3alpha-hydroxysteroid reductase and hair loss - a theory from Tressless

[jd_uk]

Who says baldness isn't related to a whole host of overlooked benefits. I am more than willing to bet that baldness is associated with increased male fertility and it might be associated with larger genitalia in general. Of course, we have no studies but why wouldn't baldness be related to increased androgenization and "male" fitness overall?

Can vouch for this theory. Hung like a horse.

J/k.

I saw you mention the scalp massage stuff and wanted to ask, do you believe there is benefit to it? Have others here tried it? I saw a guy on reddit say he had success with scalp massages from 20 minutes per day. I agree with you that the idea of doing 40 minutes of that a day is crazy, but 20 minutes...i mean thats more manageable if 5-10 mins is in the shower or something and another ten mins is sitting down reading or whatever. But that guy Rob shows some photos of people who've had success with it and they've gone from total diffuse thinning to full head of hair with no obvious thinning..and it's hard not to be sceptical with that. The results look like someone who has responded very well to finastedide or stronger.

 

[jd_uk]

Sweet! A half transplant will yield a full head of hair.

Guessing you don't have much faith in the scalp massage stuff?

 

[JaneyElizabeth]

Can vouch for this theory. Hung like a horse.

J/k.

I saw you mention the scalp massage stuff and wanted to ask, do you believe there is benefit to it? Have others here tried it? I saw a guy on reddit say he had success with scalp massages from 20 minutes per day. I agree with you that the idea of doing 40 minutes of that a day is crazy, but 20 minutes...i mean thats more manageable if 5-10 mins is in the shower or something and another ten mins is sitting down reading or whatever. But that guy Rob shows some photos of people who've had success with it and they've gone from total diffuse thinning to full head of hair with no obvious thinning..and it's hard not to be sceptical with that. The results look like someone who has responded very well to finastedide or stronger.

If that is for me, I also have used copious massage but I used his techniques up to my shed and they are harsh and can exacerbate or cause shedding on their own. Treatments that manipulate the area of baldness are referred to as mechanical and there are basically two, massage and microneedling. My opinion is that microneedling has far more support by studies and testing than massage but massage has a couple of positive studies. I don't think that people need do both and microneedling is far preferred since it heals scar tissue too. I sort of do both recently but I have stopped mostly with the massages because I am reaching my goals and I don't want to screw it up by a temporary shed even though it wouldn't affect my follicles' viability.

https://www.hairlosstalk.com/interact/threads/hair-is-not-life-but-its-pretty-damn-close-hrt-and-pictorial-posts-prove-it.130425/page-49

 

[Mustang]

Can dutasteride mesotherapy really be done at home? Or are you just referring to low dose topical dutasteride?

Yes, with a dermapen

I went to the clinic Dr Pelo in Madrid and had it done there. They use the same dermapen you can buy on Ebay and the same formula as published on some studies (Dutasteride, D-Panthenol etc..) . When you do it with a sterile solution (injection) it's at 3mm. Follicles are normally at 4mm.

They started recommending people to do it from home when Covid forced them to stop treatments so yes, you can do it 100% from home.

 

[jd_uk]

If that is for me, I also have used copious massage but I used his techniques up to my shed and they are harsh and can exacerbate or cause shedding on their own. Treatments that manipulate the area of baldness are referred to as mechanical and there are basically two, massage and microneedling. My opinion is that microneedling has far more support by studies and testing than massage but massage has a couple of positive studies. I don't think that people need do both and microneedling is far preferred since it heals scar tissue too. I sort of do both recently but I have stopped mostly with the massages because I am reaching my goals and I don't want to screw it up by a temporary shed even though it wouldn't affect my follicles' viability.

https://www.hairlosstalk.com/interact/threads/hair-is-not-life-but-its-pretty-damn-close-hrt-and-pictorial-posts-prove-it.130425/page-49

Yes. Was meant for you.

Oh ok, so you think that scalp massaging is likely to cause shedding and possibly make hair worse?

I've been dermarolling with 1mm per week for a few months now, and using keto 2% shampoo three times per week. Can't say I've seen any results at all from that as I'm sure people will tell me was unlikely anyway. The idea of scalp massaging is interesting because its natural...but only if it works. If it can make hair loss worse then obviously that makes me more reluctant.

The pics he shows are very impressive but it could just be total deception.

 

[pegasus2]

why?

You should tell Dr Couto to move on since those are his words. Not mine. I am sure you know more than him though.

Yes, I do know more about the mechanisms behind hair loss than any hair transplant surgeon.

So do a lot of people on this forum. Ask your hair transplant surgeon what is Glycogen Synthase Kinase 3 Beta? If he can't answer that he knows absolutely nothing about the mechanisms of Androgenetic Alopecia

 

[JaneyElizabeth]

Yes. Was meant for you.

Oh ok, so you think that scalp massaging is likely to cause shedding and possibly make hair worse?

I've been dermarolling with 1mm per week for a few months now, and using keto 2% shampoo three times per week. Can't say I've seen any results at all from that as I'm sure people will tell me was unlikely anyway. The idea of scalp massaging is interesting because its natural...but only if it works. If it can make hair loss worse then obviously that makes me more reluctant.

The pics he shows are very impressive but it could just be total deception.

Shedding doesn't mean worse so you have to distinguish between male pattern baldness hair loss and shedding. The difference in terminology (I know in common use shed is used for permanent hair loss) is that shedding occurs after we either introduce a new med or increase dosage in a med followed by shedding. This is virtually always positive but cis-guys always halt treatment when that happens. I plowed on and kept increasing dosages and my hair kept getting better and better.

I have written on my thread and elsewhere about the need for a back-up plan if people have a shed. For me, it was a wig that people seemed to react well to. For others, it might be temporary use of a system--you can always allege temporary hair loss since it is--that made you need to use a system for a while. People won't want to ask much more in case it is cancer or some other dread illness. If folks won't wear a system then get a great hat and try to make excuses for not taking it off. Blame it on dermatitis for example.

I think Rob is entirely on the level and virtuous and his site has amazing stuff free to the public. As all of us are wont to do, he might exaggerate the success rate in his mind but I have never seen him say that massage was better or equal to microneedling even though they are similar in many ways. But a huge amount of my core knowledge comes from reading all the articles on his site, all of them and he seems very, very fair to me. Things like zinc and onion juice or caffeine and castor oil, he give the big "eh" too and I think that he is right on these based on where the data lead. I have never seen him diss a treatment that I find valuable or overly tout treatments that to me seem marginal. He has admitted if I recall correctly that success with his massage methods requires the equivalent of 40 minutes daily of massage--40 minutes! Few mortals can keep up with that pace, lol. His are also a bit rough. I recommend milder massage especially of the forehead below the scalp to loosen it to potentially re-invigorate your gains.

I also got the botox masseter treatment that he recommends as possibly providing up to 18 percent in hair loss "gains". For me, it's a twofer because it makes MtF faces slimmer. Males actually chew food with much more force and they build these masseter muscles way up in size. Theoretically this pulls on the back of the scalp and causes tension hair loss at stress points like the crown and temples.

Janey

https://www.hairlosstalk.com/news/education/understanding-shedding-hair-loss-treatment/

 

[jd_uk]

Shedding doesn't mean worse so you have to distinguish between male pattern baldness hair loss and shedding. The difference in terminology (I know in common use shed is used for permanent hair loss) is that shedding occurs after we either introduce a new med or increase dosage in a med followed by shedding. This is virtually always positive but cis-guys always halt treatment when that happens. I plowed on and kept increasing dosages and my hair kept getting better and better.

I have written on my thread and elsewhere about the need for a back-up plan if people have a shed. For me, it was a wig that people seemed to react well to. For others, it might be temporary use of a system--you can always allege temporary hair loss since it is--that made you need to use a system for a while. People won't want to ask much more in case it is cancer or some other dread illness. If folks won't wear a system then get a great hat and try to make excuses for not taking it off. Blame it on dermatitis for example.

Janey

https://www.hairlosstalk.com/news/education/understanding-shedding-hair-loss-treatment/

Oh ok..but the shed can be that bad just from scalp massage alone? Amy idea at what point into a massage routine it might occur? And does this sort of shed always recover? (I once had one from minoxidil and that hair never really grew back I don't think).

I actually had two concerns about scalp massaging..one being the risk of traction alopecia from it and hair getting worse. The other being the idea of loosened skin actually making my face look worse eventually. Because it talks about stretching the skin..and at some point if you do enough skin stretching you'll gain new skin which has to go somewhere under gravity. Just wonder if it could cause any drooping of the skin on the face in future.

 

[JaneyElizabeth]

Oh ok..but the shed can be that bad just from scalp massage alone? Amy idea at what point into a massage routine it might occur? And does this sort of shed always recover? (I once had one from minoxidil and that hair never really grew back I don't think).

I actually had two concerns about scalp massaging..one being the risk of traction alopecia from it and hair getting worse. The other being the idea of loosened skin actually making my face look worse eventually. Because it talks about stretching the skin..and at some point if you do enough skin stretching you'll gain new skin which has to go somewhere under gravity. Just wonder if it could cause any drooping of the skin on the face in future.

I had added spironolactone, a powerful AA at the time that I started the massages plus I was on HRT and so I had a massive shed to baldness. But this accomplishes something very important. The body is then able to link anagen for essentially all follicles and anagen issues are much more important to baldness than hair counts are, since all follicles produce at least colorless hairs that are viable.

Well, I microneedle weekly on my face, neck and forehead too. It is remarkable in how much it can make us look younger and remove sun and age spots as well as wrinkles. As I tell the Min whiners about circles under their eyes: What? Compared to hair? You actually think eye circles matter when you are bald! Then I tell them the female trick they don't know about which is portable concealer in a lip stick tube. It costs 10 bucks and works great. You just draw it over the circles. My approach is holistic and not only based on hair loss. As my hair gets better I will start adding in things about facial improvement, scar improvement, even improvement in aging hands. Clothes matter much more for bald guys so I also focus on style and for MtF's who seek it, I try to help them feminize in a way that they can not only pass but also be viewed as attractive. I am so bad but attractive intact MtF's are in great demand by men while post-surgical MtF's tend to be less so because there is something about "she-males" or "trannies" that revs a lot of XY's up even more than a viable vulva<winks> I can say it since I am one of those, lol.

I enjoy the attention from both genders although officially I am gynephilic and more so even auto-gynephilic.

 

[jd_uk]

I had added spironolactone, a powerful AA at the time that I started the massages plus I was on HRT and so I had a massive shed to baldness. But this accomplishes something very important. The body is then able to link anagen for essentially all follicles and anagen issues are much more important to baldness than hair counts are, since all follicles produce at least colorless hairs that are viable.

Well, I microneedle weekly on my face, neck and forehead too. It is remarkable in how much it can make us look younger and remove sun and age spots as well as wrinkles. As I tell the Min whiners about circles under their eyes: What? Compared to hair? You actually think eye circles matter when you are bald! Then I tell them the female trick they don't know about which is portable concealer in a lip stick tube. It costs 10 bucks and works great. You just draw it over the circles. My approach is holistic and not only based on hair loss. As my hair gets better I will start adding in things about facial improvement, scar improvement, even improvement in aging hands. Clothes matter much more for bald guys so I also focus on style and for MtF's who seek it, I try to help them feminize in a way that they can not only pass but also be viewed as attractive. I am so bad but attractive intact MtF's are in great demand by men while post-surgical MtF's tend to be less so because there is something about "she-males" or "trannies" that revs a lot of XY's up even more than a viable vulva<winks> I can say it since I am one of those, lol.

I enjoy the attention from both genders although officially I am gynephilic and more so even auto-gynephilic.

Ah ok, so hard to tell then I guess if scalp massage alone can cause a big shed.

Yeaj I heard that microneedling of the gace can help with wrinkles. I'm talking more about whether excess skin can be created by stretching massage exercises and whether it can then cause saginess of the skin in the face.

I'm siding with massaging being BS really for hair loss..just curious because of the people who say they got big results with it. Of course I don't know if they're just helping sell Rob's product.

 

[JaneyElizabeth]

Ah ok, so hard to tell then I guess if scalp massage alone can cause a big shed.

Yeaj I heard that microneedling of the gace can help with wrinkles. I'm talking more about whether excess skin can be created by stretching massage exercises and whether it can then cause saginess of the skin in the face.

I'm siding with massaging being BS really for hair loss..just curious because of the people who say they got big results with it. Of course I don't know if they're just helping sell Rob's product.

I would not say BS but this is one of those things that might work for a few other people but you are likely not one of those people. So the people that it works for come forward while others don't and who knows what the hit/fail ratio is.

I don't want to be one of those people who say something is good for everything but microneedling might very likely tighten loose skin, I think that I have seen improvement in my neck area so maybe after two years of weekly DR, you will too but who knows? We are all using different needles and pressure amounts but from what I have heard, as long as you microneedle you are likely to see rejuvenation/regeneration effects.

The other thing as someone was discussing with me quick loss of improvement after stopping derma-rolling and this might be due to the fact that DHT doesn't so much seem to cause baldness as to be a trigger to the system perhaps to commence baldness. The inflammation effects of DHT are likely because it produces more sebum which increases normally commensal bacteria and yeast colonies that excrete on our faces and heads and our skin can't clear enough of it and hence inflammation results.

 

[jd_uk]

I would not say BS but this is one of those things that might work for a few other people but you are likely not one of those people. So the people that it works for come forward while others don't and who knows what the hit/fail ratio is.

I don't want to be one of those people who say something is good for everything but microneedling might very likely tighten loose skin, I think that I have seen improvement in my neck area so maybe after two years of weekly DR, you will too but who knows? We are all using different needles and pressure amounts but from what I have heard, as long as you microneedle you are likely to see rejuvenation/regeneration effects.

The other thing as someone was discussing with me quick loss of improvement after stopping derma-rolling and this might be due to the fact that DHT doesn't so much seem to cause baldness as to be a trigger to the system perhaps to commence baldness. The inflammation effects of DHT are likely because it produces more sebum which increases normally commensal bacteria and yeast colonies that excrete on our faces and heads and our skin can't clear enough of it and hence inflammation results.

Yeah makes sense (regarding likelihood of it working).

I don't have any loose skin currently..was just concerned with that being a long term side effect of scalp massaging given the talk of stretching the skin every day.

Do you mean that people see increased hair loss when they stop microneedling?

 

[JaneyElizabeth]

Yeah makes sense (regarding likelihood of it working).

I don't have any loose skin currently..was just concerned with that being a long term side effect of scalp massaging given the talk of stretching the skin every day.

Do you mean that people see increased hair loss when they stop microneedling?

It seems to (not shed) fall out really, really quickly when one desists. If it isn't DHT actually causing follicular damage, because it doesn't seem to, then we struggle to identify the cascade of factors involved in male pattern baldness. I don't know the dosage of increase in DHT over life but it might peak at 50, say and with those amounts, the signalling increase to implement baldness by the body goes into over-drive and it all falls out like in a month or two, not even in the years, that it used to take. This is also likely related to an immediate and huge drop in the length of the anagen phase which in a sense, implements the signal from DHT to drastically halt hair production.

So this is the question deriving from all of this: Why are XY caucasian bodies so geared towards the production of beard follicles for life and concomitantly to the destruction of hair follicles? We can't blame it on DHT say, clogging anything on its own. But DHT probably signals much more production of sebum which leads to over-colonization by yeast and bacteria, which leads to toxic by-products that women can handle but men cannot because the sebum drives the endless circle of colonies that drive inflammation and also male pattern baldness which is either associated with inflammation or actually caused by it indirectly through the sebum food chain. If this is correct as a hypothesis then it shows just how important it is to halt all inflammation as quickly and as permanently as is possible whenever it arises as a secondary check on male pattern baldness in addition to lowering levels of DHT.

I am uncertain how many of the guys who report all but immediate hair loss upon desisting are on either finasteride/Duta but it might be pointless to microneedle one's scalp without duta or finasteride to at least hold back some/most of the signalling.

 

[Jakejr]

As I remember Rob has a full head of hair. So he is astute, but he’s like the Bob Lazar of male pattern baldness. He has his carbon dioxide theory, his mitochondrial energy theory & this whole scalp massage business. I’ve tried all of them & concluded as far as scalp massage.. I’ve seen the videos, I bought a growband, I’ve has several electric models, I’ve done it by hand.. After few months I sold them all. For scalp massage I just use a scalp brush I got from Virtue shampoo & it works better than the rest. Microneedling makes more sense & you can do it yourself. It’s no panacea however, but I do it several times a week. I wouldn’t pay much attention to people with full heads of hair trying to lecture on male pattern baldness.

 

[JaneyElizabeth]

As I remember Rob has a full head of hair. So he is astute, but he’s like the Bob Lazar of male pattern baldness. He has his carbon dioxide theory, his mitochondrial energy theory & this whole scalp massage business. I’ve tried all of them & concluded as far as scalp massage.. I’ve seen the videos, I bought a growband, I’ve has several electric models, I’ve done it by hand.. After few months I sold them all. For scalp massage I just use a scalp brush I got from Virtue shampoo & it works better than the rest. Microneedling makes more sense & you can do it yourself. It’s no panacea however, but I do it several times a week. I wouldn’t pay much attention to people with full heads of hair trying to lecture on male pattern baldness.

Lol. I only read his articles and his published studies and I rarely if ever disagree but he is a salesman. The only thing that semi offends me is that he clearly tries often to act like he is one of our bald fellow homies with male pattern baldness to .sort of ingratiate himself into the baldness club which I care zero about with a lot of chatter about his 25 cent piece size baldness which could be covered by about $200 of grafts in about ten minutes, lol. But I think his analytical skills apart from that are top level. Hopefully mine are similar but I read for the data points and science and not for encouragement or discouragement either way. I probably started both HRT and microneedling based upon his articles and I still often refer back to them. I use higher doses than he recommends but I went through both articles on oral min for men and women and everything he says is correct and if he doesn't know how high is safe, he is virtually always giving risk adverse advice such as not going higher than 5mg of oral min for men.

 

[Armando Jose]

toxic by-products that women can handle but men cannot

IMHO hair lenght, density and thickness hair is a crucial point to avoid problems with sebum flow.

https://www.jstor.org/stable/20421401?refreqid=excelsior%3Aae5d4b23b167eada0cc58c091b6c4d16&seq=1

 

[Jakejr]

Huh?

 

[fugged]

re: massages and scalp tension/fibrosis/calcification.. I really don't know. Rob clearly doesn't have bad hair loss but maybe on the vertex he caught it early. It is so polygenetic everyone is different. I did major massage after becoming interested about 2 years ago and it blew out most of my weak hair.. felt really good though and also led to the exfoliation a weird hard skin layer for lack of better description.. The hair is slowly recovering, but I had sort of stopped massage for a long time in exchange for needling. I will say, on the exact areas I have the most struggling/minaturtized follicles, my scalp is very, VERY tight and difficult to push together with two hands and "pinch", whereas it is very easy elsewhere.. So it does resonate personally that that skin/scalp difference and its thickness/tightness is related. I'm back to trying pinch type massage and seems somewhat positive, in my case anyway.

 

[Finasteridegyno]

Alopecia is caused by inflammation, not DHT.

All androgens cause inflammation.

Inflammation reduces bloodflow and nutrients to the follicle. A hair follicle or graft is an organ that dies without proper oxygen and blood.

If you block DHT you reduce inflammation, if you block T you reduce inflammation. If you use minoxidil you increase blood flow despite having inflammation and the same with laser level therapy. The more things you do the better.

The big 4. Dutasteride Mesotherapy, finasteride/dutasteride, minoxidil and laser level light. You can expect the same results as these 2 guys posted above. It will halt and reverse hair loss on 90% of guys. The rest will need CB or RU being sensitive to T.

There is not one cure to reduce inflammation. Everything helps.

Basically every cortison reduce inflammation but they don’t work against AA....

 

[Mustang]

" Evidence and implications of inflammation as a characteristic feature of MPHL and FPHL are highlighted through evaluation of clinical and quantitative data. Comparable results suggest the presence of significant perifollicular inflammatory infiltrates, such as lymphocytes and histiocytes, as well as the involvement of inflammatory genes, such as CASP7 and TNF, in the presentation of MPHL and FPHL. Resurfacing of the inflammatory aspect in MPHL and FPHL pathogenesis will advance future developments in MPHL and FPHL therapeutic options."

" In a related study, biopsy specimens obtained from over 400 patients with MPHL and FPHL were used to evaluate the presence of perifollicular inflammation with results indicating that approximately 71% of the MPHL and FPHL specimen samples exhibited inflammation"

"Inflammatory infiltrates have been characterized and suggested in the pathogenesis of MPHL and FPHL as observed by an increase in lymphocytes.17 Immunohistochemical analysis of biopsies obtained from 3 males and 1 female with progressive alopecia revealed follicular infiltration of CD4+ T-cells at the bulge of the hair follicle while control specimen showed a sparse number of T cells.17 This study concluded that infiltration of inflammatory T-cells at the follicular bulge may be the culprit of the impaired hair cycle and successive hair loss in MPHL and FPHL. Similar evaluation of the role of the inflammatory process in the onset of MPHL was conducted using biopsy specimens from 19 MPHL patients and compared to 6 control subjects.18 Histopathology of the specimens revealed significant lymphocytic infiltrates in the MPHL patients in comparison to the control subjects. More recently, the role of inflammation in FPHL was studied using scalp biopsies from 52 women with female pattern hair loss.19 Lymphocytic folliculitis was observed in the obtained biopsies, indicating the presence of inflammation and suggesting lymphocytic infiltrations as a histological feature of MPHL and FPHL"

"The inflammatory role in the pathogenesis of MPHL and FPHL is supported by clinical, histological, and sequencing findings. Perifollicular infiltration of inflammatory cells such as lymphocytes, histocytes, and mast cells is exhibited in biopsy samples of MPHL and FPHL patients. Significant follicular infiltration of CD4+ T-cells has also been observed as a source for impairment of the hair cycle and the consequential hair loss in MPHL and FPHL. RNA sequencing data signifies differential expression of inflammatory genes in MPHL pathogenesis. Conclusively, these findings suggest inflammation is elemental to MPHL and FPHL pathology and reinforce the need to address inflammation in prospective therapeutic developments. "

"We review evidence supporting and challenging dihydrotestosterone’s causal relationship with androgenic alopecia, then propose an evidence-based pathogenesis model that attempts to answer the above questions, account for additionally-suspected androgenic alopecia mediators, identify rate-limiting recovery factors, and elucidate better treatment targets. The hypothesis argues that: (1) chronic scalp tension transmitted from the galea aponeurotica induces an inflammatory response in androgenic alopecia-prone tissues; (2) dihydrotestosterone increases in androgenic alopecia-prone tissues as part of this inflammatory response; and (3) dihydrotestosterone does not directly miniaturize hair follicles. Rather, dihydrotestosterone is a co-mediator of tissue dermal sheath thickening, perifollicular fibrosis, and calcification – three chronic, progressive conditions concomitant with androgenic alopecia progression. These conditions remodel androgenic alopecia-prone tissues – restricting follicle growth space, oxygen, and nutrient supply – leading to the slow, persistent hair follicle miniaturization characterized in androgenic alopecia."

"Biopsies from men with androgenetic alopecia showed a similar pattern of inflammation and immunoreactant deposition. Serologic assessment for antibodies to androgen receptor, estrogen receptor or cytokeratin 15 were negative. Combined modality therapy with minocycline and topical steroids along with red light produced consistent good results in the positive immunoreactant group compared to the negative immunoreactant group.

Conclusion: A lymphocytic microfolliculitis targeting the bulge epithelium along with deposits of epithelial basement membrane zone immunoreactants are frequent findings in androgenetic alopecia"

The studies go on and on and on and on ............

But let's listen to a 25 year old forum kid who knows more than all hair transplant surgeons in the world.

Quite a bold statement. I wonder what powers he has to know exactly what every single doctor has studied and their knowledge about the mechanisms of hair loss.