The many strange ways you can regrow long lost hair!

We’ve all been told to preserve what hair we have by being proactive… well I never did that and didn’t care for almost 2 decades as I continued to become increasingly bald. This has led me to investigate various methods of hair recovery and their efficacy. Some of the items listed here are very well known and established; primarily listed merely to be thorough.

Other items are more novel and unquantified clinically. Largely the success of various chemicals and applications varies between individuals; age, gender, ethnicity, genetics, etc. all play some role in hair recovery.

1. Minoxidil

In extensive AA (more than 75% scalp involvement), 5% MS demonstrated 81% terminal hair regrowth versus 38% in 1% MS group.54 Moreover, Olsen et al demonstrated that a combination of prior systemic corticosteroid use (for more than 6 weeks) followed by 2% MS application (three times daily) provided a better outcome with persistent hair growth than without the combination.55

2. Minoxidil + Microneedling

(1) Hair counts – The mean change in hair count at week 12 was significantly greater for the Microneedling group compared to the Minoxidil group (91.4 vs 22.2 respectively). (2) Investigator evaluation – Forty patients in Microneedling group had +2 to +3 response on 7-point visual analogue scale, while none showed the same response in the Minoxidil group. (3) Patient evaluation – In the Microneedling group, 41 (82%) patients reported more than 50% improvement versus only 2 (4.5%) patients in the Minoxidil group. Unsatisfied patients to conventional therapy for AGA got good response with Microneedling treatment.

3. Estradiol / Transgender

We believe that the mechanism responsible for achieving scalp hair regrowth in transgender women is the suppression of testosterone to normal female levels. In our experience, this usually requires therapy with both spironolactone and estradiol. However, if transgender women treated with estrogen alone can achieve testosterone at normal female levels, we would expect to see scalp hair regrowth in these patients as well. Furthermore, it would be interesting to determine whether more scalp hair regrowth occurs over time as this patient continues hormone therapy.

This less than scientific article is interesting in regards to the theory of calcification rather than a focus exclusively on DHT as the cause of hair loss:

The short-answer: hair regrowth from male-to-female hormone replacement therapy likely has less to do with eliminating DHT… and more to do with hormone replacement therapy’s one-two punch: eliminating DHT + increasing estrogen. The end-result: 1) potential (small) skull bone structural changes, and 2) the likely atrophy of scalp muscles, both of which may lead to the relief of chronic scalp tension — the very tension that is the precursor to scalp inflammation that kicks off the DHT-hair loss cascade. When this chronic scalp tension disappears, hair begins to regrow.

In regards to the efficacy of Estradiol coupled with low DHT/Testosterone, I’ve had castration levels of androgens and mid to high levels of Estradiol/Estrone for at least several months (started HRT roughly 6 months ago). This did lead to a dramatic increase in hair on the head which was long lost… however it has not led to a full recovery yet. Realistically I started at Norwood 7 and have recovered to Norwood 5 in 6 months. Without microneedling and minoxidil I believe I have little to no hope of a full recovery. Namely the frontal hair loss is much harder to recover. Top/back of the head hair has almost completely recovered.

4. Finasteride

Results: Finasteride treatment improved scalp hair by all evaluation techniques at 1 and 2 years (P < .001 vs placebo, all comparisons). Clinically significant increases in hair count (baseline = 876 hairs), measured in a 1-inch diameter circular area (5.1 cm2) of balding vertex scalp, were observed with finasteride treatment (107 and 138 hairs vs placebo at 1 and 2 years, respectively; P < .001). Treatment with placebo resulted in progressive hair loss. Patients’ self-assessment demonstrated that finasteride treatment slowed hair loss, increased hair growth, and improved appearance of hair. These improvements were corroborated by investigator assessments and assessments of photographs. Adverse effects were minimal.

5. Dutasteride

Results: Ninety men with androgenetic alopecia were recruited. The increase in total hair count per cm[2] representing new growth was significantly higher in dutasteride group (baseline- 223 hair; at 24 weeks- 246 hair) compared to finasteride group (baseline- 227 hair; at 24 weeks- 231 hair). The decrease in thin hair count per cm[2] suggestive of reversal of miniaturization was significantly higher in dutasteride group (baseline- 65 hair; at 24 weeks- 57 hair) compared to finasteride group (baseline- 67 hair; at 24 weeks- 66 hair). Both the groups showed a similar side effect profile with sexual dysfunction being the most common and reversible side effect.

6. Retinol

Topical all-trans-retinoic acid (tretinoin) alone and in combination with 0.5% minoxidil has been tested for the promotion of hair growth in 56 subjects with androgenetic alopecia. After 1 year, the combination of topical tretinoin with 0.5% minoxidil resulted in terminal hair regrowth in 66% of the subjects studied. Tretinoin was shown to stimulate some hair regrowth in approximately 58% of the subjects studied. One female subject with pronounced alopecia for more than 20 years had regrowth of hair using only tretinoin for a period of 18 months. Tretinoin has been shown to promote and regulate cell proliferation and differentiation in the epithelium and may promote vascular proliferation. These factors are important for hair growth promotion. These preliminary results indicate that more work should be done on the role of retinoids in hair growth. The synergistic effect of retinoids in combination with a low concentration of minoxidil should also be further investigated.

7. Stem Cells (Experimental)

In total, 23 weeks after the last treatment with HFSCs mean hair count and hair density increases (Figure 4D) over baseline values (Figure 4A). In particular, a 29%±5% increase in hair density for the treated area and less than a 1% increase in hair density for the placebo area. At the baseline, no statistical differences in hair count or hair density existed between the HFSCs treatment area and control area of the scalp.

In this preliminary report, we showed the clinical effect of the injection of scalp tissue suspension. However, we hypothesize that stem cells can improve the formation of new follicles, but this hypothesis must be demonstrated in a following study.

8. Novel History of Scalping / Abrading the Skull

Robertson’s first experience with treating a scalping victim was in 1777. The patient was scalped so “nearly the whole of his head skinned.” Dr. Vance was treating the man but could not remain for a prolonged period of time so instructed Robertson in the art of skull boring. Vance demonstrated how to bore holes as the skull became black. Robertson described the method, “I have found that a flat pointed straight awl is the best instrument to bore with, as the skull is thick, and somewhat difficult to penetrate. When the awl is nearly through, this instrument should be borne more lightly upon. The time to quit boring is when a reddish fluid appears on the point of the awl. I bore, at first, about one inch apart, and, as the flesh appears to rise in those holes, I bore a number more between the first.”[9] Besides boring holes in the skull the wound had to be cleaned and dressed at least once a day to prevent infection. The patient recovered from the scalping.

Apparently, the success rate for this treatment was very good. The scalped head, according to Robertson, “cures very slowly” and the average recovery period was two years. Remarkably, Robertson reported that hair would even grow back, although not as thickly, on the new scalp. The patient would regain feeling once the new skin grew sufficiently to attach to the edge of the uninjured part of the original flesh remaining on the skull.

9. Hair Transplantation

Hair transplantation is one of the most rapidly evolving procedures in aesthetic surgery, accompanied by regular improvement in techniques. The recent advances in technology and the concept of using follicular unit grafts have made this procedure reach a new height. The ability to provide very natural-looking results has encouraged larger number of balding men and women to opt for this surgical solution.

10. Dr Powers Hair Loss Remedy

I have been gradually messing with this serum over a few years. I’ve been trying to add more and more medicines which are known to facilitate hair growth, and battling with supersaturation. It previously had 20% minoxidil but it crashed out of solution when it got even slightly below room temp. This is currently the best iteration of it, but I tend to continue to improve it over time, stealing little bits from other magic hair creams that I can find scientific basis for.

11. My Theory Regarding a Cause and Cure for Androgenetic Alopecia

Accompanying the finasteride, I use a topical synthetic VDR agonist (activator) called calcipotriene. This is my main weapon for increasing localised VDR activation and upregulation in the scalp to compliment supplemental cholecalciferol and magnesium (among other cofactors). This is prescription-only (in Australia), but very tame and easy to get when I asked my doctor. It’s often used to treat psoriasis – an ailment of reduced VDR activation. I usually try to do this twice a week as it’s messy so I time it with a Nizoral shampoo (see below for why). I’m not sure whether I will increase that frequency or not as I’ve only been taking it for about five months. Calcipotriene is still a relatively crude calcitriol-derivative, in that it still has a lot of the same calcemic qualities of calcitriol and can cause (if used in way, way higher dosages than I do) toxicity. But there are new, improved synthetics coming out all the time. Fingers crossed one comes out soon that is not prohibitively expensive, has no risk of hypercalcaemia and a ridiculously long half-life!

Finally, one thing I started taking early on was 150mg of the ubiquinol form of co-enzyme-Q10 daily. It was the first sort of mitochondrial supplement I had ever taken, and I cannot stress the difference this made enough. Anecdotally, in the last few years I have had about 5-10 people (including my own father and close friends) ask me if I’ve started dying my hair. It’s that much darker. Also, important to note, all these comments came long before finasteride or calcipotriene. On top of this I also take 20mg PQQ, 500mg nicotinamide (B3) and 1.5g acetyl-L-carnitine each day for mitochondrial health, but it’s too early to tell if these have had any effect on hair – though I can definitely say I have more energy day to day.

12. Nutrition

If there is a nutritional deficiency of vitamins / proteins / minerals, it can lead to hair loss; however, as pointed out in this NCBI research article; without a deficiency, the efficacy is low or questionable.

There is very limited research on the role of nutrient supplementation in the absence of deficiency. Despite this, patients often seek nutrient supplements as a treatment for hair loss. In fact, direct-to-consumer advertising promotes the use of supplements for hair loss, and many such products, containing a wide variety of formulations, are easily available for purchase.

Physicians must counsel their patients on the lack of research supporting these products. Since supplements are not regulated by the FDA, it is up to the physician and the consumer to review the efficacy and safety of supplements. Websites such as the Natural Medicines Comprehensive Database [76] or the National Institutes of Health Office of Dietary Supplements’ PubMed Dietary Supplement Subset [77] and Dietary Supplements Ingredient Database [78] may be of help in this exploration. Equally important is a discussion of the potential toxicity of some of these supplements. Over-supplementation of some nutrients may result in multiple toxicities, while over-supplementation of certain nutrients, including vitamin A, vitamin E, and selenium, may actually result in hair loss.

13. Blood Flow

Overall hair loss is caused by follicles receiving insufficient oxygen and nutrients. DHT is thought to miniaturize the follicles; retracting them from access to blood vessels. Without access to a sufficient blood supply, the terminal hairs miniaturize. This citation really nails down how important vascularization is to terminal hair growth.

A female patient, 8 years of age, presented with baldness of the right scalp following deep scalds from boiling soup landing on the head, neck, and chest. The depth of the burn was severe enough to cause baldness. She was primarily advised to wear a wig to address the problem of baldness on one side. Surgery was planned to use uninjured scalp skin to offer hairy skin coverage of the bald site. A left scalp skin flap (2.5 by 7 cm) based on the superficial temporal artery and vein was transferred to the bald area, with microvascular anastomosis to the superficial temporal vessels on the right side. There was complete survival of the flap with uneventful recovery and satisfactory growth of hair. Hair growth from the flap was comparatively thicker than from the rest of the scalp. This microvascular flap has produced sufficient hair to cover the entire area of the baldness and the patient does not need to wear a wig.

14. Head Massage

Unfortunately this particular citation was very short term; however, as with most increases in hair count, it is preceded necessarily by shedding as new, thicker hairs replace the old ones.

Hair number decreased in the massage area at 12 weeks after initiation of standardized scalp massage. Some telogen hair in the massage area might have fallen by scalp massage and decrease in the number of hair occurred temporarily. On the contrary, hair thickness increased significantly at 24 weeks after initiation of standardized scalp massage. Improvement in blood flow is one possible explanation for hair thickness improvement as previously reported 10

15. Severe Burns

Effect of scalp burns on common male pattern baldness
A 78 year old man with common male pattern baldness was dozing in his armchair when he fell head first into a coal fire. He sustained full thickness burns to the left parietotemporal region, the bridge of the nose, and the left ifraorbital area. He refused hospital admission and early surgery and was consequently man as an outpatient. Two weeks later he commented that his bald patch had started to grow hair again, and over the next four months this hair continued to grow. Although interesting, it is -difficult to see how this type of stimulation could be applied therapeutically.
R BUCKLAND, G R WILSON, L suLLY, Burns Unit, City Hospital,
Nottingham NG5 1PB.

Leave a Reply

Your email address will not be published. Required fields are marked *