Only Two Hair Loss Theories To Explain The Data

[Jesse Wilson]

I started thinning this year and was researching causes for hair loss. Based on my research, there are only two categories of explanations: Skull Growth and Pattern Follicle Sensitivity to effects of 5-AR.

Skull Growth

Premises for Skull Growth Argument
1. DHT causes skull enlargement (no source, but will obtain if asked).
2. Skull enlargement tightens space where blood vessels are (mechanically obvious).
3. Tighter space may result in decreased blood flow to follicles (assumption).

Conclusion of Skull Growth Argument
If there are insufficient blood vessels in the area and skull growth is large enough, then this will result in follicles not getting enough blood and going dormant.

Benefits of Skull Growth Argument
1. This explains the horseshoe pattern (always tons of blood in the horseshoe region on all humans because muscles are there).
2. This explains why the vasodilator, Minoxidil, can work for a time. It's been claimed many times in many places that other vasodiators don't work. Any information on studies where other topical vasodilators didn't work?
3. This explains why if you just use Minoxidil and then stop, you lose all the hair you would have lost if you had never taken it (because the skull kept growing while using Minoxidil - the hair will grow as much as the blood allows).
4. This explains why extracellular matrix, PRP, and botox have been shown to regrow hair - increasing blood supply.
5. This explains why Finasteride doesn't work forever... it only blocks 60% of DHT. Skull growth still occurs.
6. This explains why Minoxidil doesn't work forever... eventually the constriction will be too great from an ever growing skull.
7. Explains why women usually only start balding after menopause (that's when they produce DHT).

Problems with Skull Growth Argument
1. It's unclear how a small amount of skull growth could effect follicle blood supply so much.
2. Maybe some balding people go bald rapidly after DHT should have already peaked. Why the sudden skull growth?
3. Transplanted hairs seem to do well. How are they getting blood supply? Maybe the added tissue from the doner area helps cushion it allowing blood flow.
4. Finasteride regrows hair sometimes. Is the skull shrinking? Maybe the start of skull growth sucks up the blood supply and when it's no longer growing the blood supply returns a bit.
5. This doesn't explain why hair doesn't return in older people who eventually have skull shrinkage from age. This, however, could be explained by the scalp being clogged or just a number of things once you're that old.

Cure with Skull Growth
Unknown topical drug that greatly increases blood circulation more than Minoxidil. Unknown injection that supports blood flow. Surgery that moves blood vessels under skin to top of scalp to increase blood flow there.


Pattern Follicle Sensitivity to effects of 5-AR

Premises for Pattern Follicle Sensitivity to effects of 5-AR Argument
I couldn't figure out the argument. Please give yours. It should be better than "Nothing else makes sense."

Conclusion of Pattern Follicle Sensitivity to effects of 5-AR Argument
If genetics cause you have some follicle sensitivity to effects of 5-AR, then you will only lose hair in the sensitive areas.

Benefits of Pattern Follicle Sensitivity to effects of 5-AR Argument
1. Explains why hair transplants work. What if we transplanted hair from balding areas to the back of the head and they didn't fall out, but grew? That would be an enormous hit against this theory.
2.Explains why Finasteride works to regrow hair sometimes. The recent hair loss hasn't been damaged enough by effects of 5-AR so it recovers when 5-AR is inhibited.
3. Explains why some women have experience hair loss after menopause.

Problems with Pattern Follicle Sensitivity to effects of 5-AR Argument
1. It seems strange that the pattern lines up with blood flow, yet has nothing to do with bloodflow.
2. Doesn't explain why increased blood supply works from Minoxidil, scalp massages, extracellular matrix, PRP, and botox. Maybe it washes DHT away from the site (if that's the case, then the cure is still more blood supply and then you wonder why there wasn't enough blood supply in the first place which leads back to skull growth).
5. Doesn't explain why after stopping minoxidil, the effects go back to if you never had taken it.
5. Doesn't explain why hair doesn't return when DHT levels are reduced with age. Could be due to scalp being clogged or a host of issues that may come with age.

Cure with Pattern Follicle Sensitivity to effects of 5-AR
Unknown drugs or transplant with DHT resistant hairs or clones of DHT resistant hairs.


Thoughts
After writing this I was surprised by how little support I could find for the Pattern Follicle Sensitivity to effects of 5-AR theory. Please let me know your thoughts and supplement or counter each theory.

 

[Hairlineforever]

Good theories
About blood flow and dht ive read that dht in muscle is converted to another hormone and doesnt stay dht that could explain why the side areas arent effected
But still we need answers why transplanted hair grows on balding areas forever and if not forever at least 10 years or so

 

[Jesse Wilson]

Good theories
About blood flow and dht ive read that dht in muscle is converted to another hormone and doesnt stay dht that could explain why the side areas arent effected
But still we need answers why transplanted hair grows on balding areas forever and if not forever at least 10 years or so

This was when I was still learning a lot. I now believe that the reasons I liked the skull growth theory are no longer valid because there is "catch up" hair loss after you stop taking finasteride.

The underlying abnormality has to be present before the increase in DHT from puberty. If you read my most recent forum posts, then you'll see I know believe that hyper responsive androgen receptors are the major part of the underlying abnormality if not the direct genetic cause. My question now is if androgen receptors in the hair are programmed genetically or if something on the scalp tissue causes them to be hyper responsive. A question that transplanting hairs helps to give insight on.

What you said about muscles absorbing DHT is interesting. I'll keep that in mind as I continue to think about this issue.

So in summary, my new 3 questions are:

1. Are DPCs' (hair follicle) androgen receptors programmed genetically to be hyper sensitive or is something on the scalp tissue causing them to be hyper responsive?

2. How come too many ARs in the DPC result in hair loss when combined with DHT?

4. What causes the pattern: direct genetic expression or something more?

 

[irondude221]

The person with the worst balding in my family has a small skull.

 

[Hairlineforever]

This was when I was still learning a lot. I now believe that the reasons I liked the skull growth theory are no longer valid because there is "catch up" hair loss after you stop taking finasteride.

The underlying abnormality has to be present before the increase in DHT from puberty. If you read my most recent forum posts, then you'll see I know believe that hyper responsive androgen receptors are the major part of the underlying abnormality if not the direct genetic cause. My question now is if androgen receptors in the hair are programmed genetically or if something on the scalp tissue causes them to be hyper responsive. A question that transplanting hairs helps to give insight on.

What you said about muscles absorbing DHT is interesting. I'll keep that in mind as I continue to think about this issue.

So in summary, my new 3 questions are:

1. Are DPCs' (hair follicle) androgen receptors programmed genetically to be hyper sensitive or is something on the scalp tissue causing them to be hyper responsive?

2. How come too many ARs in the DPC result in hair loss when combined with DHT?

4. What causes the pattern: direct genetic expression or something more?

Im sorry I didnt understand this DPC
and also yes dht is somehow related but its not the main cause cause dht inhibtors would work for most people and we would see great results in people
Also with age our body produces less testoterone so less dht why then does the male pattern baldness continue
Fyi iw read in so many scientific papers that dht in muscle doesnt stay dht it gets converted right away in another hormone I forgot the name though that could explain the horseshoe pattern god knows best

 

[Armando Jose]

Did you read this study?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2536995/
Bilateral ligature of the superficial temporal arteries and of the posterior auricular arteries is proposed as a treatment for seborrheic alopecia. The arterial circulatory dynamics are, thus, replaced by capillary circulatory dynamics. Hypoxia is produced which inhibits enzymatic systems and lessens nocuous action of androgen and lipid factors on the pilosebaceous effectors. The histologic study shows that the production of sebum is greatly reduced and the condition of the hair follicle is strikingly improved.

 

[Hairlineforever]

I will read into it
And also I believed that round shaped small heads dont get bald I dont know I always saw this people with adam sandler egg shaped heads or round shaped and theyv always had a full head of hair and even juvenile hairline
If someone could show me someone with these types of head with hair loss with before and after pics that would bring me these theorie down

 

[irondude221]

I will read into it
And also I believed that round shaped small heads dont get bald I dont know I always saw this people with adam sandler egg shaped heads or round shaped and theyv always had a full head of hair and even juvenile hairline
If someone could show me someone with these types of head with hair loss with before and after pics that would bring me these theorie down

The person with the worst balding in my family literally has that shape. Round and small skull with very little height or vertical growth. Meanwhile my other 5'8 family member with a large skull (i'm guessing 23") has the best hair at 28, it's sparse and roughed up, but no one calls him bald.
Personally, I'm a 5'5 bubblehead with a 23" skull and I'm still a NW0.5/1 at almost 19.

E: I also saw a guy with a very tiny skull in college who was bald.

 

[Rudolphus]

Im sorry I didnt understand this DPC
and also yes dht is somehow related but its not the main cause cause dht inhibtors would work for most people and we would see great results in people

DHT is initial trigger which sets off a chain of events that result in miniaturization of the hair follicles. 5-ar inhibitors do work for the vast majority of users. A large-scale 4-year study on Dutasteride showed that it had a 99.4% success rate.

Also with age our body produces less testoterone so less dht why then does the male pattern baldness continue

The number of androgen receptors in the hair follicles increases with age, making the follicles more sensitive to DHT.

 

[Hairlineforever]

So why does the number of AR increase
I guess to counteract the reducing of hormone production than this can happen even if you reduct your hormones artificially like with dutasteride
Also I wish it was for everyone dutasteride effective like the data is saying but I dont believe this stuff you see and read to many horrow stories in forums and if it were so effective you wouldnt see bald people on the streets at least not a norwood 4 and up

 

[Hairlineforever]

And please can I see some proòf for that 4 year study on dutasteride

 

[Rudolphus]

Also I wish it was for everyone dutasteride effective like the data is saying but I dont believe this stuff you see and read to many horrow stories in forums and if it were so effective you wouldnt see bald people on the streets at least not a norwood 4 and up

That's because 99.9% of bald people you see on the street have probably never even heard of dutasteride. Hypothetically, if every person in this world who has male pattern baldness were to have taken dutasteride permanently from when they had the earliest signs of hair loss, there would hardly be a single balding head in sight wherever you look, and the sight of a completely bald head would be pretty much non-existent.

And please can I see some proòf for that 4 year study on dutasteride

Here is a link to the study: https://www.gsk-clinicalstudyregister.com/files2/9aa74623-1d92-4a80-8634-5a3231c37d45

 

[abcdefg]

That's because 99.9% of bald people you see on the street have probably never even heard of dutasteride. Hypothetically, if every person in this world who has male pattern baldness were to have taken dutasteride permanently from when they had the earliest signs of hair loss, there would hardly be a single balding head in sight wherever you look, and the sight of a completely bald head would be pretty much non-existent.


Here is a link to the study: https://www.gsk-clinicalstudyregister.com/files2/9aa74623-1d92-4a80-8634-5a3231c37d45

I agree dutasteride works for 99.9 percent of bald people, but im not convinced it works for them forever. I think over the years maybe more androgen receptors develop, and hair continually gets more sensitive as you get older. Eventually for a lot of men I think balding resumes at some point as sensitivity overpowers the AA

 

[Rudolphus]

I agree dutasteride works for 99.9 percent of bald people, but im not convinced it works for them forever. I think over the years maybe more androgen receptors develop, and hair continually gets more sensitive as you get older. Eventually for a lot of men I think balding resumes at some point as sensitivity overpowers the AA

I guess the way I put it was a bit exaggerated when I said "there would hardly be a single balding head in sight". Although I do think that dutasteride should be expected to be able to stop hair loss permanently for a majority of users given the fact that it inhibits 98-99% of DHT production from the 5-ar 2 enzyme. It hasn't been around long enough for there to be any reports available from people who have used it over a very long period though, so we can't really know for sure at this point in time.

 

[IdealForehead]

Just one point to add to what you're saying @Rudolphus , dutasteride does not even lower DHT in some men.

I'm one of them.

I took 0.5 mg daily for a year. Lost hair. Got my DHT tested and it was completely normal (no suppression effect). That was brand name Avodart. I went to 2.5 mg daily for a month and still DHT was unchanged.

So finasteride and dutasteride are not magic miracles for all of us. For some of us they do nothing at all.

 

[Rudolphus]

Just one point to add to what you're saying @Rudolphus , dutasteride does not even lower DHT in some men.

I'm one of them.

I took 0.5 mg daily for a year. Lost hair. Got my DHT tested and it was completely normal (no suppression effect). That was brand name Avodart. I went to 2.5 mg daily for a month and still DHT was unchanged.

So finasteride and dutasteride are not magic miracles for all of us. For some of us they do nothing at all.

That's very unusual indeed. You must be in a very, very small minority of people for whom it doesn't have any effect on DHT levels. In the four-year study I quoted, Dutasteride had a 99.4% success rate. I'm sorry it didn't work for you. Have you tried finasteride instead to see if that works for you?

 

[IdealForehead]

That's very unusual indeed. You must be in a very, very small minority of people for whom it doesn't have any effect on DHT levels. In the study I quoted, it kept 99.4% of users above baseline over a four year period. I'm sorry it didn't work for you. Have you tried finasteride instead to see if that works for you?

Yeah I did finasteride for a year previously and lost hair too. Never checked DHT levels on finasteride to confirm what was happening. Will probably do that at some point just for academic interest.

I presume I have a polymorphism in my 5-alpha reductase enzyme that prevents finasteride/dutasteride from binding to it at all.

I saw a guy in India post once on a forum many years ago complaining of the same problem. He also had his DHT checked and there was no change. We probably don't know how many of us like this there are out there because most people never have their DHT levels checked.

 

[Rudolphus]

Yeah I did finasteride for a year previously and lost hair too. Never checked DHT levels on finasteride to confirm what was happening. Will probably do that at some point just for academic interest.

I presume I have a polymorphism in my 5-alpha reductase enzyme that prevents finasteride/dutasteride from binding to it at all.

I saw a guy in India post once on a forum many years ago complaining of the same problem. He also had his DHT checked and there was no change. We probably don't know how many of us like this there are out there because most people never have their DHT levels checked.

But yeah, it's likely rare and just doubly shitty genetic luck. That's why I have to f*** around with things like RU58841 and possibly spironolactone. Maybe even enzalutimide one day.

Guys who get responses on finasteride/dutasteride are f*****g lucky in my opinion.

I'm sorry that finasteride and dutasteride did not work for you. Is RU58841 giving you results? Have you thought about trying oral minoxidil? It is risky of course, but I know people who've had a lot of success with it.

 

[rclark]

It does take time to know if something is working or not. Sometimes years.

 

[IdealForehead]

It does take time to know if something is working or not. Sometimes years.

That's one of the hardest parts of this whole process. And then by the end of that year or years if you haven't got what you want, man is it hard to swallow that lost time and Norwood.