Why Are Hair Growth Drugs So Ineffective?

Read time: 15 minutes

Why This Article?

I was diagnosed with male pattern hair loss before graduating high school.  The prospect of being bald by my mid-to-late twenties terrified me. I spent the better part of a decade researching ways to reverse the condition. I bought every hair care product I could find. I used Rogaine for six years. I even tried laser therapy, albeit very briefly.

Reflecting back, I’m thankful for the diagnosis. It catalyzed a desire to better understand my body, my health, and why my hair was falling out.

This article discusses the reasons why hair loss drugs rarely (if ever) result in 100% reversals of pattern hair loss. And of the drugs that are somewhat effective, these might not be working via their intended mechanisms. For some people taking prescription hair loss drugs, the treatment can be worse than the disease.

DHT – The Cause Of Hair Loss, Or A Misunderstood Symptom?

If you’ve ever looked into the causes of hair loss, you’ve probably heard of dihydrotestosterone, or DHT. DHT is a hormone that comes from testosterone. DHT levels are higher in people with thinning hair.

Because of this connection, most hair loss surgeons say that DHT is the root cause of hair loss. Their explanation is as follows: for reasons not fully understood, higher amounts of DHT begin to bind to scalp tissues. The scalp’s hair follicles become sensitive to the elevated DHT and shrink over a series of hair cycles. This process eventually leads to thinner, wispier hair, until the hair disappears and follicles become dormant. Here’s a picture:

DHT Shrinks Hair Follicles

 

What’s wrong with that explanation? It’s only partially true. Yes, DHT is implicated in hair loss. But it’s just one of many symptoms observed in those with thinning hair. There are a variety of other factors that are largely ignored by hair loss surgeons. Some of these factors are:

  • Calcification of the scalp sutures
  • Calcification of blood vessels leading to the hair follicles
  • Fibrosis of the scalp skin and hair follicles
  • Collagen remodeling of balding scalp tissue

Interestingly, elevated DHT isn’t just observed in balding scalps… It’s also observed in inflamed body tissues. There’s also evidence that DHT actually helps regulate inflammation, and that in some tissues, DHT is anti-inflammatory.

Now let’s take another look at that list of conditions. Of the above factors, there are two major threads: fibrosis and calcification. What do both have in common?

If chronic inflammation leads to calcification and fibrosis, and elevated DHT is a response to inflammation, then DHT probably isn’t the root cause of hair loss. DHT is probably just a symptom of a chronically inflamed scalp.

Unfortunately, nearly all hair growth drugs are designed to block your body’s DHT production. But these drugs don’t address the inflammation. As a result, they aren’t very effective. They’re also dangerous, since DHT production is critical to sexual health, and inhibiting it can lead to erectile dysfunction and even impotence.

What Are Hair Growth Products, And How Do They Work?

The Big Three

Of the few FDA-approved hair growth drugs, these are the most popular:

  • Finasteride (branded as Propecia)
  • Dutasteride (branded as Avodart)
  • Minoxidil (branded as Rogaine)

Finasteride Prevents DHT Conversion

How does Finasteride work? Finasteride prevents testosterone from converting to DHT, so that less DHT collects on your scalp. Testosterone is converted to DHT by the enzyme 5-alpha reductase. Finasteride is a 5-alpha reductase inhibitor (or blocker). The conventional rationale is as-follows: by inhibiting testosterone’s conversion to DHT, less DHT gets to your scalp, so you lose hair less quickly. If enough DHT is blocked, you might even halt hair loss or experience minor regrowth.

Dutasteride Does The Same Thing

Dutasteride is very similar to Finasteride, but was never intended to treat male pattern hair loss. It was originally developed to reduce the size of enlarged prostate glands by acting as a 5-alpha reductase inhibitor. After realizing that the drug helped reduce the conversion of testosterone to DHT and in some cases reduce hair loss, it was later rebranded as a hair loss treatment.

Minoxidil Provides Blood Flow To Scalp

Minoxidil provides blood flow to the follicles. When applied twice daily, it can help reduce and sometimes stop hair loss by allowing a little more circulation to get to your hair. It doesn’t prevent the DHT build-up in the scalp. The mechanisms by which Minoxidil halts hair loss still aren’t fully understood.

What’s The Problem With Finasteride Or Dutasteride?

Finasteride & Dutasteride Can Ruin Your Sex Life Forever

The enzyme 5-alpha reductase plays a number of hormonal roles in the body, many of which aren’t yet fully understood. Finasteride & Dutasteride inhibit this enzyme, which yields unintended consequences. For example – in some men, taking Finasteride for a mere few weeks resulted in unresolved erectile dysfunction, even after stopping the prescription.

Fasteride & Dutasteride Use May Result In Prostate Cancer

In 2011, Finasteride and Dutasteride (eg, anything branded as Propecia, Proscar, Avodart, or Jalyn) were forced by the FDA to amend their warning labels after research suggested that prolonged use increased the risk of high-grade prostate cancer. Think about that. These drugs are intended to reduce enlarged prostate glands, but might give you prostate cancer in the process.

That doesn’t sound like a fair trade-off, especially when you’re the one paying for the prescription.

Finasteride & Dutasteride Reduce Your Sperm Count

In 2007, scientists found that Finasteride and Dutasteride reduced total sperm count by ~30% after 6 months of use. Sperm volume, concentration, and motility were also reduced. Because of this (and the other long-lasting hormonal changes these drugs induce), you can’t donate blood until you’ve stopped using Finasteride for 1 month and Dutasteride for 6 months.

Pregnant Women Aren’t Allowed To Even Touch Finasteride & Dutasteride

Why can’t women use either of these 5-alpha inhibiting drugs? Because Finasteride and Dutasteride can potentially mutate and inhibit the development of male fetus genitalia. Women are even advised to avoid touching the drugs’ capsules if they are pregnant.

Looking for more reasons to never touch either of these drugs? Feel free to dig deeper into the aggregated research here or here.

What About Minoxidil?

Rogaine’s Ingredients Are Banned In Other Countries

If you’re unconcerned about using Minoxidil, it’s worth mentioning that some of the ingredients in Rogaine Foam are banned outside the US because they are considered carcinogenic and tumor-promoting. This is a product you put on your scalp, everyday, twice a day. That’s pretty close to a few important things – your brain and your eyes to name a few. With each application, you roll the dice for cell mutation. It seems like quite a risk, especially when its efficacy is more limited to arresting hair loss, not necessarily reversing it.

Rogaine Kills Cats (Don’t Get Any Ideas)

For reasons not entirely understood, Minoxidil is also highly toxic to cats – so toxic that some have died just through unassuming skin exposure to the drug. Regardless of how you feel about cats, how can this be good for humans? Rogaine is to cats as insecticide is to insects, and cats are much closer in size to humans than insects. Are you sure you want this on your scalp everyday? (Update: please see the comments section for further explanation on this analogy.)

Minoxidil’s Ability To Stop Hair Loss Isn’t Even Understood

Similar to Finasteride, Minoxidil’s ability to slow hair loss also isn’t fully understood. I’m a firm believer that you should never put something unnatural into your body, especially if you don’t understand how it works. While the same level of research isn’t there, who is to say that Minoxidil isn’t capable of the similar unintended consequences as Finasteride or Dutasteride?

Then Why Do Some People See Regrowth With Finasteride, Dutasteride, And Minoxidil?

While Finasteride and Dustasteride are designed to inhibit DHT conversion, that’s probably not the mechanism by which these drugs help to achieve minor hair regrowth.

Aside from reducing DHT, Finasteride also downregulates MMP2 and MMP9. MMP2 and MMP9 are two protein coding genes that influence collagen modeling and remodeling. Collagen remodeling is on our list of conditions associated with balding scalps. There’s a good chance that much of Finasteride’s regrowth success is contingent on the effects it exerts on collagen.

As far as Minoxidil – we know that Minoxidil increases blood flow to the scalp. But how? Aside from opening potassium ion channels, new research indicates Minoxidil also increases Prostaglandin E2 (PGE2) at the sites where it’s applied. Increased PGE2 is associated with vasodilation, muscle relaxation, inflammation resolution, and even the anagen (growth) stage of the hair cycle. We know that calcification of the scalp sutures and blood vessels supporting hair follicles can significantly restrict blood flow at balding sites. If Minoxidil increases blood flow, it probably helps counteract (to a degree) calcification or fibrosis, and temporarily maintain hair – at least for however long it’s used.

In either case, the reason why we don’t see 100% recoveries from either drug is probably because they don’t target the causes of hair loss that are furthest upstream – inflammation – nor do they resolve the chronic, progressive conditions that chronically elevated DHT (in combination with other factors) can cause – calcification and fibrosis.

Without Addressing Inflammation, Fibrosis, And Calcification, These Products Will Never Be 100% Effective

Minoxidil may stimulate blood flow to the scalp, and Finasteride may help prevent the conversion of testosterone to DHT, but these are just band-aids to larger underlying causes of hair loss. They never actually strike the core of the issue, and so they’ll never really result in permanent reversals.

What’s worse, success rates for hair transplants aren’t very high because your healthy hairs are often transferred into calcified areas. It’s only a matter of time before they die out, too. That’s why you’re asked to use Rogaine or Propecia after a hair transplant – since you need all the help you can get.

Inflammation is further upstream to hair loss than DHT. Calcification and fibrosis are chronic, progressive conditions downstream to DHT, but by taking away DHT, you don’t take away the already-existing calcification and fibrosis. It’s my belief that this is why hair loss drugs targeting DHT are so ineffective and limited to slowing, not reversing, the condition. If you want to reverse hair loss, you should target calcification and fibrosis.

179 thoughts on “Why Are Hair Growth Drugs So Ineffective?”

  1. So why does Test replacement therapy make hair fall out? By your explanation more testosterone would mean better and more hair (since the test:estro ratio would be better), but actually the oposite happens. Please explain

  2. Hey Alan,

    Thanks for reaching out. To answer your question, the body processes exogenous testosterone (ie: testosterone replacement therapy, or TRT) and endogenous testosterone (testosterone manufactured from your own body) much differently.

    While TRP is purported to increase your total testosterone, TRP can also decrease testosterone production in other parts of the body — specifically, the testes.

    http://www.amepc.org/tau/article/view/2249/3145

    Moreover, if you receive exogenous testosterone via TRT, it doesn’t always mean it remains as testosterone inside your body. Testosterone can be converted into estrogen via the enzyme aromatase. Aromatase levels are largely determined by your diet and lifestyle, so if you choose to do TRT but are living a lifestyle that perpetuates higher-than-normal aromatase levels, you’re likely going to convert a significant amount of the exogenous testosterone into estrogen. In effect, TRT might not increase your testosterone:estrogen ratio. In fact, it could make it worse. It’s why many doctors also recommend estrogen monitoring during TRT, and sometimes even prescribe aromatase inhibitors.

    The healthier, less costly, and more effective approach is to address t:e ratios and aromatase production with dietary and lifestyle changes.

    Two big factors associated with higher aromatase levels are 1) alcohol consumption and 2) prescription drugs.

    Alcohol:
    http://www.ncbi.nlm.nih.gov/pubmed/11163119

    Prescription drugs:
    http://www.hormonebalance.org/userfiles/file/Medications%20that%20increase%20aromatase.pdf

    Certain soy-based foods and cooking oils can also be problematic.

    To wrap this up — TRT might inject testosterone into your body, but if you’re otherwise unhealthy, it will 1) limit the production of testosterone in your testes, and thereby disrupt your endocrine system; and 2) convert mostly to estrogen, and thereby decrease your t:e ratio. Both of these factors are likely to yield hair loss in the long-run.

    Best,
    Rob

    • Exogenous testosterone cannot aromatize, this is why it is most doctors have to keep an eye on the ratio when prescribing TRT; just a side note.

  3. There are clearly a lot of faults with the items listed here. I wont go into each and every one as there are a lot that are half-truths and not researched, but I found it funny that one of the arguments was “If minoxidil is bad for cats, it must be bad for humans also!”. Nuts, grapes/raisins, chocolate, coffee, etc all kill cats and dogs with very little amounts needed. Maybe we should all avoid those deadly substances as well…?

    • Hey Tic,

      Let me clarify my position (as a former Rogaine user of 7 years). The mechanisms by which minoxidil works are very unclear. It’s speculated that minoxidil opens potassium ion channels, promotes collagen remodeling, and improves blood flow to the scalp. However, researchers don’t yet understand the relationship between minoxidil’s metabolic pathways AND its efficacy as a hair loss solution. Consequently, researchers also can’t explain some of the potential side effects (headache, chest pains, scalp irritation, or the development of bags under eyes).

      The cats/minoxidil reference isn’t meant to be paraphrased as a causal relationship that “anything bad for cats is also bad for humans.” However, it is supposed to highlight the mystery behind minoxidil’s metabolic pathway, and in the same light, a lack of understanding as to why it is poisonous to cats. Another example is insecticide. Most insecticides don’t kill humans, but I’m not going to put insecticide on my scalp everyday. Conversely, we understand why chocolate and grapes are toxic to cats and dogs. There are components within nuts that they either 1) can’t digest, or 2) digest much more slowly than humans.

      As far as any research points that are unclear, please let me know. I make an effort to provide links to any claims throughout each article, mostly primary sources. The makers of Finasteride and Dutasteride are in the middle of a class-action lawsuit for the same claims listed above. The last thing I want is for you to feel like I’ve told you a half-truth.

      • I can explain two of those things.

        Scalp Irritiation: It’s the Propylene Glycol that causes skin irritiation and guess what? You have skin on your scalp.

        Development of bags under your eyes: People applying the product and then immediately going to sleep, causing the product to rub onto your pillow and subsequently your face (eyes). This is extremely obvious by the fact that the (eye bags) are not common and if you follow the instructions properly this will never happen.

        Also You “logic” on it’s bad for cats so must be bad for humans is so inherently flawed. Plenty of things are poisonous to humans but safe for animals and vice versa. Minoxidil is NOT poisonous to humans in anyway through normal usage, it wouldn’t be legal if it was, there would also be a lot of warnings on the bottle if it was poisonous in anyway to humans.

        Blocking DHT is definitely not the way to go as it’s extremely important for your body but Minoxidil simply increases blood flow to your scalp, from my experience it aids minor regrowth but mainly stops hair loss AND as I am not sensitive to Proplyene Glycol it causes me no irritation, much better then the burning/itching/pain from before I was taking it as my hair was thinning. Massage + Minoxidil will probably work wonders, maybe massage alone BUT Minoxidil is not dangerous unless you ignore the basic instructions, even then it’s not dangerous.

      • Hey Ian – great points here. I’d like to clarify my position and keep the dialogue going.

        RE: Rogaine & bags under eyes–

        The latest research suggests that Rogaine (Minoxidil) partially helps in hair regrowth by activating PGE2 synthesis. There’s an association with PGE2 production and hair growth:

        http://www.ncbi.nlm.nih.gov/pubmed/17697149
        http://www.ncbi.nlm.nih.gov/pubmed/9008235

        But PGE2 synthesis also naturally increases with aging. In fact, it’s associated with age-related skin damage:
        http://www.ncbi.nlm.nih.gov/pubmed/25905589

        So encouraging PGE2 synthesis with Rogaine might help with hair growth, but it might also prematurely age your skin. Especially if you’re applying it before bed, resting your head on your pillow, washing your pillow sheets infrequently and allowing other parts of your face to come in contact with the residual Rogaine accumulation. This is probably why some people report bags under their eyes, that don’t go away, from long-term Rogaine usage. Some minoxidil is also probably absorbed systemically, which could lead to the same problem via another route.

        My guess is Propylene Glycol is probably a factor in the scalp irritation / bags under eyes, but very secondary to PGE2.

        RE: cats and Rogaine–

        I agree with you. My logic here isn’t very scientific. The statement was more to illustrate a point of comparison and in doing so I was a bit lax with the science. But since you mentioned it, I’m happy to discuss further.

        The research behind neurotoxicity and activation pathways between animals and humans is complex, and you’re absolutely right that for us humans, chemicals that are toxic to certain animals (like chocolate to dogs) pose much less a threat to humans. Why? Humans have the metabolic pathways to process chocolate – and specifically, the theobromine in chocolate – faster than dogs can, so our toxicity threshold is much higher.

        That way of thinking – that if we have the metabolic pathways to process something, then it’s fine for us – is becoming outdated. Much of this is due to the emergence in research in the microbiome, which constitutes, in total, just as many (if not more) cells than we have that are human.

        So how does our microbiome – the bacteria and other organisms that regulate up to 70% of our immune system – react to the presence of something like theobromine? It’s still being determined. But theoretically, not all our non-human cells have the metabolic pathways to process it. Which means there’s probably a lower threshold for toxicity for those cells, which means a higher potential for microbial die-off and thereby an impaired immune system.

        But again, we need to do more research. Until then, all we know is that Rogaine might be harmful to cats.

        All the best,
        Rob

    • There’s a few layers to the answer. First, dietary and lifestyle changes will greatly help stop hair loss by reducing the scalp inflammation that’s associated with calcification, fibrosis, dandruff build-up, sebum overproduction, and consequently, increased levels of DHT. But for hair regrowth, using mechanostimulation to change gene expression in the scalp is absolutely crucial. It’s necessary not only to return the state of the scalp to healthy, but also to upregulate the genes associated with hair growth, and downregulate genes associated with hair loss.

    • Hey Bill,

      I don’t use PayPal because their services don’t enable a sliding scale for payments. I want people to have access to the information regardless of financial circumstances, which is why I like the Pay-What-You-Want model. Gumroad offers sliding scale purchases, and they have the same encryption/security standards as PayPal. As a result, they better align with the intentions of the book and the site.

      There have been a few cases where an individual wants the book, but feels extremely uncomfortable using service providers other than PayPal. If you fall under this category, please email me. I do have a PayPal account for situations like this, but prefer to avoid going down this route. Using PayPal services as a Pay-What-You-Want model requires the following steps: 1) a person emails me the amount they’d like to donate, 2) I change the PayPal purchase price to match their requested donation, 3) that person downloads the book, and 4) I reset the price. It’s time-intensive and often a bit frustrating given the lag time between email exchanges, and overall, I think Gumroad provides a stronger service.

      Best,
      Rob

  4. Hello Rob,

    [1]I was planning to take bodybuilding suppliment (ZMA) that is supposed to increase testosterone levels in the body. Will this increase hair fall?

    [2] I am taking a medicine for hair growth (Andronagen by Croatia). This medicine has saw palmeto that blocks DHT? Is it safe to use this kind of medicine.

    Please advise

    • Hey Rajesh,

      In general, I’d say save your money and avoid supplementation.

      RE: ZMA–
      The supplement is essentially differing forms of zinc, vitamin B-6, and magnesium. In the US, people usually have significant magnesium and zinc deficiencies, but by tweaking your diet, you can avoid supplementation. The testosterone-raising effects of ZMA can probably also be achieved just through dietary changes. And the absorbability of the forms of zinc and magnesium in ZMA are also debated.

      RE: Androanagen–
      The benefits of saw palmetto as a topical is questionable (versus oral consumption). As a product, Androanagen also contains minoxidil, which can be problematic when used in the long-run.

      https://perfecthairhealth.com/why-are-hair-growth-drugs-so-ineffective/

      I’d avoid both of these products and invest the money saved into diet.

      -Rob

  5. What are your thoughts on magnesium oil for de calcifying the scalp ie regrowing hair because of the massaging as well as mag oil??

    • Anecdotally, some people find magnesium oil very helpful. As far as magnesium as a topical (or magnesium baths), it seems to be more effective at reversing deficiencies versus oral supplementation. Magnesium deficiencies are very prevalent, especially in the US.

      As far as a direct link between topical magnesium and hair regrowth, I haven’t seen it yet. I view adequate magnesium intake as just one of the many things people need in a “hair” support system. Magnesium oil is great, but in the majority of cases, I don’t think it will make the difference between regrowth and no regrowth. With that said, it definitely won’t hurt!

  6. hello rob i am a mioxidil user and i found your article intresting and i agree with you partially.use of finastrade will cause series side effects is right.but i disagree about minoxidil scientific study doesnot know the exact side effects but the proper usage of minoxidil will reverse hair loss because i am a victim of bladness at 28.but after using minoxidil for six months and with a good supplement with saw palmetto revers bladness and hair thinning and i have about 80% recovery and stooped minoxidil after 6 months.now i am on a strict diet for 5 monts and no more huge hair loss. every one is different but i gurantee you with a good doctor you can reverse bladness below 40.

    • Hey Amil,

      If you’re experiencing an 80% recovery rate with saw palmetto + minoxidil, that’s great! And I totally understand if you disagree about the potential long-term side effects of minoxidil. I’m of the belief that in the long-run, minoxidil does more harm than good. But not everyone agrees, and I respect where you’re coming from. Just as a note — a lot of long-term users claim to develop lingering bags under their eyes, myself included. So, if you start using minoxidil again, keep an eye out for these a year or two into use. It’s not something most people like dealing with.

      Best,
      Rob

      • Hi how are you just a few questions how long was it before you saw results? also do you think the more hair loss you have the longer it will take to see the results? p.s have you any before and after photos?

      • Hey Phillip – it took ~10 months for me to see results I was happy with, but I’ve continued to experience thickening beyond that point (up through ~2 years of massaging now). The process takes commitment. As far as photos – I will share some on the site soon! Best, Rob

  7. Hi Rob,

    I have started your program with hopes of regaining some of the lost ground on my scalp over the years. I just have one question, do you have any before/after pics of your own hair loss. You have quite the head of hair from what I can see and I just want to see how you started out, as to temper my expectations.

    Thanks,

    Andrew

  8. Hi Rob,

    Female Hairloss

    I’ve read your article and i’m wondering, how do you know when a person has calcification and scalp fibrosis?
    Also, I am having excessive hair loss and haven’t found a way to stop it as yet.
    I have never tried any of those hair loss products except hair loss shampoos and argan oil shampoos. Now I’ve switched to an organic shampoo called “Mii”. None worked.
    I am afraid to try things like mioxidil because of the very reasons you discussed. I was diagnosed with endometriosis and doctors said that this is not related to my hair loss, but that pcos is, however I don’t have any symptoms of pcos except hairloss but the endocrinologist insisted that is my problem and prescribed metformin. I don’t believe this will help although I haven’t started the metformin as yet.
    But here’s the strange thing….I had 6 months of a drug called zoladex last year for my endometriosis, this injection takes away estrogen from your body in order to lessen the effects of estrogen on the endometrial tissue. One of the side effects is hair loss because obviously estrogen is not present again. (Please note I had my hairloss long before using zoladex). Surprisingly enough, when I used this zoladex, during the last 2 months or so of the 6 month period my hairloss eased alott and almost stopped!
    So my question is, do you have any idea if my hairloss is linked to DHT being trapped and why when estrogen was removed, hairloss eventually eased, but within a matter of months when the zoladex was stopped, hairloss came back with a vengeance!??
    I have 1/3 the amount of hair that I used to have.
    Please note my estrogen levels and progesterone levels are fine.

    Thanks for your time and sorry for this long message but ill be looking forward for a reply!

    • Hey Michelle,

      Thanks for reaching out. It’s interesting you had the opposite of the expected reaction to Zoladex. It’s a hard question to answer, because it’s almost impossible to track all of the hormonal interactions these kinds of drugs have within the body. Are you a diffuse thinner, or is your hair falling in a specific pattern? Calcification and fibrosis play a role in almost all types of hair loss, unless the fall-out is due to something like an autoimmune condition, traction alopecia, or cancer treatments. A lot of this can be determined with the pattern of loss. If you’re losing hair in patches, that’s different for women than if you’re diffuse thinning and noticing a decrease in the density of your ponytail.

      Best,
      Rob

  9. I’m a Teen of 18 years old. Im suffering from frontal hair loss but not much. Im afraid of getting bald.

    1) I’m using 10% Minoxidil
    2) Is it safe?
    3) what are the other ways to regrow frontal hair?

    • Hey Dijo,

      I don’t think Minoxidil is safe long-term. The above article discusses a few reasons why. On a personal note, I used Rogaine for seven years, continued to lose my hair, and eventually developed huge bags under my eyes (a side effect of long-term use). After stopping use for years, these are only just starting to fade.

      There are plenty of safer ways that help with hairline regrowth. I’d look into mechanotherapy, mechanostimulation, and any other recommendations in the eBook. Check out detumescence therapy.

  10. Hey Rob,

    I’m going to buy this e-Book with whatever money i got left tomorrow (I’m a poor student). I like your website and all the articles. I like the way u accept payment.
    Will your e-Book go into (scientific/theoretical) detail about how it can come to calcification in the first place? or how it can come to hairloss in some people and not others in general?

    Thank you.

    • Hey Nate – please don’t feel like you need to pay anything extravagant for the book, especially if you’re struggling. Yes – there’s a lot of science behind hair loss, thyroid health, hormonal pathways, etc. But as far as the exact mechanisms as to how calcification develops.. that’s something much more multi-faceted. It’s addressed in a few sections, but the fact of the matter is – the science isn’t yet there to determine which exact mechanisms cause calcification build-up. It seems to be some sort of combination between diet, heavy metal (iron) overload, and perpetuating hormonal imbalances. The microbiome might also play a critical role due to its influence on epigenetics and even hormone regulation. But to answer your other question – yes, there are a few theories as to why some people lose hair and others don’t, and those are addressed in the book.

      Best,
      Rob

  11. hi im intersted in your ebook… dont matter if it is a scam or not im desperate I know a guy that did scalp exercises to promote bloodflow and other guys having success with it.. anyway your theory isnt all bad at all.. I want to buy the ebook I dunno how on his page.. you dont accept paypal ? I pay you right now 1 million dollars haha jk.. seriously I want your ebook so I can get more INFO on the matter…I know a shit ton of things about hairloss and all methods and treatments been glued to my screen everyday for years…some say vitamin k2 helps with calification or how u spell it..also apple cider vinager..but ya I want more info about all this thanks how do I go about getting ur ebook?

    • Hey Daniel,

      You can now use PayPal to buy the book! After you type in your donation amount, you can choose the “Use Paypal” option and pay through their service. You can pay whatever you want for the book – I don’t mind. Just click on any of the Buy Now links on the main page.

      Best,
      Rob

  12. the most important is to find exactly in natural food ,what is going to to help 5AR , we must find the solutions to avoid side effects or surgery ,most of desease solution in front of our eye but we do not see it well

  13. Hi Rob,
    I just discovered your website and am very interested in reading your e-book. But I don’t understand why you don’t show us your before/after pics. Although I see you provide scientific evidence to back your claims, a picture is still worth a thousand words.

    Another thing that I don’t understand is that you say parietal and frontotemporal regions’ scalp get calcified and as a result vessels passing through foramens to reach scalp get narrower so blood flow to scalp decrease. But shouldn’t this also be the case for women? What is the difference between two sexes regarding this point of view?

    Thank you

    • Hey Edhel,

      Thanks for your comments. The before / after photos were reserved initially for those who requested them by email, but I’ll make them along with other readers’ photos available on the site soon. As far as the calcification process in the scalp and why it doesn’t occur in men versus women, there’s definitely a hormonal component involved. Men produce more testosterone and thereby more serum and tissue DHT than women on average. As far as why the calcification process begins earlier for men and predominantly in the scalps, no one is really sure. The research is still ongoing. The idea is that in a calcified scalp, less blood flow means fewer nutrients in and out, including scalp tissue DHT. By addressing the underlying issues associated with hair loss (a calcified scalp) instead of just treating the symptom (hair loss), the chances for hair regrowth and maintenance dramatically increase. Best, Rob

  14. Am so eager to buy the ebook. Please dont expect much from me as am just a student living on my pocket money 😛 But i will give as much I can. Can you please provide me the link of your paypal or whatever may the way be 😀

    Thank you so much.

  15. Hi Rob, I’d love to know your thoughts of combining lllt with the scalp massage. I’m wondering if it may speed up the hair growth process.

    Thanks,

    Paul

    • Hey Paul — we’ve spoken about this at length via email, but it should be fine so long as you reduce the length / number of massage sessions leading up to each LLLT session and after. The idea is to allow for enough of a recovery period between all forms of treatment so that there’s a balance between inflammation generation and wound healing.

  16. Hey Rob
    On the average, How long do think it should take to see any results?
    And if possible, could you send me before and after pictures.

    • Hey Yarray – before / after photos will be up on the site soon. As far as time until results — this is mixed. Some people respond relatively quickly (a few months); others are seeing continued thickening / regrowth still even 1.5 years into the techniques. It’s definitely a long game, but was well worth it for myself and others. Best, Rob

  17. Dear rob,

    Do you think a full baldness will reverse, and if yes how long will it take, does the genetical make up will affect the reverse, let’s say the therapy will increase the blood flow around the hair follicles/ scalp but what if the blood flow goes beyond the normal flow, will it increase an wanted hair production/ over production or I mean does the excess flow have effect ?

    • Hey Eul – the research suggests that dormant follicles can regrow from vellus to terminal and that full recoveries are possible. As far as an overproduction of hair, these techniques are centered around returning the scalp to a healthy state so that those dormant follicles can regrow. That’s the difference between stem cell therapies and this — whereas stem cell therapies focus on implanting new hairs into this skin, these techniques are centered around awakening what’s already there. So promoting blood flow shouldn’t encourage new follicle proliferation beyond what’s already available, but rather return the scalp skin / hair to its original state before thinning began.

  18. I am a diffuse thinner and my hair has been thinning so alarmingly that my scalp can be seen.. Its just between 4 years that I developed this kind of hair thinning. I am 31+ . I tried finasteride, it was working but I felt the side effects. . and Rogaine gave me eye bags and a little pronounced wrinkels around my eyes which I did not like. Recently I went to a doctor.. he was nice and advised me Bioexidil leave on lotion ( Capixyl ) to apply once in the night. I am more than 2 months on into this treatment but seeing no improvements.. Though I know I have to wait. .. But problems lies elsewhere. Using Bioexidil I am feeling increasingly tired, muscle loss, pain in the arm and back… thats devastating… I could not take it anymore. Bioexidil (Capixyl )does the same on scalp as dutasteride does in the blood. It blocks both types of 5AR in the scalp, probably in the blood.. Am I thinking rightly Rob? Can I get out of this balding? Its depleting my confidence so badly…

  19. Hey !
    What would you say about H2O2 for scalp Decalcification? Since it is said to also clean up calcifiaction in the rest of the body why not in the scalp ?
    If you are not familiar with the H2O2 therapy it may sound a little odd to take it orally ,but there are thousands of people that successfully used it over years , do some digging 😉
    Thanks.

    • Hey Moritz – I’ve looked into it in the past, but had reservations ever trying it orally based off the reactivity of H2O2 with foods, gut microbes, etc. As far as your comment about H2O2 and decalcification, there was an interesting paper that came out not long after you left this post about just that, albeit on rats:

      http://www.ncbi.nlm.nih.gov/pubmed/27300444

      But hydrogen peroxide also plays a role in oxidative stress and possibly atherosclerosis:

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2397455/

      I haven’t researched this enough to form an opinion, but I do have significant reservations about oral ingestion.

      Best,
      Rob

    • Hey Sam – massages are a good place to start. Check out Detumescence Therapy. Make lifestyle changes that support the thyroid. Eat an anti-inflammatory diet (I currently subscribe to a moderate carbohydrate paleo diet). That should get you started.

  20. Sorry but no. Your armchair doctor nonsense doesn’t add up to tried and true science.

    “Doctors are wrong but I’m Right” is typical from blogs like yours who prey on victims with hairloss.

    Transplanted hair moved to balding areas stays there permanently. Hair from the back of the head is immune to the effects of DHT. It’s not scalp calcification or whatever new lie hairloss blogs have blamed it on next.

    Finasteride and Monoxidil are clinically proven. When combined the results can be much better than Rubbing Exercises: http://www.belgraviacentre.com/success-stories/

    Especially Monoxidil (rogaine) when combined with Derma Rolling: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746236/

    You’ve simply stumbled on a placebo effect exersize and are trying to market it around for money. Not bad but still, please don’t infect the internet with this nonsense.

    That’s probably why you had to halt sales of your ebook. Due to high chargeback rates your credit card processor probably dumped you.

    • Hey Chris,

      I re-read my article after reading your comment and I understand your response. It’s not my intention to come off as an armchair doctor, and it’s definitely not my intention to prey on hair loss victims. I’m speaking from my own research and my own personal experience. But I do want to clarify parts of your comment so that we’re on the same page.

      RE: transplanted hairs staying forever in balding regions–

      A while back there was a paper about hair transplants and what you’re referencing. Researchers took thick healthy hairs from non-bald regions in the back of the scalp and transplanted them to balding regions. These hairs continued to grow normally for the duration of the study, and so the conclusion was that these hairs would continue to grow in perpetuity because they were protected, for reasons unknown, from MPB. This became the basis of support for all hair transplant surgeries, but the study didn’t run long enough.

      Transplanted hairs weren’t tracked over a series of hair cycles, but rather for relatively short periods of time. During this time, it was concluded that transplanted hairs weren’t miniaturizing at the same rate of other hairs in the same region, so the transplanted hairs must be protected from MPB. This turns out to be a misleading conclusion. In actuality, transplanted hairs do begin to miniaturize and eventually fall, but the process takes longer because the transplanted hairs are so healthy to begin with.

      Anecdotally, I’ve spoken to a lot of people with hair transplants. Of the group who received them 5-10 years ago, almost all of them claim that most of their transplanted hair is already gone. I have a friend with a hair transplant who’s experiencing the same problem right now. So at least from everyone I’ve talked to, that paper doesn’t add up with the anecdotal evidence.

      This is also why hair transplant surgeons ask you to go on finasteride and minoxidil after a transplant (in hopes it will address some of the conditions of the MPB-affected scalp). They also ask you to join a hair club, and some now even mandate massages to promote elasticity (you can find YouTube videos of doctor demonstrations on this).

      The idea I want to present is that transplanted hairs don’t survive because they’re transplanted into inflamed tissues wrought with calcification, fibrosis, etc.

      RE: Finasteride and Minoxidil–

      You’re absolutely right that they are clinically proven to help with hair loss. But if DHT were the main culprit, we’d expect 100% reversals using the drugs that reduce them (like Finasteride). Instead, we see only modest regrowth, plus a host of unintended side effects, like impotence. With that said, the Minoxidil + Derma Rolling study is an interesting one and already mentioned in the book.

      I’m not saying Finasteride and Minoxidil aren’t effective. I’m saying their efficacy is limited because of issues beyond DHT, and that there can be unintended consequences to using these drugs.

      RE: Belgravia Centre photos–

      They’re great photos. But the majority of those photos highlight hair transplants. Hair transplantation isn’t hair regrowth – it’s hair rearrangement.

      RE: postponing downloads due to chargebacks–

      This isn’t true. In the year that the book was available, I had two refunds. The book was also pay-what-you-want, so you could choose to pay $0.

      Best,
      Rob

  21. Dear Rob, can I please buy your ebook?
    My hair loss is causing me anger and ruining my confidence (I am in my twenties).
    I don’t need any email support, if that helps?

    Very best and really appreciate this.

      • Glad to hear this! I’ve been checking back for months and months now.

        Almost all the hairloss I’ve experienced was back in high school, in my opinion due to malnourishment and stress.

        Cut to 16 years later and I’ve not really lost any more at all, still looks pretty much the same.

        Would like to reverse it for sure.

        Again, def glad to hear this update. 🙂

  22. Rob,

    So….what do you say of all the people that eat clean organic foods and exercise regularly, people who live a healthy lifestyle yet still experience hair loss. And people who live a completely opposite life and have no hair problems. Homeless people who whose hygene is very different from other people, yet have no hair loss, or in prison where the population pretty much has the same diet…..some suffer hair loss others dont. Its all genetics and the end of the day…right? Ive heard about dermarolling your scalp and chemical peeling your head and blood flow, then why is there a pattern in male baldness? If dht is not the problem then why are people just loosing hair up top and not on the sides. Wouldnt calcification happen all over your head??

    Regards

    • Hey Dave,

      Great points. The comment about homeless people and hygiene is actually addressed in the book. The gist is that for those who are chronically dirty / exposed to the outside (read: certain demographics of the third world, homeless, etc.), there’s a higher propensity for these people to be exposed to bacteria, viruses and parasites that may inform our immune function development as we age, and help shape it.

      One great example of this is in helminths – or hookworms – which are present in up to 40% of the population globally but are completely eradicated in the first world. Hookworms leach blood from our small intestines, and in order to ensure their survival, they must trick your immune system into making it appear as non-threatening. They do this by suppressing certain behaviors of our T cells, which would normally identify and attack the invading hookworms.

      http://www.ncbi.nlm.nih.gov/pubmed/22398370

      In doing so, the helminths ensure their survival but also modulate our immune reactions to similar aggressors. People with lifelong, non-threatening helminth infections have almost a zero incidence of allergies and auto-immune disease. It’s why researchers are now testing human helminths for the treatment of multiple sclerosis, IBS, allergens and beyond. Early results are promising but more studies need to be done.

      http://onlinelibrary.wiley.com/doi/10.1002/ana.21438/abstract;jsessionid=534C758BFA62C5D83A6EC0A39663ADB9.f04t02?userIsAuthenticated=false&deniedAccessCustomisedMessage=

      Couple that with an even more beneficial thing helminths do… blood depletion. Now if you’re over-infected, helminths deplete too much blood, which is a bad thing for obvious reasons. But across the first world, iron overload is a very prevalent problem in men. And there’s no way to deplete iron aside from blood letting (donation, phlebotomies, helminths).

      Just look at some of the research summarized about iron overload and aging here:

      http://roguehealthandfitness.com/iron-accelerates-aging/

      So when we talk about homeless populations or the third world being less healthy than us, we have to keep in mind the context of the Old Friends Hypothesis, the Hygiene Hypothesis, and the microbiome. There are even bacteria that eat cholesterol and help inhibit arterial calcification.

      http://www.france-science.org/A-cholesterol-eating-bacteria-in.html

      Scalp calcification is a factor in hair loss, and it’s possible the absence of certain bacteria could be a part of why the first world appears to bald faster than the third.

      So in short, it’s complicated. Genetics definitely plays a role in an individual’s susceptibility to hair loss. But does genetics determine destiny? I think epigenetics and the emergence of the importance of the microbiome refutes that idea.

      As far as the pattern formation of MPB, there are a few theories (Gravity Theory, Scalp Expansion Theory) that I’ll link below. Some of these tie into the idea of calcification, but the research is still ongoing:

      https://www.sciencedaily.com/releases/2013/10/131030092856.htm
      http://www.ncbi.nlm.nih.gov/pubmed/18789604

      Best,
      Rob

  23. Hi Rob,

    Thanks a lot for providing this information. I was wondering if I could buy a copy of your book. I used finasteride for years until I discovered it’s terrible side effects.

    I’ve tried everything imaginable including laser therapy with little success. I was considering a hair transplant until I read the posts. Thanks for that.

    I hope I can figure it out before it’s too late and it’s all gone.

    Thanks a lot.
    Ty

    • Hey Ty – thanks for the message. The updated book should be available in about two months. In the meantime, you can check out JD Moyer’s blog posts about hair to get a head start on the process. I advocate for a moderate carbohydrate paleo diet (with some tweaks), lifestyle changes to support thyroid health, and massages (Detumescence Therapy) for addressing calcification and the other localized symptoms of male pattern hair loss.

  24. HI rob… Your article is the last hope in getting my hairs back… I m waiting your ebook.. Please send it to me or help me in buying.. Whatever is the solution… I have less time in my marriage and before that I want to get my hairs back… So please provide me your ebook

  25. Rob, I am interested in your book. Sounds fascinating. I read the Detumescence Study. Can you open up another spot so I can download it?

    • Hey Shashi,

      Aside from being a 5-AR inhibitor, Finasteride also helps address some of the symptoms associated with MPB by down-regulating two protein coding genes – MMP-2 and MMP-9…

      http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0084757

      What this means is that finasteride likely helps remodel collagen in scalp skin. But collagen remodeling and calcification are two different factors in MPB.

      With that said, androgens probably play a role in calcification…

      http://www.ncbi.nlm.nih.gov/pubmed/19176322

      …But whether DHT (an androgen) is the driver of that calcification is unclear. The reason why is we see men with similar testosterone levels suffering from different levels of male pattern hair loss, and some not suffering at all. We’ve observed calcification of the scalp in those with MPB, so we know calcification is a factor. But because two men with the same testosterone level can be either totally bald or with a full head of hair, it doesn’t make complete sense that androgens, or DHT levels, drive the balding process entirely.

      Based on what we know, I think hormonal ratios (testosterone to estrogen) drive more of this process than androgens alone. But the research is still ongoing! As research shifts away from MPB drug testing and more toward MPB pathology, we will know more.

      Best,
      Rob

  26. Hi Rob. When will the book be available again. I’ve been looking every day in the hope it will come back. Can we not download it and not ask questions if you’re too overloaded. I just need to get more info asap. Thanks

    • Hey Richard – we spoke via email already, but I’m shooting for a book update and release in two months. I’ll keep you posted with timing.

  27. Hi Rob

    Not sure this is the right place to be posting but i’ve been struggling trying to contact you.
    I recently discovered your methods to halt and regrow hair through J.D Moyer’s blog, I was desperate to purchase your ebook, but after speaking to him I learnt that you had stopped to release of it so that you could focus on helping people who have already purchased it which I can completely understand.
    However, I’m only 19 and my mpb is getting to the stage where I can’t even hide it anymore (temple points gone, crown thinning, hair on top getting lighter etc.) I was wondering whether there was a way that I could still purchase and access your ebook so that I could to benefit from it… Or if not then perhaps you could let me know when it would be available again’m very reluctant to use minoxidil and propecia but at the same time I can’t just do nothing

    Thanks in advance

    • Hey David,

      I’m in the process of updating the book with readers’ before/after photos, a new demo video, a follow-along video, video interviews with the best responders, transcripts, and an FAQ. I’m shooting to finish everything in two months time. If you’re signed up to receive more information, I’ll be sure to send you an email.

      All the best,
      Rob

    • Hey Bart,

      I’m planning on releasing a book update in about two months, so everything will be back online then!

      Best,
      Rob

  28. Hi Rob,

    Eagerly awaiting the updated book, after reading JD Moyer’s blog I started doing pretty intense massages but I’m not sure if I’m doing them right so I’m looking forward to being able to get some guidance and videos from you!
    In the meantime is there any chance you could email me your before and after pics?

    Thanks for all you do!

    • Hey Alex – my plan is to put the before/after pictures on the site. I’m still waiting on permission from readers, so when that’s ready I’ll let you know! As far as the massages, JD Moyer’s blog is a great starting point, as are the comment sections of his / these articles. Otherwise there will be plenty of videos and demonstrations in the new update.

  29. Hey dude I’m a 17 year old kid. My dad started balding at 13 years old. I am not balding. My question is can I prevent baldness for a lifetime by preventing calcification. Is eating a paleo style diet really a preventative to baldness