Hair Loss: The Pits

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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Episode Transcript

Speaker 1 (00:01):
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

(00:22):
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?

(00:43):
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

(01:03):
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

(01:25):
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,

(01:46):
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.

(02:08):
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.

(02:30):
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

(02:51):
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

(03:12):
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

(03:34):
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,

(03:54):
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

(04:14):
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.

(04:35):
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

(04:57):
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,

(05:19):
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

(05:41):
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

(06:01):
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

(06:23):
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

(06:45):
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

(07:05):
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

(07:27):
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

(07:48):
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

(08:10):
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,

(08:31):
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

(08:51):
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

(09:13):
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

(09:36):
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

(09:58):
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

(10:22):
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

(10:46):
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,

(11:07):
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

(11:27):
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

(12:04):
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

(12:25):
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

(12:47):
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.

(13:09):
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.

(13:29):
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

(13:50):
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,

(14:15):
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

(14:37):
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,

(14:59):
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

(15:22):
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

(15:43):
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

(16:04):
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

(16:26):
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

(16:48):
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

(17:09):
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

(17:33):
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

(17:55):
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

(18:17):
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

(18:39):
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

(19:02):
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,

(19:22):
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

(19:45):
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.

(20:09):
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,

(20:32):
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

(20:53):
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.

(21:18):
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

(21:41):
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

(22:02):
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

(22:25):
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,

(22:45):
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,

(23:07):
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.

(23:30):
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,

(23:52):
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

(24:15):
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

(24:36):
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

(24:59):
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.

(25:21):
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

(25:43):
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.

(26:03):
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,

(26:23):
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

(26:44):
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

(27:06):
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

(27:29):
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

(27:49):
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.

(28:11):
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

(28:35):
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

(28:58):
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.

(29:19):
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.

(29:42):
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

(30:02):
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

(30:24):
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

(30:46):
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

(31:09):
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

(31:32):
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,

(31:53):
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

(32:14):
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

(32:34):
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

(32:54):
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

(33:16):
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.

(33:36):
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

(33:58):
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

(34:19):
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

(34:42):
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

(35:05):
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

(35:25):
for thousands of years to combat hair loss. Shot. All right,

(35:56):
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

(36:18):
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

(36:38):
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

(36:59):
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

(37:19):
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

(37:40):
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.

(38:01):
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,

(38:23):
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,

(38:43):
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

(39:05):
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

(39:26):
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

(39:47):
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

(40:12):
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,

(40:37):
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

(41:00):
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

(41:22):
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

(41:44):
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

(42:05):
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.

(42:25):
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.

(42:47):
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

(43:08):
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

(43:30):
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

(43:54):
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

(44:14):
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

(44:35):
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

(44:59):
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

(45:21):
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

(45:41):
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

(46:04):
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

(46:26):
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,

(46:49):
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

(47:10):
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,

(47:30):
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

(47:53):
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,

(48:14):
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

(48:36):
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

(48:58):
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

(49:20):
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

(49:41):
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

(50:05):
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

(50:26):
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

(50:49):
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

(51:12):
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

(51:33):
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

(51:56):
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

(52:18):
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

(52:38):
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,

(52:58):
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

(53:19):
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

(53:42):
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,

(54:05):
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

(54:28):
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,

(54:49):
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

(55:11):
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

(55:33):
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

(55:54):
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

(56:14):
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,

(56:35):
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.
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