Detumescence Reloaded

Rob @ PerfectHairHealth.com has returned with a new paper published in a peer reviewed journal.

Years ago when Rob & JD Moyer promoted the benefits of scalp massage this forum was alight. You and I tried our own rendition of scalp massage and almost universally failed to recreate JD's results.

As I failed I began to scrutinize Choy's study in detail. I even phoned him. The weaknesses in his article included no peer review, a pay to publish journal and a study that was never replicated.

That aside, I've always liked the way Rob has conducted himself. Our email exchanges have been enthusiastic and helpful. I've felt he's a person who genuinely believes in the benefits of scalp massage ...

... Even if Choy is notably not featured in the citations of his paper:

https://perfecthairhealth.com/update-2018-published-research-paper/

Rob, to me at least, has distinguished himself from other bro-scientists inc. Danny Roddy. This article has challenged me to look afresh at scalp massage. Now we need Rob to publish more success stories.

https://www.youtube.com/watch?v=VBk-3W0e0v4

Its common sense scalp massages are beneficial, you don't need a scientific study with that. Poor western Science is more behind then it believes

You can wait your whole life waiting for a science paper that will most likely be inconclusive. Start doing stuff, lower inflammation, experiment, go to a doctor maybe 2 doctors get a blood, allergy test etc see what vitamins you need and get to work

Hairbeback wrote:You can wait your whole life waiting for a science paper that will most likely be inconclusive. Start doing stuff, lower inflammation, experiment, go to a doctor maybe 2 doctors get a blood, allergy test etc see what vitamins you need and get to work

Lol. I take it you're a NW1? Peer reviewed papers are helpful.

Helpful.....maybe....most peer review are poorly constructed and biased. You have to use intuition also

Hairbeback wrote:Helpful.....maybe....most peer review are poorly constructed and biased. You have to use intuition also

Nobody here is stating peer reviewed papers are infallible (As stated in your new thread). You're living in a fantasy world.

We're simply stating peer reviewed research is more credible than a random blog post.

It is in theory, never claimed a blog post was

And what did you think of Rob's paper?

Going to check it out tonight can't wait

I skimmed through the study as its late and my mind is foggy. Maybe this is out of context, but this is the conclusion I reached and many others have reached.

More vitamin K2 is also needed, no wonder the bottom of my teeth are translucent, all the calcium is probably going to my arteries and cappillaries, which is why I have stiff cappillaries on the side of my nose

Its adding up

Hotspur, this isn't 'DT Reloaded', as you state, instead Rob has done a 180 turn around and is now saying that mechanical force / mechanotransduction is a major cause of inflammation and onset of AGA (what I have been warning everyone about for years). Scalp massage - as with CDtos bottle rolling technique (DT) induces mechanotransduction, and, according to the theory, is said to promote growth factors which lead to hair growth. These were also the continuous claims of Keanoseg.

So, take this into account for a moment. Rob previously claimed that he cured his ten year battle with baldness via conventional DT techniques (mechanotransduction), and did so within seven months. Now he is saying that mechanical force causes inflammation and baldness.

Here's what he submitted:

"Explaining TGF-β1 activation in AGA through mechanotransduction
If TGF-β1 is androgen-induced, why might TGF-β1 express more highly in AGA tissues versus secondary body and facial hair tissues? Evidence strongly implicates that this is due to mechanical tension.

One study found that mechanical tension from the GA matches the pattern and progression of AGA, with peak tension points corresponding to the first places of hair loss. AGA-prone hair follicles reside within the dermis and subcutaneous fat layers of the scalp, and these layers are fused with the GA as a singular unit. As such, tension from the GA carries into these fused tissues, and thereby AGA-prone hair follicles. The investigators concluded that TGF-β1 expression may result from the tension-mediated induction of the AR coactivator Hic-5/ARA55, and that a “stretch-induced and androgen-mediated mechanotransduction in DP cells could be the primary mechanism in AGA pathogenesis” [57].

Interestingly, TGF-β1 is not only activated by androgenic activity [54], but also by reactive oxygen species (ROS) [58]. ROS are found in AGA-prone tissues, and androgen-induced TGF-β1 in hair follicle DP cells is mediated by ROS [59]. Increased ROS activity may partly explain differences in TGF-β1 expression in body, facial, and AGA-prone follicle tissues.

Mechanical tension can also mediate ROS activity in muscle cells – specifically, muscle stretch [60]. Studies of mechanotransduction (i.e., the mechanisms by which mechanical forces are converted to biological stimuli) demonstrate that mechanical tension in skin, muscle, and bone tissues can alter pro-inflammatory pathways, cytokines, and signaling protein expression [61]. Mechanical tension has also been shown in periodontal tissues to induce cyclooxygenase-2 (COX-2) expression [62], a pathway activated during prostaglandin D2 (PGD2) synthesis. Cell-generated mechanical tension also upregulates TGF-β from stiff extracellular matrix [63].

Collectively, these findings highlight the presence of GA-transmitted mechanical tension in AGA onset alongside the induction of ROS, PGD2, and TGF-β1 – all of which are pro-inflammatory substances and overexpressed in balding scalps. This implies that the inflammation observed in AGA is likely tension-mediated, and that GA-transmitted tension may be the starting point of a chronic inflammatory cascade that results in baldness.

Chronic inflammation may, in turn, increase androgen activity. Studies show that DHT modulates the inflammatory response during acute wound healing [64]. In prostate tissues, DHT is shown to exert broad anti-inflammatory effects [65]. One study demonstrated that the pro-inflammatory cytokine interleukin 1 (IL-1) increases androgen metabolism in chronically inflamed gingivitis tissues and the periodontal ligament [66]. This verifies that androgen activity can be a response to inflammation, and that tension-mediated inflammation may increase DHT, AR, and TGF-β1 in AGA by inducing ROS and other pro-inflammatory biomarkers."

P.S. The author of the paper (Rob) is called Robert S. English. Anyone have any background info on him? All Google reveals is a dermatologist by the same name, but this guy can't be Rob as he is an MD with over 19 years experience in the field of medicine.

Lol. Rob was asked about your post in the comments section. Here's his reply:

Hey Maya — I cut out the quoted text since it was so large of a copied/pasted segment. But to answer your question — no, that’s not true. That user appears to be misunderstanding (and thereby mischaracterizing) the paper’s presentation of evidence alongside its actual hypothesis.

If I had to guess why, it seems like they’re under the impression that mechanotransduction is synonymous with mechanical force, and that mechanical force is synonymous with mechanical tension and chronic tension. This is an easy mistake to make — but if made, it leads to a false interpretation of the paper. Those terms are related, but they aren’t interchangeable.

The paper actually argues that if we can relieve chronic scalp tension while simultaneously promoting a wounding-healing environment in AGA tissues, we may be able to reverse AGA-related fibrosis and thereby achieve better hair recoveries. That’s why the nuance in terminology is so important.

Best,
Rob

Oh the irony, this is why I posted the the article about people misrepresenting science articles and not knowing what they mean. I was called "triggered" by Xenon. Oh the irony

Hotspur, what he is saying is, the overgrowth of skulls bones + surrounding musculature basically causes the scalp to be pulled downward and become tight against the skull, thereby causing cellular compression (mechanical tension). However, the end result is no different from pressing down with the fingers (mechanical force) - both would lead to cellular compression against the skull, and ultimately mechanotransduction. We could pretty much say the same thing about pillow compression or wearing a tight hat.

Also, DT is based upon using the finger presses to remove (non existent) layers of grease because this is what Choy argued was causing the skin to swell and the skin to stretch and become tight. This simultaneously creates mechanical force, and apparently growth factors to increase.

So, after promoting DT, and telling everyone that it cured his baldness, Rob is now pretty much suggesting that the scalp needs to be loosened, and we need to prevent mechanical force, as this is the culprit in AGA. This isn't DT, rather this is based upon Maliniak's method of loosening the scalp.

Oh, and he used Keanoseg's "progress" pics as proof of DT working? Really? Horseshoe hairline, then within 2 months, he has complete regrowth? I don't buy it for a second. You tried this method (as did countless others), and by your own admission, it made things even worse. Many more people came forward and said exactly the same thing -- even people who tried this for years. However, there will always be a get out of jail card excuse why it has all failed - 'You're not doing it right' 'You gotta do it 3 years', etc. i can't say I blame people for being confused about all of this. One is saying press down and induce mechanical force, now another is saying mechanical force must be reduced via scalp loosening.

Rob will keep saying whatever he wants to say so long as the $$ keep rolling in. If people literally buy into his bullshit, then more fool them. I have to hand it to him, he is a smart marketer, and is very savvy to the fact that baldness is big business. He's just not smart enough to bullshit me.

Damn Xenon is bitter

I'd also like to add: Rob suggests the use of a boar brush, right? Again, like Maliniak's scalp loosening exercises, this was another failure (and boar brushing caused worse inflammation and hair loss), as reported by countless people. I knew this from my own experience because excessive combing / brushing (for stylistic reasons) was a major player in accelerating my own loss, so I knew exactly what others were in for.

All Rob has done is lurked on the boards and silently milked the minds of many on here, and elsewhere. Everything in his paper / ebook has come directly from past posts from CS, myself and others. He even PMd me a few years back to ask if he could use some of my info in the ebook he was compiling at the time, but he failed to realize that not only was my information at odds with boar brushing and DT, but the latter actually causes worse hair loss - something he never anticipated at the time.

Yes, he seems like a decent guy in his communications, but sincere? Nope. Any good marketer knows he has to win the trust of customers before they hand over their money. Would people seriously be willing to hand over their $$ if he had an attitude and was an abrasive asshole (like myself)? Of course not. It's pretty much comparable to a guy being overly nice to a girl he's just met because he must present a front that will win her heart, or he doesn't get the "goods" at the end of the night.

Rob is an alumni in economics / marketing (from the University of California); he knows how to make money pretty much out of nothing. But what can I say? If people are willing to hand their money over to him, and get a raw deal as a result, then that's their fault.

Oh well, Rob might just get a Lamborghini and a mansion out of all this yet.

How does one maintain a life with out making money? I don't know rob and just skimmed through his website and he is selling book packages and has free e-mails to get you started.
I have no problem with people charging anything, the packages are not that expensive and honestly if you research hair loss on your own you can probably get a long fine with out the packages and just the e-mail. A lot of scientists/researchers "borrow" information and theories and add their own spin to it. Science is a "constant" it doesn't just stop because someone can't interpret a study.

Which probably has been retracted

Xenon. I can think of many hucksters in this industry. Including some of the 'knowledgeable' contributors on this board. Rob doesn't strike me as a dishonest person. Rather a researcher who has adjusted his views as he's learned more.

Rather than accusing him of being a scam artist your energy would be best focused on dismantling the citations used in his paper. Segura's 2015 study, for example, was of particular interest to me:

Involvement of Mechanical Stress in Androgenetic Alopecia

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4639964/

'The result of this analysis indicates a constant linear dependence between elastic deformation of scalp and AGA patterning, which clearly identifies mechanical stress as an active factor in AGA.'



As one of the more knowledgeable contributors I'd be curious to know your opinions on this research. And your take on interventions inc. dermarolling and botox as effective methods of reducing mechanical stress.

Wow that's pretty cool, also I'm happy for Rob because he seems like a really nice guy!

That's a whole lot of information though, I hate to ask but........Is there a TLDR version of steps to take? I'm also very glad that scalp massage is getting more attention.

From Rob's site:

"Rather, I was just reading hair loss forums, articles, and ebooks -- then emulating their proposed remedies.

Why is this bad? Because hair loss forums, articles, and ebooks are (at best) second-hand information. They're written by random people on the internet -- most of whom are scientifically illiterate or financially motivated to misrepresent the very drug, topical, or supplement they praise.

If I wanted real answers, I'd have to do the research myself. I had a background in analytics; there was no reason I couldn't do it. I even had access to scientific journals. My hesitation was simply the time investment."

^^There's Mr Good Guy for you. He did nothing but lurk, went and took all of the information from here and other forums, compiled it all into an ebook, starts making a living off the backs of other people, and has the nerve to claim it all as his own research, while - yes - labeling people - whom he took this knowledge from - as scientifically illiterate and motivated by financial gain. You simply couldn't make it up.

However, there's a number of Trojan horses his naivete allowed to slip through the gates, and these very Trojans are what's caused him to take the recourse he has because he is now fully aware that he has a shitload of baldness cases to tend to, but he wont tell you this.

But anyway, to address what you asked of me in your post. First of all, yes, I do consider mechanical force to be a huge factor in AGA, but in terms of skull growth and muscular tension creating mechanical tension, I do believe that this does happen, except when the scalp is constantly pulled tight, then, it must also gradually stretch and become more pliable. In other words, if the scalp remained tight, and the skull continued to grow, then the scalp would rupture due to this chronic tension.

I've mentioned before, when an individual puts on a rapid amount of weight, the dermis begins to increase it's collagen and elastin levels so the bulging under layers of adipose tissue don't cause it to rupture. But once it has become pliable, then mechanical tension is eased. This would also apply to the scalp; if it didn't increase it's collagen levels, then homeostasis would be severely interrupted, not to mention the tissue tearing apart from the continued force.

So, as the scalp is going through this natural stretching process, it could well be that the follicles are being crushed against the skull. And if we then add pillow compression to the equation, then we have tissue that is suffering heavily from the effects of mechanical stress.

Anyways, because the scalp does become more flexible - in accordance with skull growth, is it really necessary to use the scalp loosening massages? I don't think so. The body understands the right level of pliability the scalp needs to be at in order for homeostasis to be maintained.

There was a fellow on YT who was cueball bald, and via stretching exercises, he did end up with a very loose scalp, but presented no evidence of regrowth. We also had Maliniak harping on about his massages regrowing his hair, but the catch was, you needed to buy his special Tesla violet wand in order to "reactivate dormant follicles". Right. So, the loosening massage alone is pretty pointless - by his own admission.

If you want to alleviate mechanical force from the scalp, I'd personally concentrate on this pillow issue, and finding a way of sleeping so that the follicles of the temples or crown aren't being squashed every night you go to bed.

As for dermarolling, I've never done it and have no intention on doing so. I'm one who understands that wounding just makes things worse. One of the chief reasons - DHT seems to directly affect this wound healing process by preventing progenitor cell maturation. So, even though it's logical to conclude that wounding causes cells to come back stronger - not in the case of AGA. Think about this for a moment: how much wounding are follicles subject to via the inflammatory process? If this was beneficial for hair, then it wouldn't cause hair to miniaturize and shed. So, I don't see how adding extra inflammation to the equation is going to help. it simply wont, and that's because of this progenitor cell problem.

Botox injections... I don't think entirely necessary, and no guarantee of bringing hair back to the anagen phase.

Just two main issues need to be focused upon: 1. Alleviation of inflammation 2. Progenitor cell maturation. The latter is the most crucial aspect, and at present, it would seem that DHT blockers have an effect in triggering this process into action. But not always with spectacular results.

Of course massaging alone won't regrow hair. Its obvious

Oh, and as for "perifollicular fibrosis", this may simply be excess collagen resulting from the scalp stretching and becoming more pliable. This is what typically happens to stretched tissues, and it doesn't necessarily indicate that this hinders hair growth, or that it needs removing via massaging.

You think of this for a moment; how much inflammation are alopecia sufferers subject to via auto-immune attack? And yet, even after years or decades, they are known to regrow their hair. If fibrosis was such a huge issue, many of these people wouldn't experience regrowth - ever.

As I also understand it, only one portion of the follicle is attacked by pro-inflammatory cytokines, and that portion is known as the matrix. Yet, these cells are continually renewed via each growth cycle, so there would be no scar tissue here.

What this means is, you don't need to be massaging in an attempt to remove this collagen; it is there to keep your scalp loose.

Well it is good to see a science based debate with minimum personal strife and over rated opinions.  I have not dug deep into the subtle differences in the experimental terms and abbreviations.

I will state the obvious.  There is a big difference between temporary pressure and long term tissue compression.  For example, I could enjoy a brief period of a lady walking on my upper back as massage. If she stood there for 12 hours I would have serious injury.  

Perhaps hat wearing, stretched skin over scalp,   pillow compression, and   other long term pressure is not good for hair bearing tissue, and may very well lead to hair loss.   This is very different than a few seconds of pressure to regenerate the skin.

For me I can skip to personal results.  It is not that it has taken 3 years to show any growth,  I have been showing growth since the first few months with my DTC-CPR pressing method.  On the border areas, it is hard to tell and keep track of progress with photos.  I took a remote forehead patch, usually the hardest and last area to regrow; and used this as a tracking area.  From slick bald to short slightly thin hairs with a handfull of terminal hairs developing in 2 1/4 years.  

If the strong pressure about an hour a day had any damaging effect, I would have quit long ago.  Not in it for the money or fame, just the evidence and a well documented method. I will post updated photos soon. Regrowth is very clear, and yes if you want to naturally regrow 20 years of hairloss,  it will take a few years.

The fact of the matter is this site is turning dogmatic because people can't read nor comprehend the literature they are reading