What Causes Hair Loss and How to Stop Hair from Falling Out

On this two part episode of Anti-Aging Hacks, I discuss all things hair and hair loss with Dr. Ryan Welter.

We discuss the following items relating to hair loss:

1. Why do we lose hair, and is it genetic?

2. What are hair cycles and what do they mean?

3. Is female hair loss similar to male hair loss?

4. Top 3 ways we can protect our hair from falling

5. How to use the top 3 ways for most effective protection for our hair

I broke this down into two episodes, the first part deals with the basics of hair loss and how you can protect the existing hair on your head from falling out. In the second part, we get into restoring and regenerating our hair using Hair Transplants and regenerative technologies such as Stem Cells and PRP.

Hair loss is an incredibly important part of anti-aging and longevity, and it is one of the sure shot giveaways that we are aging.

Dr. Ryan Welter is the CEO and Medical Director of Regeneris Medical. Dr. Welter obtained his doctorate in biochemistry and molecular biology from Oklahoma State University and his M.D. from the University of Oklahoma.

In 2005, Dr. Welter began a successful hair restoration practice and founded the New England Center for Hair Restoration. Finding success in cellular therapy for hair restoration, Dr. Welter began pursuing research into regenerative medicine and founded Regeneris Medical which today is involved in several clinical trials utilizing regenerative medicine technologies. He performed the first ever stem cell therapy treatment for hair loss in 2011 and continues to pioneer bio-cellular and stem cell therapies for a host of medical conditions and anti-aging regeneration.

Here are the highlights from the call:

Dr. Ryan Welter’s background 3:00

– Father had hair transplant surgery and looked great

– Dr. Welter Started researching, and integrated Platelet Rich Plasma for hair

– Also incorporated Stem Cells into practice

How Does Hair Loss happen in Men and Women 7:10

– Male hair loss caused by Androgenic Alopecia – mostly genetic or hormonal situation

– Women hair loss more complex, certainly more hormonal

– Dihydrotestosterone or DHT also damaging to hair follicle

– Half of men over age 50 lose some percent of hair

– Men have a pattern to hair loss (male pattern baldness) while women have more diffuse, over the entire scalp

– They do general medical work-up on women to figure out Thyroid, Anaemia, Hormones

Is Hair Loss Genetic 11:20

– Can be genetic for both men and women

– Genetics is a strong indicator

– Multi-factorial: not all genetics or hormones play a part

– Genetics have variable penetration, it’s not a sure shot but does have a big impact

– Some people have strong hair loss in the family, but can be spared genetically

Other Contributing Factors 13:40

– Family history and hormones

– Women lose hair during pregnancy, during menopause, and can also have typical female pattern hair loss

– Anaemia or iron deficiency is also a cause for hair loss

– Everyone has age related hair loss, depending on factors

– Fluctuations in weight can cause hair loss

– Gastric bypass, Lupus. Diabetes can also cause hair loss

– Stress is also a factor to hair loss, can precipitate a lot of these conditions above

What is the Hair Cycle 16:15

– Three to Four stages to the hair cycle

– Anagen: growing phase, lasts 2-7 years, most hair in this phase. This phase is critical, ideal to keep hair in this phase

– Catagen: is a phase where hair is regressing. Some cells die and follicle shrinks. 

– Telogen: is the resting phase in hair cycle where hair wait before growing back

– Normal to lose 200-250 hair follicles per day

– The more hair you can keep in the Anagen phase, the lesser the chance of losing them

What are Terminal Hair vs. Vellous Hair 21:30

– Terminal hair is the mature hair that would be an anagen hair. It is active, healthy and growing and has a nice thick shaft

– Vellous hair are soft, small hair on border of hairline, or nape of neck, or in the moustache area

– Vellous hair can be precursors to Terminal hairs. When you use Rogaine for many months, vellous hairs develop and then can turn into Terminal hairs which are the normal hair

– For best anti-aging strategy for hair, it is desirable to keep the terminal hair instead of letting them degrade into vellous hair

Dihydrotesterone or DHT is the main culprit in hair loss 23:30

– Testosterone in our bodies combines with an enzyme called 5-Alpha Reductase to create Dihydrotestosterone or DHT

– DHT is a very potent hormone

– Binds to receptors in the hair follicle, and causes miniaturization. Starts in the front and the back (crown) areas and meets in the middle

– Both men and women make DHT from Testosterone

– Can be blocked with Propecia or Finasteride (more on those below)

– DHT is a very important part of the hair loss story, but not all of it as there are also other causes

– The hairs on the back of the head are not susceptible to the DHT hormone, which is why hair transplants work (these new hair wont fall out)

How are Patient’s Hair Measured 30:30

– Standardized set of Photos

– Hair check – Measuring device that gets standard grouping of hairs that measures thickness and amount of hair. This provides a hair mass index.

Hair Loss Framework 32:10

– Three tiers to hair loss

– Maintenance: Slow or stop the hair loss

– Enhancement: Options to rejuvenate the hair

– Surgerical: Options to restore hair 

Maintenance Tier: Option 1 – Propecia/Finasteride/Proscar 33:20

– 5-Alpha Reductase enzyme inhibitor

– Blocks conversion from Testosterone to DHT

– Finasteride for prostate is at 5mg dose, for hair loss just 1mg

– Important to maintain the hair and keep them from falling out

– Propecia is FDA approved

– Dutasteride is another 5-Alpha Reductase Inhibitor

– DHT may be 40% of the problem

– Side effects of Finasteride: Impotence, LAck of interest in sex, trouble having an orgasm and lack of ejaculation

– Side effects occur in less than 2% of men. 

– Some recent reports mention permanent issues because of Finasteride

– Women should not take Finasteride at child bearing age

– Men should not donate blood while on Finasteride, this blood could cause complications in the fetus of a pregnant woman

Maintenance Tier: Option 2 – Minoxidil/Rogaine 41:20

– Generally given topically on the hair

– Women in particular are very responsive to Minoxidil

– Challenge is need to do this twice a day, and need to get into the scalp

– Can cause some challenges with styling hair

– More compliance challenges, but most people are good responders

– It causes some initial shedding phase for 3 months, so need to get through that phase

– Most side effects tend to be scalp irritation, may lower blood pressure, or cause dizziness – very low in side effects

Laser Therapy for Hair 47:50

– Laser therapy has shown benefit in helping hair

– In-office machines for 2 times/week

– Many caps/hats/head devices have been made

– Laser combs can also get laser light to the hair follicles

Supplements:

– Nutrafol supplements have shown benefits

– Help Hair Shake by Larry Shapiro

How to use Maintenance Items 50:45

– All maintenance items work differently

– All add to each other synergistically

– Combination therapies work best: If you can do most or all these treatments, then that is recommended for best anti-aging protocol for hair

Dr. Ryan Welter’s Contact Info:

– Regeneris Medical