Hair Loss: The Pits

Published Apr 15, 2021, 9:00 AM

Losing your hair is a situation that seems to be universally considered to absolutely stink. Unsurprisingly, humans have been trying all sorts of weird stuff to combat hair loss for millennia, but we’re only just now starting to get a handle on it.

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Welcome to Stuff You Should Know, a production of I Heart Radio. Hey, and welcome to the podcast. I'm Josh Cubal Clark. There's Charles W. Mr Clean Bryant and Jerry Shad O'Connor rolling rounds it out for Stuff you Should Know. The hair loss edition. Remember when Sinad O'Connor and wheneveron got mad because she ripped up a picture of the boat to protest Catholic Church. Yeah, we talked about this like a couple of weeks ago, did we Yeah? Did Yeah? You go, You're going up in octave each time. It's pretty much I don't remember that. We talked about a saturatite live sketch where Frank Sinatra had her on and the dis and stuff. Of course the great Phil Hartman as chairman of the board. But Nato O'Connor wasn't losing her hair. She made a conscious decision to basically stick it to the establishment and say, hey, I'm shaving my head. Yeah, and you know, my um, I know that we haven't seen each other, but I'm I'm starting to get a little thin on the crown after my hair being like my only decent defining feature as a as a man for many years. Sure, it's starting to thin out a little on the crown that. I mean, it happens. Mine's been doing that for a little while. It is distressing at first, and then you just get used to it, especially when it's plateaus for a while, like your mind's in a plateau stage and I'm like, Okay, I can live. Let's just let's hold here. Okay, holding here. Um. But yeah, it is. It's a thing, for sure. It's not the funniest thing in the world to realize your hair is thinning. Yeah. I mean, I'm not doing anything about it, certainly because I'm I don't know, I just I don't have that kind of vanity of other kinds of vanity. But it's uh, and I don't see it. So I was talking to Null about it a movie crush and he was like, you just gotta back out of every room you walk into. That is good advice. That's like hair club level of advice. Yeah. But I mean, I'll just you know, I've have I've shaved my hair about once a year anyway, so I'm fine to live that life too. Yeah, And I mean, it just it happens. It's one thing that like really kind of came through and researching hair loss is like, there's really nothing wrong with it. It's not medically debilitating. In most cases, we should say, pattern baldness the the far and away the most frequent reason people lose their hair, both men and women. There's nothing wrong with you. There's no disease, there's no there's no problem with your metabolic functioning, nothing like that. It's strictly cultural, like cultural norms and preferences of beauty. That's it. That's the only thing. You're just kind of involuntary violating beauty norms of your culture. And if the rest of the culture can just get over it, which they generally do, um, you can get over it too. And that's that. And I've just dug my own grave because now I'm going to have to take my own medicine and get over it. I'm sure all my hair is going to fall out in the next hour. No it's not. But you know, we're we're going to cover the types of hair loss and also some remedies, and we'll get into the couple of um sort of prescription remedies that they have found over the years, which really hit me today more than ever, sort of how cruelly it's one of them at least is which is like, Hey, if you're a young and single man and you're starting to lose your hair and you're worried about, you know, attracting ladies, we have something for you, and and it might give you a rectile dysfunction and you might not be interested in sex, but you'll have your hair back. You're gonna have some hair, baby, Like, man, what a what a weird cruel trade off? I know, chemistry giveth in, chemistry take it away. So I guess that was a spoiler, but I think most people know that and know what we're talking about. Yeah, we'll get into that in a little while. But first I think we should talk about if we're talking about hair loss, which we are talking about hair loss, we should talk about how hair grows in the first place, because it is just part of the natural order of things that your hair falls out. There's like three stages of hair growth that applies not just to human hair but also to animal for two, because don't forget you are an animal to human um and so we have the same three stages of growth, um, shrinkage, and then resting. Uh. That's basically the broad strokes of them, but it's a little more interesting in the details. Yeah, I mean I kind of linked um. I kind of thought of it as little gremlins under your scalp, little knitting gremlins. And when you're in that anagin phase A N A G E N, that is when your hair is growing and cells are forming a little protein root at the base of every little hair follicle that produces hair, and that's that's when those gremlins are down there knitting the hair. And they're continuously knitting, like you know, when hair is growing growing out of a follicle. They're just they're hard at work, and it just keeps going and keeps going, and you're cutting it and they they keep sending it through that shoot and everything's great. Yeah, And like that, those gremlins basically form an organ. Each of your hair follicles is basically an organ. There's a lot of stuff going on down there's a lot of a lot of growth factors and proteins working, and cells being converted from stem cells into epithelial cells and um. The um follicle is lined with muscles that are pushing the hair up as new new hair cells are formed. It's pretty interesting stuff. And this phase that you're talking about where the gremlins are really working in overdrive is called the Anergin phase and at lasts anywhere from two to six years for your hair, and you get haircut so often we used to before the pandemic that, um, you don't think like a single hair that you're getting cut like every you know, six or eight weeks. However often you go in, um it's trying to grow out for like six straight years, but you keep cutting it. It must be very frustrating for the hair follicle must be. The next phase is basically grimlins go on vacation. This is the I guess the catagin phase, and at some point this little protein cellsis matrix at the root of the hair follicle is gonna run dry. The follicle stops growing new hair cells, and those grimlins are taking some time off and that hair strand though it's not like that hair falls out immediately, it still is getting kind of pushed through and you think it's growing almost said it's growing. It's not. It's not growing anymore, but it's just being kind of pushed through to the very end. And finally it just pop goes through and that's it for that hair and that follicle, right, and so that that happens, I didn't even given points time. I think there's like, oh I saw the percentage. I can't remember right now, but there's like somewhere I think maybe six percent of your hair is in the cattagin phase at any given point in time, and you lose something like fifty to a hundred hairs a day off of your head totally normal. Those are just hairs that have reached that cattage and phase and finally got pushed all the way out. And I guess between the hair we lose and the dead skin cells that we slough off of our our epidermist every day, if you could manage to sweep it all together into a little pile, it way about one point five grams every day, hair and hair and dead skin you're losing. But imagine if you could like you know, collect that and really get a pretty good pile going after a few months. You know, well, I think there are some people you might do stuff like that. Sure, there are, there's there are definitely there's somebody who does everything, and there's probably some there's somebody who's turned on by the idea of that as well. Out there too, it cuts off to you guys, this skin cell collectors and the dead skin cell um kink kinks. Yeah, what about Yeah, for sure, we don't judge. What about the last as long as you're not harming anybody, right, that's right. What is the last phase? Because there's a third phase two that this is really like the resting phase where it's kind of regrouping, Like the gremlins are laying around there, spent, they're exhausted, they're catching their breath basically, that's the I mean, I think their vacation is kind of winding down at this point during the intelligent phase, and that, like you said, that's dormant. The follicle is sort of resting. Those gremlins are resting. Uh, they're forming and they're getting those needles sharp again to those knitting needles sharp, which in the body means they're forming a new protein matrix and they're getting ready to punch the clock and go back to work. And that dormancy is a few weeks. They get a few weeks maybe a few months off before it kicks off in that anagin phase all over again. Yeah, what's interesting, um, is you know, hair loss has been viewed as basically cosmetic. Like you know, almost all cultures. I couldn't find any that seemed to like really have no opinions about it. It seems like all cultures view hair loss as sucking, right, But in the West it's viewed as a cosmetic problem. So there hasn't been like a ton of research into it, certainly very little government funded research into it. Um. I am too, But it was explained in something I read that it's it's just cosmetic. It's like ts that happens, get over it. But in the in um the East, in Asian countries in particular, it's a much less frequent occurrence, but it's picking up UM and they think because of a more hectic, unhealthy lifestyle, more Asian men and like China career in Japan are losing their hair, especially in a younger age, and that is a big deal in those cultures, and so there's a lot more government funding that's being put into it in the last decade or so. But the interesting thing that stuck out to me is that we are learning about how hair grows by doing research on how to prevent hair loss. And we know less about how hair grows than I realized. So basically everything we said is a pretty good understanding, but there's still a lot of different components to the whole thing that science doesn't fully understand that we probably will have a better grasp on than in the next time to twenty years from hair loss research. Yeah, I think it's Asian heritage and African heritage, and uh, it seems like there was one more Native American Native American, right, they think they suffer hair loss less frequently. Yeah, from what I saw, it's Caucasian. White um and African American tend to be the two dominant groups for hair loss, but far and away white men lose their hair more than any other group. Well, that's why I was surprised that wasn't more research, even though it's cosmetic, because it's just largely white man. I was like, well, we need to get on this right now, gentlemen. It's happening to white man. Do I have to repeat myself? Yeah, that's a great point. Should we Uh let's take a break here, and well is that good with you? Yeah? Yeah, I think that's a great idea. Okay, I know that it's funny we get emails where people want us to come to blows over taking breaks. I know, do you guys ever get mad? Not want to take a break? Like not really? Huh? Do you? All? Right? Well, we will take a break then, since Josh agreed, and only because he agreed, and we'll come back and talk about some of the less common causes of hair loss right after this shot. Okay, So um, Chuck, you've heard the word alopecia before, right, yeah, for sure. Anytime I've heard alopecia, it's a it's in reference to the condition that I didn't realize, but it makes sense as an autoimmune disorder where you have no hair whatsoever, no eyebrows, no head hair, no hair on your legs anywhere. Um. But it turns out that all hair loss scientifically speaking of any kind, including you know, thinning of the hair that you and I have, is considered alopecia. And alopecia actually comes from the Greek for um, the Greek word fox, which makes tons of sense. Right, yeah, I thought that was kind of interesting. Um. Supposedly, in ancient Greece there were some foxes that could get a type of mange that caused him to lose hair and big patches, and so they just that's where the word came from. Uh. I'm not sure how it got transferred to humans, but you know, the ancient Greeks marched to the beat of their own drummer. I think somebody was being droll and said, oh, that's that's fox. Like really, that's what I'm getting from. And I know it was it was Hippocrates that popularized it. So that guy, Yeah, that guy, that guy, what are you doing what we do in the shadows? Yeah, but you gotta go that deafing guy. Uh, I know you're rewatching that right. Yes, it's so good. It's a good time, isn't it. Yes, it is. Um. So there are few. Like you said, it means any kind of hair loss, so obviously there are a few different kinds. But alopecia ariata, that is the autoimmune condition specifically that's gonna fool your body into attacking its own healthy cells because it's an autoimmune condition, and especially the hair follicles in this case. And if you have alopecia ariata, you're gonna lose hair and patches. Um. If you lose all the hair on your scalp, that's alopecia total us. And then I think what you were talking about. There is the most of air condition where you know, someone doesn't have any hair on their body at all. I can't remember the actor's name. Who Hank from Barry. I don't know who that is from Barry Barry. Yeah, remember Hank the gangster? You know, I didn't only watched a little bit of the first season of Barry, which one was Hank. Hank was the super lovable, like murderous psychopath who is like the I can't remember if they're Ukrainian. I think they're Ukrainian right there. It doesn't need like work for the Ukrainian mob. I don't know, man, I didn't get far enough into Berry and you met Hank. I promise, all right, Just I don't know if that's the actor I'm talking about, but there is a famous actor who suffers from alopecia, uh universalice. And that's the one where you don't have any hair on your body. Right um. But again, any like any kind of hair loss medically speaking, is referred to as alopecia. That is correct, and so um alopecia, like I was saying, it's a it's a autoimmune disorder and they're working on it, but it's basically they don't really have much of a cure for right now. Um. And the same goes from what I understand for another condition that has to do with hair loss called telligent fluvium um. And fortunately for people who have telligent fluvium that hair loss is kind of temporary. But really interestingly, it can come as the result of like a a profound emotional hardship. Yeah, it could be a life trauma or something. If you're some suffering from any kind of traumatic event, that could be the case. And this is when basically the gremlins are is uh, they're on like Aerosmith, they're on permanent vacation and it is stuck in the dormant phase for basically longer I guess semi permanent vacation because like you said, it is temporary, but it's stuck in that phase for longer than usual. And you know, it could be anything. You could have a big surgery that was stressful, or given birth or any sort of I mean, there could be just a traumatic emotional event in your life that caused that kicks us off. Yeah, and when your hair is in a normal UM cycle of growth like the Like I said, there's constantly hair that's in the the the cattagen phase, that resting phase of the intelligent phase, of the super resting phase of the re regrouping phase I guess UM. And then more most of them are in the engine phase. UM. With telligent effluvium, you've got the same cycle going on. It's just they stay in that cattagen phase longer, so there's less hair coming out at any given point in time or growing out at any given point in time, So it seems thinner, but again it's just temporary. Once you your body kind of goes back to its previous normal or baseline emotional state, it can it can be fine. UM. This can also come about from a thyroid deficiency or iron deficiency, and both of those things are involved UM. Thyroid growth hormone and iron are involved in cell division. Remember you talked about the gremlins working over time. Well, one of the things they're doing is UM growing cells, dividing cells very quickly to turn them into hair that's growing. And so if those two things aren't feeding this hair growth, UM, that can cause this telligent effluvium too. That's right. Uh. And then of course there's chemotherapy. Anyone who's ever had a family member or themselves been through the really powerful medications you have to endure with chemotherapy that can also lead to temporary hair loss UM and you know it's it's targeting cancer cells, but it's also targeting hair cells because what they're trying to do is stop the fast growing cells, and the hair cells are among those. So it is one of the unfortunate side effects of chemotherapy, but again temporary. And you know, our our heart goes out to anyone that's had to go through chemotherapy. It's really rough and most of us have probably seen it through someone that they know pretty closely. And hair loss can be a big, big, big part of it. UM. And then there's u androw genetic alopecia, And this is the one that is far and away the type of hair loss that that most people suffer, both men and women. It's called male pattern baldness is another word for it, but there's also pattern baldness for women as well. Um. It's just that again, if you're a white man, the chances are that you have some form of or some degree i should say of Androw genetic alopecia. Yeah, I think it's about of anyone who suffers from pattern pattern baldness are women. But it's not talked about as much, um I think, And it's it's not like it's only ten percent. I meant is substantial, but it's usually not as severe. So and it happens in a different way which we'll get to. But um, so it's it may not be as noticeable to others. And I think and that just with you know, probably male biases. The reason why you don't hear pattern baldm has talked about for women as much I would. I think you're exactly right for sure. Plus also, I mean the basis of it too seems to have to do with male sex hormones, So it seems like, you know, like it it it's more directed towards males in general as well. Well yeah, so what's what's the deal with that? So androw genetic um refers to the Greek root word ander for man um, and what it's really talking about our androgen's, which are um sex hormones, and in particular, one of the culprits is a form of testosterone called dihydro testosterone, which is like testosterone on testosterone basically, UM, when testosterone comes in contact with something called five alpha reductase, which is uh some sort of enzyme that you can find a muscle tissue, it gets converted into this die hydro testosterone d H TEA. I feel like we talked about this. Was it in the male puberty? Maybe probably I would guess either that or ballpoint pens one of this too. You know, it's funny as you're saying that, I was trying to think of a funny one, and then there you had it under control. Nice. Thanks, one of us always has it under control. And if then we're in big trouble, Yeah, that's when it's time to go away. So this d HT stuff, this is this is the this is the weird thing. Like, there is a general understanding that die hydro testosterone has to do with pattern baldness, whether in males or females, but it um, it's not exactly understood how it produces pattern baldness. We just know and have known since I believe the late nineteen forty. These um that if you have pattern baldness, you have a higher concentration of d HT and your scalp than people who don't have pattern baldness. So that seems like a pretty big clue. Yeah. And the reason it happens to both men and women is because both men and women produce testosterone. Um. I think most people know this, but if you didn't pay attention in biology class, you may not know that women produce testosterone in their ovaries. Uh, and just not as much as men obviously, so they have lower levels of testosterone, lower levels of d HT as a result. And so that's why a there in um, they're in the minority as far as suffering from pattern baldness and why it happens to a lesser degree when it does happen, right, Um, But it's a really weird paradox that die hydro testosterone would um produce pattern baldness because we actually need it to produce pubic hair and armpit hair. Um, So you wouldn't have either of those. If you have a d HT deficiency or a testosterone deficiency, you have less pubic hair armpit hair, and you don't develop those types of hair until you start to develop testosterone and then in turn d HT after you reach puberty. Head hair has nothing to do with d h T, And yet at some point later in life, d HT for some reason starts to accumulate in the in the scalps of a lot of people, and it actually causes hair loss rather than hair growth, which at the very least you'd think, you know, what if what if it converted our hair into pubic hair later in life, that would be hilarious, especially in the areas in the same pattern that you bawl. But if that just got replaced with pubic hair, hey, that would be pretty sweet. It'd be the nineteen seventies all over again. It would be It would be awesome. You wouldn't have to be Mike Brady getting that that tight curl going. I love that, man. I remember that smell. Man. I don't know if I don't know if your mom ever did that, but my mom um would get the perm, the at home perm every now and then for a few years in the seventies, and that smell for some reason, you know how you just tired to tie these things together in your brain. She was doing it one night while the Circus of the Stars was on. So to this day I can't think of the Circus of the Stars without thinking of that smell of Yeah, I guess it's better than elephant poop. Sure, I always I associate, Well, the smell of elephant poop is not pleasant. There's the perm. I know it's I think the perms probably worse than elephant poop. At least elephant poop is like an organic smell. This is just straight chemical nightmare, you know. Um, I always associate Pizza Hut home delivery with solid Gold because my parents would, um, if they were going out on a Saturday night, you know, they'd be getting ready and they just ordered pizza Hut or something for us to eat, and we would sit there and watch Solid Gold and eat pizza Hut. So funny, man, I always thought, even as a kid too, I was funny. They called it a perm because it wasn't permanent, and I learned it stood for permanent. And I remember being like eleven and saying like they should call it a temp and yeah, then getting beat up on the playground while we were all standing around talking about firms or yeah, or being the most popular kid at your experimental middle school high school. Perhaps. Um So back to d h D, we should point out that that was discovered in uh this ananomous named James Hamilton's discovered the role or I guess uncovered the role of d h D in pattern baldness. So that was a big step forward as far as kind of getting a semi understanding. Yeah, so what they think happens, think we still understand it is that um testosterone comes in contact with that five alpha reductees in those muscles that pushed the hair up in the follicles, and that in those follicles it's converted to d h T and then for some reason, somehow, some way, the d HT shrinks the hair follicle, and the hair follicle stays in the anagen. The growth phase far less frequently produces thinner, less robust hair, and then eventually just stops functioning at all. And that's it. Yeah, they say, enough of this d H stuff. I used to enjoy this neighborhood, and now the d h T came along and I don't like it. He always wants to fight and push people around and talk about how much he can lift, and uh, you want to come to his cross fit class because he'll show you what real working out is all about. Yeah, and his dad's an attorney and he'll sue you for all the money you've got. Yeah, exactly. It's just a just a general pain. So if you recognize the name, if you suffer from pattern baldness, you probably have done a lot of research and the name Hamilton's might seem familiar because he is also one of the cats who identify first those stages of the of the pattern balding. And it's called the Hamilton's Norwood scale. So you've probably heard the Hamilton's Norwood scale. That is when huh Yeah, I mean I think if you start to um, if you have an internet connection and you start to lose your hair, you probably find out pretty quickly. But it's not just like something people talk about unless it's you know, people that are all suffering hair loss and they're all talking about where they are on the scale. It's not like the Bristol stool scale, which everybody knows about. Where the was it the Scoville hot pepper thing? Yeah, not commonplace like that, but the common uh pattern that emerged that was recognized by Hamilton's. And I don't even know who was Norwood? Do you know? Uh? Norwood was Mr Glenn Norwould. I can't even make this joke. Anywhere to stop here, all right, and that seria on out yea. So uh. The common h pattern is you get an M sort of at the front of your hairline, at your forehead. The upper corners start to recede, and you might hear it call a receding hairline, and it sort of looks like the letter M because like the little Eddie Monster, it kind of comes to a point and then goes in on the sides. And that's step one. I think it's a very handsome look M hairline. Receding hairline is I think it's sharp. No, I do, and I haven't you know, mine went straight to the crown. I don't really have here much of the receding hairline up front. But that's what's next, is the bald spot on the crown or the vertex of the head. And the idea is, in the cruelest possible form, is the crown is losing it, the forehead is losing it, and they say, hey, why don't we meet in the middle and talk about this and that to what happened? They creep, The crown creeps forward and the hairline creeps backward, and eventually they meet in the middle and they go hey, it's nice to meet you. I'm let's go on vacation forever. And then you have no hair on the top of your head. And if you if you let all your hair grow, that's still there. You're gonna have that hair on the sides and in the back because it's weird, but it just it doesn't affect the sides in the back of the hair in the same way the follicles are are different. You basically you go from Gene Hackman in the French connection to Gene Hackman in Absolute Power, and eventually, if it keeps going, you end up as Gene Hackman in Superman, okay, and then eventually the Royal tannembombs and then you retire. Right but so um, there's also this this possible outcome of the m receding hairline meeting up with the bald spot on the crown in that there's a little island tuft of hair in the forehead that was like the dip or the the lowest point of the M or the downward point of the M that got left behind. So you still have a little, a little cute, little tin tin patch of hair right there. That is a possible outcome of this, but more likely than not, you're gonna end up with just that ring of hair, kind of like Patrick Steward and Star Trek the next generation. Yeah, and and again it's because that the hair on the sides, the follicles on the sides and the back are naturally d HT resistant. Even if you have that pattern baldness, it's you know, it's just a shame it wasn't reverse because maybe it would be different. But you know, people, it is a hairstyle to shave the sides in the back and to have the faux hawk or the mohawk or the sort of military looking cut. Um. There is no hairstyle that is mere male pattern baldness. I mean, you can, you can grow it out and rocket kind of like Phil Colin did for a while in the eighties and that and that's fine, man, we're not yucking anyone's young. But if it were somehow reversed, I don't think it would be as big of a deal, like if you lost your hair on the sides and in the back, you know, or would it be culturally shifted to where that was like, oh boy, yeah, that's that's exactly what happened. Because everybody's always got to have a problem with something on everybody. Yeah, yeah, I think it'd be bad either way. But I think I think you're right. Phil Collins managed to rock it out. I think, um, Bruce Willis did a great job with it as well. Um, and he went he started shaving pretty early on too. He he just went with it eventually, but he still had the stubble. He didn't go like straight up like you know, just like Jeff Bezos or anything like that. Yeah, he eventually did like Travolta now, like props for finally giving in and and getting rid. I mean I think he he probably had hair plugs, which we'll get to or at the very least whatever. You know, we'll talk about the newer treatments. And uh, it's one of those things where they're certain male actors where when you compare photos of them today two photos of them, uh fifteen years ago, and they have more hair now. It's one of those things really all right. Uh, it's the Jeremy Piman effect, Like I think we know what's happening here, and you know, especially if you're an actor, uh, that that is your I mean, it may be harder to just embrace the like, all right, I'll just shave my head thing because you may think you may not work as much or something, or you may not be appropriate for certain kinds of roles you want to get. So you know, I could see them tying it into work somehow. And and certainly actors are not historically short on ego, so that plays a part as well. Sure. I was reading a BBC article and then interviewed an actor named James Nesbit who's fairly well known, and he um credited his hair restoration with basically restoration of his career. He started getting parts again that he was getting passed over for. He said, his confidence went up, and I mean, more power to you. If you want to do something about your hair loss, that's fine. If you want to go to the Travolta way, that's fine too. But yeah, I mean that's um. I think people who who are like, yeah, there's before and after pictures, like there's a very famous one of elaw and musk Um in his PayPal days. He was young, very young when he started to thin pretty dramatically. And then now if you like at Elon Muski has a beautiful, full head of hair, and I think Um, he cares exactly bagel of whether you realize that he got hair plugs or not, because he's got hair again, so he probably invented some treatment that only he is pretty too. That's right, that's right. But then if you look at Jeff Bezos, the he went the other way. He's definitely got a few bucks that he could spend on that, I would guess, and he decided not to, which I'm surprised by. Actually, he seems like the type who would go full like, yeah, maybe Bob Ross, maybe yeah. I mean, he could have a an underground illegal scalp farm for all we know that he's mining, right, has nothing to do with with with hair growth. He's looking at sell that stuff. They'll deliver it to your porch via drone one day, right, something like robot just drops a bloody scalp on your porch and a big thud. There you go put it on. I didn't order to just put it on the drone watching you tremble. So that is male pattern baldness. With women, if they suffer from pattern baldness, it is going to be uh, not as predictable. It's not like male pattern baldness in that the thinning kind of happens more everywhere. It's not like it just happens from front to back and then you lose all your hair in that you shape that kind of horseshoe pattern. It is much slower than male pattern balding. And again it's because they have low testosterone and low d h D as a result. But again it's women. Um, I'm sorry, fort of pattern baldness are women who suffer from it? So uh and it is a thing, you know. You know, a woman's hair is very important to their esteem and and their body image. So when a woman's hair starts thinning and falling out, it is just as traumatic. I would say more, I would argue much more. And yeah maybe so, I mean it is certainly not and maybe more so because there's not as much attention paid and maybe like, hey, is anyone even listening that this is an issue? Well, I think women are unfairly held to even more um beauty standards than men. You know. Oh yeah, like guys, really good to shave your head? Who cares? It's fine, that's that's a cool look. Yeah, women also have their own scaled Ludwig scale, or if you want to get fancy the Ludwig scale. They have type one to three, and apparently the thinning um is tracked on the Ludwig scale along the natural part, and you know, type one to three is just different degrees of how thin it is along the natural part of the woman's hair. That's right. Should we take another break. Yeah, let's take a break and then we'll come back and talk about all of the things people have been doing for thousands of years to combat hair loss. Shot. All right, So this is one thing I know for a fact. If you are a young man and you are wondering if this is in your future, just look at your mom's dad, and you've solved the problem. So that is a myth. Allegedly, Yes, oh you will hurt man. You're just an amazing actor. You always say you're not, and you really are. Allegedly, I mean, I don't think they've they've said outright, it has nothing to do with it. Right now, there was a German study from two thousand five that actually found there's a little bit on the X chromosome that baldmin share in common. So it's possible because you get your X chromosome from your mom and there's a fifty chance that the X chromosome came from your grandfather, that's where the basis of that old myths came from. It may be true, but what they seem to be thinking is that there's way more genes involved in saying just one on the X chromosome, Um that that are involved in pattern baldness. But the upshot of it is, um, if you really want to know whether you're going to go bald, are your chances of going bald? How many bald men are there in your in your family? That's really what yeah, like on both sides, just start looking at old family albums and uh, maybe pour yourself a drink sure to steady your nerves. Yeah, I mean we have pretty good hair and my family my you know, my brother he has this legendary thick black wavy hair. It's just infuriating get a trophy. But like my grandfather, my mom's dad, he died with a big thick head of cur curly hair. And my uncle's my mom's brothers both have really robust hair. Still my brother does. My dad's I'm pretty much my dad. I mean, my dad now is eighty ish and um, he started thinning on the crown. You know quite a few years ago, and it's it's pretty thin on top, but it never like it never went away on top. It's just pretty thin. My dad did the same thing. It's like he's got a pretty decent circle. You can calibrate a compass by, but it's it is like, um, it's stayed. He's he's gonna be eighty three this year, and it's just it's stayed. He's still got you know, hair in between his forehead and the crown of his head on the sides. Um, So I anticipate mineill Polly be similar because I'm tracking a very similar pattern that he he tracked as well. Yeah. I even have the same haircut these days as is your dad. Yeah, from the seventies. Is it pretty long right now? Yeah, it's pretty It's pretty long. And think, yeah, which is good. It's good. I'm happy with it. But I definitely have that balts by just like just like dear old dad has well, I had been. I had shaved my head I think more than ever before in lockdown over the past year. I shaved it fully I think three times, and then did a couple of drunk in late night um, completely bald on the sides sort of Hawkeye and the last of Injuris movie look okay, uh, and it was kind of cool. I kind of liked it cool. I have not been doing anything experimental with my hair. Actually, m has been doing a good job of keeping me from looking like totally shaggy. She's she's just clean and coming hair. Yeah, that's good. Um yeah. And and definitely like shaving the neck that gets kind of burly back there, but I haven't. I haven't shaved my head in years and years and years. It's just not a very good look for me. Oh no, no, I like that. I never did. I never liked pictures of me. Yeah, especially the shaved head with glasses. I'm like, boy, I saw an old picture of us the other day that was I'll just say it was pretty funny and I was gonna Instagram and I was like, Josh should be really mad if my Instagram. Oh yeah what I Oh, it just wasn't your best look. You're you. You've come a long way, baby. Oh I'm not. I'm not shy about that kind of thing. I know now. I'm an admis though, so who cares? So again, look at the pictures of all your family I think, uh, it does increase with age. If you're white man, about of us are going to experience, um, some sort of pattern involving in your twenties. Um, and that's you know, that's that can be rough if you're if you're in your twenties and you start to lose your hair um in your thirties and then so on and so on. I think women, I think usually see it later, usually in their forties and fifties, and menopause can actually kick it off for women. Right, Because again, hair growth and sex hormones are very much tied together. So any fluctuation, weirdness, any sudden change, all of that stuff, uh, can can have some sort of effect on your hair growth or hair loss. So that must mean if you have like tons of testosterone and you're that dude, you must be really really bald for early right. You keep getting me. That's another myth, right, Yeah, there's like supposedly people who are bald have no more testosterone levels in their body in general than people who have a full head of hair. So we're busting myths all over the place. Chuck, Well, why don't we talk about some of these? It's always fun. Sawbone style to talk about some antiquated medical practices in the fifteen fifties b C. Egyptians would everyone's always been rubbing stuff on their head to see if they could regrow it. It was hippopotamus fat, porcupine hair they would boil in water. They would grind up donkey hoofs and rub that into their scalp. Yeah. Uh. And then that was on the Ebbers papyrus, which I think we talked about in the Ethnobotany episode. Yeah. Um. And then about a thousand, eleven hundred or so years later, our buddy Hippocrisies shows back up, makes the comparison with Foxes with Mange, which is not very pleasant, and then also says, hey, get your hands on some opium and horseradish, get some pigeon poop and some beats and uh spices, like he's suddenly Colonel Sanders or something. Put it all together, right, yeah, and then there you go. You're fine after that. You don't care about your hair loss any that's right, um. And then put it all together and rub it on your head. Uh. And apparently he also said, you know what, court eunuchs um tend to have really nice hair. Which I've never seen. I've always seen him bald, but he said, if you have really bad hair lost, just go ahead and castrate yourself. And there you go. I'm Hippocrates, go ahead and base all medical science after my teachings. About a thousand a d. There was a Celtic remedy for you had to hunt down a raven, burn it and then mix up those ashes and render it was some sheep fat. Rub that on your head, right, And then of course the Kellogg brothers. I don't think it wouldn't surprise me if they had a machine, but they were very Kellogg like machines by the twentieth century, where I think there was one called the Crossley Servac that if you look a picture of this, it is very Kellogg like. It's a you know, this big machine and you would sit with a like a bowl on your head that was connected to and I think it would supposedly try and literally suck hair from your scalp. Yeah, apparently Fredis Stair had one, and I mean the Cross League Company still to this day has on their blog a little article about it and they say that you know, it worked, it seemed to really work. Something about it worked but they're not exactly sure why. Um. There's another thing called the thermocap that used like um heat and blue light, and I know there's one today called the Capellus which uses some sort of maybe red or infrared light UM. And there's a class action suit against Capellus right now because they have a claim that it's clinically proven to regrow hair. And apparently that clinically proven is based on a single two thousand and fourteen clinical trial that was sponsored by Capellus. So somebody who tried spent seven hundred bucks on a Capellus system is suing them, and that a bunch of other people have joined. As far as real things that work, we mentioned the onset of the show, there are a couple of drugs that have we're sort of accidental and uh in this so far as the side effect they found was that it helped regrow hair and medoxidil active ingredient, and rogain is one of them. In the eighties, it was developed as a blood pressure medication and it's a vasidilator, so it's gonna enlarge blood vessels and they think, um that what it does is in large hair follicles that are shrinking due to that pattern baldness and just slows that process down and it works pretty good. I think UM, supposedly it it. I don't think it's uh. It depends on what you're after. Like I think they say um hair regrowth because that's what you want. You want to you want to start early and stop it in its tracks and try to regrows some. So for hair regrowth was found to be very effective and only sixteen um effective or moderately effective in six which is pretty good of men, you should say, yeah, of men, and then ineffective in sixteen percent. I think for women reported moderate hair regrowth with medocodel, and that's just for a hair on the top of your head. It has apparently zero effect on the hair on the side of your head. Yeah, like that crown. If that's where you're losing it and you get in there early with that road game, that's uh, you might want to give that a shot. Yeah, And they think basically it's just UM opening up the blood supply to those you know, withering hair follicles and gets them, gets those gremlins working again. That's right, makes sense. There's also finasteride um, which was originally under the trade name Propecia. I think the patent ran out on it, and I think by now, uh, if not, monoxide will definitely did because that was ro gain. One of the two is not in the patent phase any longer. But it was originally developed to shrink in large prostates because it's a UM five alpha reductase inhibitor. UM and in large prostates are the result of die hydro testosterone. So um rogain or finasteride basically inhibits five alpha reductations from converting testosterone into die hydro testosterone or d HT. So that would reduce hair loss because there's less DHT in the hair follicles, right, and finasteride is is I think rogains a foam like hair moose or maybe like a gelled a liquid too, and then finasteride like we don't know, and then I'm just kidding. Actually did buy some rogaine. I use it for like two weeks and I was like, I'm not gonna do this for the rest of the Yeah, well that's stopped. You got We should say, like, um, both monoxidet and in finasteride have to be used beforeever for as long as you want to keep trying to work on your hair. Yeah, I ran up and it was just one of those things. I have a hard time doing a thing every day anyway, and I was like, they just did not last. So I've got three or four things of If anyone wants some free rogaine, I'll send it to him. Oh, that's nice of you. I'll just mail you in my leftover things. I'm sure that that's nice. It's if it's over the counter. I think we're okay legally speaking. And one more thing about finasteride, Chuck is is it's like you're saying, it produces a rectile dysfunction and loss of interest in sex and men, and then in animal studies it produced um birth effects in male genitalia for pregnant animals. So it's been that's been kind of um extended to pregnant women human women, saying like, if you don't get anywhere near finasteride because it may produce birth effects in your baby. I did not know that. Well. The one of the reasons you did not know that is because apparently there's lawsuit against Merk and this judge in Brooklyn, Judge Brian Cogan, allowed this. These documents Merk internal documents to be sealed. That basically said, yeah, we're well aware of this and we can't let this get out because people won't want um propitia any longer if they know about the prolonged sexual side effects, which is terrible. That is terrible. So then you get the hair plugs that we talked about. This was from the nineteen fifties. Uh, sometimes it looks that way. Um. Dr Norman or in Treaque or or in Treach, I'm not sure which it is, came up with this um sort of crude method where they would punch out little circles of skin from a donor side on the back of your head where you still you know, like we said, the follicles are working great back there, and these were little plugs about four millimeters in diameter, and then they would transplant those to where you were balding and hopefully regrow your hair. And it was it didn't look great at less scars in the back, and it took time for it to grow in upfront, so it would look very sort of planted if you will. Well, yeah, I mean it's like in these neat little rows, these little plugs of hair, you know, like that. It left a lot to be desired for sure. That's it has come a long way since then. Now they use something called f U E follicular unit extraction, and that allows them to extract what they call follicular units three or four follicles and there's no scarring back there, and they can transplant them much more closely and fill in you know, if it's if you were liking it to like a row of corn, uh, filling in those rows in between as well, so it looked better, yeah, where it was thinning. You know. Something interesting I saw is that um doctor or in treach, he followed in the footsteps of some other people that data back to. There was a Turkey believing manach Um Hodara, who apparently was the first one to really do a hair transplant procedure. And then there was a Japanese guy doctors show Jewey Okada, who in the thirties was the one who pioneered that punch technique. But in the West, Dr Orange Treats usually is credited as the pioneer of hair transplants. Now they are starting to look into stem cells and this has a lot of promise because researchers found out I guess figured out through a lot of study is that one of the reasons that why hair follicles are can continue, those gremlins can keep working is because each hair follicle has a little well of stem cells, including those follicular stem cells and dermal papilla cells that you were talking about. I think at the very beginning and in Japan and here in the States, there were scientists who figure out how to extract those stem cells grow these new follicles in a lab. And the thing with anytime you're doing that, you have to you have to shape this thing. Like if you're gonna, uh do something in the shape of an ear, you would three D print out this like a model, this like scaffolding model to allow it to grow into the right shape. Because growing something from stem cells, you know, organs from stem cells, it's you know, you've gotta shape it yourself. It's not you can't just say form of an ear or form of a hair follicle. It just doesn't work that way. Uh yeah, exactly. This woman at Columbia University named Angelo Cristiano, who was threatened by alopecia areata, started basically this three D hair farm, creating these printed molds that mimic the underside the internal structure of a scalp, so she growth these sounds so gross, but grow these little hair fields that I was kind of talking about with Bezos. Yeah, because here's the thing, like, if you are already bald, you don't have any donor sites to get the follicular extraction from, right um. And if you do have some, you know eventually you're gonna start to thin that out when you're harvesting it. This stem cell like hair farm that's grown in vitro solves that problem. You've got all the donor follicles that you need right there without having to take any from the head, which is beautiful, pretty cool, And this is like this could be the future, you know. I think it definitely is there basically at the point where they can grow hair. Um. They just are now trying to figure out how to make it not wiry or pigmented the right way. And all it seems to be is that figuring out in more granular detail what the actual conditions are in your hair follicle in your scalp, and then recreating that in vitra. Yeah, and how to name it something other than a hair farm. Right, So I think we should close with the idea. You know, we like to talk about evolution and whether or not something was an evolutionary adaptation to to stick around. And you might think, if if women are always being surveyed about attractiveness of men, and balding men ranked low on that list, why on earth would it stick around as an evolutionary trait. And I think it took a doctor named Frank Muscarella to come around and say, maybe we should ask women a lot of things attractiveness, but also did does this guy look smart? Does he look trustworthy, does he look approachable? Does he look like he might be a good long term mate? And balding men did rank lower and attractiveness, but they ranked a lot higher in all those other areas. So that might explain why it's stuck around as an evolutionary adaptation, even though not everyone agrees. Yeah, and there was another study from the University of Pennsylvania that basically said, um that, like, I think bald men are viewed as ten percent more masculine, m more calm, vident, stronger even and they were like, this doesn't really jibe with what we what our understanding is, So they got another set of photos, and they showed people, um with a guy with hair and then digitally manipulated without hair, so to make sure it wasn't like there was some difference among the actual guys. That wasn't. They were controlling for hair loss basically, and they still found the same results. But it's like you said, they keep trying to pigeonhole things into like what the evolutionary fitnesses you know, um, and some people are like, just not everything fits that that very in a neat, tidy way. It's possible baldness is just an aberration, like it's not something we're supposed to do. But it had nothing to do with with um helping the species along or holding it back. You know. That's right? You got anything else? No, I hope we've displayed the proper sensitivities here. Uh. If anyone is suffering from hair loss, then it can be a tough thing and and handle it the best way, you know how? Yeah, greed um. And since Chuck said the best way, you know how, I think it's time for a listener mail. It is. This is believe it or not. Sammy Davis Junior enters the picture and this is from Molly. She says, I recently found out at a distant but kind of wild Sammy Davis Junior connection. Turns out, my great great great aunt is the one who caused the car accident that called Sammy Davis Junior to lose his eye. Oh my gosh. Her name was Helen Boss. She was seventy two when she stopped in the middle of the highway in California and started to reverse because she missed her exit and caused the infamous car wreck. She missed her exit and was lost because she was from Akron, Ohio, and had just done a cross country road trip to California. She says to my whole family is from the Cleveland Acron area. Shout out Ohio, Molly Minus, my wife says as well. So there was another woman in the car with her that had been taking turns driving. They both suffered from injuries some injuries as well, and there were some suits flying from all parties supposed to accident. I believe Sammy was cleared of any wrongdoing, even though he rear ended them. Uh. This isn't really a proud family moment, but when my mom told me the story, I thought it was pretty interesting. I love the podcast I'm a tax accountant. I wanted to say there's at least one person that absolutely loves when you cover tax and financial topics. That is from Molly B. Nice work. Molly, appreciate that. That is a Rando family history if I've ever heard one, it's good. I agree, totally interesting. If you've got some weird part of your family history that you want to share with us, we'd love to hear it. You can send it in an email to Stuff podcast at i heart radio dot com. Stuff you Should Know is a production of I Heart Radio. For more podcasts my heart Radio, visit the i heart Radio app, Apple Podcasts, or wherever you listen to your favorite shows.

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