Update (2018): My Research Is Now Published In A Scholarly Journal

Rob Misc. Research 120 Comments

Challenging What We Know About Hair Loss

I’ve spent the last ten years researching hair loss, and the last four years sharing what I’ve learned on Perfect Hair Health — analyzing anything from clinical trials to treatment breakthroughs to my own theories on what causes hair loss (and how to reverse it).

Now, I’m excited to share some big news: I just published a paper in a scholarly journal.

The paper is called, “A hypothetical pathogenesis model for androgenic alopecia: clarifying the dihydrotestosterone paradox and rate-limiting recovery factors“.

I know that’s a mouthful. I also know that reading scientific literature is the last thing on most people’s to-do list. That’s why I wrote this article — to summarize the paper’s biggest takeaways, and more importantly, to give everyone a chance to ask questions about it.

What Is This Paper About?

I wrote this paper to reveal the major paradoxes in hair loss research — and to explain why I think DHT’s role in hair loss is misunderstood. I also wanted to build a better model to illustrate why men and women develop pattern hair loss — since no such model exists.

Essentially, the manuscript achieves four things:

  1. It presents evidence that challenges the commonly held belief that the hormone dihydrotestosterone (DHT) directly causes hair loss
  2. It looks beyond DHT and catalogues all other biological and physiological biomarkers also associated with hair thinning
  3. It builds a better pathogenesis model for what causes hair loss — a model that accounts for (1) these additional biomarkers, (2) DHT’s relationship with hair loss and hair growth, and (3) why DHT-reducing drugs stop hair loss, but rarely lead to full hair recovery
  4. It uncovers three targets to potentially improve treatment outcomes, and maybe lead to full hair regrowth

I’ll get into more details in the coming weeks — and even update this article to break down every part of the paper into lay terms. But for now, I’d rather just explain my motivations behind publishing.

Why I Wanted To Publish My Research

This is my first scientific publication, and it’s important (to me) for two reasons.

Firstly, it’s a major step toward legitimizing these theories behind what drives hair loss — concepts I’ve written about for years; concepts that are finally beginning to gain traction in medical literature.

Secondly, it creates an opportunity to share these theories at an academic level. The reality is this: no drug exists to regrow all our lost hair. This paper explains why. Moreover, it provides insights for research teams to refocus their treatment targets… so that we can improve hair loss outcomes for everyone.

The Paper Is Open-Access

Most scholarly journals protect their publications behind a paywall. That means that if we want to read beyond a study’s abstract — we need to actually buy the paper. This can cost anything from $7 for a paper “rental” to $200 per month for a full-blown journal subscription.

This is how journals financially survive. But there’s a downside: by restricting information behind a paywall, those journals also limit the number of people who see that information, and thereby benefit from it.

Fortunately, not all journals do this. In recent years, there’s been a push to adopt a policy known as Open Access. This is when a journal publishes all parts of a paper — and for free.

My paper is Open Access — meaning you won’t need to pay to read it. My hope is that this will encourage more sharing (and reading) of its content.

The Paper Is Also Peer-Reviewed

Peer review is the gold standard for scientific publishing. It’s the evaluation of any manuscript by professionals working in that field. In other words, investigators or academics familiar with pattern hair loss pathology had to read my paper, critique it, and then recommend whether to reject it or accept it.

Peer review is long and arduous (often several months), but it’s also a crucial step to publishing. Without it, we undermine the scientific process.

Lately, there’s been an explosion of pay-to-publish journals — where authors pay journal editors a fee to publish their manuscript. These journals are not taken seriously — nor are they indexed in most journal databases. This is why I made it a point to publish in a peer-reviewed journal. I want the paper indexed, and I want it to be taken seriously.

Want To Read The Paper?

You can access the entire paper right here. You can also download it… or read it on Science Direct… or read it on several other indexing databases.

If you have any questions about the paper — or my research — please feel free to leave a comment. I get back to everyone!

Comments 120

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        Hi Amar,

        Do you mean addiction as in dependency on the supplement for results? While saw palmetto can reduce serum DHT, I’ve yet to see any studies or anecdotes demonstrating that saw palmetto visibly improves hair loss for any pattern hair loss sufferer. So in order for their to be dependency on results, there needs to actually be results — which we’ve yet to see.

        With that said — supplements that combine saw palmetto with other compounds have shown results, and typically, those results are dependent entirely upon the usage of the supplement. This is also true with finasteride (Propecia), and also of pretty much any hair loss topical (including minoxidil (Rogaine)).


  1. Wow, great job! Peer reviewed and everything, great accomplishment! On a side note, any update on that possible grey hair article you mentioned possibly coming out with ? 🙂

    1. Post

      Hey Fernando — thank you. That article took a backseat recently, I’m sorry! I still have it on the agenda. So far, what I’ve read seems to suggest that greying hair and miniaturizing hair are from two separate processes, and there may not be much overlap. So it’s a bit like relearning everything! I’ll absolutely email you when it’s ready.


  2. Hi Rob ,

    Congratulations on your paper.

    Since undertaking scalp excersize to reverse calcification and fibrosis more than a year ago I noticed the following. Which adds further proof your hypothesis.

    My scalp skin has become more pliable and loose, to a point where I can move my whole scalp over my skull, during for example a towel massage.

    This has also coincided with hair regrowth and thickening.

    I’m truly in debt to you , you helped me overcome a very stressful and anxious period.

    I’ve also started essential oiling , and continue with the massage regimen.

    Due to diffused thinning, my hair cycle is out balance, but it’s all there. This will take more time . ( Some hairs longer than other’s)

    But overall it’s amazing to where I was , and now am .


    Kind regards

    1. Post


      This is fantastic news. Congratulations! And thanks for reading and contributing to the articles on this site. I look forward to your continued success!

  3. Really good paper – congrats! I’ve had a few peer-reviewed papers published in a different field and it is not an easy thing to do.

  4. I am currently reading your free book and much impressed – the best books do tend to be free nowadays.

    I notice that you say of your paper that “It challenges the commonly held belief”.
    Ironic in the context of the first quotation in my own book (Experts Catastrophe), at top of page 2 of Chapter 1 at http://www.pseudoexpertise.com, which specifically mentions challenging of existing beliefs as one of the taboo things to be avoided in a scientific career.

    So you might find various quarters being dismissive of your efforts or at least unenthusiastic. Anyway let’s see.

    Cheers, Robin P Clarke

  5. I’m currently shaving my head after I started thinning on my crown and a slow recessing hairline. Can I continue the scalp massage techniques while continuing to shave my head, or do I need the hair to grow while massaging?

    1. Post

      Hey Phil,

      You can certainly shave your head. In many cases, people find that shaving makes it much easier to grip the scalp, and even apply topicals (since there’s less hair to get in the way). Having longer hairs is just a way to gauge progress.


      1. Rob, can’t seem to find your blog post about which topical oils to use? Do you mind linking? I had been using black castor oil, but the odor was overwhelming.

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  6. Congrats Rob, I remember the first time I spoke to you, I truly thought I was speaking with a Dr- your knowledge and research is astounding!
    You are always bright, positive and happy to help and brain storm…
    This paper is an achievement of life, but much more in the sense that it could help many others in the future cure this.
    Congrats again. Great guy, great paper!

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  7. Rob, amazing work as always. A single non-Doctor who is dedicated at heart can always win the race over a whole team of qualified hair loss “professionals.” Believe me when I say this is only one of the “first fruits” of your labor.

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    1. Post

      Thanks Reza! I don’t consider myself a scientist or an authority figure — though I may have an opportunity to contribute to a treatment pilot study for AGA this year (which I’m excited about).

      In general, I think it’s healthy for everyone to discuss and debate science — and in this case, the science behind what causes hair loss. I also think it’s especially important to engage with others who disagree with your position — so long as the debate stays rational and respectful.

      Sadly, this is getting harder and harder to do. The advent of social media has given us the ability to block, unfollow, remove, or publicly (and anonymously) smear any voice with whom we disagree. The ending result is that we all form into small camps of “echo chambers” — where we’re surrounded only by people who reverberate things we want to hear. In my experience — and in every aspect of my life — I’ve learned more from trying to understand the “other side” than I have trying to substantiate my own position.

      So, healthy debates are a wonderful idea — and not just for hair loss!

  8. Medical Hypotheses – I myself have had two papers published in Med Hypoths, accepted by the founding editor Prof David Horrobin. In his journal intro he explained the reason why he did not endorse “peer review”. Numerous others have likewise condemned “peer review” – my own writing includes probably the most extensive presentation on the subject.

    Prof Horrobin died in 2004, and a few years ago the publishers Elsevier took over the journal and thereafter depublished two important papers which had already been accepted by the editorial people. That is the publishers interfered in the editorial process, which is seriously improper. The editor and entire editorial board resigned in protest and the publishers then imposed a “peer review” system in order to prevent “inappropriately” heretical things being published.

    My own epidemics paper was refused by 18 “peer reviewed” journals including Med Hyp, on pathetically pseudic excuses, for the simple reason that it exposes such a gigantic crime of pseudoexpertise, millions devastated. (The whole subject is heavily censored.) I can’t copy in whole chapters or links here but will just add this quote from Prof David Healy:

    “Academic journals and societies show an auto-immune response to information that should be the life-blood of medicine.”– Prof. David Healy, author of Pharmageddon

    None of this reflects on the credibility or otherwise of your or any paper in the journal. Hopefully I will have time to read your paper later today, shortly before my last hair falls out.
    Cheers etc.

  9. This is complete bullsh*t: “The absence of full AGA recoveries from androgen inhibition is puzzling, and highlights the necessity to reevaluate AGA pathology consensus.”
    You do not know anything about the underlying changes from androgenetic hairloss. Cotsarelis has already proven without a doubt that balding scalp creates ever increasing levels of PGD2 and PGJ2 which prevent stem cell renewal and ultimately follicle growth in general. Thus someone with recent loss CAN regrow remarkable amounts of hair on 5AR- or androgen inhibitors while someone who has lost it years ago will mostly only maintain what he currently has.
    You are presenting your lack of knowledge as if others haven’t already figured out things that seem to go way over your head. What a travesty. Whoever “peer reviewed” you should be fired.

    1. Post

      Hey Enden,

      The data suggests 5-AR inhibitors like finasteride can stop hair loss and lead to a 10% increase in hair count. To me, that’s far from a full hair recovery – especially for those who are NW3+.

      The mechanisms governing stem cell to progenitor cell failure are still speculative, though one pathway might be through PGD2 (like you said). Interestingly, PGD2 precursors also express in chronically contracted ligaments, and PGD2 is associated (in other body tissues) with the tissue remodeling we observe concomitantly in the balding process.

      PGD2 inhibition protocols — at least anecdotally in hair loss forums — have yet to really move the needle in terms of hair regrowth. If stem cell to progenitor cell failure is entirely due to PGD2, it’s puzzling why we’ve yet to see better hair recoveries from PGD2 inhibitors — especially from people trying those in conjunction with finasteride.

      To my knowledge, Cotsarelis and other investigators also have no explanation for the arrival of PGD2 in balding scalp tissues. My paper presents evidence to theorize one way this could happen. PGD2 expression in the scalp may be a symptom of inflammation induced by chronic tissue tension. This leads to slow, persistent tissue remodeling (fibrosis, dermal sheath thickening, calcification) that eventually culminates into hair thinning (a symptom of the remodeling).

      To be clear: I’m not saying Cotsarelis is wrong, or that I’m right. All I’m doing is presenting a case that maybe, we should try to reverse pattern hair loss by targeting to reverse tissue remodeling — rather than mono-targeting PGD2, KROX20, IGF-1, lactate, DHT (to a degree), or anything that makes headlines as a “new hair loss breakthrough” but soon fizzles.

      Evidence in mechanotransduction suggests that mechanically offloading tissue tension while simultaneously creating a wounding-healing environment can significantly revert scar tissue. Why not apply those same principles to the scalp in an attempt to better improve AGA outcomes? I don’t see what’s so controversial about that.

      To summarize — I don’t understand your negativity here — because most of the comments you just presented still fit within the paper’s arguments, and in some ways, reinforce them. This gives me the impression that you didn’t read the full paper, or didn’t understand it. I’m happy to clarify.

      There’s also no need to throw jabs —- we’re all trying to help each other.

      And finally, I’m always open to the idea that I could be 100% wrong about everything. That’s part of the scientific process. Ideas are written, rewritten, and refined as more data is published. The paper re-evaluates many of the mechanisms behind AGA. But the only way we can test its hypotheses is with more studies.


    2. Re. Enden
      I smell a vested interest in “pharmaceutical solutions.” Consider the source, Rob, and keep up the OUTSTANDING work.

      In addition to all the fine qualities expressed in your work and your willingness to share information, I read your reply to this apparent ‘pharma shill’ and I admire your consistently positive, service-oriented attitude.

      Recall the phrase, “You sir, are a gentleman and a scholar.” Well Rob, you are that…literally.

      I scanned your paper and read carefully several sections. As always, I think you’re on the right track – and we all much appreciate your efforts. FWIW, I completely stopped my hair fall months ago after several years.
      After six or eight months I MIGHT be seeing limited regrowth now as a result of these methods:

      1. Galea flexing (for lack of a better term) ala Tom Haggerty
      2. My own version of “massage” that involves two hands pressing the skin toward one another (scrunches/wrinkles/folds the tissue between the hands).
      3. Weekly dermarolling with 1.5mm needle length.
      4. Topical application of Essential Rosemary Oil in a Coconut Oil carrier
      5. Increased protein intake (I eat very little meat)
      6. Increased healthy fats intake (mostly as olive oil)
      7. Learned to make and consume Bone Broth (mostly chicken feet)
      8. Minimum of 320mg Saw Palmetto daily

      I think these methods are in line with your hypothesis, and I’m proof at this point that hair LOSS can be stopped.

      1. Post

        Thank you Tom. I appreciate the kind words. And congratulations on your success so far! A lot of the book’s first round of best responders also reported success doing the massages in conjunction with Tom Hagerty’s exercises. The biggest benefit to TH’s exercises is likely their ability to retrain those muscles out of chronic contraction — so your scalp can finally relax when you’re not doing them. Please keep us all posted as you continue on, and congrats again!

  10. Hey Rob!

    Congratulations on publishing your research paper. Having read both your book and the article more than once, I can only thank you for your extensive work. Although I do not have any scientific background, I can only imagine that your point of view might be heavily critizised by some fellow researchers, now that you have made it accessible for a broad public, as you have a valid argumentation against the main theories concerning hair loss as well as plausible alternatives on how to treat male pattern baldness.

    I hope that you do not let yourself be discouraged by negative feedback and wish you all the best in your future endeavors.

    I am currently at the 5 month mark of the massage regimen and the lifestyle/diet changes. Although I am still waiting for significant regrowth, my shedding has stabilized over the last few months and the condition of my remaining hair has changed for the better. My hair seems healthier overall, has a darker colour and “feels” thicker. I generally feel healthier and my daily energy levels are more stable throughout the day.

    I want to get bloodwork done in order to rule out possible malnourishments (Vitamin D is a big suspect for me as I clearly do not get enough sunlight on a regular basis due to where I live, as well as possible hypothyroism) and spend blood more often.
    I had discovered your website during a very dark period of my life and your diet/lifestyle/health advices have given me a lot of hope concerning my hair loss and health in general.

    I hope that my results will be similar to some of your best responders and would be incredibly happy to share them with you in a couple of months, possibly even before the 1-year-mark.

    I wish you all the best and please continue your hard work,

    Sincerely, Michael

    1. Post

      Hey Michael,

      Thank you for your kind words. And congratulations on seeing some early signs of success. Please keep me posted with your vitamin D labs — I’m curious to hear your results. Winter shedding is certainly a reality for many people living far from the equator — which is when a lot of people generally notice a decrease in the quality of their hair. But interestingly, a lot of readers also report more shedding in combination with more thickening in the summer time. Vitamin D is likely one (of the many) substances that regulate this process.

      I look forward to your progress!

      All my best,

    1. Post

      Hey RJ — this is nearly impossible to do in a comment response — since this depends on what kind of hair loss you have (alopecia areata versus androgenic alopecia versus telogen effluvium) and your comfortability with the array of treatment options.

      You can start by first trying to familiarize yourself with hair loss research — either by reading this site’s articles or signing up for the free email course.

  11. Hey Rob,

    This guy from immortalhair saying that you changed your mind about massaging,as you can see at bottom,can you clarify this? I cant seem to understand details of your paper very well.

    Thank you

    1. Post

      Hey Maya — I cut out the quoted text since it was so large of a copied/pasted segment. But to answer your question — no, that’s not true. That user appears to be misunderstanding (and thereby mischaracterizing) the paper’s presentation of evidence alongside its actual hypothesis.

      If I had to guess why, it seems like they’re under the impression that mechanotransduction is synonymous with mechanical force, and that mechanical force is synonymous with mechanical tension and chronic tension. This is an easy mistake to make — but if made, it leads to a false interpretation of the paper. Those terms are related, but they aren’t interchangeable.

      The paper actually argues that if we can relieve chronic scalp tension while simultaneously promoting a wounding-healing environment in AGA tissues, we may be able to reverse AGA-related fibrosis and thereby achieve better hair recoveries. That’s why the nuance in terminology is so important.


      EDIT: to be clear, I think there are several ways we can mechanically offload tension in the scalp + create a wound-healing environment. The massages might be one way to do it. They certainly work well for some people — probably because they can improve elasticity and evoke some acute inflammation. But for non-responders, or for those who want better results, there are probably other (potentially more effective) ways to do this.

  12. Hello Rob and fellow regrowers,

    Rob, as I told you, I’m using topical coconut oil for diffuse thinning. You mentioned that shampooing in the morning would not harm the scalp since the oil is absorbed.
    I haven’t been using shampoo and washed my scalp with warm water, however, I scratched my scalp today with my nails and it was clear the it was clogged with some residue from oil.

    Is it wrong to scratch the scalp with my nails? or do you recommend shampooing instead, if so, which brand is the one you think would suffice (sulfate/paraben-free).

    Thanks to you and all the readers for your support.


    1. Post

      Hey Julián,

      Let’s hop on a Skype call soon. I can answer these questions in better detail there — and discuss some new updates.

      In general, if you’re using oils nightly, shampooing shouldn’t be too much of a detriment. In addition, the oil residue shouldn’t hurt either — nor should scratching this off with your nails.


  13. Hey Rob,
    Is your book updated with the full research of this paper?
    I’m thinking about buying the book. Should I wait or it has the same content?

    1. Post

      Hey Carlos,

      The book isn’t updated with this research yet, but if I do release anything in the future, it will be significantly discounted for anyone who’s already picked up a book package.


  14. Hello Rob,

    I have a question. If castrated men don’t produce DHT how is their lack of hairloss explained? Is it because their bodies can’t produce inflammation on the scalp with the help of DHT? If they suffer from the same scalp tension how don’t they loose hair?

    Thanks in advance 🙂

    1. Post

      Hey Riszard,

      It’s a great question, and one that’s answered in detail here:


      But the short answer is that pattern hair loss is likely a two-part equation: 1) inflammation mediated by chronic tension, and 2) our body’s response to that inflammation (ie, the arrival of DHT). The evidence seems to suggest that the concomitant presence of both DHT and TGFB-1 leads to scarring and thereby pattern hair loss. But castrated men produce 95% less DHT than non-castrated men. As a result, their “tool kit” for responding to inflammation favors other substances that aren’t DHT. The end-result is that even if these men are carrying a lot of tension in the scalp, they’re likely not responding to that tension-mediated inflammation with DHT — since they no longer have the testes to help produce the testosterone necessary to make it. As a result, they stop losing hair.


  15. Hi Rob quick question.

    Have you changed any of your opinions on diet ?

    Ie gluten and grains.

    How would the above effect pre and post puberty skull bone growth , in regards to standard mpb.

    The difficult question is. Can one who does lifestyle and mechno therapy still consider a diet free from these foods.


    1. Post

      Hey Paz,

      This is a very difficult question to answer (ie, “Does diet influence skull bone growth or muscular tension in relation to AGA?”). To be clear — diet absolutely influences bone growth and muscularity — there’s no question about that. If you don’t eat, you won’t grow. If you stop eating, your muscles will eventually start to waste.

      But in terms of “in relation to AGA” — I’m not sure yet. Here’s my working hypothesis:

      An anti-inflammatory lifestyle / diet / environment changes 1) the severity of an inflammatory response, and 2) the substances our bodies use to respond to inflammation (ie, TGFB-1, DHT, etc.). So if you’re eating foods that you’re allergic to — and as a result, you’re increasing 1) your inflammatory response to other stressors (like scalp tension), and 2) your likelihood of responding with TGFB-1 and DHT (and thereby increasing your likelihood of scar formation) — then yes, diet / lifestyle / environment have a role in pattern hair loss pathology.

      But from what I now understand, I think that if you’re eating generally well and you’re nutrient replete — this should have very little impact. The evidence seems to suggest that pattern hair loss is a localized phenomenon — with genes and androgens at the top of the flowchart in terms of its onset.

      As a result — if you can correct the tension (via mechanical stimulation or other means), then there’s a good chance that, conversely, diet / lifestyle / environment will play an equally small role in its maintenance (provided you’re getting the basics right — generally anti-inflammatory, and generally nutrient replete).


  16. Hey Rob,

    Congratulations on your paper. I think we’re all one step closer to solving this problem for good.

    I’m a diffuse thinner with hair casts and dandruff. I also suffer from face and shoulder acne. There’s definitely some kind of connection. My acne flares up and gets all red and itchy around the same time my scalp also starts to itch and shed more hair. My derm diagnosed me with Seborrheic Dermatitis and prescribed shampoos, vitamins and Clobetasol Propionate lotion. Can seb. derm really cause hairloss? And is it reversible ?


    1. Post

      Hey Michael,

      Thanks for reaching out. Have you had a chance to read this article?


      In general, seborrheic dermatitis seems to often just be a symptom of scalp inflammation. Whether this is the result of pattern hair loss or just a fungal infection — it’s hard to say.

      I’d recommend reading that acne-hair loss article as a start toward finding an effective treatment. There’s a chance you’re experiencing an overgrowth of pathogenic microorganisms surrounding SD and thinning hair sites — and that these bacteria are contributing to your hair thinning. But without more testing / treatment trialing, we won’t know for sure.


  17. Hi Rob just to add to my question above regarding diet.

    If the theory hypothesis skull bone growth.

    How does this work on a demographic level ? , Ie nation’s which have more Mpb than other’s ?

    My vague answer would be growth genes ? From parents.


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      Hey Paz — it’s most likely determined by genes and possibly even skull suture settlings in early childhood / adulthood. But there’s very little data on this, and so everything in this territory is entirely speculative.

    1. Post

      Hey Infino90 — I’m absolutely considering creating some sort of community for this site — and most likely a forum. But I’m apprehensive to create a Whatsapp group because that would mean I’m constantly accessible. I like to separate my day-to-day life from my professional life, and my professional life from this site — and with a Whatsapp group, I can’t do that. It’s the same reason why I also don’t have any social media (professionally or personally).

      With that said, one of my goals this year is to create a way for readers to exchange ideas without my presence. So some form of the group is coming.


      1. I’d say start with a discord server Rob. I haven’t used it much personally but I’ve seen all kinds of different communities use it to exchange ideas in real time and I think it would work out well here. You’d be able to have a place with a strong sense of community about this topic without necessarily needing to be online all the time to make it work. It should allow you the separation you need while still allowing people to connect more than they can with a comment section.

        Just a thought.

  18. Hi,

    It is really difficult tu understand your paper as I havent taken a medical training, but still it is really hopeful to read someting academic about hair loss. so so hopeful. Thank you. Readers were mentioning about your book. How can I get it?

    1. Post
      1. Hi Rob. Thank you for your answer. I would like to buy the whole package but need to consult about my case first. Doctors told me it is not genetic but it might be as well because I have this condition as far as I know myself, from infancy I mean. When I use medicine or some essential oils, my hair seems to respond. Doctors also told me I have active hair follicles. but still they do not reproduce enough hair it seems. I am 36 years old and live in Turkey btw. Thanks again for your support. It is really hopeful to be able to reach out something solid.

  19. Hi Rob!

    I would like to know your opinion about the research showing that peppermint oil diluted in jojoba oil helps hair loss more than minoxidil?
    I also have another question. Can we say that if a particular oil (jojoba) works great for eyebrew regrowth, it also helps for scalp (for the same person)?


  20. Hi Rob,
    Are there any cases of scalp relaxing/loosening in users of propecia that saw hair regrowth? If yes that could be another point for the tight scalp theory.
    Thanks for your time

  21. Just wanted to say congratulations on getting the paper published Rob. You’re doing wonderful work here and I have to say that I’m noticing the cross over with different emerging areas of health I’ve seen, so I think that one day your years of research and hard work will go further than just within the field of hair loss. Your website and the original detumescence study gets mentioned a surprising amount on the Orthoropics youtube channel for example, a seemingly unrelated field, but I believe that it points to a growing trend for people to look deeper for answers to their health problems than the band aid approach to dealing with symptoms that the medical industry tends to present, and this is a wonderful thing in my opinion.

    At the risk of getting quite philosophical, the internet is allowing us to start connecting and helping each other as opposed to being stuck with the lacklustre answers to some complicated health issues that those with the authority tend to leave us with. (Not trying to knock them or be negative, but there are things that they just can’t or won’t do for various reasons that are really limiting our ability to deal with many modern health issues in my opinion, and it’s an incredible thing that people are starting to use the internet to help themselves.)

    Hair loss might just be classed as a cosmetic issue, but there are clearly many holes in that view on it within the medical industry and many obvious signs that it is an issue with our health and not something to be treated lightly in my opinion, and I think it’s wonderful to see people like yourself building communities like this that are actually digging deep and looking for real answers to these issues. The modern environment is causing so many problems for us as a species that this trend I’m seeing where real answers are starting to appear is something I look forward to seeing grow in the years to come.

    On that note, please keep up the excellent work. Looking forward to what happens for you next.

    1. Post

      Thank you Gray! I really appreciate the comments. There are more updates coming this year! It’s time we build a community around this site. That’s my goal for the next few months — and just as you mentioned, hopefully it’ll allow us to facilitate information better and faster — and maximize everyone’s potential for (and degree of) results.


  22. Rob, did you read this book of David Wolfe’s?


    He’s talking about calcification forming microorganism. And what he advises for calcification (horsetail extract, msm, dmso..) is also used widely by hair loss fighters. He is also mentioning deep tissue massage. I think it’s what really should be focused on.

    1. Post

      Hey Mert,

      I haven’t read David Wolfe’s books — but thank you for sharing. In general, I think calcification is an adaptive response to certain enviornmental stressors — and microorganisms can include that definition. For instance, we’ve seen in tuberculosis patients that lung tissues will literally form calcium deposits around infection sites — almost as if the body is attempting to wall off that infection from spreading beyond those tissues. And interestingly enough, we also see the disappearance of those calcium deposits later on (at least for ~30% of young patients).

      Calcification can also result from mechanical stress — like the chronic pinching of a blood vessel. The blood vessels that provide most of the blood flow to our thinning regions above the galea have to weave through GA-connected muscles, and if those muscles are in chronic contraction, that’s almost a recipe for calcification of those vessels. So it’s all interconnected.

      I’m not sure how effective horsetail extract, MSM, or DMSO will be for infection-related or mechanical tension-related calcification — since the pathology is so different despite the same outcomes.


  23. Hi, Rob. I´ve been suffering AGA for almost 8 years, but somehow I`m not bald yet. So, I´ve been searching for natural treatments that could help me at least to halt my hair loss, and the best options I could find are your treatment (the mechanostimulation therapy) and Tom Hagerty`s scalp exercise (which I´m pretty sure you have heard about ). Reading your articles I found out that one of the main causes of AGA is chronic scalp tension – which is caused by muscular overdevelopment, and chonic contraction of the muscles surrounding the galea-. Before I read that, I was thinking that the only options I had for my hair loss was the scalp exercise and your therapy, so I thought about mixing both therapies every day with the hopes they would bring great results. But now, I really don´t know if the scalp exercise is really going to help me, because it is mainly based on the voluntary contraction of the scalp muscles to increase the blood flow that is coming to the hair follicles; and based on what you have written I think that it (scap exercise) could even worsen my condition.

    Thank you, Rob!

    1. Post

      Hi Mónica,

      It’s a great question — and providing clarity of the mechanisms behind Tom Hagerty’s exercises might help to relieve some of your concerns.

      In general, I think the benefits behind Tom Hagerty’s scalp exercises are that they teach us how to control specific muscle groups connected to the galea aponeurotica, and thereby become more cognizant of them. From trying his scalp exercises on and off for years — I can say that, without a doubt, I’ve always felt that these exercises actually helped “relax” these muscles out of a chronically contracted state.

      In other words — while the exercises might’ve improved the development of GA-connected muscles, they also taught me how to keep them relaxed when I wasn’t doing the exercises. In my opinion, this is likely the biggest driving force behind why those exercises can help hair loss sufferers.

      So I wouldn’t worry about mixing both therapies! In fact, some of the first book’s best responders did just that — and saw success.


  24. Rob just to add something I’ve been researching regarding calcification.

    An article I read and a conversation I followed remarked how, magnesium deficiency and vitamin D3 deficiency, lead to unregulated calcium in high dairy consuming people.

    For example tissue calcification of arteries and follicles could stem from low amounts of vitamin D3 and magnesium. All of which are low in a lot of Western people, and Diets.

    A forum post from an individual stated how he believed that scalp tension was a process initiated by calcium overload and mineral deficiency.

    So in other words less consumption of dairy , and more consumption of D3 and magnesium could help reverse calcification.

    Now I looked at demographics of dairy consumption and hair loss.

    Most consumers of dairy are European nation’s, and United States. Lowest amounts are Latin America. And china , Japan , Asian Nation’s, are not even on the list. ( I take the list with a pinch of salt)

    And guess what, china , Japan, India and Latin America also have the highest number of non -balding people, and least suffer from hair loss.
    Of course most of these diets culturally speaking consume more water based foods, and zinc , magnesium , vitimn D3 rich.

    I’m not saying dairy is bad , it’s important for bones. But unregulated amounts due to deficiency in other minerals is rather striking.

    Could consuming less dairy and sugar make a difference. As blood sugar levels also contribute to the process.

    Also I’m shocked at the amount of female hair loss sufferes both on this site and in real life. Something is up , and I believe woman are facing hair loss due to hormone and diet issues via stress. If they have calcification, then it would be small amount s. And your doing a great job in offering them alternatives , via lifestyle changes and sibo awareness.

    Kind regards

    1. Post

      Hey Paz,

      Thanks for sharing your research and thoughts — I really appreciate it. Lately I’ve been reevaluating whether dairy in my diet is helping or hurting. The science is sort of split depending on how we decide to look at it, but in general, I think the Ray Peat camp overstates dairy’s importance while the strict paleo camp understates its importance. It’s hard to draw a line between who’s wrong or right.

      Things get more complicated when you begin to control for type of dairy (milk versus cheese versus ghee versus butter), separation (low fat versus whole fat), and quality (Jersey cows producing A2 beta casein milk versus Holstein cows and A1 beta casein milk.

      Dairy also constitutes 60-70% of our dietary estrogen exposure — which can be problematic for men with an imbalanced t:e ratio who are already expressing the biomarkers of chronic inflammation.


      For the time being, I’m probably going to start minimizing dairy again. I don’t have a lot of dairy already — mainly just once-monthly hard cheeses and daily as a creamer in coffee. But it probably wouldn’t hurt to reduce this even further — and make up for the loss in K2 through other means. While the research doesn’t support that the calcium in dairy causes calcification — I’m open to the idea that under the wrong circumstances, dairy could contribute to the inflammation that precedes calcification (and thereby be indirectly correlated, as you suggested).


      1. Rob, what do you think of the importance of having at least a 1:1 ratio for calcium and phosphorus as being recommended by Ray Peat followers?

        I know you are not that much of a fan of dairy but in your book, you listed one of your daily nutrition with Calcium and Phosphorus being not that far of.

        That could be a day where you consumed dairy, since its almost hard to get more than 1k of calcium without dairy.

        What about on days without dairy though… are you still mindful of your ratio?


  25. Paz, how long did it take from getting your scalp loose and regrowth? I have now gotten most of my scalp looser than before, how long did it take for you to notice sonething after this? And how much regrowth have you had?

    1. Hi Henry

      It took me around 6 months of persistent regimen to get the scalp at a decent pliable rate and then further.

      The skin may be still be tight, but gives in around 8-9 month mark.

      This is where I could pinch my vertex with more ease . The hair line and ridge’s can take around the same time, make sure you do exactly as Rob mentioned in the book regarding the sides.

      I did
      Hairline pinches 3 mins with both hands and around 3 mins two hand around like he shows.

      Regrowth I strongly believe depends on individual weather it’s 5 months or more , even less.

      My situation was slightly different as mine was to do with diffused / thinning hair , miniaturized weak hair , and hair which stopped growing full length, and strength.

      My hair line was intact and receeded slightly at the right Temple, while my left Temple had been further for many years.

      I believe tight scalp has caused disruption to my growth cycle, and nutrition lacking hair.

      So I have been doing the massages for 14 months plus.
      I can grab most scalp with ease , and can move the scalp more easily.

      In terms of recovery.

      Full . HOWEVER.

      My growth cycle is slowly improving, thanks to continued massages, lifestyle diet and importantly rosemary oil twice weekly with pumpkin seed / coconut oil blend.

      This week my left Temple is filling , it’s a Long process. But hell yes worth it. Almost miraculous for me.

      My issue now is I have some hair longer than others , due to the cycle problems.

      But it’s slowly growing.

      My advice would be

      1. Detumesence excersize twice daily for 12 months or whenever Happy with result

      2. Essential oils if you have diffused hair or growth issues.

      3. Healthy diet and lifestyle

      Signs of improvement I noticed at the start.

      Reduced itching , and sebum.

      At month 4 -5 they all disappeared.

      Then signs of regrowth .

      I know Rob wanted my pics which I want to send but am reluctant for the following reasons.

      1. I was too distressed to take pictures of thining areas close up .

      2. The pictures from afar don’t show anything expect a greasy head , because I allowed my hair to grow.

      3. My regrowth pictures won’t show much loss

      All I have is my testament.

      The process works if given time and dedication.

      If you have standard pattern loss at a slow rate and no hair cycle issues…. Then it’s easier, as you just have to massage and diet .

      Hope that helps.

      Kind regards

      1. Hi, Paz

        I’m currently in the middle of my seventh month of massaging (no regrowth yet as far as I can tell), and still am experiencing shedding to a great extent (in my opinion); ~50 hairs per massage. It gets worse if I don’t shampoo my head once per week, as it gets really dry and falls out more often. I naturally also see a lot more dandruff, which my sister (who’s a hair dresser) finds problematic and puts me on some hard shampoo product.

        I have male pattern baldness.

        Thank you

      2. Hello,

        Did you ever experience dryness or brittleness of hair during that 4-5 month mark? I am doing the exercises 2x daily or happy with results, no shampoo, healthy diet and lifestyle. My hair feels kinda dry even when its oily. It feels brittle. My shedding has reduced since partaking the exercises and been doing them for over 2 months now. I guess I’ll just have to wait 4-5 months to find significant results (stopping hair loss) and then 8-9 months for regrowth?

        I am at a lost and I just want to make sure I am on the right track and that there is hope for stopping hair loss and promote regrowth.



      3. Post

        Hey Abraham,

        If your shedding is already reducing at month two, that’s typically an indication that you’re on the right track. As always, these changes take time (several months), and the data suggests that a stop in hair loss should be achieved around month five for the average responder.

        The brittleness could just be the result of a more aggressive massage technique, which we talked about in our last email exchange together. There’s no harm in tapering the intensity to find an equilibrium. Regrowth is a long game, and if you’re finding that you don’t like the dryness of your hair currently, it’s okay to 1) reduce the massage intensity to see if this is part of the cause, and 2) adjust accordingly based on the data you get from the experiment.


  26. Thanks for answering. I am hoping to get all of my scalp loose in 2-3 more months and in the next 6 months I hope to see regrowth.
    If and when I have success, I will surely give a full and detailed report on here, and to Rob so he can get another example of what worked and how.

    1. I would give it a lot more time if I were you. I’ve been doing the massages into my seventh month now, I have seen nothing but receding and a lot of hair shedding but my scalp has become somewhat looser. I expected to see at least a little regrowth around the fifth month, but I got quite disappointed, heh. Your situation might be different from mine, though. I have seen people say that they use to lose some hair before they start to regain, so I’m still going.
      Just don’t be discouraged if you don’t reach your “deadlines” on time. This takes time.


  27. Hi Benjamin

    50 hairs , seems alot per session. But I use to see around 30 when I first started , and shedding would either decrease or increase depending on time and season.

    Are you doing Rob’s massages like in the video ?

    I also stopped using shampoos and did cold water rinse / showers which I believe may of helped my sebum production.

    I started using rosemary Avalon organic shampoo which has no harmful substances, and found it good. This was after month 11.

    Try cold water and no shampoo. How about diet ?

    Shedding isn’t entirely bad in my opinion . Look at the type of hair that is shedding, if it’s weak or curled at the end.


    I wish you the best of luck !

    Kind regards

    1. Hey, Paz

      I am doing the massages shown by Rob to the best of my ability.
      Some hairs are thick, some are even, some are barely visible, but overall the hairs tend to be thinner towards the root.
      My mother also sheds hairs on a regular basis, but I don’t want to rest on the assumption that I have it from her.

      I am doing cold water, and I went several months without shampooing until recently. I found that the longer I go without shampooing, the more prone I become to shedding.


      1. Benjamin

        I’m also using essential oils.

        Two drops of rosemary oil on a table spoon of either pumpkin seed or coconut oil. After night massage, leave until morning and Wash out with rosemary shampoo. Twice a week

        This has made a difference for me. Hair has thickened and improved.

        Regrowth is a long and slow process.

        Good luck.

  28. Hey Rob,

    Very nice stuff you have here. But I remember reading somewhere that scalp hair that is transplanted to the arm falls out at the same rate as the remaining scalp hair. Also, what about guys with DUPA? How do all these fit into your model?


    1. Post

      Hey Serena,

      Thanks for reaching out. Right now I’m working on an article to address the few studies we have about hair transplants and transplant survival rates. In general, there’s a lot of misinformation surrounding the “donor dominance” theory and, in my opinion, a misinterpretation of that study’s original findings. This is partly covered in the discussion section about hair transplants:


      I also covered a few more points here…


      I recently had an interview with Dr. Brian Freund (who piloted the botox-hair loss study), who also acknowledged during the interview that transplanted hairs still thin. So it’s a pretty widely recognized phenomenon — and it’s also one reason why most transplant surgeons will push hard for recipients to start taking finasteride for the rest of their lives.

      In terms of diffuse unpatterned alopecia (DUPA)–

      This is mainly believed to be androgen-mediated, but I’ve actually seen this present most often in men and women with hyperparathyroidism (as a symptom of the condition). I’ve yet to see research determining whether DUPA is scarring or non-scarring, but in either case, I’m not yet totally convinced that DUPA is actually a form of pattern hair loss. In any case, I’m happy to reevaluate as more information arrives.


  29. There is an instructor in one of my classes. He is totally bald. Today I was examining his scalp, I’ve seen a skin difference in forehead and former hair area. It’s totally the same shape as galea, there is a V where galea connects to forehead. It’s not just the shape of old hair area, because when we are young our hairline is straight. But it’s obvious that scarred tissue is exactly the same shape as galea.
    Secondly, what I noticed about myself after cutting my hair really short is, my temporalis muscles are super developed. When I chew, you can see strong muscles in the sides. Can it be somehow tied to hair loss and galea calcification?

  30. Hey Rob, diffuse thinner here and I appreciate your work and as soon as I read your article it totally made sense to me. Right now I’m using microneedling, essential oils, emu/argan oil, minoxidil, topical panax ginseng/herbal DHT blockers every day and especially with microneedling. There are a lot of new studies on pubmed showing panax ginseng promoting hair growth and not just through DHT inhibition. You might look into it, very interesting stuff.

    Do you think magnesium oil can help with scalp calcification, combined with microneedling perhaps?
    I signed up for the email course. Do you list things that help fight calcification/fibrosis? The only things I know of are microneedling and maybe massage. Thanks for your work.

    1. Post

      Hey Dustin,

      Thanks for reaching out. I’ve looked into magnesium oil in the past, and even used to recommend it to readers a few years ago. Unfortunately, I’ve yet to see magnesium oil make a significant difference in improving hair loss outcomes — both anecdotally and in the literature.

      The problem likely comes from deliverability. Theoretically, magnesium seems like something that would help to encourage calcium deposit degradation — but the calcification observed in AGA appears to be below the skin and in the blood vessels / arteries that run through balding regions. Magnesium oil deliverability is likely just limited to the upper parts of the dermis and epidermis, and as a result, won’t likely reach the targeted areas.

      With that said, one of the success stories in the book (Joseph) used magnesium oil for a portion of his time massaging and dermarolling, and he reported some success. But aside from that, I’ve yet to hear other anecdotes — or see their progress appear in photos.


  31. Hi Rob, great website and work you did to demolish the so-called science between hair loss. I’m a post finasteride syndrome sufferer, who have been told by doctors that finasteride is unlikely to provoke so serious problems. And now, after years of that nasty drug, I’m forced on TRT, after all the other treatments failed. I would like to ask you if you know any scalp massage device that could help in the daily massage process, hopefully making it shorter than 40 minutes, and what you think about LLLT laser combs (like this one https://tophairlosstreatments.com/product/deep-penetration-laser-comb).
    Kind regards.

    1. Post

      Hey Appassionato,

      Thanks for reaching out, and I’m sorry to hear about your PFS. For post-finasteride syndrome, you might find these articles helpful:



      And in terms of LLLT, I also wrote an article about this here:


      In general, I think the helmets are more effective than the combs.


  32. Hi Rob. I’ve got a question that no one has been able to answer for me and I haven’t been able to find online. I understand that a ‘fibrotic’ or balding/bald scalp should be hard and difficult to pinch/move/press. My scalp however is very soft. I can pinch and move it around like crazy and even pressing with some force leave indentations similar to play dough haha. However I’m at NW4/5. No idea what the hell is going on. Any idea as to why this is?

    1. Hey Curruthers,

      I have a bit of similar experience, although I definitely have some hardened regions, the balding areas are very loose (probably because I’ve focused on them a lot for more than a year).

      I’ve come to understand why Rob says that we should focus on all of the scalp, because it’s all connected.

      In my opinion, you should implement the massages and focus on all your scalp. Even if you feel like it’s nice and loose, perhaps its a little bit less than it was before and you don’t realize it.

      Do the massages twice a day, get some sunshine, a little exercise, relax and eat plenty and well for a year and there should be some sort of improvement. Don’t overthink this before you feel like your scalp is already ”very soft”.

      Good luck!

    2. Post

      Hi Curruthers,

      The short answer is that tension at the epidermis (where you can touch your skin) isn’t always going to be the same as tension felt a few layers below the surface (the galea) — even if these tissues are fused.

      The other thing is that as a function of this chronic tension (and the degradation of the arrector pili muscle (APM)), the skin literally remodels — and sometimes leaves increased fatty depositions in place of where the APM used to be. This could explain why your balding regions feel soft. When the dust settles, the fibrosis doesn’t always present as hard, tight, and visibly scarred.

      Again — I’m happy to be 100% wrong about all of this. But based on the data, those are my best guesses.


  33. Hey Rob,

    Congratulations. I read your article a month ago and many times since then, in conjunction with a lot of the Peat litterature.

    Based on my understanding, there are basically two pathways to act upon in terms of scalp mechanical stimulation: 1) using the massages to remodel the scalp and ”soften” hardened soft-tissues, and 2) decreasing overall tension.

    Is this a correct perspective. In this regard, as others have mentioned, Tom Haggerty’s techniques as well as inversions and maybe even shoulder and back messages should be employed as they reduce muscle tension connected to the scalp.

    Thanks again,


    1. Hey Rob, to follow up on my comment above, can you tell me what you think of this video:


      The first obvious thing is that the guy’s scalp is very malleable and soft, but more interesting is the massage techniques used, going all the way down the back.

      I’ve read in a few places that scalp tension can be connected to upper and lower back tension, so does it make sense to try to tackle and resolve trigger points in the back as a way to decrease tension in the scalp (and the galea)

      1. Hey Paz! Yeah I think it’s not only interesting but also a very relaxing video.

        In my mind the big take away is that reducing tension in the neck/upper back has to be very important in an overall tension-reducing regimen. I’d read years ago how tension in the shoulders and upper back affects the scalps, but this massage really brought the point home.


      2. Post

        Hey David,

        I think it’s potentially a great idea to focus on tension further down from the scalp — particularly the neck and shoulders. I also think refocusing our attention on relaxing the muscles connected to the galea aponeurotica — which are all located along the sides of the scalp — is a great idea. Taking these muscles out of chronic contraction, and maybe even massaging the neck and shoulders, should help!

    2. Post

      Hey David,

      I think those are great ideas! And newer insights from the recent crop of best responders are revealing that it’s even more important than previously thought to target to massage the muscles surrounding the galea aponeurotica. So don’t skip out on the “sides” of the scalp — it may be that hyper-focusing on those muscle groups is a key toward the massage’s ability to tackle that tension, and thereby improve hair loss outcomes.


      1. Thanks Rob! I’ve realized the importance of the sides only with experience, sadly…One thing I’ve noticed is how tension seems to accumulate in my scalp when I’m stressed. Let’s say I’ve got a deadline to meet or anything and I work all night on a project. 10 times out of 10, my scalp will be hard as a rock afterwards, as will my shoulders.

        From doing yoga and focusing on the upper back a lot, I’ve found that it’s nearly impossible not to have a relaxed scalp if your shoulders and neck are relaxed and free of tension.

        Years and years of this tension, compounded by calcification process, has to be a major factor. That being said, women are similarly stressed, but alas that is the complex nature of MPB.

        BTW, I know you alluded to it before, but it is high time to create a forum or something so we can have these discussions in a more sane and organized manner.


  34. Hi Rob,

    thank you very much for all the good work and effort you put into this.

    I‘d be interested in the success rate of the tequniques described in the e-mail course and the book. I know it‘s difficult to say since everybody does it slightly different and you probably wont get a feedback from everybody, but that would help a lot in terms of motivation and staying focused even after a few months of not seeing results yet.
    So I would really appreciate if you could give us your opinion on that. Like, is it closer to 20% or closer to 60%.

    Thank you again for your amazing work!


    1. Post

      Hey Tim,

      Based on self-reported data from a survey, it seems like 70% of readers trying these methods are reporting a stop in hair loss or an improvement — with rates of regrowth varying by each individual. I hope this helps! I plan on writing an article about all of this soon.


      1. Hi Rob and everyone else

        I would like to emphasize the massages on the sides of the scalp.

        I definitely did not ignore these ,even if they felt looser.

        You have to make sure that you can grip and pinch the scalp ridge’s . If we look at the Galea structure , and Galea fusion then these areas are mandatory ! . These areas then allow the scalp to move freely over skull , for example when towel massaging after a shower the Galea should move .

        I noticed this around month 13.

        Everyone’s progress is different and personal.

        I would also like to mention Danny Roddy and Ray peats emphasis on prolactin, cortisol, and estrogen reducing through diet and lifestyle. These are all connected to fibrosis and calcification.

        Anyone wanting better chances of regrowth and improvement, need to focus on these areas especially all massages in Rob’s book.

        I know on some forums people are picking and choosing Rob’s massages.

        Kind regards.

      2. Post

        Paz — this is great insight, and well-aligned with much of what the survey data suggests from past readers. Everyone should focus significant attention on massaging the sides of the scalp, and specifically, the muscles connected to the galea in an effort to relax them. Here’s a map of where they are:



      3. Hey Paz and Rob,

        The scalp muscles map is fascinating. And you’re right about the ridges. I didn’t pay any attention to them after reading the Choy paper, and didn’t get any results even with close to 2 years of massages. If you feel out a woman’s (or a man with perfect hair) scalp, everything is just so ”even”. It’s really a shock when you compare to your own scalp and how it used to feel the same.

  35. Hey rob,

    Should I use eco nuts for washing my hair? And if I cheated one/twice on a paleo diet by eating grains and sugar, is it okay or will it just go no where with stopping inflammation?

    1. Post

      Hey Zach — I don’t recommend using any shampoos or conditioners, but using either occassionally shouldn’t make a huge difference either way.

      In terms of eating grains — it really depends on the individual. For instance, Cyrex testing reveals that I have a significant antibody reaction to gluten-containing foods — with my doctor recommending I eat gluten no more than once or twice per year due to its potential for inducing inflammation. Ironically, I feel great whenever I eat gluten-containing foods — and would’ve had no idea of the severity of my response had I not done the test.


  36. Rob, ive just found out about some guys theory on Skull expansion, in that the potential real reason we recede is based on the skull bone growth changes as we get older. This causes the hair follicles to suffocate, in other words where the head is flat, hair grows. Where the head is round, hair doesn’t grow.

    Skull expansion will cause the surface area of certain skull bones to increase. This will progressively stretch and pull tight the scalp tissue that overlies the skull (and can quite often also make the scalp feel very itchy and tight).

    This disrupts the microvascular blood supply to the hair follicles. Blood flow is reduced and so the supply of nutrients to the hair follicles decreases. In time, this causes hair follicle miniaturization. Thinner, weaker hair growth then follows and hair loss develops.

    Whats your thoughts on this Rob? I’d love to know if you’ve heard about this or even considered this as a possible theory.

    Thanks again, reporting from New Zealand, over and out.

      1. Post

        Thank you Kieran! Yes, that link covers Paul Taylor’s paper. And his paper is also cited in the paper I just published. We’re getting closer to answers!

    1. I definitely believe this is part of it.

      I have some bony growths on my scalp in areas where it’s balding that I started noticing around 21, and then my hair disappeared really fast.

      That’s why mechanical stimulation is so important, and you need to go kind of hard to undo these kind of changes.

      I’ve tried the massages at a laid back pace for 2 years without any improvements. It needs to be a very involved regimen (including inversions, headstands, red light therapy, dermarolling, oil, scalp exercise, relaxation etc.) to make a difference I think.

      1. Hi David, have you made much of a difference would you say?
        Better yet have you got your juvenile hairline back? Wow now wouldn’t that be a success story to talk about!

  37. Hey Rob,

    Congratulations on publishing your paper. I’m currently making my way through your Perfect Hair Health book and accompanying materials. Really enjoying the content thus far-Gives one hope.

    After all your research, personal experience, & the feedback you’ve received, do you personally believe that follicles in the MPB regions are genetically different from the ones in other areas less susceptible to loss? (e.g. more androgen receptors, etc.). Or do you believe that the follicles are the same & it’s the environment that results in MPB? A combination of both?


    1. Post

      Hi RPM,

      Thanks for the kind words, and for your support.

      I think the question we want to ask is if AGA-prone hair follicles are epigenetically different from non AGA-prone hair follicles on the sides of the scalp — since genetically, all cells are exactly the same (but the genes turned on/off all vary). We know that at a base level, there are epigenetic differences — because at a minimum, there’s a difference in signaling protein expression (which indicates different activity levels for the genes that code for these signaling proteins).

      However, the real question we want to ask is: are these differences due to epigenetic programming differences in those hair follicles… or are they due to influences on those hair follicles’ environment? I’m of the belief that it’s the latter. There’s an overwhelming amount of evidence to support this (much of it is discussed in the paper).

      But if you really want to dive in deeper (and more evidence), check out Goldman’s paper from the 1990’s — which shows that even small changes in transcutaneous oxygen transport in hair follicle tissues may completely change the hormonal profilings of a tissue — and consequently explain a lot of the biological observations we see in balding scalps:


      Fascinating stuff. On the other side of the coin, the strongest argument against the “environmental influence” of AGA is the concept of ‘donor dominance’ from hair transplants — the idea that transplanted hairs never miniaturize even when placed in AGA tissues. This concept was responsible for the dismissal of fibrosis as a consequence to AGA many years ago. But now, new research is challenging the validity of donor dominance (also mentioned in my paper), which is why I’m still of the belief that while you need the right (or wrong) genes to develop AGA, the mechanisms governing its onset all stem from slight changes to tissue environment.


  38. Hi Rob,

    You have done a great service for everyone suffering hair loss, thank you!

    I am a woman (47 yrs old), and I have a question:

    Will I find enough supporting material in your programme to address my hair loss cause?

    The cause for my hair loss was Chemotherapy (completed Feb 2015)

    My hair did grow back, but only by around 60%

    It did gow long, past my shoulders, but is thinner and weaker, with most loss at crown.

    This summer 10% of that meagre hair re-growth broke odd around 5-10 cm from the scalp (I am in Australia, so our summer has just finished for 2018).

    I look terrible, and am terribly upset.

    Interestingly, I have suffered from sebbhoreaic dermatitis on my scalp for 25 years, and have never been able to get rid of it. I was excited when one of your clients wrote that this condition went away for him!

    My mother has tons of thick hair (at 74) my dad (75) is nearly completely bald (started losing at 23).

    So, is it worth trying your protocol in an endeavour to re-grow my hair, in light of why it fell out?

    You do mention your protocol has helped women re-grow lost hair from chemo (or am I reading that wrong?)

    Kind regards,

  39. Wow-Thanks for the in-depth response Rob. Hope you’re right & by altering the environment we’ll get a more desirable genetic expression.

  40. Hi, Rob. I have been using an organic shampoo: dr bronners organic baby shampoo and I add to it some caffeine and peppermint oil. I’m currently at the beginning of my second month of the scalp massages. Do you think that I can still use this shampoo or the best will be to stop using it?? And what about dandruff? I’m presenting a lot of it.

  41. Can you do these exercises too much? So i was wondering if its more effective to mix a combination of physical treatments like your exercises, as well as other types of scalp massages and inversion therapy, will that quicken the regrowth process? Or will that be counterproductive.

    i heard somewhere that If you were to do it all the time, your scalp would quickly become accustomed to this treatment and would eventually slow the hair growth.
    It’s the starting and stopping that keeps your scalp guessing. . . I guess, whats your thoughts on this?

  42. Hi Rob,

    I’m about to start the dermarolling and betadine / isopropyl alcohol swan treatment and I have two questions. In your book, you recommend a 1.5 mm, 192-count dermaroller, but the dermaroller you link in your book suggests that the 0.5 mm should be used for hair regrowth (with no checkmark under the 1.5 mm roller column along the hair regrowth row). Do you still suggest 1.5 mm? Second, the dermaroller site your referenced suggests using a numbing cream before rolling. What are your thoughts on that? Thank you for your time! Here’s the linked dermaroller page: https://mtdermaroller.com/shop/mtdermarollers/1-5-mm-mt-dermaroller/

  43. Hey Rob, I really hope you’ll answer my questions.

    So, I’m on the verge of buying your book, I’ve been reading your articles and e-mail updates for quite some time, but there’s a few questions I’d like to ask.

    First – I’m 22 years old, diagnosed with androgenic alopecia, and I’ve been losing ( dramatically ) hair since 19 years old. I’d say that your theory indeed makes sense because just when I ended puberty, my face shape started to slightly change ( along with scalp bones I suppose ) to some sharper construction ( jawline etc, more ‘eggy’ head shape, etc) . In these 3 years I practically went from NW 1.5 to NW 3.5 along with some moderately overall thinner hair ( except the sides and back of course ). My question is – do I have a better chance of regrowth since I didn’t lose all this hair a long time ago? I read somewhere that hair lost in the 3 year window has the most chance of regrowth. I also went from really thick hair to moderately thin hair, and it’s not like my temples are completely bald, they’re covered with vellus hair and even some terminal ones that are constantly miniaturizing. It’s like my hair generally ( aside from non-balding regions ) is just weak and really easy to strip away from the scalp, a mild pull is enough to pull it off the scalp. I do have seborrheic dermatitis which could be contributing to hair loss ( maybe ? ), my scalp gets oily real fast and scalp is constantly itchy also. I’ve tried all sorts of treatments except for Minoxidil and Finasteride, and of course, they didn’t work.

    Second – Earlier here in the comments section, you mentioned that there are even more potent methods of mechanostimulations than massages, what are they? And are the scalp exercises (from Tom Hagerty) really necessary for a good regrowth?

    Third – I’ve been having increased body hair growth since I started losing hair rapidly, do you think there’s a correlation? I’m thinking that that’s just the proof that my body is flooded with DHT and that I’m genetically predisposed to counter inflammation with DHT, so, my body sure doesn’t need to worry about the supply for DHT.

    Fourth – I’ve been hitting the gym lately and I love it but I read somewhere that lifting weights will increase my hair loss due to increased DHT production. What’s your take on this?

    Fifth – I can actually feel some really hard bumps on my temples which you’d thought are actually skull bones. I read that with your massages, people actually were able to ‘level’ this bumps back to normal ? I also do feel that some non-balding areas ( that don’t go bald ever) are also hard to pinch, why is that?

    Thank you a lot for your time and contribution Rob, and I hope that you’ll find time to answer my questions.

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