so, I have terrible scalp cleavage. I also have to be careful with using bobby pins to hold down my whispies, as it will expose more barren scalp.

My regime is quite minimalist in comparison to yours xD

Morning:
I wash my whole head every 3 days with a shampoo bar, and wash my fringe/top of head every day inbetween. ACV rinse after the whole head wash. Towel dry. 2 drops of jojoba oil to the length whilst still damp.
I've recently started doing black tea rinses pre-poo for 30 minutes, although this means I'll need to move my whole-head-washes to after work instead of before.
Air dry most of the way, often end up blow drying my roots on cool setting to speed things up before work.
Finger comb mostly. Only use my tangle teezer to detangle pre-wash & post-wash on dry hair only.
Also use 4 drops of jojoba oil as my facial moisturiser.
Lip balm, eye drops, hair up in a bun or braid, pin down the whispies/growing out face-framing layers, and run out the door.

Evenings:
Take hair down from the day's do. Finger comb, then hair up in a nautilus top knot with a clawclip. Rarely have my hair down for very long except on special occasions. I really dislike silky fabrics against my face, so unfortunately I can't tolerate satin pillowcases. And sleep caps look a bit old fashioned to me... >_> I reckon my other half would laugh himself silly, seeing me in a sleep cap.
I'm also taking a heap of supplements from my naturopath and my doctor, which I take in the evenings.

I do think my shedding has reduced somewhat - I was losing about 150-200 hairs/day previously, but since finger combing & tea rinsing, it's gone down to about 100-150/day. I am not sure which has made more difference, I suspect the finger combing. Shampoo bars & ACV rinses have really helped with the strength and smoothness of my hair strands, I don't have a single broken hair anymore which is marvelous.

[Reyesuela]

The short "hair only" regime is this:

Morning:
Brush hair, infused minoxidil, style with coconut oil.

Evening: Brush hair, more coconut oil right before the bath, CWC with medicated shampoo, dry GENTLY with towel, brush hair, coconut oil and slip agent, infused minoxidil and later mixed scalp oils, sleep in cap on silk pillowcase.

Take some hair-benefiting supplements.

Then dermaroll once a week and deep oil with coconut oil once a week.

The problem is that this is woven into the other things I'm doing, so they don't take as long as they would if I did them separately. My bath isn't longer because I wash my hair. I just wash my hair about six minutes before I want to get out of the bath.

My ENTIRE morning routine, from reaching the bathroom to being dressed to my shoes, complete with make up and hair styled, takes 15-30 minutes. Add 15 minutes to do a quick bathroom wipedown and make my bed, then another 30 minutes to an hour with my first cup of tea and house chores, and then I'm at work. :) The average woman takes an hour and fifteen minutes just on hair and makeup in the mornings.

The daily bath is my choice. It's mental unwind plus a way to deal with chronic pain. The kids and husband know that those 30 minutes from the time I step into the bathroom to the time I step out, are mine, or else! Hair is maybe 15 minutes of my evening, spaced throughout the day. It literally takes thirty seconds to a minute to apply minoxidil, thirty seconds to a minute for the slip agent, about a minute for coconut oil, ditto for the scalp oil. The most time consuming is the phytoestrogens because they come in a cream!

[Reyesuela]

The best thing you can do now is minoxidil + switching to Nizoral from the shampoo bar 2x per week. I don't even know WHY they have the 2% anymore. Just try the 5% once per day and see if your scalp tolerates it. You can probably build a tolerance. If your scalp starts to get really pissed off, skip a day. Do it every other day for a while. Then move back to once a day. I really think that the liquid is just SO much faster and easier with long hair...but some people disagree. :)

[Aredhel]

I also want a candle warmer for my coconut oil. My hands are sometimes too cold for them to melt the stupid stuff in a timely fashion.
I always warm my coconut oil by running the closed jar under hot water for a few minutes before I use it; my hands are always frigid so hand warming is rarely an option. :p

[Reyesuela]

You can see how much the stuff helped here: http://m.imgur.com/a/jdUcM

The long hair is from the plain minoxidil and the ketoconazole and Denorex shampoos and nothing else.

The short hair is from all the other stuff I added over the last month and a few weeks. :)

That area wasn't entirely bald, but the lower part is 100% new, and the upper part was very thin and short-cycling.

I'm still having new terminal hairs pop up along my hairline, thickening it.

Those are not bangs. They were not cut. That's new, thicker growth.

It's the same side, BTW. I used both the selfie and the regular lens.

[Reyesuela]

I always warm my coconut oil by running the closed jar under hot water for a few minutes before I use it; my hands are always frigid so hand warming is rarely an option. :p

Smart! In the evening after the bath, it's not a problem. Actually, not a problem in the morning because I've already washed my face in warm water. Hmm. Maybe I should just always wash my hands in warm water!!!!

I feel stupid now. LOL.

[Aredhel]

Haha you're definitely not stupid, sometimes it just takes an outsider to help put the pieces together! :p

[Reyesuela]

My life:
http://media.carddit.com/a/tLC0Ff231.jpg

[Agnieszka]

Thank you for putting so much work into these articles. I read it all before but not to such a great detail.

You reminded me of some treatments. I will start using Nizoral again and will add peppermint oil to my mister.

I'm a perfect candidate to start using Minoxidil but so scared of weight gain, darkened under eyes and initial hair loss. I will commit to Nizoral for a year. It this doesn't change anything I'll consider minoxidil.

Thank you again!

[Aredhel]

My life:
http://media.carddit.com/a/tLC0Ff231.jpg

Lol! I know the feeling all too well.:lol:

PS this is a great thread! DH (who's 29 years old) has been experiencing quite a lot of thinning (tons of scalp showing now, he compares himself to Gollum in jest...) and I've been doing my best to try to find a way to fix this, as cutting it all off is not an option for him...like me, long hair is a part of him and his identity. I figured his autoimmune disorder probably has a lot to do with it, but I'll be perusing this thread for options. :)

[Reyesuela]

The only way it would cause weight gain is through bloating. That is also what causes under eye circles, if you get them. I'll be honest. I'm using the men's dosage, so I'm getting the expected side effect of longer hair everywhere. I already was depilating majorly, so I don't really care. But I don't have any bloat at all, and my eyes are the same. These side effects are rare and reversible.

I was already losing so much hair that there was no noticeable increase in shedding for me. I had to brush, empty my brush, and then brush again, then empty my brush again to brush my hair.

[Babyfine]

Thank you for such an informative and interesting thread! I have been using step 4 Nioxin for a number of years in conjunction with an emu oil Shampoo in rotation(use the Nioxin scalp treatment with every wash) Also a follicle booster containing Trichogen. My hair. is very fine and thin, and I have always had fine hair but I can speak for the Birth Control pills during my 20's and 30's I struggled with acne and thinning hair both on some preparations and acne galore when I quit them for good at age 31(30 years ago.)
Pregnancy in my late 30's and childbirth and nursing brought me thicker hair for awhile but then thinned out. So my hair does react to hormones. I think the Nioxin(which contains an antifungal, DHT inhibitor and peppermint oil high up on the ingredient list)has helped a lot. Still, I've been looking at Rogaine at times. But I'm scared off it by the fear of declining skin quality and under eye bags and bloating face and dark spots. I googled Rogaine side effects and came across a men's fitness forum where there was a thread on Rogaine side effects and some of the guys were complaining of bags under their eyes and dark spot. I wonder if the same would happen on the women's strength? I've been taking such good care of my skin and getting it to look good that I'd rather have bad hair(at least which I can camouflage somewhat) than bad skin which I can't hide. I'm wondering if it's only the higher strength that would cause this.

[pamrlyn]

Wow Reyesuela so much information - you have put so much work into this. it is a wonderful resource for our community. I really appreciate all the research you have done, even though a lot of it goes over my head. many kudos to you! :applause: :bowtome: :applause:


Personally, I have the post-menopausal aging type of hair loss. my hairline was receding fast. I first tried Castor oil & massage, then added minoxidil. deleted castor oil. after 6 months & was worse off than when I started, with about 2-3 inches of pink scalp at my front hairline. Then started on Viviscal, just based on the reviews in various places on line. This has worked really well for me - down to less than 1 inch of pink scalp at the front hairline & ponytail circumference increase 3/4 inch, after 9 months on this supplement. Why it works is a mystery to me - since the Aminomar complex ingredients are not divulged - maybe it has that algae oil?? Also the fish/shark component troubles my conscience.

I added Soy Isoflavones - 40% Flavones Extract Powder about a month ago hoping to get additional benefits especially with aging skin. Estrogen is not an option due to already high risk for cancer. Too soon to tell if that will help.

Speaking of estrogen & cancer, I had a large (9 cm) ovarian tumor (stage 1) removed (complete hysterectomy) about a month after starting Viviscal. After reading all of your research, I'm wondering if that ovarian tumor wasn't a large part of the problem. hmmmm....

At any rate - I wanted to thank you & seemed like this might be a good place to share my experience - without meaning to step on anything that you have done, or imply that any product that I've tried is any better.

Many thanks to you, again for this wonderful resource material. You totally rock!

[Reyesuela]

Don't be scared of minoxidil. It won't cause skin effects aside from bloating...which is a really rare side effect. And it WILL go away after you stop it. People ascribe weird things to meds out of paranoia--men on baldness forums occasionally claim Nizoral made them impotent (which is entirely impossible). Thinning hair in women often coincides with menopause in women because of the drop in estrogen, which causes both hair loss and for the skin to get bad really fast. Slap on a nice phytoestrogen cream (that doesn't activate estrogen receptor A, which is the cancer receptor) and save your skin while treating your hair. :)


For those who have had cancer, check with your doc about his advice about topical phytoestrogens and probably avoid oral supplemental ones, regardless.

[Reyesuela]

I've only covered about half. From here, it goes into stuff with less research, but there's a ton that's suggestive.

[lizardspots]

My ENTIRE morning routine, from reaching the bathroom to being dressed to my shoes, complete with make up and hair styled, takes 15-30 minutes. Add 15 minutes to do a quick bathroom wipedown and make my bed, then another 30 minutes to an hour with my first cup of tea and house chores, and then I'm at work. :) The average woman takes an hour and fifteen minutes just on hair and makeup in the mornings.

The daily bath is my choice. It's mental unwind plus a way to deal with chronic pain. The kids and husband know that those 30 minutes from the time I step into the bathroom to the time I step out, are mine, or else! Hair is maybe 15 minutes of my evening, spaced throughout the day. It literally takes thirty seconds to a minute to apply minoxidil, thirty seconds to a minute for the slip agent, about a minute for coconut oil, ditto for the scalp oil. The most time consuming is the phytoestrogens because they come in a cream!

Well, I guess I am a very atypical woman because I cannot be stuffed to wear make-up for work xD I spend probably 10 mins on face/hair/dressing per morning. When I do wear make up for special occasions, I am sooo slooow it takes me like 30 mins just to do basic eye make-up xD I fail at being a girl.

Having a private moment for mental unwinding is very important!


The best thing you can do now is minoxidil + switching to Nizoral from the shampoo bar 2x per week. I don't even know WHY they have the 2% anymore. Just try the 5% once per day and see if your scalp tolerates it. You can probably build a tolerance. If your scalp starts to get really pissed off, skip a day. Do it every other day for a while. Then move back to once a day. I really think that the liquid is just SO much faster and easier with long hair...but some people disagree. :)

Thanks for your advice, I really appreciate it. Is minoxidil & Nizoral safe to use in pregnancy? How quickly do you think I would see results re: reduced shedding & increased hair growth with any treatment? I think finger combing has helped reduce excessive breakage, but probably hasn't done anything for my shedding. I just started black tea rinses as a caffeine pre-poo treatment for my scalp, no specifically noticeable results yet, but I've only done it for 2 weeks so far.

[Reyesuela]

Nizoral is going to be safe. Minoxidil doesn't have enough research to rule out issues, but I'd be more comfortable with minoxidil than with camomile tea or pumpkin oil, for instance. :) I wouldn't use either of those if I was planning to get pregnant. I would just stop minoxidil during pregnancy.

It took 2 months on mostly Nizoral and a lazy very irregular minoxidil application for me to see a big difference, but 6 months is more typical for either.

[xnibn]

Very informative thread , l love it, can you please go into more detail about what you infuse your minoxidil with please?
And what oil blend and and about the phytoestrogen cream do you use ? I assume on your face and scalp

[SeRe]

This is off topic but could you also share the recipe of your homemade face cream? Thank you so much! :D

[Reyesuela]

My face cream has a lot of different things, but it's basically a water-based vitamin C serum (ascorbic acid--the other types are crap no matter what they promise) with coQ10 and ferulic acid as a stabilizer, plus hyaluronic acid and other goodies. My night creams are RetinA, then a space, then an oil based on Vit E that I'm still formulating, then a lisopsomal isoflavone commercial cream and a cheap but effective occlusive right on top.

I erased every little line on my face but then fell off the bandwagon for a long time because I guess I knew I could make any lines go away whenever I got around to it. LOL. But this hair thing is no joke, and so it forces me to have a morning and evening routine, so I'm on the bandwagon because I can't afford not to be. :P Takes much longer to grow hair than erase lines, for sure.

[Reyesuela]

Very informative thread , l love it, can you please go into more detail about what you infuse your minoxidil with please?
And what oil blend and and about the phytoestrogen cream do you use ? I assume on your face and scalp

The phytoestrogen cream is here: https://www.amazon.com/Source-Naturals-Phyto-Estrogen-Advanced-Liposomal/dp/B000GFJJHE/ref=sr_1_1_a_it?ie=UTF8&qid=1491403697&sr=8-1&keywords=estrogen+cream

Fabulous for face and hair! Lol. If you have or have had breast cancer, consult your doctor before use. However, it is estrogen receptor beta selective, so it is as safe as you can get.

RIGHT NOW, I'm putting azelaic acid, EGCgs, astralagus, melatonin (just .1%! also important!), caffeine (just .3%!! Important!), and rosemary extract in my minoxidil.

RIGHT NOW, my oil is evening primrose, castor, Vit. E, rosemary oil, peppermint oil, and beta sitosterol. Looking to add retinol--it's pretty pricey for the stabilized stuff, though.

[Reyesuela]

Active Treatment: Topical Azelaic Acid
Quality of treatment: Adjunct.
Level of evidence: Moderate
Level of effectiveness: Comparable to other topicals
FDA approved: No
Method of action: DHT inhibitor...but also other things because it works on alopecia areata
Application: Topical only

Azelaic acid has been shown to greatly reduce DHT in the skin directly under where it's applied. This should not only improve scalp hair growth but reverse dark body hair. However, it's also been shown in a study on alopecia areata to be a general hair growth stimulator.

This is a good option for people who can't or don't want to take oral antiandrogens.

[Reyesuela]

Active Treatment: Hibiscus Extract
Quality of treatment: Adjunct.
Level of evidence: Low
Level of effectiveness: Only studied with negative controls; leaf works better than blossom
FDA approved: No
Method of action: ????
Common side effects: ???
Application: Topical only--hibiscus tea can cause miscarriage, so don't ever drink if you might get pregnant

Topically, hibiscus, especially leaves, force more hairs into the anagen phase and increases hair growth rates according to one study. There have been no studies on oral hibiscus.

[Reyesuela]

Active Treatment: Vitamin E
Quality of treatment: Adjunct.
Level of evidence: High
Level of effectiveness: Only studied with negative controls, but it looks as good as 2% minoxidil
FDA approved: No
Method of action: ????--vague speculation about blahblah oxidative stress, but these explanations make zero sense in terms of the results actually seen
Common side effects: ???--very unlikely
Application: Both topical and oral have shown effects. I recommend topical supplement and oral through food!

Topical vitamin E has been shown to accelerate the hair growth of rabbit (by 2.4x!) but not the maximum terminal length. Both oral and topical supplementation have been shown in a number of different studies to increase hair numbers in people with alopecia and with telogenic mice.

[Reyesuela]

Active Treatment: Castor Oil
Quality of treatment: Adjunct.
Level of evidence: Low, but the theory is sound
Level of effectiveness: Not well studied
FDA approved: No
Method of action: Increases PGE2 in the form of ricinoleic acid, but in the triglyceride, maybe not?
Common side effects: Oral--diarrhea
Application: Oral definitely works but extremely dangerous early in the first trimester and might possibly cause premature labor in the 3rd trimester--avoid if pregnant or might become pregnant. Topical is fine but may not do anything--but it may make other oils penetrate better.

PDE2 is one of the rare prostaglandins that increases hair growth. Most things that decrease bad prostaglandins also decrease PDE2. Castor oil is one of the few things that increases PDE2. However, it is only certain to work when the fats take the form of ricinoleic acid after being digested, but it may not work when bound in a triglyceride, as it is topically. However, it does increase absorption of other things, so if you add peppermint oil or rosemary oil to it, it might work better than in other carrier oils.

Taking oral castor oil during pregnancy is dangerous. It's also unpleasant to take much of it since PDE2 stimulates contractions in the intestines. :)

[Reyesuela]

Don't Put This On Your Head, Really

I now bring you a brief break sponsored by things you shouldn't put on your head.

GINGER is often listed as a traditional growth stimulant. It actually is quite good at making hair fall out. Don't put it on your head.

TOPICAL CAPSAICIN was frequently used in Victorian hair stimulants. Through the capsaicin and vanilloid receptor, however, it convinces your skin that it's too hot and makes your hair fall out.

TOPICAL LICORICE causes hair to fall out.

CITRUS OILS of all sorts are photoreactive and can leave you with second to third degree burns when they react with UV light.

HIGH LEVELS OF CAFFEINE have the opposite effect of low levels of caffeine and stunt growth.

HIGH LEVELS OF MELATONIN also stunt growth, while low levels promote it.

[Reyesuela]

Oh, and someone's eventually going to ask about my note about the anti-cancer effects of hot baths. :) Raising your core temperature for a short period regularly has been shown to have both cardioprotective and anti-cancer effects. I happen to love hot baths and hate saunas, so I pick the bath. Saunas or steam showers will work every bit as well.

Heating burns calories and improves glucose control and has anti-inflammatory effects: http://www.tandfonline.com/doi/abs/10.1080/23328940.2017.1288688?journalCode=ktmp20
Sauna use decreases cardiovascular and all-cause mortality: http://media.jamanetwork.com/news-item/sauna-use-associated-with-reduced-risk-of-cardiac-all-cause-mortality/
It also improves sleep (the steep dropoff in body temperature after makes you sleepy) and decreases stress. It also improves chronic pain, which I have.
It reduces Alzheimer's disease, too, and dementia rates. I'm all for that.

The cancer link is one that is poorly investigated but one that I suspected from the hormonal cascade associated with hyperthermia. Some whole-body hyperthermia is used in cancer treatments--it actually is shown to be quite helpful with certain kinds of established cancer, either slowing it or stopping it or making chemo more effective. But I looked at different countries with similar diets and BMIs, comparing sauna cultures to nonsauna cultures within those diets, and I found that epidemiologically, sauna cultures have much lower cancer rates than expected. Pretty darn compelling when you compare similar countries head-to-head.

Bikram yoga can do the same, but I don't recommend it because the chances of injury are much higher when you're stretching under hyperthermic conditions.

[SeRe]

My face cream has a lot of different things, but it's basically a water-based vitamin C serum (ascorbic acid--the other types are crap no matter what they promise) with coQ10 and ferulic acid as a stabilizer, plus hyaluronic acid and other goodies. My night creams are RetinA, then a space, then an oil based on Vit E that I'm still formulating, then a lisopsomal isoflavone commercial cream and a cheap but effective occlusive right on top.

I erased every little line on my face but then fell off the bandwagon for a long time because I guess I knew I could make any lines go away whenever I got around to it. LOL. But this hair thing is no joke, and so it forces me to have a morning and evening routine, so I'm on the bandwagon because I can't afford not to be. :P Takes much longer to grow hair than erase lines, for sure.

I agree with your point that ascorbic acid is the best form of Vit C. The Vit C institute (Linus Pauling) has the same take.

How do you make your Vit C serum? I buy mine because I don't know how to correctly make one. I was hoping for a 25% recipe.

I also just introduced Retinol into my skin care, mainly to get rid of my freckles. I am just got a prescription for 0.1 tretinoin, I am trying to figure out how to use it. I take 2-3 g of Vit C a day.

[SeRe]

The phytoestrogen cream is here: https://www.amazon.com/Source-Naturals-Phyto-Estrogen-Advanced-Liposomal/dp/B000GFJJHE/ref=sr_1_1_a_it?ie=UTF8&qid=1491403697&sr=8-1&keywords=estrogen+cream

Fabulous for face and hair! Lol. If you have or have had breast cancer, consult your doctor before use. However, it is estrogen receptor beta selective, so it is as safe as you can get.

RIGHT NOW, I'm putting azelaic acid, EGCgs, astralagus, melatonin (just .1%! also important!), caffeine (just .3%!! Important!), and rosemary extract in my minoxidil.

RIGHT NOW, my oil is evening primrose, castor, Vit. E, rosemary oil, peppermint oil, and beta sitosterol. Looking to add retinol--it's pretty pricey for the stabilized stuff, though.

Which form of Vit E are you using, and from where? I have a few capsules lying around but i dont know if I can add them to my ayurvedic oil mix. I'm also wanting to add rosemary essential oil to the mix but I do not know if they are compatible.

Have you looked into licorice? Ayurveda claims it can reverse hair loss.

[Reyesuela]

Rosemary oil is a pretty powerful way to prevent oxidation. It shouldn't cause an issue.

I'm just using a cheap tocopheryl acetate right now, but I'm looking at related mixes when I run out.

I had actually looked into licorice, and I forgot! It causes hair loss, very nicely: https://www.ncbi.nlm.nih.gov/pubmed/24785361

[Reyesuela]

I agree with your point that ascorbic acid is the best form of Vit C. The Vit C institute (Linus Pauling) has the same take.

How do you make your Vit C serum? I buy mine because I don't know how to correctly make one. I was hoping for a 25% recipe.

I also just introduced Retinol into my skin care, mainly to get rid of my freckles. I am just got a prescription for 0.1 tretinoin, I am trying to figure out how to use it. I take 2-3 g of Vit C a day.

I don't know that tretinoin will do much to remove freckles. Sun discoloration, yes. Freckles, not so much. It does help with wrinkles.

You can just mix 25% by weight with water and apply it daily, if you want. Measure it out a few times until you can guesstimate it. :) Otherwise, you can make up enough for a week--and store it in the fridge to prevent oxidation.

My mix is very complicated and involves sodium EDTA and a jeweler's scale.

[SeRe]

Rosemary oil is a pretty powerful way to prevent oxidation. It shouldn't cause an issue.

I'm just using a cheap tocopheryl acetate right now, but I'm going to upgrade to a mix when I run out.

I had actually looked into licorice, and I forgot! It causes hair loss, very nicely: https://www.ncbi.nlm.nih.gov/pubmed/24785361

Interesting! I found this paper with the opposite conclusion. I'm confused. Licorice is very popular for hair loss in ayurveda.

https://www.researchgate.net/publication/281478067_Phyto-Pharmacological_Perspective_of_Yashtimadhu_Glycyrr hiza_Glabra_LINN_-_A_Review

[Reyesuela]

That's not quite what the paper is saying. This is NOT a study. It is merely mentioning that some constituents are known to promote hair growth in isolation, noth that licorice has ever been shown to. Isoflavinoids do, many terpinoids do, some sterols do, lignans do, and coumarins probably do. But the glycyrrhizin, which is in VERY large amounts, stunts hair growth and makes it fall out. Licorice is a traditional depilatory in some regions because it works so well!

This is a very, very speculative list of things that licorice MIGHT be good for based on known pharmacological effects of some of its constituent chemicals. None of this report is based on actual research of any of these effects. Some of it is, in fact, just flat BS. Read the intro paragraph. It's just silly.

Get your isoflavinoids from soy or red clover and stay away from topical licorice.

[Reyesuela]

Also, it was published in a journal with a near-junk impact factor. Not impressed.

https://www.researchgate.net/journal/1029-2454_Biofouling

[SeRe]

Also, it was published in a journal with a near-junk impact factor. Not impressed.

https://www.researchgate.net/journal/1029-2454_Biofouling

Okay, I see what you mean. What is your opinion on fenugreek?

In India, women consume half a teaspoon of soaked fenugreek every morning. This has helped a few women overcome hair loss at the parting (I read this on an Indian woman's forum called Indusladies)

[SeRe]

Also, what is your opinion on peppermint?

[Reyesuela]

I use peppermint oil and think it's great.

External fenugreek is meh--it's a weak phytoestrogen, and red clover in better. Internal fenugreek has real potential to increase insulin sensitivity and decrease DHT, so it could definitely work. No studies prove that it does yet--none have been conducted.

[ChloeDharma]

I use peppermint oil and think it's great.

External fenugreek is meh--it's a weak phytoestrogen, and red clover in better. Internal fenugreek has real potential to increase insulin sensitivity and decrease DHT, so it could definitely work. No studies prove that it does yet--none have been conducted.

I can confirm the insulin sensitivity issue. I'm a T1 diabetic and found that I had a hypoglycemic reaction within half an hour of eating a meal that contained fenugreek sprouts, hypos really shouldn't happen soon after eating a meal by definition! Still, it gave me a good excuse to eat some Hagen Daz ice cream :-)
My father who was a type 2 also found he could regulate his blood glucose levels by eating fenugreek seeds when he ran out of his tablets a few times so there is definitely something to this.

I looked at the liquorice before because I see it in some traditional Indian hair oils but then found a lot of info online saying it removes hair so decided it's just not worth the risk to use a strong blend of it.

Interesting thread :-)

[lizardspots]

Just posting to have a whinge. Today was wash day, and I lost over 300 hairs :( :( :( Cursed shedding! My little ponytail will reduce to nothing at this rate.

I think I am going to take the plunge and try Nizoral & Minoxidil, at last. I hate having half-finished bottles of products lying around (I have 4 shampoo bars, 2 bottles of ACV, 1 bottle of sulphate-free shampoo, 1 bottle of sulphate shampoo, and 2 bottles of coney conditioner) but I am getting increasingly stressed looking at all this shedding. I don't know if it's seasonal, because in all honesty I wasn't paying much attention to my hair until a year ago.

[Reyesuela]

I shed nothing at all last night for some reason, and this morning I had my worst shed in 4 months.

Ready to see it?

http://i.imgur.com/GN67pLw.jpg

After 2 years of sheds that could be mistaken for actual rodents, this is amazing.

I may need to tweak my regime though. I think I need some polysorbate and water emulsion for my scalp oil so I can get coverage without globbing it on.

[lizardspots]

Reyesuela that is amazing! My shed this morning was a massive hairball bigger than my palm :(

[Reyesuela]

Like I said, I was brushing, filling up the brush so it didn't go through my hair, empty the brush, brush again, and then empty my brush again.

The difference is amazing.

[Reyesuela]

I apologize for the goofy looking expression. I'm wearing invisible aligners, and between them and my overbite (that they're fixing), it gives me the weird pout thing unless I force myself not to. But this is for people scared that minoxidil will age you. I've been on it about 6 months now. I'm 37 and a half. I don't think I'm suddenly aging faster. I'm wearing translucent concealer/highlight under my eyes, translucent BB antiredness cream just around my mouth and on my nose, brow powder, lip liner and colored gloss, and mascara. I have no eyeshadow, heavy concealer, foundation, primer, setting spray, rouge/blush, powder, contouring, etc, etc. I'll post a naked face shot later.

http://m.imgur.com/a/UHgv2

[SeRe]

I apologize for the goofy looking expression. I'm wearing invisible aligners, and between them and my overbite (that they're fixing), it gives me the weird pout thing unless I force myself not to. But this is for people scared that minoxidil will age you. I've been on it about 6 months now. I'm 37 and a half. I don't think I'm suddenly aging faster. I'm wearing translucent concealer/highlight under my eyes, translucent BB antiredness cream just around my mouth and on my nose, brow powder, lip liner and colored gloss, and mascara. I have no eyeshadow, heavy concealer, foundation, primer, setting spray, rouge/blush, powder, contouring, etc, etc. I'll post a naked face shot later.

http://m.imgur.com/a/UHgv2

Wow, you look really young and have great skin, I see no wrinkles!

Since when are you on retinol?

[Reyesuela]

I've been off everything for 3 years. Lol. I'm just now restarting. I managed to get down to very young skin quality, but it was so easy that I got lazy. Some of the lines have really come back, but I'm back on the wagon again. I order my retin A online because my prescription coverage is crap--I get it from All Day Chemist in India.

[lizardspots]

Reyesuela you look really beautiful :flower: Your skin is flawless!

I have never been troubled with lines/wrinkles, but I have oily skin and am still troubled by adult acne which leaves lots of blemishes. I care less about the blemishes, though, than the bother of putting on heavy concealing make-up, so I just put up with it. So I guess I don't feel worried about minoxidil aging me, since I've always had a young looking face.

Also the hair at your hairline and top of head looks lovely and thick. I hate how I look with my hair scraped back, I feel like I look bald. xD

[Reyesuela]

My hairline has really filled in!

I have adult acne. I even get pimples in my ears and on top where my glasses sit. I use 30% salicylic peels twice a week and it stays away. I had been skipping my back so I've been careful not to get my neck in hair shots so I don't gross anyone out until I get it back under control. Lol

[Reyesuela]

No makeup! http://imgur.com/iawlJul

This is because there are lots of scare posts about minoxidil horribly aging you going around. It doesn't. Hair loss often coincides with menopause. Menopause coincides with rapid skin aging. I hate taking selfies and I suck at it, but there's no better way to reassure people that you won't look 20 years older just by using minoxidil. :). That's my terrible selfie skills making my nose look bigger and my just-gotten-up puffy, swollen face because I've got terrible allergies right now and am just coming off from a cold and I slept on my stomach last night. But telling you I don't have terrible lines and circles isn't the same as showing.

Also, I keep taking pictures in front of the book pile of books to be shelved downstairs culled from around the house. I swear I don't live in filth. Lol. The book pile is today's task.

[Rebel Rebel]

Reyesuela,
You look amazing and your hair looks so healthy and pretty. Your selfies are just fine! I don't even known how old you are but you obviously take good care of your hair and skin. Lovely eyebrows too!
I thought I came across some article that explained how it compromised collagen production in some way. I don't believe it ages people like you read on the internet but I do wonder if you've researched rogaine and collagen. Just curious if it has any effect to be aware of.

[Rebel Rebel]

Does taking collagen have any effect on skin/hair? Anything scientific you've read in your research? I'm always so skeptical. Just curious about your thoughts on it.

[Reyesuela]

Gelatin and cysteine have been shown to improve skin and increase hair growth. Because gelatin is a pain to get in food (I don't really have time to boil chicken carcasses with bones and skin every week, and I don't like most foods with prepared gelatin), I take 3g of gelatin tablets and 500mg of NAC (more active form of cysteine) every night. The glycine in the gelatin will make you sleepy so it's perfect before bed. Collagen has a subset of the amino acids in gelatin.

They can do nothing topically. The molecules are too big.

[Reyesuela]

Reyesuela,
You look amazing and your hair looks so healthy and pretty. Your selfies are just fine! I don't even known how old you are but you obviously take good care of your hair and skin. Lovely eyebrows too!
I thought I came across some article that explained how it compromised collagen production in some way. I don't believe it ages people like you read on the internet but I do wonder if you've researched rogaine and collagen. Just curious if it has any effect to be aware of.
Extremely high levels of minoxidil can inhibit one collagen type, shifting production to other types. That's waaay more than the concentrations you get in topical minoxidil for hair loss. :)

[Reyesuela]

Minoxidil is a vasodilator and so can, in some people, make your face puffier. I have noticed this side effect, but it's sooooo subtle, and it's not progressive. It's most noticeable in the morning which is why I took that morning photo. :)

[Reyesuela]

Okay. Crazy realization.

You know that low-level laser therapy? Yeah. It doesn't have to be laser. It just has to be in the 600-700 nm range for the best hair and skin effects. In the 770-900 nm range is best for muscle pain and neurons. (700-770 doesn't seem to be biologically active and no one knows why.)

Near-infrared heat lamps do a GREAT job of covering the 600-900 nm range. So for $35 (250-watt near-infrared bulb plus 300-watt clamp light base), you can have your very own acne/rosacea/eczema/wrinkle/hair loss/muscle pain/dementia light. (Dementia might not do too much unless intranasal, lol, but anyway....)

Eh. I got it. The studies on the wavelengths look very good, there are a number of FDA cleared devices, and it might help my husband's neck pain and eczema.

[Reyesuela]

I pulled up my full morning serum formula. It's a three-phase formula with 19 ingredients. I was still refining it. :) It did get me stopped by people I hadn't seen in a while who would say, "WHAT DID YOU PUT ON YOUR FACE GIVE ME THAT!" lol.

[lizardspots]

Reyesuela love your selfies! I am still super jealous and admiring of your thick crown hair. I can only dream of such thickness! I ordered some Nizoral and Minoxidil, and feeling tentatively hopeful..

Adult acne is a massive pain, I use Oxy10 as a spot treatment, which contains benzoyl peroxide. It seems to work pretty well. The rest of my skin care is pretty basic - a mild face wash, a scrub twice a week, witch hazel as a toner, and jojoba oil as a moisturiser. When I can remember (like once a fortnight) I use a clay mask - it feels good, but not sure it does anything for my acne.

[xnibn]

Reyesuela Love your selfies, and agree with others you have amazing skin and hair , l have already started minoxidil with nizoral and your pictures gave me hope of better things to come , l want to spice up my minoxidil but my diy skills are next to zero , but was thinking about buying a hydrobrush from roots hair club which is sold on amazon with their own lotion called spark to make applying minoxidil easier , what are your thoughts on that?

[ravenheather]

I don't have thin hair at the scalp, but I have always shed alot. Sometimes excessively. Now I am like 30-60 or so a day. Used to be well over 100. But my hair is tapered and I haven't gotten over 29 inches. Of course I hope this isn't terminal for me. Is minoxidil a good idea to increase thickness and length? I am a 2 1/4 " circ. I am 42, but age related thinning doesn't seem to be a huge problem based on my mom. We just tend to have thin hair in general. I am the only one attempting to grow long, so I don't know my family length genetics.

[Reyesuela]

If you're willing to commit to minoxidil, it should increase your terminal length. Even my body hair's terminal length is longer on the super fine pale invisible hairs the insides of my arms. Lol. They're still pale fine and nearly invisible, but in the right light, I can see how much longer they are. Minoxidil pushes hairs into anagen AND lengthens anagen.

I haven't tried the brush! I like the dropper's fine control.

[Reyesuela]

Ok this is hilarious.

Can you guess where the hairloss treatment hair starts????
http://i.imgur.com/HkvIZsn.jpg

[dansyl]

Ok this is hilarious.

Can you guess where the hairloss treatment hair starts????
http://i.imgur.com/HkvIZsn.jpg

I can! But i will say... that that's such an improvement!!!! That's so awesome!

[duchess67]

That is exactly how my mother's hair looked after two years of using Rogaine. Thicker hair till below shoulders and the rest only a few strands. It was amazing to see the new growth and difference in thickness.

I have taken a couple of photographs but they are in her phone. If she still has those pics I shall ask her to send me those, and then I can post it here. When I visited her in January, she asked me to cut it and so I did cut off the longer thinner strands.

[Rebel Rebel]

Does minoxidil only work where you put it or does it have an effect on surrounding areas of the scalp?

You mentioned body hair is a little longer by using minoxidil? Obviously one would be putting it on the areas where there is obvious hairloss/thinning but you're only allotted a small amount each day which doesn't cover the entire scalp. Maybe the foam vs the liquid is a bit different in that way?

Thanks again Reyesuela, for your time and thoughts on this topic.

[Aredhel]

That is some killer regrowth, Reyesuela!:happydance:

[Reyesuela]

It works best where it touches, but it does affect nearby areas, too. I have pretty extreme side effects compared to the average person. Most people don't notice a difference in body hair at all.

I was already depilating my face before I started minoxidil and using Silk'n home laser on my legs and once a season on my arms. (When I was in high school, I started bleaching the hair on my arms.). I never had actual hirsutism. I was just always "normal but on the hairy side." Lol. Then, when I hit 30, my upper lip hair got longer, so I start depilating my face. That's why the extra growth, which is on the extreme side for side effects, doesn't bother me at all. The areas that had light hair before still have light hair, but I can see that they are longer in REALLY strong light. No one else would ever notice. My husband can't tell.

My bare-faced selfie was just before my weekly depilation of my face, so that's "peak hair."

That said, minoxidil is supposed to be used over the entire top and sides of the scalp. A single ml was more than enough for my whole head until my hair got so thick that it started sucking some of it up. Now I have to use a little more.

[ravenheather]

So is nizoral also a smart option in my case? I think my problem is a lot of my shed hair is 6 " long.

[ravenheather]

Sorry double post.

[Reyesuela]

Nizoral is a great first step for most people because it requires so little change in habits. :)

[lucid]

Are there any downsides of using nizoral? Like excessive shedding at first or anything like that?

[ravenheather]

Are there any downsides of using nizoral? Like excessive shedding at first or anything like that?

I was wondering if it was drying to hair.

[duchess67]

I had used Nizoral a couple of years ago, and all I remember is that it had made my hair very dry. If you use a good conditioner that can be rectified, I guess.

Let's see what Reyesuela has to say about this shampoo.

[littletiern]

Is anyone using Provillus for their minoxidril? I'm super intrigued by it and ordered a three month trial, but based on Reyesuela's routine I'm worried I would have to start washing my hair every day. I only wash about once a week and I can't find any information online about this. Do I only use it the days I was my hair? Can I leave it on without washing it? I'm totally stumped!

[Aphra]

I've been using Nizoral for a couple of weeks and I haven't noticed it doing anything bad to my length. I CWC or WCC, and only scalp wash with it.

It's not supposed to cause unusual shedding as far as I know. I do shed a bit more than normal with it, but I think that's because I'm rubbing it well into the roots of my hair for scalp cleaning and like any scalp massage that dislodges the hairs that re just about to fall. Ad of course double conditioning dislodges the ones that have detached but are clinging on by friction to other strands.

[lapushka]

I've used Nizoral plenty of times, on and off. It is the same as any other sulfate shampoo - you just use it differently.

[Syaoransbear]

Is there a difference between Minoxidil for men and Minoxidil for women?

[Syaoransbear]

Is there a difference between Minoxidil for men and Minoxidil for women?

Sorry for bumping this, but I haven't been able to find an answer. Minoxidil for men seems much cheaper and more available than the stuff for women which I am having trouble finding. Seems the main difference is that for whatever reason the stuff marketed for women is $30 more expensive for less of the active ingredient.

[Arctic]

Sorry for bumping this, but I haven't been able to find an answer. Minoxidil for men seems much cheaper and more available than the stuff for women which I am having trouble finding. Seems the main difference is that for whatever reason the stuff marketed for women is $30 more expensive for less of the active ingredient.

I don't think there are differences (or if there are they are not meaningful). Where I live Rogaine products are not even gendered, they just come in 2% and 5%, no gender specified. I have read that the only difference in the gendered versions are the packaging, marketing, etc, so very surface level stuff. The product and most importantly, the active ingredient (minoxidil) are the same. You might want to test different application methods, but my own expression has been, that pipette/dropper might be the best for long hair.

[Syaoransbear]

I don't think there are differences (or if there are they are not meaningful). Where I live Rogaine products are not even gendered, they just come in 2% and 5%, no gender specified. I have read that the only difference in the gendered versions are the packaging, marketing, etc, so very surface level stuff. The product and most importantly, the active ingredient (minoxidil) are the same. You might want to test different application methods, but my own expression has been, that pipette/dropper might be the best for long hair.

Thank you so much!

[lizardspots]

For those who are using Nizoral, are you using 1% or 2%? I bought a bottle of 2%, and I found it a little drying - this was easily fixed with an ACV rinse. But mostly I'm wigging out about how expensive it is. The 1% is half the price. After my 2% bottle is finished, if I choose to continue using Nizoral, I'll go for 1%.

[parkmikii]

I'd start using the peppermint or rosemary essential oils but I wonder which would be better: in shampoo or just with an oil pre wash? (I have S&D so I can't keep oils for too long on my scalp)

[Aphra]

For those who are using Nizoral, are you using 1% or 2%? I bought a bottle of 2%, and I found it a little drying - this was easily fixed with an ACV rinse. But mostly I'm wigging out about how expensive it is. The 1% is half the price. After my 2% bottle is finished, if I choose to continue using Nizoral, I'll go for 1%.

I'm using the 1% - I think it is the only one I can get here anyway, and I also wanted to start low in case my scalp disliked it.

The only semi-negative thing I've noticed is my hair gets massively greasier by the end of day 2 - I can still wash alternate days, but certainly can't stretch further. That's with using it twice a week. On the other hand, my scalp is much happier - I guess the sebum is being freed up and spread down the hair rather than getting trapped in pores.

[pandabarrier]

I'd start using the peppermint or rosemary essential oils but I wonder which would be better: in shampoo or just with an oil pre wash? (I have S&D so I can't keep oils for too long on my scalp)

Be careful if you use either peppermint or rosemary EO.
I accidentally put 3 drops of peppermint EO instead of 1 in my diluted shampoo and it was way too strong. 1 drop made my scalp tingle a bit for a few minutes. 3 was hurting my scalp even half an hour after the wash. I did another water rinse, and my scalp went back to normal.
I used rosemary EO in the diluted shampoo, and that didn't irritate my scalp, but added in scalp oiling made me shed like crazy. So now I rarely use EOs.
IMO, I don't know much about S&D, but if you are concerned about leaving oils on your scalp for too long, better not put them at all and leave your scalp alone.

[akurah]

Hi!

So when I started pill form BC to replace an IUD, my hair started thinning a bit, but because I don't measure with tape, only my hands, I'm unsure. I'd guess less than one quarter, but I could be underestimating. I'm reasonably certain nobody but me can tell it's thinner.

I'm considering switching to either a Ketoconazole/Nizoral shampoo (currently use Head & Shoulders because it makes my scalp happier than the other stuff). I wash 1x a week, sometimes 1x every week and a half to two weeks.

Leery of topical applications that might require more frequent washing, because I'm lazy and my hair seems to prefer less washing over more (the most washing I can convince it to do without getting fluffy and frizzy like whoa is about 1x every 3 days). Though I'm not opposed to the idea of something like a rinse since my hair doesn't mind getting wet, it just minds the washings.

Despite being leery of topical applications, have also considered Minoxidil. But I have really sensitive skin, and I haven't gotten that sorted yet with a doctor or dermatologist (I really should). I am worried Minoxidil could make my scalp itchy. Plus, again, do not want to wash more often than I currently do.

One of the other things I've done is quit smoking (123 hours, or 5 days, without a cigarette) due to other things, but from reading this thread I'm doubly glad I did, since it looks like it can (or does) contribute to thinner hair).

I'm not so distressed by the thinning that I absolutely positively have to fix it (because it's not continuing to thin, it's settled down), but I figured I'd look into it as a nice-to-have. It doesn't look especially thin either.

[lizardspots]

Hi!

So when I started pill form BC to replace an IUD, my hair started thinning a bit, but because I don't measure with tape, only my hands, I'm unsure. I'd guess less than one quarter, but I could be underestimating. I'm reasonably certain nobody but me can tell it's thinner.

I'm considering switching to either a Ketoconazole/Nizoral shampoo (currently use Head & Shoulders because it makes my scalp happier than the other stuff). I wash 1x a week, sometimes 1x every week and a half to two weeks.

Leery of topical applications that might require more frequent washing, because I'm lazy and my hair seems to prefer less washing over more (the most washing I can convince it to do without getting fluffy and frizzy like whoa is about 1x every 3 days). Though I'm not opposed to the idea of something like a rinse since my hair doesn't mind getting wet, it just minds the washings.

Despite being leery of topical applications, have also considered Minoxidil. But I have really sensitive skin, and I haven't gotten that sorted yet with a doctor or dermatologist (I really should). I am worried Minoxidil could make my scalp itchy. Plus, again, do not want to wash more often than I currently do.

One of the other things I've done is quit smoking (123 hours, or 5 days, without a cigarette) due to other things, but from reading this thread I'm doubly glad I did, since it looks like it can (or does) contribute to thinner hair).

I'm not so distressed by the thinning that I absolutely positively have to fix it (because it's not continuing to thin, it's settled down), but I figured I'd look into it as a nice-to-have. It doesn't look especially thin either.

I have been using Ketoconazole 2% shampoo & twice daily Minoxidil 5% for about three weeks now. The Minoxidil liquid doesn't leave any residue or greasiness for me, as long as I ensure most of the product is on the scalp, rather than the hair. I've never had problems with sensitive scalp, maybe you could try the lower strength formulations first and see how you tolerate them?

[akurah]

I have been using Ketoconazole 2% shampoo & twice daily Minoxidil 5% for about three weeks now. The Minoxidil liquid doesn't leave any residue or greasiness for me, as long as I ensure most of the product is on the scalp, rather than the hair. I've never had problems with sensitive scalp, maybe you could try the lower strength formulations first and see how you tolerate them?

I have a dermatologist appointment this week, so I've actually decided to hold off on either one. I've started taking daily pictures of my scalp every morning to see if I can tell if there has been an increase in thinness over a period of months. I'm thinking, pending what the derm says, switching to Ketoconazole from H&S and not doing the minoxidil, since I understand minoxidil is sort of a lifetime commitment if you want regained hair to stick around. However, if the hair pictures show my hair is continuing to thin after about 3-4 months, I may reconsider.

How frequently do you wash your hair?

[lizardspots]

I have a dermatologist appointment this week, so I've actually decided to hold off on either one. I've started taking daily pictures of my scalp every morning to see if I can tell if there has been an increase in thinness over a period of months. I'm thinking, pending what the derm says, switching to Ketoconazole from H&S and not doing the minoxidil, since I understand minoxidil is sort of a lifetime commitment if you want regained hair to stick around. However, if the hair pictures show my hair is continuing to thin after about 3-4 months, I may reconsider.

How frequently do you wash your hair?

Fair enough, I hope the derm appointment proves fruitful! I wash my hair every 3 days. On the bottle I have, it recommends using it twice a week. At first, I found it a little drying. But after about 3 weeks of use, I haven't noticed any dryness/roughness. It's like any regular sulphate shampoo.

[xnibn]

Just an update , l was using minoxidil 5 once a day for about 3 months , but wasn't seeing much results , this thread inspired me to be more aggressive, added nizoral 2 times a week as recomened in this thread , then went to derm last month and she added some topical hormones to my minoxidil at night and recommended increasing minoxidil dosage to 2 times a day , l have new growth everywhere and my hair looks fuller , very happy����

[bjt]

Great thread, with lots of great info. Thanks Reyesuela for posting all your info!

I'm sorting through a lot of this because of early menopause (45!) and trying to get a handle on my hair. I'm trying a lot of the things mentioned in this thread at the advice of a dermatologist who specializes in hair problems.

My question is does anyone get significant drying? If so, what do you do about it?

And Reyesuela, did I understand your regime correctly in that you wash your hair every day? Is it just a scalp wash or do you wash your length as well?

Thanks in advance!

[lizardspots]

Congratulations xnibn that is wonderful, I'm so glad your regime is working! I've only been using Nizoral & Minoxidil for 1 month, haven't noticed any hair growth yet. :pray:

bjt Yes, I have experienced drying and flaking. I wash my fringe every day though, so it doesn't really show up much on me - at least from the front when I look in the mirror, maybe my crown is full of flakes! :tmi: Pre-wash, I give my scalp a good scritch to dislodge the flakes.

[bjt]

bjt Yes, I have experienced drying and flaking. I wash my fringe every day though, so it doesn't really show up much on me - at least from the front when I look in the mirror, maybe my crown is full of flakes! :tmi: Pre-wash, I give my scalp a good scritch to dislodge the flakes.

Thanks lizardspots for your reply! I tried just washing the flakes away but I'd end up washing my hair 4 or 5 times--it was overwhelming and wasn't working. I am a bit crazed about it because I've never had dandruff or flaking--its completely new to me. so, I'm really trying to make it work! but I'm not a fan of the flaking. I just switched this week to a daily scalp wash in the morning after a nighttime Fluocinolone oil treatment.

So far this has worked, but its only been a few times. and its a huge change for me--way more work than I've ever done on my hair before. I'm off from work this week and taking a break from the gym (spending my time with some visiting family) but once I get back to work & gym, we'll have to see if I can keep this up. :( I think I probably need a support group more than advice. :(

[bjt]

PS. Lizardspots, it took me near 3 months before I noticed any real growth. and even now while I have quite a bit of new growth, its still thinner than my old hair. My doc says that it can take up to a year for it to thicken up. So hang in there, it'll start working eventually!

[lizardspots]

Hello everyone, just checking in to see how we are all doing with our hair regrowth journeys.

I have been using Minoxidil and Ketoconazole shampoo for 7 weeks now, and I think my excessive shedding phase has come to an end. I still lose around 40-60 hairs per day during detangling, but this is much better than the 200+ I was losing before I started my regrowth regime. Also I think I see some new baby hairs coming through at my parting!!!!

[pandabarrier]

Hello everyone, just checking in to see how we are all doing with our hair regrowth journeys.

I have been using Minoxidil and Ketoconazole shampoo for 7 weeks now, and I think my excessive shedding phase has come to an end. I still lose around 40-60 hairs per day during detangling, but this is much better than the 200+ I was losing before I started my regrowth regime. Also I think I see some new baby hairs coming through at my parting!!!!

Hi lizardspots congrats on the smaller shedding and hair regrowth. Happy hair growing! :)

[Aredhel]

Hello everyone, just checking in to see how we are all doing with our hair regrowth journeys.

I have been using Minoxidil and Ketoconazole shampoo for 7 weeks now, and I think my excessive shedding phase has come to an end. I still lose around 40-60 hairs per day during detangling, but this is much better than the 200+ I was losing before I started my regrowth regime. Also I think I see some new baby hairs coming through at my parting!!!!

That's wonderful news, so glad the shampoos are working for you! :)

[Synester]

Been directed to this thread (even though I just posted my own thread whoops) My I lost a lot of my hair a few years back and it hasnt really grown back right since, and its been 4 years. And I still have a pretty visible "bald" patchy spot on the back of my head. (the only area effected is the top back of my head) I tried Minoxidil solution, 5% for several months, seemed to reduce my shedding...not really much growth progress. I stopped that long long ago. My hair loss was due to some hormone imbalance and I was put on spironolactone to block some of my androgen production...But all of that has seemed to have calmed itself. I just want to recover the hair that is lacking in the patch in the back of my head. It just will not grow. The hairs are shorter and thinner than the rest of my whole head. Im digging through this thread lurking for answers right now. But I just wanted to post where im coming from right now.

[esfand]

Today, I met a wig seller and she said I have thick hair - and then I met a hairstylist to trim my hair, and he said I have thinning hair and said I must be tying my hair in a really tight ponytail (I don't). Hah.

That said, I do wonder if I am losing hair. Yet at the same time I get a lot of compliments on how thick my hair is. It's that the parting on the top seems a bit thin.

[lapushka]

Been directed to this thread (even though I just posted my own thread whoops) My I lost a lot of my hair a few years back and it hasnt really grown back right since, and its been 4 years. And I still have a pretty visible "bald" patchy spot on the back of my head. (the only area effected is the top back of my head) I tried Minoxidil solution, 5% for several months, seemed to reduce my shedding...not really much growth progress. I stopped that long long ago. My hair loss was due to some hormone imbalance and I was put on spironolactone to block some of my androgen production...But all of that has seemed to have calmed itself. I just want to recover the hair that is lacking in the patch in the back of my head. It just will not grow. The hairs are shorter and thinner than the rest of my whole head. Im digging through this thread lurking for answers right now. But I just wanted to post where im coming from right now.

I was under the impression from your other thread that you had no idea why you shed the amount you did. I had no idea it was due to hormonal imbalance, and that you had gone to the doctor already. :flower: I had hormonal imbalance at age 13/14 as well, and it took 2 years to recover from.

[Synester]

yes my hair loss was due to a big spike in my androgens when i got bloodwork done, that was in late 2013/early 2014. Since then I stopped dying my hair black...(god i miss it) because my thinning white scalp against the pitch black hair and my lighter ash brown roots made it look even WORSE, like i said minoxidil didnt help that much, i also dont feel that commuted to it. And my spiro medication made me get do dizzy i would passout. and yes its been about 3 years and i havent seen much improvement, if anything it looks the worst it has in a long time. if i ever get the money for it id get more bloodwork done. until then i guess all i have going for me is some castor oil :[

[leayellena]

my hair was thinned out because of stress. in 6 month the hair worl got covered with hair. then my scalp got fuller from 7 to 8 cm. buuuut: when I discovered conditioner (thank you LHC) I found out I have a huuuuuge braid taper from collarbone to the ends
http://forums.longhaircommunity.com/attachment.php?attachmentid=27800&d=1499080906
. my hair was breaking in masses! I bought a cien-kur mit keratin-formel and I shed 80-90% less! stupid me I tried "mild" stuff and the shed returned. plus I didn´t feel any power in my shampoo and conditioner so I came back to cien. love it. I tried by than my first co-wash. I expected it to be a fail, because I knew that when you change something in your routine, your body must re-adapt. the second co-wash was last friday. even today I look ok for a walk outside. what I doscovererd since co-wash: my scalp didn´t produce so much flakes, sebum. I am planning to cwc next time. I don´t want to over react with co-washing and... have dandruff in the future! :O

[lapushka]

Cien is the Lidl brand of products, if anyone's wondering. ;)

[Hoopybunny]

I've been using Triaxon for about 15 years and it has saved my hair!!!

[lapushka]

I've been using Triaxon for about 15 years and it has saved my hair!!!

First time I've heard of "Triaxon". Is it a regular shampoo? I've been off to Google it, but it seems to not be available here.

[checkuponit]

Reyesuela, curious to know if the minoxidil is still working for you?

[ravenheather]

Minoxidil is working for me. I have been using it for a year. I did not have severe hair losd, but rather a lot of shedding and refusal to grow. My ponytail circ is a quarter inch thicker and my shedding is much less. I hope that this will allow me to gain some length.

[Reyesuela]

Haha! Obviously, Minoxidil is awesome for me. Lol.

[fhairyqueen]

Oh no I look like the dandylion you describe in the OP
Not good for me

[dropinthebucket]

Thank you so, so much Reyesuela, for this incredibly informative thread! I posted on the Mane forum and was recommended to this thread (which I just read all the way through :D) - I will def be trying some of these. I'm also taking a lot of hydrolyzed collagen for my joints/cartilage, hoping that will help, as well. Will report back periodically with results, as well. Thank you, thank you!

[Wendyp]

Thanks for posting all this info. I have just bed prescribed Spironolactone. My testosterone has always been high and I have a lot of facial hair. No one has ever wanted to treat it until now. I’m pretty sure all the learning I have done from this site is I don’t have fine hair in fact and most likely have some hair loss from all the testosterone shudder: so frustrating wish I had this dealt with much sooner

[Sarahlabyrinth]

My background:

I started lurking here...some time before 2008. I'd always had what lay people call "long hair" (hips to APL, depending on what I felt like) and decided to actually grow it out. I got it to pinkie length before I got bored and chopped it to pixie. After that, I had it various lengths and various styles--lots of conventional dye, highlights, etc. Had more kids and less time, so decided to go long again (sooo much less work than anything but pixie). But then my hair started to fall out. A lot. I had never measured my ponytail width officially before, but I lost between 33% and 75% of my hair at the base of my neck. At BSL, my hair was the same density it had been at my thighs!

Thinning hair runs in my family. It's probably not classic androgenic alopecia because even my father, who has it the way my grandmother did, just has very diffuse but profound thinning across all of the top and sides of his head. Nevertheless, I felt that proven balding methods would work for me. It takes months for definite results, of course, but the evidence is now all over my head--and NOT IN MY BRUSH!!! I look like a dandelion, with hair sprouting everywhere, and I am losing 0-5 hairs daily. That's right. Some days I don't lose a single hair. Most days I now lose 1-3.

I remembered this community, which gave me hairstyling ideas back when I had really long hair, and I wanted to see if others were dealing with or had overcome similar issues. I see that a lot of people are struggling with hair loss and even defining hair loss (is it "thinning"? is it hormones? is it "shortening"? is it breaking?), and I thought that I actually had something to contribute now. So I signed up!

I also found out that, while hair thinness (in terms of ponytail diameter) and terminal length are somewhat genetic, there are things that anyone can do that are very likely to increase both. Whether you want to call this restoring you to your genetic potential or manipulating growth is up to you. :) NO, I'm not claiming that you can start cranking out 2" of hair a month. But you can likely increase your growth rate and terminal length on the order of 5% to 30% if you don't have anything wrong, depending on how stunted your normal growth is compared to your potential--and if you do have something wrong (and contrary to what people think, virtually all women who make it past 60 will have SUBSTANTIAL hair loss), you can likely do far more than that...if and only if catch it early enough, before the hair follicles have actually died. (Once they're dead, they're probably dead.)

Hair Quantity vs. Ponytail Diameter

Lots of people drastically underestimate how much hair they've lost (or how thin their hair is). They go from a 4" pony to a 2" pony, and they think they've lost half their hair. Really, they've lost 75% of their hair! That's because the area of a circle grows much faster than the circumference. So as my initial post, here's a circumference-change-to-hair-loss guide. Most women with longer hair will notice their thinner ends long before they notice a thinner ponytail or scalp. That's because the longest hairs often fall out first. Other first targets are the hair around the face, especially at the temples, getting thinner and shorter.

If your ponytail is one eighth smaller around, you've lost one quarter of your hair.

If your ponytail is one quarter smaller around, you've lost 46% of your hair.

If your ponytails is 3/8 smaller around, you've lost 51% of your hair.

If your ponytail is one half smaller around, you've lost three quarters of your hair.

If your ponytail is 2/3 smaller around, you've lost 89% of your hair.

If your ponytail is 3/4 smaller around, you've lost 94% of your hair.

This is what I would like to know. When I had my big shed, my ponytail circumference went from 4.25" down to 3.5", but I don't know how to work out what percentage of hair I lost?

[Joules]

I shed a lot. Enough to be visible all over my floor whenever I'm too lazy to vacuum, and enough to clog my drain when I wash my hair.

My ponytail circumference has been the same for the past ~7 years (I never measured it prior to 7 years ago). The taper is insane, but it's been the same for years, too (it did worsen at one point, I think due to breakage because of poor quality oils I was using on my hair, but it bounced back). I had a stressful couple of weeks last summer which resulted in quite a bit of hair loss last September/October, but it didn't seem to affect my ponytail that much.

I really don't know what's the deal with the taper. My braid looks similar to Reyesuela's profile pic, except my hair isn't that thick at the roots, but the drastic loss in thickness throughout the length is very similar. I need to get my thyroid checked, cause I have almost every single symptom of hypothyroidism (but I literally have no energy to go to the doctor, lol). Or maybe my hair is just that fragile and it breaks every time I sneeze.

[pinutzz]

Swollen thyroid - weight?

I have had issues with my thyroid for about two years now. It is visibly swollen, most of the time uncomfortably so:
https://i.imgur.com/XvtqdQa.png
I have been to three doctors, but since all my thyroid related values are in the normal range I am not getting any treatment at the moment. Along with the swollen thyroid I have been shedding significantly. My ponytail circumference used to be 7cm, intermittently it went down to 4.5cm and is now back at 5.5cm, slowly recovering. The only useful advice I got from one of the doctors was to lose weight, which I am working on, but I still have a looooong path ahead of me at my current pace. Without having been explicitly told I assume that stress also has something to do with it and I try to meditate, but lately a little less often than I would hope. Aside from that I am basically watching from the sidelines while my thyroid selfdestructs sufficiently until a doctor will finally prescribe hormones.

So, Joules, I feel your pain and urge you to make an appointment with the doctor so you know at least where you stand.

Since my weight loss has stalled at the moment, I could really use some motivation to forge on, since I do see small positive changes in my thyroid when I shed pounds. I would love to hear stories from forum members about lifestyle changes influencing their thyroid health (or not?) and how long it took them to grow their hair back (if ever?).

[Wendyp]

Swollen thyroid - weight?

I have had issues with my thyroid for about two years now. It is visibly swollen, most of the time uncomfortably so:
https://i.imgur.com/XvtqdQa.png
I have been to three doctors, but since all my thyroid related values are in the normal range I am not getting any treatment at the moment. Along with the swollen thyroid I have been shedding significantly. My ponytail circumference used to be 7cm, intermittently it went down to 4.5cm and is now back at 5.5cm, slowly recovering. The only useful advice I got from one of the doctors was to lose weight, which I am working on, but I still have a looooong path ahead of me at my current pace. Without having been explicitly told I assume that stress also has something to do with it and I try to meditate, but lately a little less often than I would hope. Aside from that I am basically watching from the sidelines while my thyroid selfdestructs sufficiently until a doctor will finally prescribe hormones.

So, Joules, I feel your pain and urge you to make an appointment with the doctor so you know at least where you stand.

Since my weight loss has stalled at the moment, I could really use some motivation to forge on, since I do see small positive changes in my thyroid when I shed pounds. I would love to hear stories from forum members about lifestyle changes influencing their thyroid health (or not?) and how long it took them to grow their hair back (if ever?).

I had to find a functional medicine specialist to get treated for properly. You could also call them naturopath where you are. Regular doctors can’t seem to property treat these issues, and the garbage medicine they put you on gives false readings. If your symptomatic find someone to help you. Your hair will thank you.

[Lady Stardust]

This is what I would like to know. When I had my big shed, my ponytail circumference went from 4.25" down to 3.5", but I don't know how to work out what percentage of hair I lost?

If I’ve worked it out correctly, it’s about a third. (I used formulas for the circumference of a circle and then the area of a circle for each measurement, and then worked out the percentage.)

[Sarahlabyrinth]

Thank you! Can you explain more clearly how you worked it out? I am a maths ignoramus. Also, I have just had another shed in the first couple of weeks in April and I went from 4.25" down to 4", so how much would that be? Does that mean I have lost about 10 per cent of my hair? :(

And for the folks who have autumnal shedding, what percentage do they lose?

[Lady Stardust]

Thank you! Can you explain more clearly how you worked it out? I am a maths ignoramus. Also, I have just had another shed in the first couple of weeks in April and I went from 4.25" down to 4", so how much would that be? Does that mean I have lost about 10 per cent of my hair? :(

And for the folks who have autumnal shedding, what percentage do they lose?

Hi SarahLabyrinth, no problem, I’ll write out an explanation and will calculate the latest, I won’t be able to do it until tonight though as my toddler is in her element at the moment :-)

Re Autumnal shedding, are there average figures for how much hair is lost?

[Sarahlabyrinth]

Hi SarahLabyrinth, no problem, I’ll write out an explanation and will calculate the latest, I won’t be able to do it until tonight though as my toddler is in her element at the moment :-)

Re Autumnal shedding, are there average figures for how much hair is lost?

I don't know, as I don't get autumn sheds myself, but others here apparently do. so I was curious as to how much they might lose. Thanks for helping me out. I can barely add 2 and 2 together, maths-wise :p

[Lady Stardust]

I don't know, as I don't get autumn sheds myself, but others here apparently do. so I was curious as to how much they might lose. Thanks for helping me out. I can barely add 2 and 2 together, maths-wise :p

I don’t think I can be much help about Autumn sheds, I read that they might happen because less hair is shed during the summer to protect the scalp from the sun, so it balances out by shedding more in the Autumn. No idea if that is true or utter baloney.

OK, before we start - if you want me to do any more calculations I’m happy to! You don’t need to go through this and give yourself a headache! I’ve even done a spreadsheet now so I can work it out really quickly, it would be no trouble at all. I worked out your latest shed and you’re right, it’s about 10%. Just over, at 11.4% but that was a great estimate. Your hair is, of course, magnificent, shed or no shed.

Now you did ask for an explanation so here it is, sorry if it does your head in. I’ve put in a short version in the summary at the end!

To calculate how much hair has been shed

We use the circumference, the distance around the outside of the ponytail, to measure thickness. To calculate how much hair has been lost, we need to calculate how much hair there is inside the ponytail holder. We’re ignoring the length and just dealing with a cross section, like a flat disc. The formula for the area of a circle will give us this measurement.

The formula for the area of a circle is Pi x r2. Pi is always 3.14. r is the radius of the cicle, the distance from the centre to the edge, or half the diameter of the circle.

First of all, we work out the radius of each circle. We can calculate this using the circumference measured. In your example, your initial circumference was 4.25”. It’s a whole lot easier to talk about centimetres so we don’t end up with fractions. There are 2.54 cm per inch, so the intial circumference is 10.795 cm.

The formula for the circumference of a circle is 2 x Pi x r.

So:

2 x Pi x r = 10.795

r = 10.795 / 2 x Pi

Pi is always 3.14 so 2 x Pi will always be 6.28

The radius for your first ponytail is 10.795 / 6.28 = 1.72 cm

Then we work out the area of the circle (cross section of the ponytail).

Area of first ponytail: Pi x r2 which is the same as Pi x r x r

= 3.14 x 1.72 x 1.72

= 9.29

The area of the cross section of your first ponytail is 9.29 cm

Then you do the same for the second ponytail. 3.5 inches x 2.54 = 8.89 cm

Radius of second ponytail:
r = 8.89 cm / 2 x Pi
= 8.89 / 6.28 = 1.42 cm

The radius of your second ponytail is 1.42 cm

Area of second ponytail:

= Pi x r x r = 3.14 x 1.42 x 1.42 = 6.33 cm

To calculate the percentage

We want to see what percentage the second circle is of the first circle. It’s this way around because we know the second circle is smaller.

Percentage = (smaller area / larger area) x 100.
= (6.33 / 9.29) x 100 = 68%. This is not the amount lost! The smaller circle is 68% of the size of the larger circle.

100 - 68 = 32. This means that 32% of the hair was lost.

Summary

1. Calculate the circumference of each ponytail in cm. Measurements taken in inches are multiplied by 2.54.
2. Calculate radius of the first circle by dividing the circumference in cm by 6.28.
3. Calculate area of first circle: 3.14 x radius x radius
4. Calculate radius of second circle: circumference in cm divided by 6.28.
5. Calculate area of second circle: 3.14 x radius x radius
6. Calculate percentage. Smaller area divided by larger area, then multiply by 100. Subtract that number from 100 to get the percentage. Or use the button in your calculator :-)

[Synester]

have always had fine hair my whole life and several years back i lost a good portion to hormones and then it seemed to stop but now i fear its back again ive been shedding a lot recently. more than usual not globs like before. but more than i would like...idk ive lived in florida my whole life its summer year round here so idk if id call it a summer shed. my hair is mid back length due to a recent chop (was almost waist) and it doesnt seem to be tapering but the crown of my head just remains thin and wont grow back. its like the hair there refuses to grow.
idk what to do. i used to be on spironolactone. but it made me so dizzy i couldnt work out at all or id almost passout. but that helped with my androgen spikes. anyone know how to regain some thickness. im desperate and dont have insurance to go get more blood work done this blows lol.

[Sarahlabyrinth]

Lady Stardust, THANK YOU so much for this! I read through it carefully and just about understood your workings (though it still did my head in, lol!) Anyway, I think that in future, thanks to your careful and detailed explanation, should another shed happen (heaven forbid...), I could probably work this out for myself. Anyway, I have it bookmarked for future reference in case it should be needed. I'm sure others here will find it useful too - you're a blessing :D :smooch:

[Sarahlabyrinth]

have always had fine hair my whole life and several years back i lost a good portion to hormones and then it seemed to stop but now i fear its back again ive been shedding a lot recently. more than usual not globs like before. but more than i would like...idk ive lived in florida my whole life its summer year round here so idk if id call it a summer shed. my hair is mid back length due to a recent chop (was almost waist) and it doesnt seem to be tapering but the crown of my head just remains thin and wont grow back. its like the hair there refuses to grow.
idk what to do. i used to be on spironolactone. but it made me so dizzy i couldnt work out at all or id almost passout. but that helped with my androgen spikes. anyone know how to regain some thickness. im desperate and dont have insurance to go get more blood work done this blows lol.

Synester, I don't have any advice beyond seeing a medical professional or someone skilled in hormonal imbalances. Shedding is really, really horrible and you have my sympathies. :grouphug: I hope it stops, pronto, and you regrow some lovely new hair.

[Lady Stardust]

Lady Stardust, THANK YOU so much for this! I read through it carefully and just about understood your workings (though it still did my head in, lol!) Anyway, I think that in future, thanks to your careful and detailed explanation, should another shed happen (heaven forbid...), I could probably work this out for myself. Anyway, I have it bookmarked for future reference in case it should be needed. I'm sure others here will find it useful too - you're a blessing :D :smooch:

Ah you’re welcome. I like maths :-)

I hope you don’t have another shed, but if you do, give me a shout if you’re working through the calculations and something doesn’t make sense.

[Sarahlabyrinth]

Ah you’re welcome. I like maths :-)

I hope you don’t have another shed, but if you do, give me a shout if you’re working through the calculations and something doesn’t make sense.

Ok, thanks! Let's hope it never happens. :D

[Wendyp]

Lifestyle/Health Factors that Cause/Worsen Thinning

The bad news: Much thinning is going to have underlying general age-related hair loss. That's because the vast, vast majority of people, women and men, lose hair with age. Women just lose less, on average, and in a more diffuse way.

The good news: Sometimes, thinning is partially or entirely because of other issues that can be treated. Yay!

Underweight
Effect size: Mild to moderate.

Something that will cause heavy hair loss in most people is being more than mildly underweight. Your body will ditch a lot of nonessential functions to try to lower its basal metabolic rate. That alone will eventually cause hair to fall out. For some people, even with a perfect diet, this can happen while still in the mildly underweight range. For others who maintain very good diets, hair loss does not occur until they are severely underweight.

But most people have not-fabulous diets at the best of times. With normal quantities of food, frank deficiency is rare, but people who are eating very little food tend to have an even worse diet because they are living an irregular lifestyle, they have serious food aversion issues, they have an eating disorder, or they have gastrointestinal/medical issues that cause them to avoid and restrict certain foods. Therefore, most people who are more than mildly underweight have really poor diets, which adds to the hair loss.

Hyperthyroidism
Effect size: Mild.

Hyperthyroidism is a common cause of being underweight, and it is associated with hair loss. A normal thyroid runs at extremely high efficiency. An over-active thyroid is inefficient, which means that it is wasting fuel (calories). This has many different symptoms, and thinning, brittle hair can be one. This is usually caused by a tumor on the thyroid gland.


Malabsorption
Effect size: Mild to moderate.

If you have a malabsorption issue due to Crohn's disease, ulcerative colitis, untreated severe celiac disease, or something similar, hair loss is frequent. It is not, however, your main symptom--other problems will be far more severe. Frank vitamin deficiencies manifest in many ways. Your hair is just one of them. Many malabsorption disorders are general and so present with severe weight loss and underweight. Some, though, are selective, so you can be a normal weight but not be absorbing certain nutrients. I put it in this here not because everyone with poor absorption is underweight but because most who have hair loss are.

Frank Vitamin Deficiency

Effect size: Mild to moderate-severe, but you'll be VERY sick.

You rarely get frank vitamin deficiencies in the first world, but many will cause hair loss at some point before death. They are most commonly the result of malabsorption or an extremely variety-restricted or quantity-restricted diet. You can fast for a week and not lose any extra hair, and a typical moderately bad Western diet doesn't cause vitamin-deficient thinning hair.

Vitamin A Excess
Effect size: Mild to moderate.

This only occurs with non-natural sources unless you love liver. :) Vitamin A toxicity can occur due to diet only by eating a lot of organ meats because the levels in other meats are low and the plant forms are rejected if your blood levels are too high. But if you take a vitamin A supplement with the retinol form of vitamin A or take Accutane or similar vitamin-A based prescriptions, you can have hair loss from vitamin A toxicity. Topical retinoids and tretinoin don't cause this, and getting these things in/on your scalp is no problem.

Hypothyroidism
Effect size: Mild to moderate-severe.

Hypothyroidism is linked to overweight, but not for the reason most people think. While some normal-weight women develop low thyroid function (usually due to an autoimmune disease), most women with low thyroids have thyroids that are impaired by fat accumulation around the gland. While low thyroid does cause bloating, it causes very little fat gain. Hypothyroidism is not a cause of overweight and obesity because it can only down-regulate your metabolic rate a little bit. (Otherwise, you die!) Your body already runs at max efficiency without ditching functions--getting a disease doesn't make it run better! Hair is one of the few functions your body can ditch without you dying as a result, so that's something that goes up on the chopping block pretty quickly. Low thyroid does, though, encourage you to move a lot less by making you tired all of the time! That can push down your overall energy expenditure, especially if you're trying to exercise--you just really, really won't want to. Hypothyroidism is entirely treatable with drugs, weight loss, or both, depending on what is needed. Many people find that they do much better on either a natural thyroid supplement or the right combination of natural and synthetic because Synthroid has conversion issues between the different types of thyroid hormone, so if some of your numbers look normal but you're not feeling better and getting your hair back, you might want to change the drug mix.

Higher Androgen Levels
Effect size: Mild to severe.

Some women over-produce androgens no matter what their weight. Because women's bodies are so sensitive to androgens, this can produce major hair thinning. Sometimes this is a birth defect. Sometimes this is acquired. Congenital adrenal hyperplasia is something that gets diagnosed usually soon after birth or in childhood. Nonclassic congenital hyperplasia is usually diagnosed in childhood but is sometimes diagnosed later. These are weight-independent. Rarely, an adrenal tumor or an androgen-producing ovarian tumor can cause this. So see your doctor! Normal weight women can also have the most common type of androgen excess, but is it much rarer than in heavier women, because it is closely linked to insulin resistance/type 2 diabetes or type 1 diabetes, which results in PCOS or HAIR-AN syndrome. It appears that insulin resistance and type 1 diabetes both encourage the ovaries to make more androgens. No one is fully sure why yet. But this means that if your body has poorer blood sugar management (meaning your body does, not that you make bad decisions), you're much more likely to develop androgen excess resulting in more body hair and thinning head hair.

So what's the link to fat? Fat, especially abdominal fat, secretes both male and female hormones, which tips women into an androgenic state, AND it increases insulin resistance, which tells the ovaries to go androgen crazy--a double-whammy on the PCOS/HAIR-AN hair loss scale. We are all walking around with different levels of susceptibility to fat's ability to induce insulin resistance and to androgens. If you're very sensitive, as above, and your body is insulin resistant at any weight, you can have androgen excess even at a very lean weight. If your body isn't hardly susceptible to insulin resistance at all, you could reach 400 pounds and have a gorgeous head of hair, no excess facial hair, and totally regular periods. The vast majority of women are at least moderately susceptible to insulin resistance and excess androgens, which means that the more overweight you are and the longer you stay overweight, the higher your risk goes up for everything that goes along with it, including hair thinning. The crazy thing is that intra-abdominal fat is the first fat that gets lost when you lose weight, so a mere 20% of body weight loss can drastically reduce the symptoms of androgen excess, even in people who need to lose 50% of their body weight or more.

Spironolactone is the frontline anti-androgen that is used for women with androgen excess. You can have androgenic alopecia without high androgens, though--and many older women do. In this case, your hair follicles use completely normal amounts of androgens to convert to extra DHT and destroy your hair. MOST women with androgenic alopecia don't have excess androgens. They just have mean hair follicles.

I had no idea what the true effect of having extremely high testosterone levels of my body was. No one tried to fix it until this new dr I see. She put me on Spironolactone a month ago. I have a lot more energy from it and facial hair decreasing. I’m certain now this has affected my thickness. Thank you for posting.

[ravenheather]

What size dermaroller do you use?

[Reyesuela]

https://imgur.com/a/g84wb2jI'm not sure what dermaroller I used.

I know I don't come by often. It's because there really STILL isn't that much I can do with my hair due to the taper. The taper is STILL quite huge because, YES, my hair is STILL getting thicker! It's not been a little more than 2 years that I have been treating my hairloss. My hair has now reached 4.5" thickness. It was at 2.5" when I began measuring, after I noticed that it was thickening up. I literally have 3.24 times more hair than when I began treatment!


My rate of hairfall has increased from the abnormally low rate that it fell to about 6 months after I began treatment of under 10 hairs a day to a normal and healthy sort of rate of 25-30 hairs per day. I still do have young hairs that fall more than they should in ratio to the older/longer hairs, so it's obviously a medicated head that's growing hair! lol


Every so often people ask if it's still working. Yes, it is. You can still see where I started to use treatments almost as a line on my braid.


Yes, I'm continuing to grow new hair. No, I don't know when it will peter out. The drugs can't stimulate new follicles to be created. It can only tell sleeping follicles to make terminal hair!


https://i.imgur.com/IkimtRv.jpg


And here's a standard hairstyle I use now, though I'm mostly going to bigger clips...

https://i.imgur.com/l90IUyc.jpg

[checkuponit]

Reyesuela, thank you so much for coming back to check in! I'm curious to know if you are still keeping up the same routine with minoxidil - 5% twice per day? Do you use the liquid or foam? I feel like the liquid would be a lot more effective, but it makes me scalp so insanely itchy!

Have you been using any other treatments, or just minoxidil?

[aethyra]

https://imgur.com/a/g84wb2jI'm not sure what dermaroller I used.

I know I don't come by often. It's because there really STILL isn't that much I can do with my hair due to the taper. The taper is STILL quite huge because, YES, my hair is STILL getting thicker! It's not been a little more than 2 years that I have been treating my hairloss. My hair has now reached 4.5" thickness. It was at 2.5" when I began measuring, after I noticed that it was thickening up. I literally have 3.24 times more hair than when I began treatment!


My rate of hairfall has increased from the abnormally low rate that it fell to about 6 months after I began treatment of under 10 hairs a day to a normal and healthy sort of rate of 25-30 hairs per day. I still do have young hairs that fall more than they should in ratio to the older/longer hairs, so it's obviously a medicated head that's growing hair! lol


Every so often people ask if it's still working. Yes, it is. You can still see where I started to use treatments almost as a line on my braid.


Yes, I'm continuing to grow new hair. No, I don't know when it will peter out. The drugs can't stimulate new follicles to be created. It can only tell sleeping follicles to make terminal hair!


https://i.imgur.com/IkimtRv.jpg


And here's a standard hairstyle I use now, though I'm mostly going to bigger clips...

https://i.imgur.com/l90IUyc.jpg

I am so happy to see your recent update posts in this thread, Reyesuela. I have read every post in all of your hair loss threads. I am relatively new to the site and read about your research in other threads. I searched the site and located everything you have authored here. Your research, theories, experimentation and advice is very inspiring and quite impressive. I am hoping to regain volume lost this year. I have lost a lot of volume. It is frightening how quickly the loss came about. I have thin and fine hair to begin with. I am devastated mentally and am consumed by hair issues.

I have had all thyroid levels checked and that is apparently not the source. I have been through a lot of stress the past few years, am on the lower range of normal with my ferritin level (21) and am set to have hormone levels checked next. Odd thing is my hair was looking really great in 2017. I stopped doing touch up root only highlights in October 2016 (my last highlights) and decided to stop with bleach to give my hair a rest. My hair really loved this! Then in Jan of this year my hair started feeling awful and became very matted and dry. By Feb. the shedding started.

I hope I can find some way to bring back my hair. This loss is severely affecting my life and my relationship.

I hope you keep posting on your threads as your data is far beyond helpful. You are wonderful to read!

Thank you for all you do!

[Reyesuela]

Reyesuela, thank you so much for coming back to check in! I'm curious to know if you are still keeping up the same routine with minoxidil - 5% twice per day? Do you use the liquid or foam? I feel like the liquid would be a lot more effective, but it makes me scalp so insanely itchy!

Have you been using any other treatments, or just minoxidil?

I use minoxidil 5% twice per day with the liquid. My scalp has FINALLY adjusted so I only have to shampoo every other day now!!!! I use nizoral for the shampoo.

I know I get more growth speed when I also use other things, but I haven't mixed them up in a long time.

[Reyesuela]

I am so happy to see your recent update posts in this thread, Reyesuela. I have read every post in all of your hair loss threads. I am relatively new to the site and read about your research in other threads. I searched the site and located everything you have authored here. Your research, theories, experimentation and advice is very inspiring and quite impressive. I am hoping to regain volume lost this year. I have lost a lot of volume. It is frightening how quickly the loss came about. I have thin and fine hair to begin with. I am devastated mentally and am consumed by hair issues.

I have had all thyroid levels checked and that is apparently not the source. I have been through a lot of stress the past few years, am on the lower range of normal with my ferritin level (21) and am set to have hormone levels checked next. Odd thing is my hair was looking really great in 2017. I stopped doing touch up root only highlights in October 2016 (my last highlights) and decided to stop with bleach to give my hair a rest. My hair really loved this! Then in Jan of this year my hair started feeling awful and became very matted and dry. By Feb. the shedding started.

I hope I can find some way to bring back my hair. This loss is severely affecting my life and my relationship.

I hope you keep posting on your threads as your data is far beyond helpful. You are wonderful to read!

Thank you for all you do!

Mine is just plain genetic.

As women, we so often like to blame ourselves for things that are often outside of our control--or else be in denial about them! I firmly believe that just as many women experience hair loss as men. Just go to the grocery store and look at the number of women over 40 whose scalp you can clearly see through their hair. The pattern of hair loss is different, but it's still quite evident in many, many women.

How many women have a huge, thick head of hair at 55 or 60, compared to 20 or 25? Really, not that many. Try 70. Or 80. I've actually seen the long-hair show in China myself first hand. The final "star" of the show is an old woman with the longest hair in the village. She is definitely over 70, and her hair is probably 20" longer than she is tall--but it's less than half the diameter at the base than that of any of the young women.

I was keeping an eye out for it because of my grandmother, but it's quite common with many women. :)

The most common reason in younger women is probably androgen excess/PCOS, but it's something that happens to almost all women as a part of aging, too. Some of us just get it young!

[Reyesuela]

BTW, I have a formula now I want to make into a hair elixir. Lol. I've just been super lazy about it!

[duchess67]

Hi Reyesuela, I was so happy when I received an email notification of this post of yours. You have a wealth of knowledge when it comes to everything related to hair and health. Thank you very much for sharing your knowledge with the rest of us.

Your hair looks amazing, the thickness you have gained is really wonderful!

After seeing how minoxidil helped my mother and a couple of other friends (beborani a long time member here) I wanted it badly to work for me as well. Sadly, women's 5% Minoxidil foam gave me some serious health problems, so I had to stop using it after 2 weeks. Lost a lot of hair during that time.

One dermatologist suggested that I start with low dose and slowly increase the dosage until my body could tolerate it well. Following that Dr's suggestion, I started using 0.5ml for a few months (started on May 18, 2018) Gradually increased to 1 ml. Now I can tolerate 1 ml without any problems. Can't wait till I could start using 2 ml a day. Even with this low dosage my hair fall has dramatically reduced and I have lots of new hair growth which I am very thrilled about.

A month ago I started applying Multi-Peptide Serum for Hair Density from The Ordinary at night. No idea whether this helps with hair growth or not, but it clearly makes my hair feel thicker.

Recently I read that Serioxyl serum made by L'oreal helps regrow hair. Since this wasn't available at any hair salon or stores here, I had to order it online from the UK. Once I receive this Serioxyl serum, I plan to replace The Ordinary serum and to use Serioxyl at night.

Serioxyl Ingredients:
-Estemoxidine
-Neohesperidin

Hope to see more improvements in my hair after all these treatments.

Thank you again :blossom:





https://imgur.com/a/g84wb2jI'm not sure what dermaroller I used.

I know I don't come by often. It's because there really STILL isn't that much I can do with my hair due to the taper. The taper is STILL quite huge because, YES, my hair is STILL getting thicker! It's not been a little more than 2 years that I have been treating my hairloss. My hair has now reached 4.5" thickness. It was at 2.5" when I began measuring, after I noticed that it was thickening up. I literally have 3.24 times more hair than when I began treatment!


My rate of hairfall has increased from the abnormally low rate that it fell to about 6 months after I began treatment of under 10 hairs a day to a normal and healthy sort of rate of 25-30 hairs per day. I still do have young hairs that fall more than they should in ratio to the older/longer hairs, so it's obviously a medicated head that's growing hair! lol


Every so often people ask if it's still working. Yes, it is. You can still see where I started to use treatments almost as a line on my braid.


Yes, I'm continuing to grow new hair. No, I don't know when it will peter out. The drugs can't stimulate new follicles to be created. It can only tell sleeping follicles to make terminal hair!


https://i.imgur.com/IkimtRv.jpg


And here's a standard hairstyle I use now, though I'm mostly going to bigger clips...

https://i.imgur.com/l90IUyc.jpg

[aethyra]

BTW, I have a formula now I want to make into a hair elixir. Lol. I've just been super lazy about it!

Ok Rey: I hope it is ok to call you Rey. Come on now!!! Are you going to let us know about your formula? *please* :popcorn:

[checkuponit]

I use minoxidil 5% twice per day with the liquid. My scalp has FINALLY adjusted so I only have to shampoo every other day now!!!! I use nizoral for the shampoo.


Did you have to work up to using the liquid without scalp irritation, or are you lucky enough that you don't react to it?

I've been using the foam for a while now but I honestly feel like most of it just gets rubbed into my hair. I'd like to use the liquid, but in the past it has caused crazy itchiness/dandruff.

Wondering if you could share any tips or tutorial as to your process for applying the liquid? do you drop it in with dropper and let it sort of just travel through your scalp, or rub in?

Many thanks!! Your fact-driven, science-based info on here has been super interesting and helpful.

[Kalamazoo]

Bad Fats

Saturated fats are not fine! Despite the recent hype, yes, saturated fats are clearly bad for you, even when they come from grassfed beef or butter. Limit these severely--red meats to 2 servings or less a week, and butter the same. Dairy products that are part skim are better than full fat, and cheese with fat should be limited also because of high levels of advance glycation end products (AGEs).

Were the studies on milk & butter done on raw or pasteurized? My understanding is that raw cream is extremely healthy, & that butter is the only source of butyric acid, which is an essential acid. (We have to have it, & our bodies can't manufacture it.) My personal experience is that my lips chap & my elbows get dry when I eat pasteurized butter; but those problems totally disappear when I use raw butter. Generally speaking, a lot of studies on the healthfulness of milk use pasteurized & homogenized products & never mention that fact, and a lot of people just assume that nobody would ever think of drinking it raw. But people drank raw milk for thousands of years before Louis Pasteur was born, and milk was always considered a vitally important food, until pasteurization became the norm. Suddenly, folks started having milk allergies, as the pasteurization process severely compromises milk's digestability.

And then there's homogenization. I've read that a molecule of cream is shiny & slippery on the outside, & will effectively balloon-clean out one's arteries. However, homogenization breaks open the healthy fat molecule so that all the sticky stuff is on the outside. So yes, homogenized milk, cream, etc. will clog one's arteries.

The Weston A. Price Foundation is a valuable source of information. Here's an article of theirs on Fats:

https://www.westonaprice.org/health-topics/know-your-fats/the-skinny-on-fats/

which includes the following:

"The Benefits of Saturated Fats

The much-maligned saturated fats—which Americans are trying to avoid—are not the cause of our modern diseases. In fact, they play many important roles in the body chemistry:

Saturated fatty acids constitute at least 50% of the cell membranes. They are what gives our cells necessary stiffness and integrity.

They play a vital role in the health of our bones. For calcium to be effectively incorporated into the skeletal structure, at least 50% of the dietary fats should be saturated.38

They lower Lp(a), a substance in the blood that indicates proneness to heart disease.39*They protect the liver from alcohol and other toxins, such as Tylenol.40

They enhance the immune system.41

They are needed for the proper utilization of essential fatty acids.
Elongated omega-3 fatty acids are better retained in the tissues when the diet is rich in saturated fats.*42

Saturated 18-carbon stearic acid and 16-carbon palmitic acid are the preferred foods for the heart, which is why the fat around the heart muscle is highly saturated.43*The heart draws on this reserve of fat in times of stress.

Short- and medium-chain saturated fatty acids have important antimicrobial properties. They protect us against harmful microorganisms in the digestive tract."

[Kalamazoo]

Don't Put This On Your Head, Really

I now bring you a brief break sponsored by things you shouldn't put on your head.

GINGER is often listed as a traditional growth stimulant. It actually is quite good at making hair fall out. Don't put it on your head.

TOPICAL CAPSAICIN was frequently used in Victorian hair stimulants. Through the capsaicin and vanilloid receptor, however, it convinces your skin that it's too hot and makes your hair fall out.

TOPICAL LICORICE causes hair to fall out.

CITRUS OILS of all sorts are photoreactive and can leave you with second to third degree burns when they react with UV light.

HIGH LEVELS OF CAFFEINE have the opposite effect of low levels of caffeine and stunt growth.

HIGH LEVELS OF MELATONIN also stunt growth, while low levels promote it.

Thank you, Reyesuela! You just spared me a bunch of grief from misdirected experimentation!

[Krynna]

Bumping this thread because this is solid advice you're giving.

I'd just like to add that a diet rich in protein can REALLY help your hair if you have everything under control!

[AuNaturel]

Amazing advice!

[Kalamazoo]

Reyesuela's advice is superb. We really need to keep this thread up-top where people will see it.

[windyballoons]

I have some input about minoxidil I would like to share.
I was really struggling with minoxidil application because I have diffuse hair loss as well as patchiness. It's easy in the patches, but everywhere else, it's tough.

I tried the foam and ended up going through a bottle in about 3 days! It did not work well for me and was a huge pain.

I tried the liquid, but I found it difficult to apply as well. It would run and drip down my face and into my hair but not always where I wanted it on my scalp. And, I felt like I needed extra hands to hold the bottle close to my head so it wouldn't drip out of the dropper on the way up, while holding my hair parted correctly for scalp access... And I knocked over the bottle several times, losing a lot of product :(

What I did was to get a clean hair dye applicator bottle. I pour half of a bottle of 5% minoxidil liquid in and add a few squirts of aloe vera gel. I shake it up well. This isn't a science when I do it- I just add enough to to thicken the consistency to more of a gel-consistency. It's not quite half and half, I use a ratio of approx 1 part minoxidil to 2/3rds a part aloe gel. Of course, this does dilute the solution. That's ok for me. I find the gel consistency much easier to apply and control. I gently rub it into my scalp when I apply it.

My scalp is sensitive so I only apply this every other day. It's helping fill in the patchiness, and has decreased my shedding, but I'd probably get better results from more frequent use. I'm ok with less results to save my scalp irritation though.

This is just what's working for me so far.

[Hue]

What a wonderful thread. Thank you, Reyesuela! You are so organized and evidence-based -- I love it.

[Joules]

First posts are golden. Thank you, Reyesuela.

I'm finally accepting that I'm losing hair. I haven't really lost ponytail circumference since 2010, but my hair is really really tapered and I have so many shorter hairs at the top that it's ridiculous (shorter meaning ~10-15 cm). I have to French or Dutch braid the crown area every day, otherwise my updos look like I'm a mental patient from horror movies, those hairs are all over the place, in my eyes, in my nose, everywhere. Short-cycling is kinda the perfect definition of it. Of course maybe it's not short cycling and it's just normal regrowth from sheds, but I've been shedding rodents for quite a few years now, so...

I've been using ketoconazole shampoo for 2 or 3 months now, and I just started a scalp lotion with saw palmetto (I know it's not as effective on women, but there's not much for me to choose from in my price range). I'm also using a scalp scrub with peppermint, I hope this helps too. I need to develop a more consistent plan, but I'm sorta desperate, impatient and have no idea where to start.

[elfynity]

If you want to find out how much you're shedding and what other kinds of hairs you're losing, wear your hair up or in a braid and then brush it at the end of the day before immediately containing it again for bed. Brush before your shower, too, and try to catch any hairs that come out. And COUNT them. If you're a smart, prepared person (and I'm not), you'll do this before you're worried about hair loss to get a baseline.

I am so happy to have read this, I never figured out how to count them. I am definitely going to do this a few times to get an average and keep checking every now and then. a very helpful, and easy to do failsafe!

[Elizabeth E]

I don't have any problems with hair thinning, but I enjoy reading this thread. So much interesting info here!

[share801]

This was interesting but I do not buy "hypothyroidism" being caused by being overweight as someone who was diagnosed as a young child who was borderline underweight at the time.

[gin]

I am so happy to have read this, I never figured out how to count them. I am definitely going to do this a few times to get an average and keep checking every now and then. a very helpful, and easy to do failsafe!

I recently embarked on a hair shedding/counting experiment to get a baseline shed count, you can read about it here:
https://forums.longhaircommunity.com/showthread.php?t=150562

I did it for 2 weeks, and was super strict about where I manipulated my hair to try to ensure I got all my hairs, which was probably overkill. But it was interesting to see the wash cycle patterns.