Rethinking Hair Loss: Why It’s a Whole-Body Signal, Not a Scalp Problem

Many Americans, or people around the world, suffer from hair loss. It’s kind of staggering, actually, to think about it. It used to be something that was mainly focused on men, and now we’re talking more and more about women losing their hair. Some of it has to do with genetics. Some of it has to do with some other things. And today we’re going to dig deep into it in episode 25 of Cell To Systems: hair loss.

You know, I think it’s one of those things where you take a look at the stats. It’s kind of funny, because at 50, 85% of men overall have significantly lost or have some sort of thinning hair. And that’s just a staggering statistic. I didn’t really realize that, but it sort of makes sense.

Dr. Ferree, from a female standpoint, do you see patients in your practice, women that are losing their hair and coming to you and saying, “Hey, what do I do?”

Yes, it is. It’s right up there with fatigue as the number one, number two symptom that people present with. And it’s distressing, of course, because so much of femininity is based on your hair. There’s a lot of really interesting — if you know Shanti Feldman, she talks about hair being the thing that is the most attractive thing — confidence and hair. And I have a dear friend who just went through breast cancer therapy. And she came to me and she said, “You know, the thing that bothers me the most, that makes me really retract myself from society, is having lost all my hair in chemotherapy. It’s really distressing.” And you don’t realize how much of it is your signature when you’re out in the world. Think about the people who are, for example, transitioning male to female, and one of the first things they do is get a wig, because it helps to present yourself to the world in that feminine way. So it can really be — it’s very distressing.

And so this is sort of chicken or egg. Stress can be one of the big causes of it, and then so can the — the hair loss can cause more stress. So it’s this sort of self-replicating cycle. There are so many reasons that we work with patients and treat them. There’s so many different things that can be going on. And as we’ve talked about many times on this show, it has to start with looking at what’s going on with the patient. So why is this particular patient — and this is the reason you’re going to go to a functional medicine doctor — why is this particular patient losing hair? And is it because of something that they’re doing, some nutrient they’re missing, some thyroid, iron, something that’s going on? Is there something happening in their life? And you know, if you’re not testing for deficiencies, you might be making your hair loss worse by adding too much. Most of those nutrients have a sort of Goldilocks window of too little, too much, just right. And if you’re not getting that nutrient to the hair follicle, it almost doesn’t matter what you’re getting there.

I’m sure that you guys also treat it. Kristi, what do you do? What is your sort of testing regimen, and what do you start with as far as looking for deficiencies, or taking care of people who come to you with hair loss?

First and foremost, I mean, I think one of the most valuable tools that costs nothing is a patient’s history. When did the shedding begin? Then that’s when I work backwards. Was there an illness, surgery, significant emotional stress, pregnancy, hormonal changes, or a new medication, dietary changes? And I’m sure we all have witnessed the hair loss with the rapid weight loss and the GLP-1s of not being managed appropriately, or someone that’s been on a maintenance dose for a while and then all of a sudden had a dose increase, how that shedding will start occurring. And hair doesn’t necessarily respond to a stressor immediately. There can be a delay between the physical insult and when the patient starts noticing the changes, and we have to go back to the patient’s history and ask, what was happening in this patient’s body two, three, four months ago? Right? Hair is one of those — when I’m seeing a patient, you have to work backwards and you have to work forward, regardless of what you’re doing as far as with treatment.

And so, I mean, yes, I’ll do some micronutrient testing. But I think so many of our patients, they’ve come and already spent hundreds of thousands of dollars on red light therapy, shower filters, serum, everything that social media has told me that might grow the hair back. But it’s like, the question for me is, why is this hair falling out? Not what do I need to be putting on the hair. That’s where I start.

Yeah, it’s a really interesting point. I mean, we’ve talked about this before, sort of the, what do I put on my face, what do I put on my lotion. By the way, Kristi, just one thing I wanted to point out to you: when we talked about the lotion and then we did the Think Dirty app and we looked it up, and we said — we won’t name the brand, but the brand that I was using for my dry skin. Guess what, guys? I stopped using it and I don’t have dry skin anymore. Just like that, all of a sudden. Amazing. So, pretty cool. Just a little side note, throwback to that episode.

So the one thing I was kind of curious about is, it’s like this notion of, let’s fix it from the outside, but it’s almost like what you’ve said before, Kristi, like fixing it at the gut level, what’s going on on the inside. And Craig, I think there’s an emotional component to it where you’re sort of like, hey man, this is not cool, I’m not digging this. And I’m just curious if you would share your experience with that, and sort of what your journey’s been around that. Oh my gosh. So back in my early 20s, maybe if we had met out at the bar or something like that and got to talking about hair loss and all of the various remedies, this, that, or the other thing, you would have thought that I was the hair loss expert, right? Because I was doing such heavy investigation into these things. I had amazing hair growing up. I mean, I looked like Frodo Baggins of the Shire. I just had these curly, thick locks, kinky curls. It looked great, and it was luscious, voluminous hair. But it did start to thin when I was in my early 20s, and I was very hypervigilant about it because, as Dr. Ferree mentioned, it’s part of who you are. It’s how you present. It’s certainly associated with attractiveness and all of the things that we would readily associate.

So I became very, very proactive. Of course, I started the journey with minoxidil, and they say, you know, Rogaine, use a capful, right? But I would literally smother my head with this stuff. It was ridiculous. It worked. Rogaine, or topical minoxidil, is a medication that can be used to improve blood flow through the scalp. All right? And the whole goal of that is to really improve the length of time that hair is in what’s called the anagen, or growth, phase. And so it has widespread application for that purpose, to really improve anagen cycling throughout the hair follicle. And it’s interesting — one of the things to note is that all of our hair is not all at the same time going through the same phase. They’re all in various different phases at various different times. And so the balance between the different phases of hair growth is how we maintain that appearance of density and whatnot.

Anyway, I was using minoxidil, got to the point where I felt like I wasn’t having the efficacy with that medication as I would have liked to see. And so of course I appealed to my primary care at the time for the brand name for a medication called finasteride. It’s used in a 1 milligram dose orally daily. And it is also used for gentlemen who are suffering from BPH, and it’s used as finasteride 5 milligram, or you can use dutasteride, you can double the dose of the finasteride, so on and so forth. And oh my God, did that stuff work, right?

And how does finasteride work? Well, it’s a 5-alpha reductase inhibitor. What does that do? What is 5-alpha reductase, right? Well, it’s an enzyme that’s going to metabolize testosterone in the body into dihydrotestosterone. And anybody that knows anything about hair loss knows that this is — from the standpoint of androgenic alopecia, or male pattern baldness — this is the molecule that really is going to promote a pattern miniaturization of the hair follicle over time in individuals who are genetically susceptible to that miniaturization. So by inhibiting that enzyme, you’re inhibiting the conversion of some of the serum testosterone into DHT. And DHT is a very potent androgen. And so thereby you’re having less DHT attack the follicle, which ultimately is going to contribute to improved hair density, less of that miniaturization.

So that stuff worked great. And then — I’m going to sort of wrap this up and kick it back to you all — but I’m going to talk about some of the potential pitfalls of 5-alpha reductase inhibition. This is an important enzyme, and when we think about some of the other things that are metabolized by 5-alpha reductase, well, we know that progesterone is downstream from that. We have the conversion into allopregnanolone, which is a very potent neurosteroid that’s necessary for all sorts of brain processes, right? I started diving into this — this was well before I was involved in medicine and healthcare — started diving into the potential side effects, because finasteride to me was contributing to brain fog and I didn’t like the way that I felt on it. And more and more I came to find out about the research that shows that there is potential for sexual side effects, such as lower libido, erectile dysfunction. There is a large group of people out there who deal with what’s called post-finasteride syndrome. For a lot of people this is unfortunately irreversible, and it’s very damaging to their life and their quality of life.

Wait, wait, wait a second. What’s that?

It can be anything and everything from low energy, low — you know, inability to adequately build muscle, aches and pains in your joints and in your muscles. Brain fog certainly is a symptom that a lot of people complain of. There is the sexual side effects. So the people who experience those really, unfortunately, have a lot of depression and anxiety associated with that symptomatology. And if you think about it, DHT being a potent androgen, you’re not getting the benefits of that hormone ultimately.

So what happened with me is I said, listen, I hate waking up in the morning wondering, is my hair as good as it was the day before? That was very stressful, and was inducing its own type of damage to my hair health. So at that point I was just like, screw it, I’m done. And I’m going to go through this process gracefully. And that’s the point in time where I started really trimming my hair short. And ultimately it got to the point where there was some patchy growth and I was like, okay, well, we’ve got to get rid of this. So I just started clipping it real short at that time. And man, I have never felt freer. I mean, if somebody told me today, here’s a magic pill or an injection, or you want to get some microneedling with PRP, or use this or that peptide, I would be really hard-pressed to grow my hair back. It’s just a state of mind where I feel free and relaxed and happy to be me. You know, it’s like embracing who we are.

Well, you know, it’s funny, because just having just been with you out in Maryland, I thought about this as we’re coming up on this episode, and I thought to myself, there are some people who just look better without hair, and Craig happens to be one of them. So you lucked out, man. You hit the grand slam on that one. And so I guess it was a painful way to get there, but you won the game.

Hey, Dr. Pastrana, quick question for you. There are these products that are out there right now that — you know, we talked about finasteride, dutasteride — and they’re putting it in topicals now. So there’s, again, I don’t want to really go into the names of these brands, but there are these brands and they have the usual stuff, minoxidil and finasteride and dutasteride, as part of them. But just like we talked about putting this stuff on the skin — you know, this product, this skin lotion that wasn’t so good for the body, I think it was, what, Dr. Ferree, like four out of five, right? It was bad. If we’re ingesting something, a pill form of this, how much are we absorbing beyond just the scalp into our body when we take something, or put a topical on like that? Yeah, Craig, that was a great story, by the way.

It really depends from compound to compound, right? So a lot of compounding pharmacies will put things like finasteride into their solutions for topical use. But it really depends compound to compound. For instance, with finasteride, you’ll probably have a lesser side effect profile. But if you look at something like minoxidil topical versus minoxidil oral — minoxidil topical, they’ve actually done head-to-head trials where minoxidil topical actually works better than minoxidil oral. And then you have a bigger side effect profile because it’s systemic.

And so most of these things when it comes to topical, outside of minoxidil, are mechanistically plausible, right? There’s some studies, pre-clinical models, that show that the mechanism to extend the anagen phase, or what it’s doing to the follicles, is there. And I’ve seen great results with some stuff that doesn’t typically have human studies, like zinc pyrithione. I’ve actually seen that work. One of the things that I always get is zinc pyrithione shampoo, and that works really well for me, because I’m having a hair issue myself. I’m close to where Craig was at, where it’s like, I’m just going to get rid of this thing.

By the way, there’s nothing that grinds my gears more than somebody with a really good hairline. Like, I just cannot stand looking at that. I mess around with the kids at work, you know, these guys that are growing hair like down the middle of their forehead. I’m just like, that’s just not fair. That’s not fair.

But so there’s a lot of good things when it comes to hair loss products. What I found was, the hair just looks healthier. And so I noticed that I didn’t have more hair growth, but my hair was just darker and healthier. And so I was getting comments on, hey, your hair is looking really good, did you do something with your hair? And so I’ve seen great results with topicals. The problem — not the problem, the problem for me, because I’m a bad patient, even though I’m a pharmacist — is I don’t take medications consistently. I’m horrible at remembering to take my medications. And that’s one thing that you have to be consistent with, because I’ve had great results, great before and after pictures, but I’m just not good at taking it consistently. And it doesn’t work.

But funny story, Jock, you mentioned something about gut health and the immune system. I think we saw a lot of this during COVID, when the immune system took a hit. My wife — I think I mentioned it before — had those diverticulitis flare-ups and had a lot of issues with gut health. And something really interesting that happened during that time period is that I don’t think she has a lot of hair — we didn’t realize that hair was falling out, but once she stopped having those flare-ups, once Dr. Ferree fixed her gut and fixed everything else that was going on, she started to grow an extra line of hair here. And it almost looked funny for like the first six months, because she had like bangs, because she just had an entire other unit of hair that started growing, and it took like a year for it to actually blend in with the rest of the hair. She was looking kind of funny for a while. It was shocking to me, the impact of the immune system and gut health on hair growth.

And this was the main thing that we saw around 2020, between 2020 and 2022 — so many women coming and complaining about hair loss. And I actually have a question for you guys: I don’t remember this pre-COVID being as potent, even now today, as women complaining about hair loss. Have you guys noticed an uptick? Or because it’s kind of hard to tell, it’s been the last five or six years, but it just seems like hair loss, especially in women — I just hear about it so much more than I have in the past.

I totally agree. And I think it has been since COVID. I think we’ve seen a big — I have a really dear client who had hair loss that began with COVID, but then, because of stressors that were happening in her life in addition to the COVID, I think this was sort of compounded. And most of the time this is multifactorial, at least in my experience — I’m sure you all feel the same way. It’s not just one thing, and it’s this sort of compounding. I just saw her yesterday or the day before by Zoom, and she’s like, “Look at my hair that’s growing. This is my extensions and this is my real hair.” So — but it’s taken that kind of long time. You know, she made some big lifestyle changes, social lifestyle changes, and came back.

But yeah, exactly, Leonard. It’s been really — I think it’s definitely been more before that. I saw a lot of the sort of androgenic alopecia that you see with a lot of women, where they’re coming in with that sort of big wide part at the top right there. That’s what we’re seeing. And now I’m seeing a lot — in fact, the other day I saw a couple, I’ve seen in the last couple months, that frontal fibrosing hair loss. You know what I’m talking about, where they just lose hair, but you notice it because they lose their sideburns too. And so there’s some evidence that using sunscreen can affect that, but I think that’s sort of been debunked in most of the more recent literature. I think this is more of an autoimmune, and there’s a lot of association — they’re talking about this PAI-1. And there’s that topical that’s coming out. Do you know about the EO2 topical?

No, I’m like Craig. I just gave up. Even if something says hair loss, I’m like, I don’t care.

Yeah. Funny, because my Instagram is riddled with more and more of these targeted things about how to style your hair. I’m like, I have nothing to style. Maybe my chest hair, I don’t know. But yeah, I mean, we see a huge uptick in that. I think it’s interesting, following on the heels of that, we would associate COVID — and as Kristi and Dr. Ferree were alluding to, the whole idea of, what’s the stressor that happened six to 16 weeks ago? Was there a bad infection, severe systemic illness? Were you hospitalized? Did you undergo any sort of trauma or anything like that, contributing to that whole idea of telogen effluvium, right?

So, and we’re hearing about this now in association with GLP-1s. And there’s some research looking at semaglutide and the comparison of hair loss, and what is otherwise thought to be — I think, unless you guys know otherwise, I think that the hair loss they’re associating now with GLP-1s, we’re readily sort of attributing to a telogen effluvium pattern until proven otherwise. But looking at these medications, and semaglutide, it was, I think, like 2.3 or 2.6% increase above the placebo, which was like 1%, among x amount of people who were utilizing the therapy and those that were utilizing placebo. So there’s definitely a signal there that these medications can contribute to some hair fall.

And so I think that that’s worthwhile looking into, especially for those patients. Was there really rapid or expedient weight loss that changed the way your body was partitioning nutrients? And was there ultimately micronutrient deficiencies that were coming about because of those things, right? And then we know the downstream effect of any significant stressor is impaired gastrointestinal health and micronutrient absorption through there. So it’s all related. And I think that in the wake of COVID and GLP-1s, definitely seeing an uptake.

Yeah. Kind of happening at the same time, right? It was like a double whammy, because I know that initially we always would blame any hair loss — because we did get a lot of calls about hair loss — on, oh, you’re just caloric restricting too much, you’re not getting enough nutrients in, that’s where it’s coming from. But I do think that there is some signal there, because I’ve seen rapid hair loss that doesn’t make sense when someone’s not really caloric restricting that much. And so it’s both things probably happening at the same time. But just in my experience, and from the data that you’re talking about, Craig, it does seem that there is some type of a signal there.

I noticed the same thing. And I think of it as, like, hair tissue, the body can deprioritize when resources are limited. So when it’s at stress, when there’s a stressor that’s hitting the body from an immune perspective, mitochondrial perspective, unfortunately hair is a tissue that the body can just say, you know what, I’m going to put you on the back burner. Because it doesn’t need it for immediate survival, right? I mean, it can just start making that hair fall out and get the body the energy it needs to repair whatever is going on — again, from the immune perspective, mitochondrial, and the gut, whatever things that might be going on.

And I just think hair loss to me is kind of interesting, because it forces me to look far beyond the hair loss, right? Looking at the systems as far as that iron metabolism, the thyroid, the protein, the lean muscle mass, metabolic, and then nutritional, hormonal, and the stress. So for me, the goal, when I have a patient that comes to me, isn’t to grow more hair. The goal is to understand whether that hair complaint is giving us the opportunity to really look at the patient’s overall health that deserves attention. Like, what system am I missing?

Yeah. It’s one of the things I wanted to ask you about. I was dying to ask this last week, Kristi, when I was out with Craig. I had the benefit of doing this ganglion block, and I don’t know if we got to the full Horner’s, but I’ve got to tell you, if the full Horner’s is beyond that, I’ll look out, because that was pretty amazing. It was an incredible experience. And so one of the things I wanted to ask you guys about is, how does stress really play into this? And Dr. Ferree, Kristi just alluded to it, there’s some sort of stress component to this. And Craig has talked about it, the notion of, hey, I get stressed out — and how much is cortisol affecting hair loss?

It’s huge. So cortisol works on, I believe it’s the GAS6 protein — who cares, but it’s one of the proteins that works on it. It’s going to put your stem cells in the hair follicle — it’s just like what Kristi was just saying — it puts the actual stem cell in the quiescent phase. So rather than producing a new follicle or producing a new hair, some more hair — like Craig was saying earlier, all of your hairs are in different phases at different times — rather than the stem cells helping to produce new follicles or hairs, it goes dormant. And that’s what happens when cortisol levels are high.

Interesting. Procaine can do that, can help reverse them. It increases vasodilation, and because it’s DNA demethylating it can help with restoring that. There’s lots of other things that can do that. Obviously I’m biased, but it can work on — so one of the things we have to do is work on the stem cell regeneration and turning them back on. And there’s lots of things, even things like olive oil extract — I think it’s called oleanolic acid, it’s one of the fatty acids that we take in our diet — it can be helpful. Things like apigenin. The problem with these is they have to be used topically rather than orally, because they don’t have really good bioavailability in the scalp. So maybe you use a vasodilating agent with taking those orally. Maybe you’re using those before taking them orally, and then you use the vasodilating agent locally, so that you’re getting the localization of these products into where they need to be. Because this is sort of our difficulty.

Microneedling is an option, of course, for all of these topical things, and that’s definitely going to increase, but there’s this again Goldilocks window of treating these patients. If you microneedle too much, then you’re creating more fibrosis in the scalp and creating more problems where they are needed to be. So now you’re creating fewer hair follicles because of the scarring that occurs in the scalp. Certainly avoiding any of those microneedling kind of procedures in a patient who has that frontal fibrosing hair loss, because it’s a fibrosis problem in the first place. But people who are microneedling too often — or even, there’s some evidence that using a derma roller instead of a derma stamp can cause more problems — and there’s a just right and a too much for treating it with topical things, especially if you’re microneedling them in. What I’m taking away from this is that, as Kristi said, the first thing you would do is you sit down, you just do a full complete analysis of the patient on the whole, try to get a complete picture of, what am I really dealing with holistically, and that may give me a better sense of what’s going on, right? Is that the way to go, Kristi?

Are you asking from a provider perspective or from a patient?

I’m trying to think like from a patient’s perspective. Like, the bottom line is, I think there’s a lot of confusion for consumers out there in the market. There’s just tons of marketing hype. This thing is going to be amazing. Put this red light cap on your head, use this serum, do this thing. It seems like that’s sort of just, like, pin the tail on the donkey, if you will. Doesn’t it make more sense just to come in and see a provider and try to figure that out, one that actually kind of knows what they’re talking about?

Yes. But again, it goes back to my point of, you know, as a consumer, not looking at what can I put on my hair. Really assessing why is it falling out, and looking at lifestyle. Like, do I have more stress? Has my sleep been poor? Has my nutrition been off? Am I not exercising? I mean, just like what we all talk about as far as the basics. And then going to a provider that is willing to sit down and listen to you, do the necessary labs that are needed. And then, but again, don’t go to a place where they’re throwing the kitchen sink at you either, all at once.

Kristi, what do you do to sort of prep your patients before they come to do any sort of hair restoration treatment?

Definitely make sure their thyroid’s good, their iron is good, their micronutrients are good, and then just assessing their lifestyle. I mean, if they’re not willing — I have a few patients in particular that, I’m sure, you know, they’re just not willing to make any changes lifestyle-wise, in the sense of decreasing their alcohol, or even just trying to work on their stress, or when we’re offering the procaine. Then they’re going to walk away frustrated, I’m going to walk away frustrated, and then they’ll probably leave a bad Google review for me.

Yeah. I mean, I think there are some people that are stuck in stressful situations that just aren’t going to change. So there are those folks. But then there are those that can actually make some adjustments, and I imagine that as providers that must be very gratifying, when you do make those recommendations, they take action, and then they get the great results. And it must feel great to be on that side of it.

Yeah, this is an interesting topic, and one when we first brought it up, I was like, okay, sounds interesting. And there’s so many people that are affected by it, and it seems like there’s just this plethora of things to talk about around this. What are we missing? What haven’t we covered on hair loss?

The whole angle of androgenic alopecia in women is pretty interesting. You know, when we think about the PCOS profile or phenotype, and how it relates back to previous conversations where we’ve talked about the SHBG and the insulin resistance and ultimately the propensity for someone’s androgens to ultimately become more of a burden for them — whether that’s hirsutism and acne and fluid retention, but also significant potential for miniaturization of the follicles. So I think that that’s an area — I mean, I do all the micronutrient and the thyroid and the metabolic workup. I haven’t really in my practice gotten to the point where Kristi is and whatnot, with the Acorn and the regenerative treatments for the scalp, outside of using some targeted therapies, peptides, that sort of thing. The stem cells and the Acorn stuff sounds very interesting.

But one of the things that I do like to look at is a DUTCH test, because for these patients who maybe sort of fit the presentation of PCOS — and a lot of times it’s pretty obvious — but you can get a good read on someone’s 5-alpha reductase activity through the use of a DUTCH test. And so I use that sort of as an adjunct, to really identify, okay, what might be a contributing factor here. And 5-alpha reductase activity, serum DHT levels, you can’t directly correlate them with somebody’s hair loss 100%. So again, you just have to keep it in your back pocket as something that may be a piece of the puzzle. It may not be the whole picture. And I do like using DUTCH tests for that purpose. What do you guys think about that?

Yes, we definitely do that in our practice. We use the HuMap, just because it’s somewhat less expensive for the patient, but yeah, same idea. And the goal is looking at managing their hormones, because hormones are a big part of why a lot of people lose their hair. The cool thing about the HuMap or the DUTCH is that you also get their cortisol levels, right? So now I can say, see what I was talking about when you were talking about — that we were saying that the stress level is this, and this is the thing, and so this is a parlay into, hey, let’s do some neural therapy. Hey, let’s look at your lifestyle. Are there pieces you need to modify?

We refer a lot of patients in our practice to EMDR therapy, because we feel like that’s a huge, relatively quick — as opposed to going to therapy for months and months and months and months and months, this is like a six to eight episode program where they can really get some improvement. And a lot of times when patients are really high norepinephrine, epinephrine levels, especially compensating for that low cortisol over time, you’re going to see that they can’t do things like meditation. It’s just — sitting still for any length of time, their brain’s running. I mean, sometimes I’m that way. So I can only imagine how frustrating that is.

And that’s another test we do. It’s one of the things we do as they’re coming in. Like Kristi said, “What was the start? Tell me about what happened.” And this one client I have, she said, “Hey, it started when I got COVID and then I took this job.” And it was like this sort of ongoing cycle, and that was enough. Then we did the hormone testing like you’re describing, to get to the bottom of what was happening with her, because usually there’s a terrain that we have to fix. There’s a bottom line that needs to go. It’s crazy when you think about it. At this stage of medicine, we’ve got complex biologic therapies for complex oncologic conditions. We are treating mitochondrial conditions. We’re doing all of these gene-related therapies for conditions that are genetically determined, right? And I think that it’s remarkable that this has still sort of eluded the general medical world. I mean, certainly we’re making advancements. There’s tons of research being poured into it. I just think it’s pretty remarkable that we still sort of haven’t solved this riddle of, like, how can we really just put a halt to someone’s hair loss. And it speaks to overall the complexity, the various different causes. There’s a lot of different avenues that we would need to go down to really make sure that we can address it effectively in every different type of patient. But it seems like this is an area of research that’s lagging. I don’t know.

It’ll probably make a lot of people happy that you say that. There’s a new 5-alpha reductase blocker that’s topical that’s in phase three clinical trials right now that has, in the phase three research, a 539% increase in the number of hair follicles.

Yeah. Pretty amazing.

Wow.

So we’ll see what comes from that. That’s coming down the pipeline.

Don’t put that on your chest, right?

Yeah. But I love — you know, I was just talking to Leonard this past week, and then hearing you say that today, Craig, about like keeping your hair short is such a liberation, right? Like putting my hair in a ball cap or a ponytail is like so great.

Yeah, it really feels good. Like the day of a fresh trim or fresh cut, or the day after, when you can feel the breeze literally on your skin, on your head, it’s like, oh my God, this is wonderful. So I don’t get hot at night when I’m trying to get to sleep and whatnot. So it’s really nice. Then of course, if I’m active and sweating, I can just, boom, it’s done.

So, but hey, the flip side of that is I have to be very hypervigilant about sun exposure, right? I mean, I certainly don’t want to end up in a situation where I am having to get all of these different areas excised from my scalp. So for the men who tend to want to go tressless, there’s another area of concern that you’ve got to pay attention to, which is, how do you protect your scalp, and some of the other things that can happen when you don’t have that layer of protection?

I wear a baseball cap. I mean, it’s probably limited in its overall efficacy, but I think it does help a little bit. I am one that I don’t like a lot of extraneous products, and I am light on sunscreen generally. My wife is always like, you got to put this on every day. I’m going to spend the majority of the day inside. And like, this is her, right? I’m speaking as if I was her: I’m going to spend the majority of the day inside, but I’ve got to put on sunscreen because of the five minutes that it takes for me to walk into the grocery store, walk back to my car, I’ve got to make sure I’m fully protected. And that’s just not my philosophy.

I don’t know if you guys know Laird Hamilton — he’s a professional big wave surfer, and he is definitely of the mindset that we need sun, we need sunlight, the more you get of it the better. And I haven’t fully bought into that train of thought yet, but I seem to be on my way, whether it’s a good thing or not, I don’t know. The less I put on my skin, I feel — just yearly dermatologist appointment.

Yeah, it’s going to become important for me, I’m sure.

Well, I think we’ve covered all the things we can in this topic, and it’s been super interesting. Does anybody else have any final thoughts, burning desires to talk about here before we move on?

I just want to say one thing. We always go back to this on the podcast, but it is important to work through these things with a provider. Number one, it can be associated with some embarrassment. So don’t feel shame if you’re out there, you’re experiencing hair loss, you don’t know where to go. Find somebody in one of these practices who is ready and equipped to help you. But it is important to work with somebody, because a lot of the things that are sold as over-the-counter remedies, or they’re touted on the internet as being effective hair loss solutions, if you take them in excess, they can actually worsen the problem. So you really need to know exactly what you’re dealing with, how to use them. And again, this is just why you need to seek out care that is going to be dialed into your particular issue.

All right, everyone. Well, thanks so much. Another great episode of Cell To Systems. That was super informative. If you have hair loss, you heard it from the team — go see your provider and find out what you can do about that. We’ll catch you on the next one, and thanks so much. Please remember to like, share, and subscribe. And I hope you have a great one. Until we talk to you the next time.