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Hair Today Gone Tomorrow: The Sequel!
Let's face
it, bodybuilding is a visual endeavor and sport. No one wants to have a
great body without a full head of hair to match. So, it should have come
as no surprise to me that I received so much mail after I wrote my first
article on the topic in 1997 in MMI (issue 179). "Hair today gone
tomorrow" was published in MMI and later on the BrinkZone.com web site.
It was clear to me that I hit a nerve with readers as I received more
email and snail mail then I had expected, especially considering the
fact it was an article that had nothing to do with building muscle! Why
did I write it? From the last article,
"I thought a new article for those people who are really bumming that
their hair is falling out, want to make sure their hair does not start
falling out, or are just real paranoid about their hair falling out, was
in order. If you fit any one of the above descriptions-which most people
do- than this is the article for you! So why do I care so much about
hair loss? My mother's father was bald, my father is mighty thin up top,
my hair started to thin a while back -you do the math!"
I have received countless emails and letters over the years asking me to
update the article. Here, finally, is the updated version which will
integrate info from the last article and the newer recommendations.
People who have not read the first article can view that at:
http://www.brinkzone.com/hair.html
Readers of this article may be confused by some of my comments if they
are not familiar with the last one, so I recommend you read the first
article. Go ahead, I can wait!
What causes male pattern baldness (MPB)? From 1997:
"So what makes your hair fall out? Well for a long time scientists
thought that DHT was the sole cause of hair loss, but this does not
appear to be the case. As most of you already know, androgens such as
testosterone (natural and otherwise) can convert to DHT by the
previously mentioned enzyme 5AR. People who have high levels of the
enzyme 5AR have higher levels of DHT and are prone to losing their hair.
Men with a
congenital deficiency in 5AR show no receding of the hair line. This
knowledge of the relationship of DHT to hair loss kicked off the big
race to find things that shut down the 5AR enzyme and thus reduce the
amount of DHT. Simple enough right? Well I have said it a thousand times
before and I will now say it a thousand and one times: two plus two
rarely makes four in the human body and this is the case again regarding
the relationship of DHT to hair loss."
"People and researchers who used 5AR inhibitors such as Proscar and Saw
Palmetto found it helped with the hair loss but in no way shut it down
or regrew much of the hair that was lost. What appears to be the
ultimate cause of hair loss for most people is an auto immune response
where the body actually attacks the hair follicle like some kind of
foreign invader thus causing an inflammatory response.
By yet unknown
mechanisms, DHT causes a change in the follicle signaling the immune
system to attack the follicle and your hair starts falling out (If you
take a close look, you can actually see a red line of inflammation on
the scalp of some people losing their hair). How do we know this? It was
discovered that the hair follicles of people losing their hair look very
similar under a microscope to people who experience organ rejection
after surgery. And, it has been found that the immune system suppressing
drug which is used to stop the organ rejection (Cyclosporine) grows hair
like crazy because it shuts down the immune response in the body.
A cure you say?
NO! If you take
some Cyclosporine and you grow hair it will be because you have no
immune system and you will get very sick and possibly die. I shit you
not-don't mess with this stuff. Anyway, though DHT is clearly important
in the cause of hair loss, it is not the final cause and a new race has
been started to address the inflammatory response which ultimately
causes you hair to fall out.
Clearly, you have
to attack hair loss from both the DHT and inflammatory response, and
that's what most of this article is about....sort of. There are also
other factors related to hair growth and hair loss such as nutrition,
SODases, Nitric Oxide (NO) and others, but DHT and the immune response
are the two biggies."
2005 comments:
Interestingly, almost a decade later, our understanding of the cause of
MPB has changed little. Androgens (e.g., DHT) and a poorly understood
immune response, that has interactions with SODases, NO, and other
factors, creates the environment for MPB.
1997 treatment options versus 2005:
In the previous article, I covered copper binding peptides, Nizerol
shampoo, Proscar, Minoxidil, and a very promising mystery drug called RU
58841. What follows in this section are comments on each of them from
1997 followed by my thoughts now after almost a decade of experience
with them:
Copper binding peptides: back when I wrote the first article a drug
called Iamin had just been approved by the FDA for wound healing.
Another drug similar to Iamin is Tricomin. Both Iamin and Tricomin were
invented and subsequently patented by Dr. Loren Pickart. As I stated in
the 1997 article about these compounds,
"These drugs are copper based compounds that have certain peptides added
to them. When put on the skin they have profound anti inflammatory
properties and increase the rate at which skin heals dramatically (hence
Iamin700s approval for wound healing). As I mentioned earlier, chronic
inflammation at the site of the hair follicle appears to be a major link
in the chain of what makes hair fall out."
2005 thoughts: Unfortunately these products did not turn out to be
nearly as effective for MPB as I had hoped. Feedback was lackluster at
best. I believe they still have some use in multi ingredient formulas
that may add some small additional benefit, but the general advice is
they are minimally effective for MPB alone.
Nizoral Shampoo 1997:
"Nizoral is an anti fungal shampoo and the active ingredient is a plant
derivative called Ketoconazol and is produced by Janssen
Pharmaceuticals. How and why Nizoral works on hair loss in not very well
understood. It might work by blocking the DHT at the follicle and/or
working by reducing the amount of inflammation at the hair follicle."
2005 comments:
Nizoral turned out to be a big disappointment. It was very popular when
I wrote the article, but has dropped out of use by most people. It can
now be had without a prescription in 1% strength, but it's a moot issue
at this point as Nizoral is ineffective for treating MPB in my opinion.
There was one small study (Pierard-Franchimont C, et al. Dermatology.
Ketoconazole shampoo: effect of long-term use in androgenic alopecia.
1998;196(4):474-7 )that appeared to find Nizoral about as effective as
Minoxidil, so people can use Nizoral if they want I suppose, but
feedback and experience says it's of no use.
Proscar 1997:
"...Proscar is a very specific inhibitor of the enzyme (5AR) that
converts androgens into DHT. Its official use is for prostate
enlargement which is also related to DHT levels (among other things). It
was felt originally that Proscar would not be effective for hair loss
because it only inhibits the enzyme found in the prostate and not in the
hair follicle.
Well again, nothing
is cut and dry in the human body, and Proscar has been found to reduce
the amount of DHT in circulation which reduces the amount of DHT the
follicle has to deal with and thus less hair is lost. Several recent
studies have shown Proscar is effective for hair loss and can help
regrow some hair on some people, but as I said before, the use of 5AR
inhibitors only deals with a part of the problem and are generally not
very effective when used as the only treatment."
2005 comments:
At the time I wrote the above, Proscar (finasteride) came in 5mg pills
and was approved for benign prostatic hyperplasia (BPH) only. Because
studies found 1mg almost as effective as 5mg for lowring DHT, I
recommended people split the 5mg tabs into 4, which gave you 1.25mg. Of
course the producer of finasteride (Merck) saw the marketing potential
for treating MPB, and finasteride was packed in 1mg pills and sold as
Propecia.
There is of course
no difference between Proscar and Propecia except the dose, so people in
the know still buy Proscar and divide it into 4 pieces to save money. I
would still recommend Finasteride for MPB, but it is far from the
miracle drug for MPB people hoped it would be when it came out. Side
effects such as gyno, reductions in libido, and others also appears to
be higher in the real world then the studies claimed. Finally,
finasteride does appear to work topically (contrary to what Merck
claims) which will greatly reduce systemic side effects. However,
topical is generally less effective then oral treatment.
Minoxidil 1997:
"...Minoxidil did not turn out to be the hair growth stimulant we all
hoped it would be and if it had not recently gone OTC I would not even
have included it in this list. However, being minoxidil can now be
purchased without a prescription and is about half the price of what it
used to cost, I think it is a useful addition to a person's regimen. For
hair growth, minoxidil has pretty much been a bust, but for reducing
hair loss, I have found it is definitely better than nothing."
2005 comments:
The only thing that has changed since I wrote the above is that
Minoxidil comes in a stronger version for men (5% vs. 2%) and can be
found as a generic, saving money for the user. I think Minoxidil makes a
good carrier for other compounds you may want to use topically, such a
Finasteride, etc.
1997 comments on RU 58841:
"RU 58841: This is the mother of all topical anti androgens. RU58841 is
made by the Roussel Corporation of France. This stuff shuts down DHT at
the hair follicle like nothing else. One of the major problems has been
that anti androgens such as Spironolactone and Flutamide taken orally
might be good for hair loss, but they cause all sorts of problems
related to having low androgens in your body, such as loss of muscle,
increased fat, loss of sex drive, gyno, etc.
When these same
anti androgens have been used topically (put directly on the scalp) they
do not cause the negative systemic side effects, but they did not seem
to do much of anything for hair loss or growth either. Therefore, a
topically active anti androgen without systemic effects would be highly
desirable. RU58841 is a topical anti androgen that shuts down DHT at the
follicle without any systemic side effects in the body!"
2005 comments:
If there has ever been a drug that appeared to be close to a cure for
MPB with no side effects, this was it. So what happened to it? That too
is a bit of a mystery, but the general consensus is that the company
never developed it for market for financial reasons after other drugs
for MPB faired not nearly as well in the market place as was expected.
It's a real shame. After the article came out, I knew several
enterprising people with enough money to have batches made up for their
personal use, and they all said it was the best thing they had used
topically.
Additional possible treatments for MPB:
Avodart:
Recently, a dual inhibitor of both enzyme types (5ar-1 and 5ar-2) that
convert testosterone to DHT has been approved for BPH. It's called
Avodart (dutasteride)and is made by GlaxoSmithKline. Finasteride was
shown to reduce DHT by up to approximately 70+% or so, where as Avodart
reduced DHT by 90-96% depending on dose (0.5mg - 2.5mg). So, this drug
would appear more effective for treating MPB, and Glaxo's data found
2.5mg of Avodart grew 1.5 times more hair compared to 5mg Finasteride
over a 6 month period with approximately similar side effects as
Finasteride.
Real world feedback
is that it is indeed superior to Finasteride for MPB, but side effects
are more common. Several doctors I know who prescribed it for MPB told
me many men stopped using it due to side effects, so the claim that it
has a similar incidence of side effects to Finasteride may not be true.
However, it may be worth using topically mixed into some vehicle such as
Minoxidil or some custom blend. There are many of them found on the
internet in fact, and feedback is generally good. As stated, topical is
never as effective as oral, but the side effects are minimized.
Flutamide and Spironolactone
Flutamide is not really a new drug, but an old drug being used for MPB.
It's a powerful anti -androgen used with men with prostate cancer. I
consider the side effects for healthy men FAR too great to be used
orally, though some men have gone that route. I think they're crazy.
However, topical versions are fairly common on the ‘net and this may be
viable alternative - albeit a less effective alternative -to oral
administration. Pretty much everything I have said about Flutamide goes
for Spironolactone. Gyno, reductions in sex drive, etc, is common in men
taking it orally, but topical formulations exist and appear to be
moderately effective, especially when combined with other compounds.
Best overall multi ingredient topical formula:
There are hundreds, perhaps thousands, of topical formulas on the
market. I have not viewed them all nor used them all. Keeping that in
mind, my recommended all-in-one topical formula I recommend is Proxiphen
produced by a Dr. Proctor out of Texas. Dr. Proctor is probably one of
the foremost experts on MPB and one of the good guys in an otherwise
shady industry. I have spoken to him many times and he knows his sh*%.
Proxiphen contains minoxidil, as well as the prescription agents
phenytoin and spironolactone, SODs, copper peptides, TEMPO, PBN...over a
dozen active ingredients in all. Another plus is that Dr. proctor never
sits on his success with Proxiphen in that he is constantly adding new
compounds to the formula if he feels they show promise for MPB.
Because it contains
prescription agents, Proxiphen can only be dispensed on a physician700s
diagnosis of hair loss. This is not as big a deal as you may think, but
you will have to see your doctor to get an official diagnoses of MPB.
You do not have to travel to TX to get it, but your Doc will have to
communicate with Dr Proctor for you to obtain Proxiphen. Dr, proctor
does produce non prescription products that may also be worth a try, but
none of them will be as effective as his prescription based product. Dr.
proctor can be contacted at 800-926-1752 or 713-960-1616. Web site:
www.drproctor.com
Low Level Laser Therapy (LLLT)
99% of the time, something that looks like a scam and smells like a
scam, is a scam. There is that 1% of the time when what looks rather
scam-ish at first actually may work as claimed. Such may be the case
with LLLT. Makers of LLLT devices have claimed for years they grew hair
but there was no hard data to support it, and what the mechanism was was
never really explained. Thus, I was very skeptical say the least.
I have had to alter
that opinion however as a study published in the International Journal
of Cosmetic Surgery and Aesthetic Dermatology ( Vol. 5, Number 2, 2003.)
found LLLT may actually work as claimed. The study found increased hair
counts and improved tensile strength in 28 men and 7 women who used the
LaserMax Hair Comb (www.Lasermax.net) for 6 months. The results were
impressive and no side effects were reported as one would expect. I have
also spoken to the director of one clinic that does many hair
transplants and they find greatly increased healing rates post op using
the laser comb. So, my opinion of this gizmo is guardedly positive and
it may be worth incorporating into your hair loss prevention plan.
If All Else Fails!:
Ok, so you have tried most of the above, don't want to try the above, or
don't have enough hair left on top of your head for the above to really
make a difference, and you want information on transplants. As you know,
when transplants first came out, they were pretty crude and looked
pretty damn bad. Things have changed for the better in the last few
years with some truly impressive results.
So, the good news
is there are procedures that now look totally natural. Bad news, none
are going to give you the hairline you had before you started losing
your hair. You have to have realistic expectations here to begin with.
Ok, after a great
deal of research I am of the opinion that the laser method is superior
to other methods. There is a great deal of confusion out there regarding
the laser method propagated by people using outdated information or fear
of competition. People who put down the laser method claim all sorts of
things that are simply not true today with the right laser being used by
an experienced medical professional.
Before we get to
that, a little background. Lasers are finding new applications in the
medical and cosmetic field almost every day such, such as their use in
surgery and the use of lasers in skin rejuvenation and resurfacing.
It700s been slower in the field of hair transplantation using lasers.
The reason for this is simple, the first generation of lasers used for
hair transplants were non-pulsating CO2 lasers which caused damage to
the local blood supply (dry hole) and poor hair growth resulted.
Keep in mind, blood
supply to the transplanted follicle is essential for any growth to take
place. Without adequate blood supply, the transplanted follicle simply
dies. These older lasers caused thermal damage to the area (burned the
area due to excessive heat from the laser), which of course is not what
you want. This is the main criticism of the laser approach.
However, newer
generation pulsating CO2 lasers showed a vast improvement in maintaining
blood supply resulting in improved graft growth and survival of the
transplanted hair. Later improvements added the Super Pulse laser which
is a big improvement over older lasers that caused extensive thermal
damage. Another type of laser that is used is the Erbium laser.
Both lasers appear
to have their strengths and I have seen excellent results with either.
The right laser in the hands of a doctor who has experience with this
method does not hinder blood supply at all, and excellent graft growth
follows after the hair follicle is transplanted. The laser greatly
reduces actual surgery time and trauma to the area, so post op pain is
reduced and recuperation time is also reduced.
Some other reasons
the laser method is superior to having someone cut holes in your head
with a scalpel or needle punch: every time a laser hole is made, bald
tissue is actually being removed. This reduces the total amount of bald
area present. This advantage is not seen when using a scalpel blade or
needle to prepare recipient sites. Lasers also decrease the incidence of
what is called "postoperative epidermal inclusion cysts." These are ugly
little bumps that often show up in the area of the transplanted hair,
and they look like sh*$ to be honest.
There are yet more
advantages to the use of the laser versus the "cold steal" methods
(e.g., scalpel, needle punch, etc.) that I don700t have the space or
need to cover. It's the only method I have personally seen where I
simply could not tell that work had been done on the person's head until
I saw the before pictures!
The clinic with
probably the most experience with laser transplants is the Hair and
Scalp laser Clinic in Clearwater Florida. The clinical director is John
Satino and the doc doing the work is Dr. Markou. They can be reached at
1-800-883-4247 or 1-727-572-9344. Web site is
www.hairscalplaserclinic.com
Now, if you can
find someone in your area using the laser method who has real experience
with it and can give you referrals to speak to regarding their work, by
all means use them, but not many people are currently using the laser
method for transplants. On a final note, I don700t want people to think
there can700t be satisfactory results with some of the more traditional
scalpel and needle punch methods, but in my opinion none of them are
superior, or more natural looking, than the results achieved with the
laser in the hands of an experienced medical professional.
Conclusion.
Ok, please don't bombard me with questions about the latest greatest
cure for hair loss you read about or are using. The above is about the
only treatments I have any faith in. The longer I have been researching
the topic the more I realize how few of the products out there actually
work and what a vexing problem MPB is to solve. However, the information
in this article is about as good as you are going to find in your
attempt to not end up looking like the guy in the Gold's Gym logo!
About the Author -
William D. Brink
Will Brink is a columnist, contributing consultant, and writer for
various health/fitness, medical, and bodybuilding publications. His
articles relating to nutrition, supplements, weight loss, exercise and
medicine can be found in such publications as Lets Live, Muscle Media
2000, MuscleMag International, The Life Extension Magazine, Muscle n
Fitness, Inside Karate, Exercise For Men Only, Body International,
Power, Oxygen, Penthouse, Women's World and The Townsend Letter For
Doctors.
He is the author of
Priming The Anabolic Environment and Weight Loss Nutrients Revealed. He
is the Consulting Sports Nutrition Editor and a monthly columnist for
Physical magazine and an Editor at Large for Power magazine. Will
graduated from Harvard University with a concentration in the natural
sciences, and is a consultant to major supplement, dairy, and
pharmaceutical companies.
He has been co author of several studies relating to sports nutrition
and health found in peer reviewed academic journals, as well as having
commentary published in JAMA. He runs the highly popular web site
BrinkZone.com which is strategically positioned to fulfill the needs and
interests of people with diverse backgrounds and knowledge.
The BrinkZone site
has a following with many sports nutrition enthusiasts, athletes,
fitness professionals, scientists, medical doctors, nutritionists, and
interested lay people. William has been invited to lecture on the
benefits of weight training and nutrition at conventions and symposiums
around the U.S. and Canada, and has appeared on numerous radio and
television programs.
William has also worked with athletes ranging from professional
bodybuilders, golfers, fitness contestants, to police and military
personnel.
See Will's ebooks
online here:
Muscle Building
Nutrition
A complete guide bodybuilding supplements and eating to gain lean muscle
Diet Supplements Revealed
A review of diet supplements and guide to eating for maximum fat loss
Natural
Bodybuilding at its Finest - Lift for Life.com |
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