What Actually Causes Hair Loss?

When it comes to the causes of hair loss, research paints a nuanced picture. Consider the following:
Scientific consensus is that the hormone dihydrotestosterone (DHT) causes androgenic alopecia (AGA). So then how come AGA also occurs in children with little-to-no DHT... or women with complete androgen insensitivity syndrome?
Scientific consensus is that AGA is genetic. So then how come four studies show that genetically identical twins can go bald at different speeds?
Scientific consensus is that low blood flow is a consequence of AGA, not a cause. So then how come drugs that improve blood flow can also regrow hair?
These questions have spurred countless debates online over what really causes hair loss... and what to do to fix it.
And, in true internet fashion, these debates tend to devolve into lost educational opportunities. Both sides inevitably turn to insults, ad hominem attacks, and straw man arguments to "prove out" what they believe... regardless of merit.
The end-result: nobody learns anything. So a few months later, the same debates resurface.
We grew tired of the internet tribalism. So, we spent 3+ months building a free resource that eliminates the straw manning and does what these online debates never do: steel mans all arguments "for" and "against" popular hair loss theories.
FREE GUIDE: Primary Vs. Secondary Factors In Androgenic Alopecia:
perfecthairhealth.com/the-lea...
From genes to DHT to scalp health to prolactin to blood flow to inflammation, you now have access to the best arguments, counterarguments, and rebuttals for any potential contributor to androgenic alopecia (AGA)... along with the roadmap for how scientific consensus is reached.
You'll also discover which factors are believed to be "root causes" vs. "accelerators", and why this is critical to know when navigating your treatment options.
We hope this free resource adds to your education on this topic. We've got more coming!
--
INTERACTIVE GUIDE:
Free Guide: Primary Vs. Secondary Factors In Androgenic Alopecia:
perfecthairhealth.com/the-lea...
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WANT OUR PERSONAL SUPPORT?
Let Us Help You On Your Hair Growth Journey:
perfecthairhealth.com/join-now/
--
TIMESTAMPS:
0:00 Intro: What Causes Androgenic Alopecia (AGA)?
1:45 AGA vs. Diet, Lifestyle, Environment
3:50 AGA vs. Scalp Inflammation
6:07 AGA vs. Dihydrotestosterone (DHT)
8:02 Evidence For and Against Each "Cause" Of AGA
9:15 Tribalism in Hair Loss Forums
10:35 Primary vs. Secondary Causes of Hair Loss
11:54 Interactive Guide for Hair Loss Causes
13:45 Final Thoughts
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About Rob English:
-Editorial board member of Dermatology and Therapy
-Medical editor specializing in hair loss disorders
-Peer-reviewed publications: perfecthairhealth.com/publica...

[@PerfectHairHealth]

We hope the guide helps you out!❤Explore each factor & share any input here: perfecthairhealth.com/the-leading-theories-of-hair-loss/

[@syedshadman07]

Does rosemary oil help in hair regrowth?

[@krystian777100]

The latest study shows that minoxidil is a DHT blocker. What do you think? www.ncbi.nlm.nih.gov/pmc/articles/PMC10461613/ When I started going balding I myself had never used finasteride due to fear of side effects and I have a head full of hair

[@syedshadman07]

@@user-zv8ef7gs1f I'm 16 years old, I'm losing a lot of thick hairs (there are very few thin hairs like 2-5) am i balding? Did you lose any thick hairs at your time?

[@PonteVitaRx2023]

As a physician - you are doing the absolute best job on educating and approaching hair loss - more than anyone on YT esp the influencers and doctors even. Superb job. Wow

[@PerfectHairHealth]

I really appreciate that! Thanks for watching.

[@VishalSingh-iq5sk]

@@PerfectHairHealth thanks Rob

[@oinkgoespiggy7781]

Thanks for the vid Rob, i still cant believe were in 2024 and we dont have a cure for pattern baldness yet

[@bluesummers5051]

Your last two videos have been total bangers with so much insight. Really setting a new standard for hair loss videos. It’s amazing that the only thing some people took away from this was “bro is finasteride paying you?”. Really exemplifies the lack of critical thinking and tribalism that you described within the community.

[@PerfectHairHealth]

Thank you. I really appreciate that you get it. I’m hoping you enjoy our next few videos as much as the last ones.

[@priyanshuprakhar6691]

​@@PerfectHairHealthhey rob. Last time you didn't reply me. Please tell me is it ok to shed hair during massaging?

[@PerfectHairHealth]

I try my best but cannot reply to all comments. The massages shouldn't induce hair shedding at the rate you're describing. It's possible you may be going too hard or you may have additional hair loss types outside of AGA.

[@priyanshuprakhar6691]

@@PerfectHairHealth it's about 50 hairs per massage session but I think I should go gentle on my hairs. Thanks for the tip

[@Skyview65]

@@PerfectHairHealthhey rob how is that 0.005% 2mL doing for your forum members

[@dante911ify]

Another great video. The amount of theories, possible treatments with supporting evidence and counter-evidence for them, on hair loss can be confusing and often overwhelming for an average person who wants to learn more about the mechanism of hair loss. So you have done a great job in compiling, organizing the information available and presenting them in a really digestible manner to us.

[@Gantarilho]

Loving the new videos Rob! I honestly learned so much about hair loss last year and it was all thanks to you. You are really making a difference, trust me.

[@phoenixali8479]

Thank you so much for great information, thank you rob

[@pullmyniblets]

Great info rob thanks for all your input dude

[@oliperas]

Brilliant! Not just for hair loss! A lesson/mindset on how to best approach any ailment and its proposed therapies.

[@Foba_Bett]

Your past videos are awesome. Really changing the discussion on the topic in a positive direction by explaining why certain treatments work for some people and not for others. Recently my dermatologist told me that there is new research on the "biome" of the scalp (As in: There is a biome in our gut / intestine. But also on the scalp). As in the past research focused on DHT, Blood flow to the scalp, Inflamation, Fibrosis etc.. Do you know anything about this?

[@hensenh1503]

i notice that whenever I eat certain foods, my head starts getting itchy. thinkin it might be inflammation of some sort

[@tracewaybos]

Hey Rob - thanks for the video...

[@dopander2883]

Maybe it would be a good idea to make a case study of someone with AGA who’s not seeing results from finasteride but by targeting factors like scalp inflammation, micro inflammation on scalp and lifestyle factors to see if that can make a difference. Maybe that way we can understand better why finasteride isn’t effective for everyone as maybe just maybe some people need to get their scalp health sorted out and underlying issues before seeing actual results from finasteride.

[@hosnaoude]

Love your content bro

[@mayyursudarsan3274]

excellent analysis

[@samali6109]

Hi Rob, As a long time hair loss nerd thats watch all your videos for the past few years i just wanted to say this channel is hands down the best on youtube, just wanted to ask if there are any shampoo's you'd recommend for hair loss or if you've discussed this on an older videos ? i use Nizoral once a week but was wondering if you've come across any research discussing things like optimal frequency of hair washing for example ?

[@shadowwarior2231]

been following you for over a year now and i have learned so much! thank you good sir pls keep the good work up! im not bald yet ( thx the lord ) but i know i will be at some point and i know one day i will read this comment and i wish i was still young and had hair lol.

[@isma3il2005]

Hey Rob, Great video. What is your opinion on derma rolling only as an approach if one is not ready to take medications? I have heard you mention in a previous video that some managed to get great results with high frequency derma rolling. From your experience do you think good responders to derma rollng only are so rare that its not worth foregoing other treatment options? If not, what is the upper range of frequency of derma rolling have you seen work. Thanks.

[@diarchisinteriors3827]

Rob, whats your treatment?also what do u think about infrared sauna improving hair?

[@justrelax2911]

Thank you for these information I have a question regarding height and finasteride . I am 18 years old and I wonder if it can affect height growth ,can you do a video about that?

[@f.austin]

great video! thank you for presenting information the way you do. presenting both sides of a question/answer - as well as going further to even question the question (a largely missed and useful technique). the free guide sound like a great tool! - one topic/treatment that would be interesting to hear your perspective on is topical caffeine (not shampoo, grinds, etc.). as an example, for last 7 months have been using pure caffeine (easy to get online as liquid. sold for people to add to their own beverage) that i mix with purified water at 5mg/100ml (to use as one ml applied to scalp at 0.05mg/ml daily). very easy and extremely cheap to do yourself. the research says it is highly absorbed directly at the follicle and is a substantial dht blocker with no noticeable systemic effects from the caffeine. been doing this for seven months and has seemed to be beneficial (in conjunction with other treatments have gotten significant seeable/beneficial results) and at worst have had no systemic side effects (been caffeine free for 20 yrs). like anything else, the science says it can cause detrimental effects by using to much caffeine. the available science is 0.01mg/ml to 0.05mg/ml once or twice daily. also have seen some medical doctors who offer this type of caffeine treatment in their prescriptions. thanks for sharing!

[@PerfectHairHealth]

Congrats on your improvements! The research on caffeine in AGA subjects is limited, but we summarized the studies and doses on topical caffeine here: perfecthairhealth.com/caffeine-hair-loss I think topical caffeine is probably the proper delivery vehicle. Caffeine shampoos are built on claims of rapid penetration into the dermis from ex vivo studies, but I don’t necessarily consider those study designs as strong enough to support the shampoo claims. Keep us posted with your results!

[@f.austin]

@@PerfectHairHealth thank you for the link and the response, appreciate the time!

[@angelmaldonado5657]

@@PerfectHairHealthcan you do a video on seborrheci dermatitis hairloss?

[@Lancetronium]

Great video, and grateful for what you do. Thanks much.

[@linuskvernberg6005]

Can you make a video about how to massage your hair, how often. Etc?

[@joshuanahughes5077]

Hi thank u so much for ur videos. I was wondering if u could look into or make a video about how different people like Japanese or Native American men tend to have less hair loss and what in particular the diet plays a role in it. I have been had AGA since highschool when my hair started thinning and I’m now 31. I have started to more stubbornly hit this from many different angles at once and I really think diet might play a big role I just don’t know enough but it is interesting that I have read somewhere that when Japanese men and others adopted a more westernized diet there was instances of baldness compared to those who had a traditional diet flare they’re from. Just curious if there is anything in particular about some people diets (who have eaten that way the majority of their life growing up) cuss them potential to have baldness not affect them (or not turn on the genes associated with that by epigenetics). For instance I read somewhere soy and green tea was found to lower dht more when paired and lol people is Japanese and other Asian countries consume that regularly. Not saying it’s the reason but it is interesting. Thoughts? Or like saw palmetto (apparently used by Native Americans) lowers dht and those men don’t seem to have hardly any facial hair in old pictures or hair loss. Again not saying anything concrete just an observation.

[@sharpshades]

Hey Rob, what is the solution to your father being the cause of hairloss? I woke up and I was completely bald. I’m fairly confident that he shaved my head in my sleep and will continue to do so. Just hoping to get my hair back.

[@JakobPuchmayr]

Thank you for all the information you provide👍🏻 Do you have data on focal dystonia and relation to hair loss? pretty much every man that I know who has dystonia also has some kind of hair loss. Kind Regards

[@samali6109]

as most people with hair loss don't suffer from dystonia its likely to just be a correlation rather than a cause .... it also doesn't make sense as its a neurological condition so highly unlikely to have a connection to hair loss causing pathways which mainly relate to blood flow and hormones.

[@JakobPuchmayr]

@@samali6109 thank you for your thoughts. Well, that is obviously true. but I‘m not saying that hairloss causes dystonia I‘m saying that dystonia causes hair loss. One thing that comes to my mind is that dystonia disrupts the nervous system (in particular the parasympathetic nervous system, which puts the body under stress). As stress is is linked to hair loss that might be a cause. so that‘s why I‘m interested. currently trying minoxidil with microneedling. let‘s see if I get improvements

[@MileHiGuy95]

Hey Rob, how do I ask my dermatologist which subtype of hair loss I have? Do they need to do a biopsy?

[@Aman-lw3vq]

I initially used to believe but I have had my own observation now and I think you’re missing one extremely important thing i.e a person’s belief system. I strongly believe and I’ve seen it that we react in different ways to a similar situation some of us are calm while some panic too much, some are afraid and some are not. So when hairfall strikes some people start to overthink and panic and that becomes a regular thing and they themselves start believing they’ll go bald and they do later but if you somehow make yourself believe that you won’t go bald and it’ll just reverse and keep calm and trust me everything will be restored. Our body has regenerative capacity and it can do it. Love yourself and treat yourself better. I’ve seen people change their destiny.

[@phuongthanhle9128]

Thank you. I totally agree with you. Our bodies are magical

[@jaska-jalmarixvi5757]

Crazy. Although placebo has been observed to affect few percentages compared to actual medicine

[@baker2444]

Hey, quick question. Have you had any experience with finasteride and facial hair growth? I am a 25 year old guy and have noticed that my facial hair development has stalled the last few years on finasteride. This could be coincidenental with me being such a young age, but I also hypothesize it could be due to DHT supression. Given this, I am thinking of switching to a low does topical to possibly avoid the large extent of serum supression. Any thoughts would be appreciated!

[@fangornthewise]

Hey Rob, Do you know anything about Acquired Kinking of the Hair, in the periauricular region, and its relationship with AGA? How does it fit your current understanding of hair loss and do you think any of the non-hormonal treatments for AGA could work on it? Despite being supposedly "very rare" and having only a few cases described on the literature, I have anecdotally observed it on many many men who have hair loss and/or full beards (but specially hair loss). The reason I think it's underreported is that: 1. It's probably difficult to notice on men that don't have straight or wavy hair. 2. Since it has a high correlation with severe forms of AGA, most sufferers have a bigger problem to worry about and therefore are focused on that. 3. That's a part of the scalp that tends to be kept very short in terms of length in most male haircuts, specially among men who are losing hair, so it might go unnoticed.

[@benwaggoner2156]

I’m 23, should I just do 0.25 finasteride daily starting now? I have lost a lot of hair from stress but I still have my hairline and a decent amount right now. It’s just diffuse thinning . I don’t really want side effects. But also I’ve done things like nutrafol and minoxidil is just a lot of work, messy to deal with, and very inconvenient.

[@nahomb2784]

I'm one of the guys that hated the "scalp massage", it caused all kinds of bumps on my scalp. It was not very hygienic for me to put my hand on my scalp. I really appreciate your current honest videos.

[@PerfectHairHealth]

Sorry to hear about your experience. If you're still getting those bumps (even without any interventions), perhaps give an anti-dandruff / antimicrobial shampoo a try: zinc pyrithione, selenium sulfide, ketoconazole, etc. I wish you the best with everything, and thank you for watching.

[@tarbucktransom]

I gave myself a scalp yeast infection by doing the massages after microneedling but inadequate hand washing. It wasn't the massage itself because it took over a year to get an infection. Wash your hands.

[@offensivearch]

Might want to also wash your bed sheets and bath towels more regularly.

[@Luw7]

Does the massage protocol work for diffuse thinning in men who've mostly retained their hairline? The dead center of my hairline is close to gone too now in the middle of my forehead, but this area is only a few square centimeters. Because of huge amounts of stress (don't ask) chronically for 15 years now I have diffuse thinning everywhere. But not sure if the prolactin, cortisol and IGF1 factors you listed are impacted by these massages.

[@heikorudi6105]

hey rob!

[@jcmediaoffl]

Fantastic content dude! By the way, please make a video of the topical 0.25% finastride. I have to know is that efficient as like oral 1mg finastride.

[@PerfectHairHealth]

Thanks! We have a video coming up that touches on this. Otherwise, check out our Topical Finasteride video: kzbin.info/www/bejne/hKa7ZKl7ppeAl9E

[@jcmediaoffl]

@@PerfectHairHealth yeah, I already watched that video.. it's well informative! And great, Im eagerly waiting for your upcoming video related to it..❤️

[@hrvac007]

Hi Rob, I'm a little disappointed with the change in rhetoric. When I first heard on your channel that hair loss is actually caused by tension on the galea epineurotica, I was delighted! For the first time I heard something that actually explains why some men go bald and some don't! Because as you yourself once said that it is impossible for it to be a coincidence that the strength of tension corresponds to the place of hair loss. Plus the fact that DHT actually stimulates hair growth in other places on the body, so how can it be the main cause of hair loss? The root cause of balding then should be the anatomy of the head, places where the scalp muscles are attached to the bones of the skull. Why don't you mention the Russian surgeon, whose name I don't know, who made incisions on the galea to reduce tension, and after that the patients' hair would start to grow. How that explains DHT model? I liked the previous approach much more where you encouraged people to get massages and less to the pharmaceutical industry. Well, that's what I think, and I'll continue with the massages and microneedling, as I've been doing for 4 months without any pharmaceutical preparations, and if only one additional hair grows, it means that you were right.

[@priyanshuprakhar6691]

Hey, I've been doing massaging for 1.2 months. Is it normal to shed hair during massage bcoz I shed like 50-60 hairs per session

[@hrvac007]

Honestly, I have no idea, I'm Norwood 4/5, I am bald for 20 years now and I don't know if I'm getting any sheding or improvement. And I don't really care if my hair will grow, I find the concept of hair falling out due to inflammation interesting, so I said let's try it for fun. I massage the head with "massage gun" with the softest attachment twice a day. And I microneedle with a 1.5mm derma stamp once a week, for about 4 months already. I think that I don't see any progress so far in any movement of the hairline, but what I did notice as a very interesting phenomenon is that since massaging my head I haven't had a single headache! I used to have at least one a week. So if nothing else, thanks Rob for that! ☺️

[@joshmasias3634]

exactly hopefully rob answer this

[@fi4re]

Did you watch the video? The whole point of the video is that Rob is saying that you shouldn’t get tribal about the causes of hair loss. Scalp tension can cause hair loss, and DHT can cause hair loss. Both of these statements can be true at the same time. In fact, if you go to his website Perfect Hair Health, one of his publications called “A hypothetical pathogenesis model for androgenic alopecia: clarifying the dihydrotestosterone paradox and rate-limiting recovery factors” explains _in detail_ how DHT, scalp tension, and many other factors can work together to make you lose your hair. So no, Rob hasn’t necessarily changed his rhetoric. He’s giving a full picture of his understanding of the science behind hair loss.

[@fi4re]

PS. I’m not a member of Perfect Hair Health; nor has anyone asked me to shill for them. I’m just a person on the internet trying to understand what’s going on just like you.

[@sfm8099]

Hey Rob. In your video micro needling for hair loss you have said the needles of dermarollers don't go 100% inside the skin, instead it goes only 50-70% inside. Actually in the market there are two types of dermaroller one is 192 needles where needles are horizontally stacked and another is 540 needles where needles are vertically stacked. As far as i know dermaroller with 192 needles ( horizontally stacked) will go 100% inside the skin but 540 needles one ( vertically stacked) don't go 100% inside. I think in your research you have used 540 needle( vertically stacked) dermaroller that's why it has gone only 50-70% deep inside skin. Pls correct me if I am wrong about this

[@Meghnaaad]

Hey Rob! How far do you see the cure for Androgenetic Alopecia is? Like from being bald to complete head of hair with atleast 95% of the adolescent follicles. Or like complete revival of follicles.

[@user-nl2bk1bm2d]

Hi Rob, very informative video! However, is there any complete video or research around solving the DHT paradox or rather how exactly does DHT cause miniaturisation? That seems to be the biggest issue which needs to be tackled.

[@PerfectHairHealth]

Thanks! There are a few different biological models to explain DHT-induced miniaturization, mainly involving TGFB1, ROS, IGF-1, and dysregulations to the wnt/beta-catenin pathways. As to why DHT increases in balding scalp regions, the best data so far suggests “genetics”. I’ve argued in some papers that other factors might be at play, but the evidence supporting other factors is limited. With the way research is advancing, I’m hopeful we’ll have better answers in the next 2-5 years.

[@user-nl2bk1bm2d]

@@PerfectHairHealth Thanks Rob, just a follow up question. Has there been any explanation for why DHT kills hair only on the scalp while grows it everywhere else? I believe its usually written off as DHT sensitivity but that doesnt sound conclusive enough.

[@MohammedAlfaleh]

Thanks for this great video ❤ What is the minimum dosage of finasteride daily or even weekly/monthly. I’m now on 0,25 daily, and planning to take the same dosage but 3 times a week. What do you think 😊

[@MarkJohnson-hl8jn]

Can we possibly get a video of your current hair regime&diet/lifestyle? Not that it would work for everyone to follow but it would be interesting to know. Thanks!

[@Goodmorning1221-]

Are there any studies demonstrating that serum DHT is higher in balding people than non balding people ? I'm not talking about the one mesured in scalp, but by a regular blood sample.

[@eldhobenny947]

Hey Rob i saw hair regrowth on applying saw palmetto topically what can i do further to boost my hair growth

[@v.m.a.d.l.e.6972]

Rob. Thanks for doing real science.

[@leoncca]

I'm wondering how hypothyroidism affects the scalp on men. Since I've recovered I've noticed less density but, strangely, the hair isn't receding, still like I was teenager in regards to the Norwood scale (I'm on my early 30s). It's seems the whole hair has lost density, even at the back and sides. I hope I'll regain it and it's not male pattern baldness.

[@petesantana7302]

Please let us know what is true about stem cell therapy for hair loss

[@ocoro174]

ketoconazole works for my inflammation but only for a few days, what's the deal with that? what else should I try? 🤙

[@bahacankaratas418]

Hey Rob. I sincerely want to thank you for your videos. I was struggling with almost baldness here in my early 20s but now I have completely regrown my hair almost full head hair by your methods. I use finastride, minoxidil, ketokonazol shampoo, microneedling, scalp masssages and keratin supplement. People around me accuse me of hair transplant. Thank you so much! If you need I can provide you with the full guide and the before after photos.

[@PerfectHairHealth]

That’s incredible! Congratulations. I’d love to see the photos. Send me an email. Really happy for you.

[@bahacankaratas418]

@@PerfectHairHealth sent it :)

[@PerfectHairHealth]

Wow. That was insane. You are definitely a hyper-responder! Congratulations, that's amazing.

[@bahacankaratas418]

I have a massive shedding at month 6 don’t know why its still going on but trying not to panic too much

[@mamma1506]

I’m so happy for you ❤️ congratulations!!! I’m asking for the men in my life…such a difficult thing to deal with, and so thankful to Rob for all of his hard work and dedication. Could I please ask if you’re taking oral/topical, percentages, dosages, etc. anything to help please 🙏

[@sigmamale520]

Is it possible that secondary factors affect primary factors or both affect each other?

[@adishadzo9896]

What people don't understand is that there are usually always more reasons for hair loss. Genes are in the first place, than lifestlye, diet etc. In my case it might be genes, high level of stress and bad diet which causes inflamation and hair thining. Once you know the causes, you can try to stop the hair loss.

[@khansazainab7490]

What i don't understand is that aren't primary factors like DHT caused by secondary factors?

[@Jim-oc3sp]

If after using both oral Dutasteride, oral Minoxidil, and Keto shampoo for over a year (without sides) but is still losing alot of hair and miniaturization, both visibly and under microscope, how does one know if they should 1.) increase dose of Dut, 2.) add a topical anti-androgen such as Pyralutamide, or 3.) or a form of Estradiol? In watching some of your videos, there are various terms that I don't understand such as 1.) high or low androgen activity in scalp, 2.) aromatase, 3.) whether increase in scalp testosterone could be an issue for a small group of individuals, etc.. I'd like to do something in addition to what I'm doing now but don't want to exacerbate the situation. Any input is appreciated.

[@superdr88]

What about using reishi mushroom (internally and on the scalp) to lower dht? 🙏

[@zene2550]

Thoughts on redensyl

[@SamuelVII]

Sorry about the long comment Hey Rob, my late father was full bald and my uncles from my father side are all bald (although one of them still has some portion of hair only around the crown area), my father used to smoke a lot and most of my uncles smoke too, my grandfather had all his hair minus some loss at both temples, while from my mother side she has some hair loss at the front of the head (mostly because of years pulling the white hairs) but she says that my grandfather died with a good amount of hair although how much he really had i can't really know, while in my case i have a somewhat noticeable recession at the right side temple for some years now and my left one for the last few years has started to recend, while my crown always had a noticeable cowlick with some minor loss at the back of the head, i don't smoke but i definitely could have a better lifestyle but in general all good, considering all of this should i be worried about going bald in the future? I am in my early 20's, i do have hypothyroidism but i take medicines to treat it, i take some good care of my hair with scalp massages and using some natural products with ingredients like rosemary oil on it but i still feel that i am at a dangerous situation here lol

[@leoncca]

I recovered from hypothyroidism recently and I've noticed less density for sure, my dad is bald but his dad wasn't, my uncles on his side aren't bald as well. I haven't moved in the Norwood scale, technically still no receding hairline. I wonder if it's hypo or male pattern baldness (or both! lol). I'm already on my 30s though, I think we should both check in some way if hypothyroidism messed up with our hair.

[@fangornthewise]

Might be trickier to find info on it, but try checking the history of your maternal GRANDMOTHER's side (her brothers and father). Your maternal grandfather does not tell the whole story of your mom's side. It's probably more relevant than your paternal side of the family.

[@kok3139]

I like videos with this quality and visuals

[@MrJockeys97]

Please what do you think abour the possible correlation of fapping and hair loss? I know it's a pretty controversial theme but i'm sure that in my case cause itching and an incrementation of fallen hairs. I also read on reddit and other platforms a huge amount of posts of people that describes the same reaction

[@user-qx8uv8lm8h]

Can you tell me, if my dht and dhea-s are low, why does my hair is still falling and thinning. Do its the same if I have low dht and higher dht at all?

[@Resist4]

What about inflammation caused by Psoriasis?

[@tanzil.]

Anyone experincing side effects of finasteride?

[@priyanshuprakhar6691]

Hey rob. I've been doing your guided scalp massages for 1 month and during this short period of time i don't expect any progress, but just a question. Whenever i do scalp massages many of my thin haie falls out. Just wanted to know is it something to be concerned about or not, is it natural to shed some hair during massage or it's just me. Please share your POV

[@crinu-dumitrucernat]

There’s probably too much friction with the hair follicles themselves when you massage, you want to massage the scalp without moving the hair follicles too much.

[@priyanshuprakhar6691]

@@crinu-dumitrucernat I firmly place my finger in my scalp and make sure that there is no friction between my fingers and hair still it happens

[@alb12345672]

@@priyanshuprakhar6691 all hairloss treatments have shedding. then it grows back

[@priyanshuprakhar6691]

@@luxterrae I'll give it a try

[@aditya_malhotra]

Bro first of all you are gem for hairloss industry i want to ask you rob I m on Intermittent fasting and also applying ketocanazol and bethamathason to lower inflammation and for growth applying minoxidil and eating finastride and also applying topical finastride Alternatively and taking supplements like vitamin d b12 and derma roller but my hair fall and hairloss is still progressing and my hair shedding is not controling can you plzz help me out your response is greatly appreciated well again thnxx for the video bro ❤ .

[@zya-kw4yg]

Hi Rob please help me out in my situation. I am 24M with zero family history of baldness on both sides. In 2021 march I made a stupid mistake of using 5% tropical minoxidil on my temples just to experiment if it makes them denser. Till this time i had no complains of any hair shedding just had slight issue of seb dermatitis but was managable. I used minoxidil for just a week and stopped using it due to itchy dry scalp and extreme heart palpitations. Since stopping that in march 2021 i started shedding 200+ hairs every time i shower. I am shesding in diffused manner there is no fixed pattern. I have been to 3 dermats all have said to just wait and watch. There is minor recession in hairline in these 3 years. Shedding has remained the same. Please help me what options do i have now? Should i try some safer options like hair peptides or something else. I had blood test done where for some reaosn i had very high progestrone levels and low d3 and b12 which i have fixed through supplementation.

[@elfutbolmx8650]

Im 21 similar situation but my family does have baldness

[@MyPlanet123]

After fixing vitamin deficiency, did it helped you in hair loss?

[@RK-bx1by]

You might have telogen effluvium, which seems to be consistent with your diffuse pattern of hair loss, especially if you’re not genetically predisposed to it. All this means is that there’s something which is causing you to lose hair. It could be your progestrone levels or whatever. It could also be to do with your environment and stress levels. That’s all I can say based on your post, but yeah, if you figure out the cause then your hair loss will likely stop. Look into your thyroid as well.

[@intensegamer7559]

I use minoxidil and microneedling (only at my temples) for close to a year now and no additional finasterid. Works great for me. Got almost all of my hair back. I have to say though that I don't seem to have a predisposition when it comes to going completely bald.

[@dasitmane7590]

How long before you started your treatment had the hairloss been present?

[@intensegamer7559]

@@dasitmane7590 Good question. Well, that would be 21 years. I took finasteride until my early 40s but it started to kill my libido so I stopped. Took nothing for about 6 years.

[@soots-stayingoutofthespotl5495]

Can you tell us more please? Like how far had you receded/ thinned after the 6-year lay-off and was it confined to the temples, what percentage of minox/ what brand/ type (i.e. liquid or foam) do you use, how often and when during the day do you apply it, did you get shedding or itchiness, which dermaroller do you use and how often do you do it, did you make any other changes in terms of supplements, massage etc? Thanks.

[@intensegamer7559]

@@soots-stayingoutofthespotl5495 My hair got thinner and decreased in density at the top of my scalp after 6 years, a bit more at the vertex where my scalp startet showing slightly. At my temples the hairline receded back inline with my ears. I would say a rather weak Northwood 3. I use a standard 5% liquid solution (Bio-H-Tin) twice a day. In the morning 45 minutes before washing my hair and once before bedtime. No itching or any other problems. Additionally I use a high quality derma pen once a week (.6 mm depth) solely at my temples.

[@tanzil.]

BTW, love you rob we have some hope, thanks to you.

[@wingsOfWind]

Does finasteride affect blood sugar in any way??

[@JohnFallot]

Checking out the 'Leading Theories of Hair Loss' page now. As someone that co-founded a nonprofit in a totally unrelated field - i.e. the possible impact of behavioral science and design changes on making social media less of a dumpster fire - I am thoroughly inspired! Very well done!

[@PerfectHairHealth]

Thank you. I think there's a huge opportunity to extend this argumentation format to other fields related to science, politics, etc. - and encourage a better understanding of perspectives. I'm supportive of anything that encourages education and discourages sensationalism and straw manning. I hope you see great success with your non-profit.

[@offensivearch]

I think it's fair to say we don't have a conclusive and comprehensive causal model of AGA. I believe finasteride is probably the best tool available (in terms of efficacy, taking compliance into account). However, I also think knowing how to disrupt a biological process (or even manipulate it to a degree) is not the same as fully understanding it. It seems like that is where we are at with AGA. I don't think "full understanding" is an unreachable ideal either. It sounds like I am applying an unrealistically high or idealistic standard, but I think there are a number of examples of conclusive and comprehensive pathogenic models in medicine (eg well understood viral diseases). When you have full understanding, the solution becomes almost trivial and virtually inarguable. People can only have space to argue when they are operating from beliefs rather than knowledge, or they are starting with different base assumptions or values. Unfortunately I don't see much financial incentive to pour money into AGA etiology. It seems like most people both within and without dermatology are satisfied with the current state of knowledge (ask the average MD and they will flat out say DHT is the cause of hair loss). You might think there is plenty of money and attention in this already, but it doesn't seem that way to me when you look at the number of FDA approved treatments (3) and the fact that most of the papers in this area aren't in the top medical journals. I could be wrong about the papers aspect (I don't pay attention to AGA research that closely) but based on the papers I've seen that has been the case. For someone who doesn't pay that much attention except looking at it once every 1-2 years, it doesn't seem like much is happening. It seems like there hasn't been significant progress in decades, though there are plenty of research questions that can be investigated.

[@Adam-M1]

So I know the hair grown back with minoxidil requires minoxidil for life to maintain. But say you had some regrowth with finasteride but chose to come off after a while, does this hair require the finasteride to stay? I understand the DHT will come back to affect the hair but was hoping to switch to natural remedies once the regrowth happens.

[@Leonhart_93]

It does require the finasteride to stay as it is, but on just minoxidil not all of it will fall off, just a portion. It takes a few months for the effects of the finasteride to disappear completely. Also, I found that you can further mitigate the lack of finasteride by using microneedling and massages to not have that tight scalp skin that might induce DHT.

[@PerfectHairHealth]

As a monotherapy, the withdrawal data after using finasteride for one year show that hair counts tend to return to baseline within 3-12 months of quitting. If your natural remedies also target 5-alpha reductase (like with the case of saw palmetto), you might be able to stretch out that timeline. But because those natural remedies are often less powerful 5-alpha reductase inhibitors, the general expectation is that some loss will occur after dropping finasteride.

[@Adam-M1]

@@PerfectHairHealth thank you kindly for your response. May be an avenue I explore.

[@Adam-M1]

@@Leonhart_93 thank you also for your response.

[@Leonhart_93]

@@Adam-M1 Keep a solid routine, it's definitely doable without expensive treatments 👍

[@Way_Of_The_Light]

I’m so glad you’re back to uploading videos regularly 😇🙏 what’s your hair growth protocol like these days now that you’re a busy family man? You still only do scalp pinching🤏 once a week while watching TV?

[@PerfectHairHealth]

Nice to reconnect! I’m still massaging a few times a week and focusing mainly on pinching. I still feel my crown remains above baseline. However, I’ve noticed gradual and globalized thinning over the last few years. I think that the massages (for responders) have a similar growth curve as minoxidil and other non-anti androgenic interventions: results peak in the first year and perhaps wane thereafter while still retaining some of the gains. I still plan to start a 5-alpha reductase inhibitor soon (have mentioned this in prior videos when asked in the comments).

[@prashanthachari8415]

if scalp is tight then then hormones (mainly DHT) might not have space to more so it may cause hair loss. i am 19 and also having grey hair, when i got hair loss at my corner of my forehead then i started to make my scalp loose then i noticed my grey hair was becoming black. the problem may be scalp , which you had mentioned in one video with joseph.

[@jemand7488]

Rob, do you still support your past theories that scalp massages can target dht, scalp tension and fibrosis as an effective treatment?

[@PerfectHairHealth]

Yes. I still think the evidence supports the idea that scalp tension might act as an accelerator of AGA, and that scalp massages might help improve AGA outcomes. For the DHT part, we also still want to conduct a case study on the effect of botulinum toxin injections on scalp DHT. It requires someone to get botox injections and measure scalp DHT levels, which can be done via hair plucking and/or scalp biopsies before and after the injections. If DHT lowers, that would offer clinical support to some of the mechanisms speculated in my first paper. Since 2017, there have also been some fascinating papers demonstrating further involvement of fibrosis in AGA than previously realized, perhaps even as a driver of AGA (rather than consequence of AGA). Check out this paper: pubmed.ncbi.nlm.nih.gov/33539849/

[@PerfectHairHealth]

That’s not how science works. I could find you thousands of people who didn’t respond to finasteride, but I wouldn’t use that to convince anyone that finasteride doesn’t work. Instead, I’d look at the clinical studies (there are 7-8 now for Botox, all indicating a ~75% response rate).

[@henryvonmatt]

Hey Rob!

[@scorpionmk325]

hey rob I am taking Finastride-1mg from 3 months on alternative days . As finastride cause shedding 1-2 months. does finastride shed only minutrized hair or thick hair? i still have hairfall, mostly falling hair is thick hair and some minutrized hair. is finastride not working for me I have NW-2. 5.

[@Gorrdn]

Update?

[@sadiqsiddiqui55]

Mu hairline hasn't moved at all... But my overall hair density have dropped significantly over last 2 years... The quality of the hairs are great, they're thick and healthy... I just don't know what the hell type of hair loss I'm having... Can you please enlighten me about this

[@PerfectHairHealth]

Have you seen a dermatologist for an assessment? Try to find one that is attached to a teaching hospital, and with recent publications on hair, skin, and nail disorders.

[@sadiqsiddiqui55]

@@PerfectHairHealth no I haven't... Those guys just want money anyhow... And they'll most definitely prescribe me minoxidil or finasteride... I've used minoxidil and it gave me zero results... Derma roller on the other hand has been somewhat effective

[@FranciscoJG]

Hey Rob You still look good :)

[@hamaf.kareem6856]

im pretty sure that someday you'll success to find something , i did what you say i've got thing thank you

[@codystuder8548]

Are you familiar with the work of Varis Ahmad?

[@MendeMaria-ej8bf]

I turned 70 and remark that my hair is more and more receding. My diet is vegetarian. No disease has been diagnosed, so I don't need medication. What do you advise? Thank you.

[@theawesomesausage]

go carnivore

[@NickDoraRaw]

If you value living, carnivore. Also skin and hair. Vegetarian and vegan lifestyle will kill you. Please stop,

[@MendeMaria-ej8bf]

@@Re-Destro For causing, preventing or healing hair loss? ☺

[@ahmed19567]

I want to start off by saying I really appreciate what you are doing and the content your putting out. My question is, for topical finasteride do you have to apply it daily or can you do it every other day?

[@hrh-xj4fh]

I do every second day with great results it builds up so every day is not nessesary my doc said i could even do it mon..wed..and friday...

[@ahmed19567]

Appreciate the advice

[@iDTecKt]

Hey Rob.... how you doing? 😅🤙

[@paulineweir6031]

You are great so much crap out there i am taking 2 mg finasteride and 5 % minoxidil on my hair …not much is happening….😢so upsetting for a woman

[@delt19]

Rob has left. Hey Rob is now born.

[@Amcwnyc9977]

🍁Why is no one talking about Capixyl 5% ?, which has no withdrawal syndrome, Make a video about this product I think it can be interesting 🤓

[@j.a.p.818]

Autoimmunity, & heavy metal toxicity factors contributing to hair loss, & the roles they may play in contributing to hair loss, maybe a more wholistic treatment option too, please.

[@sosome1]

i personally noticed the frequency of ejaculation has massive effect on hair loss. THe more you do, the more you lose. I havent ejaculated more than 40 days now and i noticed massive drop in hair loss.

[@lexwolf303]

WTF did this come from? 😂😂😂

[@madawa5526]

This is true I am personally noticed too. I think musterbation somehow link with Hair loss.

[@malachix780]

I'm pretty handsome and as a result quite bald, what he's saying must be true 😂

[@claudiacampbell6893]

Intro 😂

[@nimishgrover7637]

The only man except ALEX whom on whom I can trust blindly

[@goldi7372]

HEY ROB. Hello, your videos are really helpful, and your blog has helped me immensely with educating myself with hair loss, I have one question. My hair, like many other people's hair, has been shedding ever since covid, after doing some research I've found out that this can be caused by "long covid"is there anything that can be done about this? What I have found is not really promising, the condition is fairly new.

[@pulkitgoel7195]

I know it will sound unbelievable, my hairloss started after i started using minoxidil. Just a week and it has never been same

[@iDTecKt]

That's probably just shedding, and that means you're a good responder

[@pulkitgoel7195]

@@iDTecKt i have been using minoxidil twice daily, 1mg finasteride daily and oral minoxidil 2.5 mg daily for 4 months now. I still haven’t recovered from that hair loss

[@samali6109]

@@pulkitgoel7195 i started topical minoxidil and finasteride and was shedding for 6 months and recovered stronger than before by month 9, just hang in there, taking oral and topical minoxidil daily is definitely overdosing so not sure about your case tho ...

[@FaizanKhan-6326]

Bro.. I am juxt 19 my loosing frontal hair density and facing hairfall even on sides of hair … Scalp is getting more visible like parting my hair am also facing dandruff, itchy scalp, scalp pain, even my eyebrows are fallen out bcoz of dandruff issues 😢 what’s the matter

[@silversmurfer236]

Might be Seborrheic Dermatitis caused by SIBO.. Sibo can also cause nutritional deficiencies due to decreased Fat Soluble Vitamin absorption like Vitamin A, D, K and E, which definitely doesn‘t help your hair.

[@FaizanKhan-6326]

@@silversmurfer236 is it reversible after treatment?

[@mamma1506]

Have you had your TSH, T3, T4 and TPO (thyroid) tests done?

[@FaizanKhan-6326]

@@mamma1506 yeh, thats normal

[@Jake-oh9im]

It’s in the the name (androgenic )alopecia 😂 I know people who have sat on a forklift all there life for a job and smoked and drink most nights and are around Lorrie’s with fumes and gases from the forklift truck and still have a full set of hair. Them guys tend to not have much body hair or struggle to grow a beard.

[@aroyaliota]

Hey Rob …

[@Skaahn]

What do you think about Scube 3 as a baldness treatment?

[@johnlehew8192]

Who grew their hair back and how? Comment below. go!!!

[@IhsaanTyalor]

DHT is higher when we’re teens. It isn’t the sole cause, and saying it is confounds the issue.

[@lp1847]

Hey Rob

[@icebrow]

The Passing of time

[@Bathrezz1]

Lol that intro is a 10nner

[@adaeterno]

What I see, dht theory is legit by how many women you see with norwood 0 hairlines, while in men maybe 1 of 500 males have norwood 0.