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A Complete Guide to Combating Hair Loss: The Science and Solutions

If you're one of the many people desperately seeking help for hair loss, you've come to the right place . At Wish-Owl-Buys, we have dedicated our time to understanding the science behind hair loss and finding effective solutions. In this comprehensive guide, we will discuss the root cause of hair loss, known as Male Pattern Baldness (MPB), and provide you with the best strategies to combat it. We will also explore the science behind hair growth and the various treatments available.

MPB is a genetic condition that is passed down through family lines and is more common in men. MPB is characterized by a specific pattern of hair loss, typically starting at the hairline and progressing to the crown of the head. While It primarily affects males, it is important to note that some women can also experience hair loss patterns similar to MPB, although it is less common.

Understanding the causes

The process of hair loss, especially in Male Pattern Baldness (MPB), begins with the conversion of testosterone into Dihydrotestosterone (DHT) by the enzyme 5-alpha reductase, which is abundantly present in scalp tissue. DHT is a more potent form of testosterone that binds to androgen receptors in hair follicles, leading to follicular miniaturization. This miniaturization process gradually weakens hair follicles, shortens the hair growth cycle, and eventually results in the thinning and loss of hair.

Source: Natarelli, Nicole, Nimrit Gahoonia, and Raja K. Sivamani. 2023. "Integrative and Mechanistic Approach to the Hair Growth Cycle and Hair Loss" Journal of Clinical Medicine 12, no. 3: 893. https://doi.org/10.3390/jcm12030893

Treatment: Five Parallel Tracks

Broadly, there are five parallel tracks of treatment for hair loss:

1. Reducing DHT levels
   1. Five-alpha Reductase Inhibitors
   2. Five-alpha Reductase Manipulators
2. Blocking androgen receptors
3. Stimulating hair growth
   1. Inducing a wound healing response
   2. Minoxidil supplementation
   3. Platelet-rich plasma therapy (PRP) therapy
   4. Low-level laser therapy
4. Nutrition
5. Stress Management

Inhibitors

To effectively slow down or reverse male pattern baldness, it's crucial to reduce the follicles' exposure to DHT. Here, 5-alpha reductase inhibitors like Finasteride (Propecia) and Dutasteride (Avodart) come into play. These medications have been proven to significantly lower DHT levels in the body, with Finasteride inhibiting around 70% of DHT and Dutasteride up to 98%.

And how do we do this? Well, finasteride is a drug that acts as a 5-alpha reductase inhibitor. Sold under the name Propecia, the molecule is a strong 5-alpha reductase inhibitor, and has been shown to inhibit around 70% of serum (blood) levels of DHT from peak. The usual starting dose is 1mg daily. Dutasteride (sold under the name Avodart) is an even more potent inhibitor (usual starting daily dose is 0.5mg), and can block up to 98% of conversion from T to DHT: it is a much more potent inhibitor of the enzyme that converts T to DHT. Dutasteride would be an option if you wanted a nuclear option to block almost all DHT. In fact, one of my favourite studies compared the difference between Finasteride vs. Dutasteride, and as you can see below, the suppression of DHT levels from Dutasteride was significantly more than Finasteride. Not only this, but the half life of Dutasteride is significantly longer than Finasteride (~8 hours vs. 5 weeks!), and you can see that in the Dutasteride group after stopping treatment (Follow-up Period), DHT levels remained suppressed for a much longer time. Also, please note the side effects of Propecia. [https://www.drugwatch.com/propecia/side-effects/]

antagonist

Additionally, Ketoconazole shampoo acts as an androgen receptor antagonist, competing with DHT for receptor sites on hair follicles https://pubmed.ncbi.nlm.nih.gov/18498517/ This shampoo is primarily an anti-dandruff shampoo, but research has shown it may increase the proportion of hairs in anagen phase (growth phase) - resulting in reduced hair shedding. This study showed that 1% ketoconazole shampoo increased hair diameter over baseline after 6 months of use and reduced shedding. Interestingly, participants’ hair diameter also increased over baseline, showing that it may play a role in creating thicker hair. Basically, if ketoconazole is androgen receptor antagonist and hence, can get into an androgen receptor before Testosterone or DHT, it will occupy that site and block T/DHT from binding and starting their usual process of killing off hair follicles (follicular miniaturisation).

Stimulating hair growth

Minoxidil

Other treatments such as Minoxidil stimulate hair growth by moving hair follicles from the resting phase back into the growth phase. Dermarolling induces a wound healing response that promotes hair regrowth. Minoxidil stimulates hair cells to shorten the resting (telogen) phase and go back into an anagen (growing phase). Often, progress pictures will show significant new regrowth or ‘baby’ hairs growing with minoxidil treatment. I apply Rogaine, a 5% strength Minoxidil foam twice daily in areas that I feel are receding. The nice thing about the foam is that it isn’t super sticky (unlike some people report with the gel), and it also acts as a nice way to hold my hair throughout the day, like hair product.

PRP Therapy

Platelet-rich plasma (PRP) therapy is a three-step medical treatment in which a person’s blood is drawn, processed, and then injected into the scalp. Some in the medical community think that PRP injections trigger natural hair growth and maintain it by increasing blood supply to the hair follicle and increasing the thickness of the hair shaft. Sometimes this approach is combined with other hair loss procedures or medications.

Low-level laser therapy

Low-level laser therapy (LLLT) is a non-invasive, non-surgical treatment that applies low-level (low-power) lasers or light-emitting diodes (LEDs) to the surface of the body. This type of therapy has been shown to promote hair growth in both

Surgery & Cosmetic Solutions

Transplant

For those who are looking for a more permanent solution, hair transplantation is a viable option. Hair transplantation involves removing hair follicles from one part of the body and transplanting them to the balding area. The procedure is typically performed under local anesthesia and can take several hours

Cosmetic Solutions

For those who are looking for a more immediate solution, cosmetic solutions such as hairpieces, wigs, and hair extensions are available. These solutions are non-invasive and can be easily removed and replaced as needed.

Conclusion

If you're experiencing hair loss or scalp issues, it's crucial to correctly identify your condition to seek the right treatment. For male pattern baldness, treatments focus on hair regrowth or transplantation, while dry scalp is treated with scalp care and moisturizing products. Always consult with a healthcare professional or dermatologist for accurate diagnosis and appropriate treatment plans. Remember, understanding your condition is the first step towards effective treatment and management.