This episode I chat all things hair-loss with Dr Ben Behnam Board Certified Dermatologist specialising in medical hair loss management. Dr Ben is a dedicated hair loss and hair restoration specialist working alongside his brother Dr Sean Behnam Board Certified Hair Transplant Surgeon in their Hollywood practice. Together they founded HappyHead.com which focusses on providing customisable prescription grade topical solutions for men and women.
Did you know that even the most lustrous, voluminous hair could be affected by the hormonal fluctuations of the Menopause transition? Put this together with a genetic predisposition to female pattern baldness and ‘sprinkle on’ some of the stressors we encounter in mid-life, and you may find yourself shedding hair left, right and centre. Join us to get the heads up on hair loss!
listen while you boost your vitamin D levels in the great outdoors or chillax with a hair mask and hot bath.
Dr Ben tells me that “a lot of people are genetically predisposed to losing their hair, but it may be that there are other factors that accelerate that underlying tendency. “I have a lot of patients that come and see me in their 30s and they look amazing, and I know they’re going to keep their hair unless something happens.”
Factors that influence hair loss include:
1 stress. It could be a major stress like a car accident, ill health, divorce or low level insidious daily stresses we encounter at home or work. It is worth considering stress reduction strategies like spending time in nature, meditating or exercising to combat stress.
2 Daily shampooing. Dr Ben says” shower by all means, just don’t wash your hair with shampoo every day”. He recommends we reduce hair washing to around three times a week for reduced shedding. He encourages conditioning and advises “not to wrestle with hair; avoid wrapping a towel tight around your head or overly vigorous brushing.
Dr Ben’s Four Pillars of supplementation to combat Hair Loss
1. Taking vitamin D every day in the region of 1000 – 2000iu
2. A regular multivitamin Dr Ben typically suggests a prenatal multivitamin.
3. Adding collagen into your diet just one scoop of day and drink it mixed with tea or coffee, and finally
4. Iron: Adult Women need 18mg of Iron per day. Food sources include spinach, beans, lentils, soybeans, chicken liver, lean beef and oysters.
Dr Ben says “I have some female patients that come in and honestly all we do is put them on protein, collagen and vitamins, I review them 4-5 months later and they tell me they’re much better even without using any prescription drugs”.
Hair is made of Protein!
Vegetarians and vegans should be extra vigilant to ensure adequate protein in the diet and could consider supplementing. Increase the protein in your diet, for example adding more cashews, chicken, lean red meat and walnuts. You could try adding protein powder to your smoothie. Add a scoop of Collagen powder too for an added boost for skin, hair, and nails. There are two types of protein powder, the protein concentrate version and the isolate. In fact, whey protein isolate could contribute to hair loss so opt for the whey protein concentrate.
Supplements to avoid
If you are building muscle mass and supplementing with creatine, It is worth knowing that creatine raises testosterone levels and this alone can increase shedding of hair.
Healthy Scalp, Healthy Hair
As a dermatologist what can you tell us about the scalp? “A healthy scalp is important, and a lot of people come to me worried about their dry flaking scalp. This is dandruff which is usually caused by a fungus and can result in thick scaly inflammatory lesions on the scalp.
These patients may have more hair loss so in those situations we must take control of the inflammation. Dr Ben says, “you will have better hair growth and less fallout if we reduce inflammation”. This could be treated using anti-fungal shampoo. Just apply for five minutes then wash it out. By reducing the inflammation and thus the flakiness it improves scalp health.
If there’s a lot of inflammation, then a dermatologist may prescribe a steroid preparation to be applied topically directly to the scalp.
A favourite shampoo?
Just like body building where you work different muscle groups you shouldn’t use the same shampoo on your scalp everyday because your scalp will get used to it. Consider alternating a couple of different shampoos.
Help is available
Dr Ben says that things are a changing in hair restoration medicine. Only 7 years ago we were seeing 90% males that only 10% females in our practice but over the past five years the mix is changing. It could be that social media has helped to shift the taboo around female pattern hair loss. The great news is that people are talking about hair loss, there is less embarrassment and now we can have this conversation about treatment options.
Where do I begin?
Advice from a certified professional is a great starting point. Dr Ben says “patients don’t know what they need but they know they have a problem and they come to me for advice. On the other hand, some patients come with ideas of what they want but perhaps that’s not the right thing so I will always present all the options.
I always begin with simple nutritional, supplementation, and general haircare advice if necessary, explore the options for medical hair loss treatment, injectables and hair transplantation where appropriate.
The cascade of intervention
1. Topicals
A preparation applied to the skin of the scalp is an option to enhance hair health, popular products include Rogaine anti-hair loss treatment.
Inflammation of the scalp can be treated through prescription of a topical steroid such as clobetasol. Use a dropper to dispense and massage into your scalp twice a day every day for about 2 weeks. By reducing inflammation and improving the health of the scalp you can have better, healthier hair.
2 Oral Medication
Being over 50 is an advantage when it comes to some prescription medications for female pattern hair loss. For females above 50 Oral finasteride very effective and Dr Ben says “I’m a very big fan of it and I usually recommended guys typically take 1 milligram, but females could take as much as 2.5 milligrams. For the most part it is a pretty safe medication.
The FDA highlighted a possible risk of anxiety and depression and I discuss this with my patients. These side effects are quite rare and most of my female patients do well. However there is an alternative to tablets with a topical finasteride that has been shown to be as effective as the oral medication.
For Women under 50 I can recommend spironolactone; it’s a very commonly used drug for acne but it can be great for hair loss in females. Again, this is boosting the hair growth by blocking testosterone. I have thousands of patients on it and people do well.
There was a large study by UCLA at that demonstrated its effectiveness, of those taking it 50% maintained their hair and 50% regrew hair. So, for someone in their 20s or 30s losing hair spironolactone could be worth considering. Patients should be reminded to avoid foods high in potassium and please avoid getting pregnant while you are on it.
3. Injectables
Botox for hair loss?
There is some evidence to support using Botox on the scalp. Studies suggest It acts on the basis of scalp tension theory, where increased tension in the muscles of the scalp constricts the blood vessels leading to a reduced blood flow thereby cutting off the nutrient supply and contributing to hair loss. Stressful experiences can contribute to this scalp tension and
By injecting Botox in the scalp, you create relaxation of the muscles, releasing pressure on blood vessels, increasing blood flow and in turn boosting nutrient supply. This is a simplification, but I have patients that I treat this way with some success.
Non surgical approaches
The derma roller is a micro needling roller that has tiny needles that you can gently roll over the scalp to increase blood flow. While it’s tempting to buy your own dermaroller, it’s much safer to leave these devices in the hands of a licensed and experienced professional for your hair loss treatment. A licensed micro needling professional will know how to help you assess risks minimise side effects from treatment and treat any complications.
There is also a treatment called a HydraFacial, hydrating, exfoliating, cleansing, and stimulating blood flow. It could well offer some rejuvenating properties and certainly sounds like a relaxing treat.
Secrets for successful hair restoration
A holistic approach to health using a variety of complementary approaches in a personalised care plan is more likely to offer success. Dr Ben recommends we start by reducing:
Stress
Processed foods
Alcohol
Vaping
Smoking
To summarise:
Support hair with vitamins and Protein.
Wash hair three times a week with a selection of shampoos.
Avoid overly vigorous hair brushing and tight turbans!
Treat your scalp to a facial every now and again.
and did I mention manage stress!
Contributors
Dr Ben Behnam for all your hair restoration support.
Phillipa Butler Physiotherapist, Pilates, Yoga teacher and Host
Disclaimer: Please note that any advice we provide in this podcast is for information only, and if you are unsure of its suitability for your specific circumstances, you should consult your medical practitioner if you have any specific health concerns.
