Stuff You Should Know - Hair Loss: The Pits
Episode Date: April 15, 2021Losing your hair is a situation that seems to be universally considered to absolutely stink. Unsurprisingly, humans have been trying all sorts of weird stuff to combat hair loss for millennia, but we�...��re only just now starting to get a handle on it. Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.
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Welcome to Stuff You Should Know, a production of iHeart Radio.
Hey and welcome to the podcast. I'm Josh Kewball-Clark. There's Charles W.
Mr. Clean Bryant and Jerry Sinead O'Connor rolling. Rounded out for Stuff You Should Know,
the hair loss edition. Remember when Sinead O'Connor, when everyone got mad because she ripped up a
picture of the Pope to protest Catholic Church? Yeah, we talked about this like a couple of
weeks ago. Did we? Yeah. Did we? Yeah. Say it again. There you go. You're going up an octave each
time. That's pretty impressive. I don't remember that. Oh boy. We talked about Sinead Live Sketch,
where Frank Sinatra had her on and the other discussant stuff. Of course, the great Phil
Hartman as chairman of the board. But Sinead O'Connor wasn't losing her hair. She made a
conscious decision to basically stick it to the establishment and say, hey, I'm shaving my head.
Yeah. And you know, I know that we haven't seen each other, but I'm starting to get a little thin
on the crown after my hair being like my only decent defining feature as a man for many years.
Sure. It's starting to thin out a little on the crown. I mean, it happens. Mine's been doing that
for a little while. It is distressing at first, and then you just get used to it, especially when
it plateaus for a while. Mine's in a plateau stage, and I'm like, okay, I can live. Let's
just hold here. We're okay holding here. But yeah, it's a thing for sure. It's not the
funnest thing in the world to realize your hair's thinning. Yeah. I mean, I'm not doing anything
about it, certainly, because I don't know. I just, I don't have that kind of vanity. I have other
kinds of vanity, but it's, and I don't see it. So I was talking to Noel about it on movie crush,
and he was like, you just got to back out of every room you walk into. That is good advice.
That's like hair club level advice. Yeah. But I'll, I mean, I'll just, you know,
I've had, I've shaved my hair about once a year anyway, so I'm fine to live that life too.
Yeah. And I mean, it just, it happens. It's one thing that like really kind of came through
in researching hair loss is like, there's really nothing wrong with it. It's not medically debilitating
in most cases. We should say pattern baldness. The far and away, the most frequent reason people
lose their hair, both men and women. There's nothing wrong with you. There's no disease. There's no,
there's no problem with your metabolic functioning, nothing like that. It's strictly cultural,
like cultural norms and preferences of beauty. That's it. That's the only thing. You're just kind
of involuntary, violating beauty norms of your culture. And if the rest of the culture can just
get over it, which they generally do, you can get over it too. And that's that. And I've just dug
my own grave because now I'm going to have to take my own medicine and get over it. I'm sure
all my hair is going to fall out in the next hour. No, it's not. But you know, we're going to cover
types of hair loss and also some remedies. And we'll get into the couple of sort of prescription
remedies that they have found over the years, which really hit me today more than ever,
sort of how cruelly it's, one of them at least is, which is like, hey, if you're a young and single
man and you're starting to lose your hair and you're worried about, you know, attracting ladies,
we have something for you. And it might give you erectile dysfunction and you might not be
interested in sex, but you'll have your hair back. You're going to have some hair, baby.
Like, man, what a, what a weird, cruel trade-off. I know chemistry, give a thing, chemistry, take
it away. So I guess that was a spoiler, but I think most people know that and know what we're
talking about. Yeah, we'll get into that in a little while. But first, I think we should talk
about, if we're talking about hair loss, which we are talking about hair loss, we should talk about
how hair grows in the first place, because it is just part of the natural order of things that
your hair falls out. There's like three stages of hair growth that applies not just to human hair,
but also to animal fur too, because don't forget, you are an animal too human. And so we have the
same three stages of growth, shrinkage, and then resting. That's basically the broad strokes of
them, but it's a little more interesting in the details. Yeah, I mean, I kind of linked,
I kind of thought of it as little gremlins under your scalp with little knitting gremlins.
And when you're in that antigen phase, A-N-A-G-E-N, that is when your hair is growing. And cells
are forming a little protein root at the base of every little hair follicle that produces hair.
And that's when those gremlins are down there knitting the hair, and they're continuously
knitting. Like, you know, when hair is growing out of a follicle, they're just hard at work,
and it just keeps going and keeps going, and you're cutting it, and they keep sending it through
that chute, and everything's great. Yeah, and like that, those gremlins basically form an organ.
Each of your hair follicles is basically an organ, and there's a lot of stuff going on down there.
There's a lot of growth factors and proteins working, and cells being converted from stem cells
into epithelial cells. And the follicle is lined with muscles that are pushing the hair up as new
hair cells are formed. It's pretty interesting stuff. And this phase that you're talking about,
where the gremlins are really working in overdrive, is called the antigen phase,
and it lasts anywhere from two to six years for your hair. And you get hair cut so often,
we used to before the pandemic, that you don't think like a single hair that you're getting cut,
like every, you know, six, eight weeks, however often you go in, is trying to grow out for like
six straight years, but you keep cutting it. It must be very frustrating for the hair follicle.
Must be. The next phase is basically gremlins go on vacation. This is the, I guess, the
catagen phase. And at some point, this little protein cells, this matrix at the root of the
hair follicle is going to run dry. The follicle stops growing new hair cells. And those gremlins
are taking some time off. And that hair strand though, it's not like that hair falls out immediately.
It still is getting kind of pushed through. And you think it's growing, almost said it's
growing. It's not, it's not growing anymore, but it's just being kind of pushed through to the
very end. And finally, it just pop goes through. And that's it for that hair and that follicle.
Right. And so that, that happens. I didn't even give him point in time. I think there's like,
oh, I saw the percentage. I can't remember it now, but there's like somewhere, I think maybe six
percent of your hair is in that catagen phase at any given point in time. And you lose something
like 50 to 100 hairs a day off of your head. Totally normal. Those are just hairs that have
reached that catagen phase and finally got pushed all the way out. And I guess between
the hair we lose and the dead skin cells that we slough off of our, our epidermis every day,
if you could manage to sweep it all together into a little pile, it'd weigh about 1.5 grams every
day of hair and, hair and dead skin. You're losing weight. But imagine if you could like,
you know, collect that and really get a pretty good pile going after a few months, you know?
I don't think, well, I think there are some people who might do stuff like that.
Sure there are. There's, there are definitely, there's somebody who does everything and there's
probably also some, there's somebody who's turned on by the idea of that as well out there too.
So hats off to you guys. The dead skin cell collectors and the dead skin cell kink kinks.
Yeah. It's a kink. What about the last? Yeah, for sure. We don't judge. What about the last,
as long as you're not harming anybody, right? That's right. What is the last phase? Because
there's a third phase too, that this is really like the resting phase where it's kind of regrouping,
like the gremlins are laying around, they're spent, they're exhausted, they're catching their breath.
Basically, that's the, I mean, I think their vacation is kind of winding down at this point
during the telegen phase and that, like you said, that's dormant. The follicle is sort of resting,
those gremlins are resting. They're forming and they're getting those needle sharp again to those
knitting needle sharp, which in the body means they're forming a new protein matrix and they're
getting ready to punch the clock and go back to work and that dormancy is a few weeks. They get
a few weeks, maybe a few months off before it kicks off in that antigen phase all over again.
Yeah. What's interesting is, you know, hair loss has been viewed as basically cosmetic,
like, you know, almost all cultures, I couldn't find any that seemed to like really have no opinions
about it. It seems like all cultures view hair loss as sucking, right? But in the West, it's viewed
as a cosmetic problem. So there hasn't been like a ton of research into it, certainly very little
government funded research into it. I'm surprised. I am too, but it was explained in something I
read that it's just cosmetic. It's like TS that happens, get over it. But in the East,
in Asian countries in particular, it's a much less frequent occurrence, but it's picking up.
And they think because of a more hectic, unhealthy lifestyle, more Asian men like China, Korea,
Japan are losing their hair, especially in a younger age. And that is a big deal in those
cultures. And so there's a lot more government funding that's being put into it in the last
decade or so. But the interesting thing that stuck out to me is that we are learning about
how hair grows by doing research on how to prevent hair loss. And we know less about how hair grows
than I realized. So basically, everything we said is a pretty good understanding, but there's
still a lot of different components to the whole thing that science doesn't fully understand that
we probably will have a better grasp on them in the next 10 to 20 years from hair loss research.
Yeah, I think it's Asian heritage and African heritage. And it seems like there was one more.
Native American? Native American, right. They, I think they suffer hair loss less frequently.
Yeah, from what I saw, it's Caucasian white and African American tend to be the two dominant
groups for hair loss, but far and away, white men lose their hair more than any other group.
Well, that's why I was surprised that there wasn't more research, even though it's cosmetic.
Right. Because it's largely white men. I was like, well, we need to get on this right now,
gentlemen. It's happening to white men. Do I have to repeat myself? Yeah, that's a great point.
Should we, let's take a break here and we'll, is that good with you?
Yeah, yeah, I think that's a great idea. Okay, I know that it's funny we get emails where people
want us to come to blows over taking breaks or not. I know. Do you guys ever get mad and not
want to take a break? Like, not really. Huh, huh? Do you? All right. Well, we will take a break then
since Josh agreed and only because he agreed and we'll come back and talk about some of the
less common causes of hair loss right after this.
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Okay. So Chuck, you've heard the word alopecia before, right?
Yeah, for sure. So anytime I've heard alopecia, it's in reference to the condition that I didn't
realize, but it makes sense, is an autoimmune disorder where you have no hair whatsoever,
no eyebrows, no head hair, no hair on your legs anywhere. But it turns out that all hair loss,
scientifically speaking, of any kind, including thinning of the hair that you and I have,
is considered alopecia. And alopecia actually comes from the Greek for the Greek word fox,
which makes tons of sense, right? I thought that was kind of interesting. Supposedly,
in ancient Greece, there were some foxes that could get a type of mange that caused them to lose
hair and big patches. And okay, just that's where the word came from. I'm not sure how it got
transferred to humans, but the ancient Greeks marched to the beat of their own drummer.
I think somebody was being droll and said, oh, that's fox-like. Oh, really?
That's what I'm getting from. And I know it was Hippocrates that popularized it, so.
That guy. Yeah, that guy. That guy. Were you doing, what were we doing, the shadows?
Yeah, but you got to go, that deathing guy. I know you're rewatching that, right?
Yes. It's so good. It's a good time, isn't it? Yes, it is. So there are a few, like you said,
it means any kind of hair loss. So obviously, there are a few different kinds, but alopecia
areata, that is the autoimmune condition specifically that's going to fool your body into
attacking its own healthy cells because it's an autoimmune condition. And especially the
hair follicles in this case. And if you have alopecia areata, you're going to lose hair in
patches. If you lose all the hair on your scalp, that's alopecia totalis. And then I think what
you were talking about, there is the most severe condition where someone doesn't have any hair
on their body at all. I can't remember the actor's name. Who, Hank from Barry? I don't know who that
is. From Barry? Oh, Barry. Yeah, remember Hank the gangster? You know, I didn't only watch the
little bit of the first season of Barry, which one was Hank? Hank was the super lovable, like
murderous psychopath who is like the, I can't remember if they're Ukrainian. I think they're
Ukrainian, right? It doesn't need like work for the Ukrainian mob? I don't know, man. I didn't get
far enough into Barry. You met Hank, I promise. All right. I don't know if that's the actor I'm
talking about, but there is a famous actor who suffers from alopecia universalis. And that's
the one where you don't have any hair on your body. Right. But again, like any kind of hair loss
medically speaking is referred to as alopecia. That is correct. And so alopecia, like I was
saying, it's a autoimmune disorder and they're working on it, but it's basically, they don't
really have much of a cure for it right now. And the same goes from what I understand for
another condition that has to do with hair loss called telogen effluvium. And fortunately for
people who have telogen effluvium, that hair loss is kind of temporary, but really interestingly,
it can come as the result of like a profound emotional hardship.
Yeah, it could be a life trauma or something. If you're suffering from any kind of traumatic
event, that could be the case. And this is when basically the gremlins are, they're on like
erasmith, they're on permanent vacation. And it is stuck in the dormant phase for basically longer,
I guess semi permanent vacation, because like you said, it is temporary, but it's stuck in that
phase for longer than usual. And you know, it could be anything, you could have a big surgery
that was stressful or given birth or any sort of, I mean, there could be just a traumatic emotional
event in your life that kicks us off. Yeah, and when your hair is in a normal cycle of growth,
like I said, there's constantly hair that's in the the the catagen phase, that resting phase,
or the telogen phase, the super resting phase, or the re re re re grouping phase, I guess.
And then more, most of them are in the antigen phase. With telogen effluvium, you've got the same
cycle going on, it's just they stay in that catagen phase longer. So there's less hair coming out
at any given point in time or growing out at any given point in time. So it seems thinner.
But again, it's just temporary. Once you your body kind of goes back to its previous normal or
normal or baseline emotional state, it can it can be fine. This can also come about from a thyroid
deficiency, or an iron deficiency. And both of those things are involved, thyroid growth hormone
and iron are involved in cell division. Remember, you talked about the gremlins working over time.
Well, one of the things they're doing is growing cells, dividing cells very, very quickly to turn
them into hair that's growing. And so if those two things aren't feeding this hair growth,
that can cause this telogen effluvium to. That's right. And then of course, there's chemotherapy.
Anyone who's ever had a family member or themselves been through the really powerful medications you
have to endure with chemotherapy that can also lead to temporary hair loss. And you know, it's
targeting cancer cells, but it's also targeting hair cells, because what they're trying to do is
stop the fast growing cells and the hair cells are among those. So it is one of the unfortunate
side effects of chemotherapy. But again, temporary and, you know, our heart goes out to anyone that's
had to go through chemotherapy. It's really rough. And most of us have probably seen it through
someone that they know pretty closely. And hair loss can be a big, a big, big part of it.
Yeah. And then there's androgenetic alopecia. And this is the one that is far and away the type
of hair loss that most people suffer, both men and women. It's called male pattern baldness is
another word for it. But there's also pattern baldness for women as well. It's just that again,
if you're a white man, the chances are that you have some form of, or some degree, I should say,
of androgenetic alopecia. Yeah, I think it's about 40% of anyone who suffers from pattern
pattern baldness are women. But it's not talked about as much. I think, and it's not like it's
only 10%. I mean, 40% is substantial, but it's usually not as severe. So and it happens in a
different way, which we'll get to. But so it may not be as noticeable to others. And I think,
and that just with probably male bias is the reason why you don't hear pattern baldness
talked about for women as much. I think you're exactly right for sure. Plus also,
I mean, the basis of it too seems to have to do with male sex hormones. So it seems like it's
more directed toward males in general as well. Well, yeah. So what's the deal with that?
So androgenetic refers to the Greek root word andr for man. And what it's really talking about
are androgens, which are sex hormones. And in particular, one of the culprits is a form of
testosterone called dihydrotestosterone, which is like testosterone on testosterone, basically.
When testosterone comes in contact with something called five alpha reductase,
which is some sort of enzyme that you can find in muscle tissue, it gets converted into this
dihydrotestosterone DHT. Yeah. I feel like we talked about this. Was it in the male puberty?
Maybe? Probably. I would guess either that or ballpoint pens. One of those too. You know,
it's funny as you were saying that I was trying to think of a funny one. And then there you had it
under control. Nice. Thanks. One of us always has it under control. And if neither one of us do,
then we're in big trouble. Yeah. That's when it's time to go away.
So this DHT stuff, this is the weird thing. There is a general understanding that dihydrotestosterone
has to do with pattern baldness, whether in males or females. But it's not exactly understood
how it produces pattern baldness. We just know and have known since I believe the late 1940s
that if you have pattern baldness, you have a higher concentration of DHT in your scalp
than people who don't have pattern baldness. So that seems like a pretty big clue.
Yeah. And the reason it happens to both men and women is because both men and women produce
testosterone. I think most people know this, but if you didn't pay attention in biology class,
you may not know that women produce testosterone in their ovaries and just not as much as men,
obviously. So they have lower levels of testosterone, lower levels of DHT as a result. And so that's
why A, they're in the minority as far as suffering from pattern baldness and why it happens to a
lesser degree when it does happen. Right. But it's a really weird paradox that dihydrotestosterone
would produce pattern baldness because we actually need it to produce pubic hair and armpit hair.
Right. So you wouldn't have either of those. If you have a DHT deficiency or a testosterone
deficiency, you have less pubic hair or armpit hair and you don't develop those types of hair
until you start to develop testosterone and then in turn DHT after you reach puberty.
Head hair has nothing to do with DHT and yet at some point later in life, DHT for some reason
starts to accumulate in the, in the scalps of a lot of people and it actually causes hair loss
rather than hair growth, which at the very least you'd think, you know, what if, what if it converted
our hair into pubic hair later in life? That would be hilarious, especially in the areas,
in the same pattern that you bald, what if that just got replaced with pubic hair?
Hey, that'd be pretty sweet. It'd be the 1970s all over again.
It would be. It'd be awesome.
You wouldn't have to be Mike Brady getting that, that, that tight curl going.
Love that, man.
I remember that smell, man. I don't know if, I don't know if your mom ever did that,
but my mom would get the perm, the at-home perm every now and then for a few years in the 70s
and that smell, for some reason, you know how you just tied, tie these things together in your brain?
She was doing it one night while the circus of the stars was on.
So to this day, I can't think of the circus of the stars without thinking of that smell of that
home berm.
Yeah. I guess it's better than elephant poop.
Sure.
I always, I associate, well, the smell of elephant poop is not pleasant.
There's the berm.
I know it's, I think the perms probably worse than elephant poop, at least elephant poop is
like an organic smell. This is just straight chemical nightmare, you know?
I always associate pizza hut home delivery with solid gold because my parents would,
if they were going out on a Saturday night, you know, they'd be getting ready and they just order
pizza hut or something for us kids to eat and we would sit there and watch solid gold and eat pizza hut.
So funny, man. I always thought even as a kid too, it was funny that they called it a perm
because it wasn't permanent and I learned it stood for permanent and I remember being
11 and saying like, they should call it a temp.
Glaven.
Yeah, getting beat up on the playground probably.
While we were all standing around talking about perms.
Or yeah, or being the most popular kid at your experimental middle school, high school.
Perhaps.
So back to DHT, we should point out that that was discovered in 1949.
This anatomist named James Hamilton discovered the role or I guess uncovered the role of DHT
in pattern baldness. So that was a big step forward as far as kind of getting a semi-understanding.
Yeah. So what they think happens, think, we still don't understand it, is that
testosterone comes in contact with that five alpha reductase in those muscles that push the
hair up in the follicles and that in those follicles, it's converted to DHT. And then for
some reason, somehow, some way, the DHT shrinks the hair follicle and the hair follicle stays
in the antigen, the growth phase, far less frequently, produces thinner, less robust hair
and then eventually just stops functioning at all. Yeah. Yeah, enough of this DHT stuff.
I used to enjoy this neighborhood and now the DHT came along and I don't like it.
He always wants to fight and push people around and talk about how much he can lift.
And you want to come to his CrossFit class because he'll show you what real working out is all about.
Yeah. And his dad's an attorney and he'll sue you for all the money you got.
Yeah, exactly. He's just a general pain.
So, if you recognize the name, if you suffer from pattern baldness, you probably have done a lot of
research and the name Hamilton might seem familiar because he is also one of the cats
who identified first those stages of the pattern balding and it's called the Hamilton-Norwood
scale. Sure. So, you've probably heard the Hamilton-Norwood scale. That is when...
Really? Huh? Yeah. I mean, I think if you start to, if you have an internet connection and you
start to lose your hair, you probably find out pretty quickly. But it's not just like something
people talk about. Okay. Unless it's people that are all suffering hair loss and they're
all talking about where they are on the scale. It's not like the Bristol stool scale, which
everybody knows about. No. Or the... What is it? The Scoville hot pepper thing? Right. Right. Yeah.
Not commonplace like that. Right. But the common pattern that emerged that was recognized by Hamilton
and I don't even know. Who was Norwood? Do you know? Norwood was Mr. Glenn Norwood. I can't even
make this joke of anywhere. I'm just gonna stop here. All right. Let's edit that one out. Yeah.
So, the common pattern is you get an M sort of at the front of your hairline at your forehead.
The upper corners start to recede and you might hear it call a receding hairline and it sort of
looks like the letter M because like the little Eddie Munster, it kind of comes to a point
and then goes in on the sides and that's step one. I think it's a very handsome look.
It sure can. The M hairline, receding hairline is, I think it's sharp.
No, I do. And I haven't, you know, mine went straight to the crown. I don't really have...
Same here. Much of the receding hairline up front, but that's what's next is the bald spot on the
crown or the vertex of the head and the idea is in the cruelest possible form is the crown
is losing it, the forehead is losing it and they say, hey, why don't we meet in the middle and talk
about this? Yeah. And that's what happened. They creep the crown creeps forward and the hairline
creeps backward and eventually they meet in the middle and they go, hey, it's nice to meet you.
Let's go on vacation forever and then you have no hair on the top of your head and if you let
all your hair grow that's still there, you're going to have that hair on the sides and in the back
because it's weird, but it just, it doesn't affect the sides in the back of the hair in the same way.
The follicles are different. You basically, you go from Gene Hackman in the French connection
to Gene Hackman in absolute power and then eventually if it keeps going, you end up as Gene
Hackman in Superman. Okay. And then eventually the royal tandem bombs and then you retire.
But so there's also this possible outcome of the M receding hairline meeting up with the bald
spot on the crown in that there's a little island tuft of hair in the forehead that was like the
dip or the lowest point of the M or the downward point of the M that got left behind. So you still
have a little cute little tintin patch of hair right there. That is a possible outcome of this,
but more likely than not, you're going to end up with just that ring of hair kind of like
Patrick Stewart in Star Trek, the next generation. Yeah. And again, it's because the hair on the
sides, the follicles on the sides in the back are naturally DHT resistant. Even if you have that
pattern baldness, it's, you know, it's just a shame it wasn't reversed because maybe it would be
different, but you know, people, it is a hairstyle to shave the sides in the back and to have the
faux hawker, the mo hawker, the sort of military looking cut. There is no hairstyle that is male
pattern baldness. I mean, you can, you can grow it out and rock it kind of like Phil Collins did for
a while in the 80s. And that, and that's fine, man. We're not yucking anyone's yum. But if it were
somehow reversed, I don't think it would be as big of a deal. Like if you lost your hair on the sides
and in the back, you know, or would it be culturally shifted to where that was like, oh boy.
Yeah. That's, that's exactly what happened because everybody's always got to have a problem with
something on everybody else. Is that what it is? Yeah. Yeah. I think it'd be bad either way. But I
think, I think you're right. Phil Collins managed to rock it out. I think Bruce Willis did a great
job with it as well. Yeah. And he went, he started shaving pretty early on too. He just went with
it. Eventually, but he still had the stubble. He didn't go like straight up like, you know,
just like Jeff Bezos or anything like that. Yeah. He eventually did like Travolta now, like
props to Travolta for finally giving in and, and getting rid. I mean, I think he,
he probably had hair plugs, which we'll get to, or at the very least, whatever, you know,
we'll talk about the newer treatments. Yeah. And it's one of those things where there's certain
male actors where when you compare photos of them today to photos of them 15 years ago,
and they have more hair now, it's one of those things where you're like, all right,
it's the Jeremy Pippin effect. Like, I think we know what's happening here.
Sure. And, you know, especially if you're an actor, that is your, I mean, it may be harder to
just embrace the like, all right, I'll just shave my head thing, because you may think you may not
work as much or something, or you may not be appropriate for certain kinds of roles you want
to get. So, you know, I could see them tying it into work somehow. And certainly, actors are not
historically short on ego. So that plays a part as well.
Sure. I was reading a BBC article in the interview to actor named James Nezbit,
who's fairly well known. And he credited his hair restoration with basically restoration of his
career. He started getting parts again that he was getting passed over for. He said his confidence
went up. And I mean, more power to you. If you want to do something about your hair loss, that's
fine. If you want to go to the Travoltaway, that's fine too. But yeah, I mean, that's,
I think people who, who are like, yeah, there's before and after pictures, like there's a very
famous one of Elon Musk in his PayPal days. He was young, very young when he started to thin
pretty dramatically. And then now if you look at Elon Musk, he has a beautiful full head of hair.
And I think he cares exactly bagel of whether you realize that he got hair plugs or not,
because he's got hair again. Well, he knows what crazy. He probably invented some treatment that
only he is privy to. That's right. That's right. But then if you look at Jeff Bezos,
he went the other way. He's definitely got a few bucks that he could spend on that,
I would guess. And he decided not to, which I'm surprised by actually. He seems like the type
who would go full like Bob Ross maybe. Yeah. I mean, he could have an underground illegal scalp
farm for all we know that he's mining. Right. It has nothing to do with hair growth.
Yeah. He's looking to sell that stuff. They'll deliver it to your porch via drone one day.
Right. Something like robot just drops a bloody scalp on your porch and a big thud.
There you go. Put it on. I didn't order this. Put it on. Bezos through the drone watching you
tremble. So that is male pattern baldness. With women, if they suffer from pattern baldness,
it is going to be not as predictable. It's not like male pattern baldness in that the thinning
kind of happens more everywhere. It's not like it just happens from front to back and then you lose
all your hair in that U shape, that kind of horseshoe pattern. It is much slower than male pattern
balding. And again, it's because they have low testosterone and low DHT as a result.
But again, it's 40% of women or I'm sorry, 40% of pattern baldness are women who suffer from it.
And it is the thing. A woman's hair is very important to their esteem and their body image.
So when a woman's hair starts thinning and falling out, it is just as traumatic.
Oh, I would say more. I would argue much more in the last set list.
Yeah, maybe so. I mean, it is certainly not, and maybe more so because there's not as much
attention paid and maybe like, hey, is anyone even listening that this is an issue?
Well, I think women are unfairly held to even more beauty standards than men, you know?
Oh, yeah. Like guys can be like, you shave your head. Who cares? It's fine.
Yeah, exactly.
That's a cool look.
Yeah. Women also have their own scale, the Ludwig scale, or if you want to get fancy,
the Ludwig scale. They have type one to three and apparently the thinning is tracked on the
Ludwig scale along the natural part. And you know, type one to three is just different
degrees of how thin it is along the natural part of the woman's hair.
That's right. Should we take another break?
Yeah, let's take a break and then we'll come back and talk about all of the things people
have been doing for thousands of years to combat hair loss.
What advice would Lance Bass and my favorite boy bands give me in this situation?
If you do, you've come to the right place because I'm here to help.
This, I promise you.
Oh, God.
Seriously, I swear.
And you won't have to send an SOS because I'll be there for you.
Oh, man.
And so my husband, Michael.
Um, hey, that's me.
Yep. We know that, Michael.
And a different hot, sexy teen crush boy bander each week to guide you through life step by step.
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Kids, relationships, life in general can get messy.
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I'm Mangesh Atikular.
And to be honest, I don't believe in astrology.
But from the moment I was born, it's been a part of my life.
In India, it's like smoking.
You might not smoke, but you're going to get secondhand astrology.
And lately, I've been wondering if the universe has been trying to tell me to stop running and
pay attention because maybe there is magic in the stars if you're willing to look for it.
So I rounded up some friends and we dove in and let me tell you, it got weird fast.
Tantric curses, Major League Baseball teams, canceled marriages, K-pop.
But just when I thought I had to handle on this sweet and curious show about astrology,
my whole world came crashing down.
The situation doesn't look good.
There is risk to father.
And my whole view on astrology, it changed.
Whether you're a skeptic or a believer, I think your ideas are going to change too.
Listen to Skyline Drive and the iHeartRadio app, Apple Podcast, or wherever you get your podcasts.
All right.
So this is one thing I know for a fact.
If you are a young man and you are wondering if this is in your future,
just look at your mom's dad and you've solved the problem.
So that is a myth?
Allegedly.
Yes.
I'm being coy.
Oh, you will hurt.
Man, you're just an amazing actor.
You always say you're not and you really are.
Allegedly.
I mean, I don't think they've said outright it has nothing to do with it, right?
No, there was a German study from 2005 that actually found there's a little bit on the X chromosome
that bald men share in common.
So it's possible because you get your X chromosome from your mom
and there's a 50% chance that the X chromosome came from your grandfather.
That's where the basis of that old myth came from.
It may be true.
But what they seem to be thinking is that there's way more genes involved
than say just one on the X chromosome that are involved in pattern baldness.
But the upshot of it is if you really want to know whether you're going to go bald
or your chances of going bald, how many bald men are there in your family?
That's really what you should be thinking.
Like on both sides.
Just start looking at old family albums and maybe pour yourself a drink.
Sure to steady your nerves.
Yeah.
I mean, we have pretty good hair in my family.
My brother, he has this legendary thick black wavy hair.
It's just infuriating.
It should get a trophy of some sort.
But like my grandfather, my mom's dad, he died with a big thick head of curly hair
and my uncles and my mom's brothers both have really robust hair still.
My brother does.
My dad's, I'm pretty much my dad.
I mean, my dad now is 80-ish and he started thinning on the crown quite a few years ago.
And it's pretty thin on top, but it never went away on top.
It's just pretty thin.
My dad did the same thing.
It's like he's got a pretty decent circle you can calibrate a compass by.
But it is like, it's stayed.
He's going to be 83 this year.
And it's just, it's stayed.
He's still got hair in between his forehead and the crown of his head.
He's got it on the sides.
So I anticipate mine will probably be similar
because I'm tracking a very similar pattern that he, he tracked as well.
That's right.
Yeah.
I even have a same haircut these days.
As your dad?
Yeah, from the 70s.
Is it pretty long right now?
Yeah, it's pretty, it's pretty long and thick.
Yeah, which is good.
It's good.
I'm happy with it.
But I definitely have that bald spot just like, just like dear old dad has.
Well, I had been, I had shaved my head, I think more than ever before
in lockdown over the past year.
I shaved it fully, I think three times.
And then did a couple of sort of drunken late night,
completely bald on the sides, sort of Hawkeye and the Blast of Enders movie look.
Okay.
And it was kind of cool.
I kind of liked it.
Cool.
I have not been doing anything experimental with my hair.
Actually, Yumi's been doing a good job of keeping me from looking like totally shaggy.
She's pretty good at cutting hair.
Yeah.
That's good.
Yeah.
And definitely like shaving the neck that gets kind of burly back there.
But I haven't, I haven't shaved my head in years and years and years.
It's just not a very good look for me.
I don't know.
I liked it.
I never did.
I never liked pictures of me.
Yeah, especially the shaved head with glasses.
I'm like, boy, I saw an old picture of us the other day that was,
I'll just say it was pretty funny.
And I was going to Instagram and I was like,
Josh, you'd be really mad if I Instagram this.
Oh, yeah, would I?
Oh, it just wasn't your best look.
You've come a long way, baby.
Oh, I'm not.
I'm not shy about that kind of thing.
I know I used to look like a monster.
No, I'm an Adonis though.
So who cares?
So again, look at the pictures of all your family.
I think it does increase with age.
If you're a white man, about 20% of us are going to experience some sort of pattern
involving in your 20s.
And that's, you know, that can be rough if you're in your 20s
and you start to lose your hair.
30% in your 30s and then so on and so on.
I think women, I think usually see it later,
usually in their 40s and 50s.
And menopause can actually kick it off for women.
Right, because again, hair growth and sex hormones are very much tied together.
Yeah.
So any fluctuation, weirdness, any sudden change,
all of that stuff can have some sort of effect on your hair growth or hair loss.
So that must mean if you have like tons of testosterone
and you're that dude, you must be really, really bald super early, right?
Right.
No, wait, no, that's actually...
You keep being coy.
You keep getting me.
That's another myth, right?
Yeah, there's supposedly people who are bald,
have no more testosterone levels in their body in general
than people who have a full head of hair.
So we're busting myths all over the place, Chuck.
Well, why don't we talk about some of these...
It's always fun, saw bone style, to talk about some antiquated medical practices.
In the 1550s BC, Egyptians would...
Everyone's always been rubbing stuff on their head to see if they could regrow it.
It was hippopotamus fat, porcupine hair they would boil in water.
They would grind up donkey hooves and rub that into their scalp.
Yeah, and then that was on the Ebers papyrus,
which I think we talked about in the ethnobotany episode, yeah.
And then about 1100 or so years later,
our buddy Hippocrates shows back up,
makes the comparison with foxes with mange, which is not very pleasant.
And then also says, hey, get your hands on some opium and horseradish.
Get some pigeon poop and some beets and spices,
like he's suddenly Colonel Sanders or something.
Smoked the opium.
Put it all together right, yeah.
And then there you go, you're fine after that.
You don't care about your hair loss anymore.
That's right.
And then put it all together and rub it on your head.
And apparently he also said, you know what?
Court eunuchs tend to have really nice hair,
which I've never seen.
I've always seen them bald.
But he said, if you have really bad hair loss,
just go ahead and castrate yourself and there you go.
I'm Hippocrates.
Go ahead and base all medical science after my teachings.
About 1000 AD, there was a Celtic remedy for,
you had to hunt down a raven, burn it, and then mix up those ashes
and render it with some sheep fat and rub that on your head.
Right.
And then, of course, the Kellogg brothers,
I don't think it wouldn't surprise me if they had a machine,
but they were very Kellogg-like machines by the 20th century,
where I think there was one called the Crossley Cervac,
that if you look at a picture of this,
it is very Kellogg-like.
It's a, you know, this big machine,
and you would sit with like a bowl on your head
that it was connected to.
And I think it would supposedly try and literally suck hair
from your scalp.
Yeah, apparently Fred Astaire had one.
And I mean, the Crossley company still to this day
has on their blog a little article about it.
And they say that, you know, it worked,
seemed to really work.
Something about it worked,
but they're not exactly sure why.
There's another thing called the thermo cap that used like heat
and blue light.
And I know there's one today called the capillus,
which uses some sort of maybe red or infrared light.
And there's a class action suit against capillus right now
because they have a claim that it's clinically proven to regrow hair.
And apparently that clinically proven is based on a single 2014
clinical trial that was sponsored by capillus.
So somebody who tried spent 700 bucks on a capillus system
is suing them and a bunch of other people have joined.
As far as real things that work,
we mentioned at the onset of the show,
there are a couple of drugs that have were sort of accidental.
And in this, so far as the side effect they found,
was that it helped regrow hair and Mendoxadil active ingredient
and Rogaine is one of them in the 80s.
It was developed as a blood pressure medication
and it's a vasodilator.
So it's going to enlarge blood vessels.
And they think that what it does is enlarge hair follicles
that are shrinking due to that pattern baldness and just slows
that process down and it works pretty good.
I think supposedly it depends on what you're after.
Like I think they say hair regrowth because that's what you want.
You want to start early and stop it in its tracks and try to regrow some.
So for hair regrowth, it was found to be very effective
and only 16% effective or moderately effective in 69%,
which is pretty good.
Of men you should say.
Yeah, of men and then ineffective in 16%.
I think for women 19% reported moderate hair regrowth with Mendoxadil.
And that's just for hair on the top of your head.
It has apparently zero effect on the hair on the side of your head.
Yeah, like that crown, if that's where you're losing it
and you get in there early with that Rogaine,
you might want to give that a shot.
Yeah, and they think basically it's just opening up the blood supply to those
withering hair follicles and gets those gremlins working again.
That's right.
Makes sense.
There's also Finasteride, which was originally under the trade name Propecia.
I think the patent ran out on it and I think by now,
if not Mendoxadil definitely did because that was Rogaine.
One of the two is not in the patent phase any longer,
but it was originally developed to shrink in large prostates
because it's a five alpha reductase inhibitor.
And in large prostates are the result of dihydrotestosterone.
So Rogaine or Finasteride basically inhibits five alpha reductase
from converting testosterone into dihydrotestosterone or DHT.
So that would reduce hair loss because there's less DHT in the hair follicles.
Right.
And Finasteride is, I think Rogaine's a foam like hair mousse.
Or maybe like a gel, a liquid too.
And then Finasteride like we don't know.
And then, I'm just kidding, I actually did buy some Rogaine.
I used it for like two weeks and I was like,
I'm not going to do this for the rest of my life.
Yeah, well that's the thing.
And I just stopped.
You got, we should say like both Mendoxadil and Finasteride have to be used
for forever, for as long as you want to keep trying to work on your hair.
Yeah, I ran out.
And it was just one of those things.
I have a hard time doing a thing every day anyway.
And I was like, they just did not last.
So I've got three or four things.
If anyone wants some free Rogaine, I'll send it to them.
Oh, that's nice of you.
I'll just mail you my leftover things.
I'm sure that's nice.
If it's over the counter, I think we're okay legally speaking.
And one more thing about Finasteride, Chuck,
is it's like you were saying it produces erectile dysfunction and loss of interest in sex in men.
And then in animal studies, it produced birth defects in male genitalia for pregnant animals.
So that's been kind of extended to pregnant women, human women saying,
like if you don't get anywhere near Finasteride,
because it may produce birth defects in your baby.
I did not know that.
Well, one of the reasons you did not know that is because apparently there was a 1998 lawsuit
against Merck.
And this judge in Brooklyn, Judge Brian Kogan, allowed these documents,
Merck internal documents to be sealed that basically said,
yeah, we're well aware of this and we can't let this get out because people won't want
propitia any longer if they know about the prolonged sexual side effects, which is terrible.
That is terrible.
Yeah.
So then you got the hair plugs that we talked about.
This was from the 1950s.
Sometimes it looks that way.
Dr. Norman Orentriech, I'm not sure which it is,
came up with this sort of crude method where they would punch out little circles of skin
from a donor side on the back of your head, where you still, like we said,
the follicles are working great back there.
And these were little plugs, about four millimeters in diameter.
And then they would transplant those to where you were balding and hopefully regrow your hair.
And it was, it didn't look great.
It left scars in the back and it took time for it to grow in up front.
So it would look very sort of planted, if you will.
Well, yeah.
I mean, it's like in these neat little rows, these little plugs of hair, you know,
like it left a lot to be desired for sure.
That's, it has come a long way since then.
Now they use something called FUE, follicular unit extraction.
And that allows them to extract what they call follicular units, three or four follicles.
And there's no scarring back there.
And they can transplant them much more closely and fill in, you know,
if you were liking it to like a row of corn, filling in those rows in between as well.
So it looked better.
Much more natural.
Yeah, where it was thinning.
You know, something interesting I saw was that Dr. Orrin Treach,
he followed in the footsteps of some other people that dated back to 1897.
There was a Turkish doctor named Minakum Hodara,
who apparently was the first one to really do a hair transplant procedure.
And then there was a Japanese guy, Dr. Shojui Okada,
who in the 30s was the one who pioneered that punch technique.
But in the West, Dr. Orrin Treach usually is credited as the pioneer of hair transplants.
Now they are starting to look into stem cells.
And this has a lot of promise because researchers found out, or I guess figured out,
through a lot of study, is that one of the reasons why hair follicles can continue,
those gremlins can keep working, is because each hair follicle has a little well of stem cells,
including those follicular stem cells and dermal papilla cells that you were talking about,
I think at the very beginning.
And in Japan and here in the States, there are scientists who figure out how to
extract those stem cells, grow these new follicles in a lab.
And the thing with any time you're doing that, you have to shape this thing.
Like if you're going to do something in the shape of an ear, you would 3D print out this
like a model, this like scaffolding model to allow it to grow into the right shape.
Because growing something from stem cells, organs from stem cells, you got to shape it
yourself. You can't just say form of an ear or form of a hair follicle. It just doesn't work that way.
Like go under twins?
Yeah, exactly. This woman at Columbia University named Angelo Cristiano,
who was threatened by Alopecia areata, started basically this 3D hair farm,
creating these printed molds that mimic the underside, the internal structure of a scalp.
So she can grow these, it sounds so gross, but grow these little hair fields that I was kind
of talking about with Bezos.
Yeah, because here's the thing, like if you are already bald, you don't have any donor sites
to get the follicular extraction from, right? And if you do have some, eventually you're
going to start to thin that out when you're harvesting it. This stem cell like hair farm
that's grown in vitro solves that problem. You got all the donor follicles that you need
right there without having to take any from the head, which is beautiful.
Pretty cool. And this is like, this could be the future.
I think it definitely is. They're basically at the point where they can grow hair.
They just are now trying to figure out how to make it not wiry or pigmented the right way.
And all it seems to be is it figuring out in more granular detail what the actual conditions are
in your hair follicle, in your scalp, and then recreating that in vitro.
Yeah, and how to name it something other than a hair farm.
Right. So I think we should close with the idea. We like to talk about evolution and
whether or not something was an evolutionary adaptation to stick around. And you might think
if women are always being surveyed about attractiveness of men and balding men rank low on
that list, why on earth would it stick around as an evolutionary trait? And I think it took a
doctor named Frank Muscarella to come around and say, maybe we should ask women a lot of things,
attractiveness. But also, does this guy look smart? Does he look trustworthy?
Does he look approachable? Does he look like he might be a good long term mate?
And balding men did rank lower in attractiveness, but they ranked a lot higher in all those other
areas. So that might explain why it stuck around as an evolutionary adaptation,
even though not everyone agrees. Yeah, and there was another study from the University of Pennsylvania
that basically said that I think bald men are viewed as 10% more masculine, more confident,
stronger even. And they were like, this doesn't really jibe with what our understanding is.
So they got another set of photos and they showed people with a guy with hair and then
digitally manipulated without hair. So to make sure it wasn't like there was some difference
among the actual guys that they were controlling for hair loss basically. And they still found
the same results. But it's like you said, they keep trying to pigeonhole things into like what
the evolutionary fitness is. And some people are like, just not everything fits that in a neat,
tidy way. It's possible baldness is just an aberration. Like it's not something we're supposed
to do, but it had nothing to do with helping the species along or holding it back, you know?
That's right. You got anything else? No, I hope we've displayed the proper sensitivities here.
If anyone is suffering from hair loss, then it can be a tough thing and handle it the best way
you know how. Yeah, agreed. And since Chuck said the best way you know how, I think it's time for
listener mate. It is. This is, believe it or not, Sammy Davis Jr. enters the picture. Okay.
And this is from Molly. She says, I recently found out of a distant, but kind of wild Sammy Davis
Jr. connection turns out my great, great, great aunt is the one who caused the car accident
that caused Sammy Davis Jr. to lose his eye. Oh my gosh. Her name was Helen Boss. She was 72
when she stopped in the middle of the highway in California and started to reverse because she
missed her exit and caused the infamous car wreck. She missed her exit and was lost because she was
from Akron, Ohio and had just done a cross country road trip to California. She says,
my whole family's from the Cleveland Akron area. Shout out Ohio. Molly, my wife's as well. Me too.
There was another woman in the car with her that had been taking turns driving. They both suffered
from injuries, some injuries as well. And there were some lawsuits flying from all parties,
post accident. I believe Sammy was cleared of any wrongdoing even though he rear-ended them.
This isn't really a proud family moment, but when my mom told me the story, I thought it was pretty
interesting. Yeah. Love the podcast. I'm a tax accountant. I wanted to say there's at least
one person that absolutely loves when you cover tax and financial topics that is from Molly B.
Nice work. Molly, I appreciate that. That is a rando family history, if I've ever heard one.
It's good. I agree. Totally interesting. If you've got some weird part of your family
history that you want to share with us, we'd love to hear it. You can send it in an email
to stuffpodcast at iheartradio.com. Stuff you should know is a production of iHeartRadio.
For more podcasts, my heart radio, visit the iHeartRadio app. Apple podcasts are wherever you
listen to your favorite shows. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips
with Lance Bass. Do you ever think to yourself, what advice would Lance Bass and my favorite
boy bands give me in this situation? If you do, you've come to the right place because I'm here
to help and a different hot, sexy teen crush boy bander each week to guide you through life.
Tell everybody, everybody about my new podcast and make sure to listen so we'll never ever have to
say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart Radio app, Apple podcast,
or wherever you listen to podcasts. I'm Munga Chauticular and it turns out astrology is way
more widespread than any of us want to believe. You can find in major league baseball, international
banks, k-pop groups, even the White House. But just when I thought I had a handle on this subject,
something completely unbelievable happened to me and my whole view on astrology changed.
Whether you're a skeptic or a believer, give me a few minutes because I think your ideas are about
to change too. Listen to Skyline Drive on the iHeart Radio app, Apple podcast, or wherever you get your podcasts.