Re: Studies that help confirm my theory that balding = low oxygen + DHT

arnie Fri Jan 24, 2014 11:29 pm

Why do hair transplants work? Or would the transplanted hairs eventually miniaturise for the same reasons?

DeadlyDevice Fri Jan 24, 2014 11:57 pm

Complexx wrote:
DeadlyDevice wrote:
Complexx wrote:Fix your thyroid and loosen your scalp.

Fix thyroid yeah...that's what I've been trying to do since 2012. I've made progress but it's barely minimal.

Damn man... Sorry to hear that. What are you doing for it?

Since in my case this is all a result of excessive fasting and starvation, the first thing I did is stopped that and started eating normally again and put my weight secondary. I used to fast all day and only eat dinner. I think that messed up my circadian rhythm because I generally feel better at night. I try to get all my food in before sunset now to revert that.

Other than that I do some supplements, I tried a lot of things like Vitamin D, even various thyroid products but they don't work that well for me. I just get the feeling that my thyroid steps down its own production and I end up with the same level of hormones. Might try some thyroid-boosting herbs like guggul next. I guess people for whom thyroid hormones work are 'lucky' in the sense that they at least have something to help them but obviously that's not really a solution to the problem, if you have to take that for the rest of your life. So yeah I'm trying everything that makes sense, these things can be horribly difficult to fix.

youngn Sat Jan 25, 2014 1:27 am

arnie wrote:Why do hair transplants work? Or would the transplanted hairs eventually miniaturise for the same reasons?

When a new hair is transplanted obviously some angiogenesis happens to connect the capillary network to the new hair. Maybe this keeps the hair strong. Also the new hair came from a healthy place. There's countless bald vs non-bald follicle studies that show the differences (even genetically) brought by the environment that causes baldness. It could take years for healthy follicles in the MPB area to get choked out, and it could take years for them to come back.

MikeBison Sat Jan 25, 2014 4:17 am

DeadlyDevice wrote:
Complexx wrote:
DeadlyDevice wrote:
Complexx wrote:Fix your thyroid and loosen your scalp.

Fix thyroid yeah...that's what I've been trying to do since 2012. I've made progress but it's barely minimal.

Damn man... Sorry to hear that. What are you doing for it?

Since in my case this is all a result of excessive fasting and starvation, the first thing I did is stopped that and started eating normally again and put my weight secondary. I used to fast all day and only eat dinner. I think that messed up my circadian rhythm because I generally feel better at night. I try to get all my food in before sunset now to revert that.

Other than that I do some supplements, I tried a lot of things like Vitamin D, even various thyroid products but they don't work that well for me. I just get the feeling that my thyroid steps down its own production and I end up with the same level of hormones. Might try some thyroid-boosting herbs like guggul next. I guess people for whom thyroid hormones work are 'lucky' in the sense that they at least have something to help them but obviously that's not really a solution to the problem, if you have to take that for the rest of your life. So yeah I'm trying everything that makes sense, these things can be horribly difficult to fix.

Have you tried iodine?

DeadlyDevice Sat Jan 25, 2014 11:43 am

MikeBison wrote:
Have you tried iodine?

Yes. I got somewhat softer skin from it, but that's about it.

Live forever Sun Jan 26, 2014 9:58 am

Thanks for that link rdkml.
I have been rinsing scalp with cold water for about 5 months now and will continue to do so.

Back to the post, slo and complexx...have you investigated lymph drainage relating to hair loss ?

It kind of relates to "flow" if you will.

Also would love to hear CS's opinion on the original post...

SlowMoe Wed Jan 29, 2014 2:51 am

Amaranthaceae wrote:I dont see how the lymph system would tie into the theory of how bloodflow and oxygen levels affect hormone metabolism in the scalp tissue. Care to explain?

I don't believe it's tied in with THAT hair loss damage mechanism; but another mechanism in its self....
Poor waste removal will weaken the dermal papilla further.

CausticSymmetry Wed Jan 29, 2014 6:25 am

Live forever wrote:Thanks for that link rdkml.
I have been rinsing scalp with cold water for about 5 months now and will continue to do so.

Back to the post, slo and complexx...have you investigated lymph drainage relating to hair loss ?

It kind of relates to "flow" if you will.

Also would love to hear CS's opinion on the original post...

Yes, totally agree with low oxygen being a problem. Many posts on this over the last few years. Low oxygen indicates infection (or inflammation), which starves tissues of oxygen.

Iodine (specifically the iodide form) will oxidize (lending more oxygen) and will convert estradiol into estriol.

Stress itself will lower immune function.

AS54 Wed Jan 29, 2014 8:25 am

Definitely in agreement that hypoxia is a problem here. And the studies Slowmoe posted are interesting.

I hate to be a dissenting voice, but there isn't any evidence here that this is an effect of scalp tightness. We're looking at facts and making connections that aren't supported.

What the studies did suggest is there is a difference between the vertex/frontal scalp and the occipital scalp. That doesn't automatically assume its because the top of the scalp is tight. I'm not saying it isn't possible, but we can't just throw around the word "proof". This could easily (and likely) be a difference in receptor sensitivity in the vertex.

There are other things to consider:
- local androgen levels and the specific paracrine mechanisms for type/amount of androgen synthesis in local tissues (highly variable)
- number of receptors
- sensitivity of receptors (genetic)
- levels of local enzymes: 5-ar, aromatase, 3b-HSD
- mutant androgen receptors
- androgens cause an upregulation of IGF-1 in facial hair growth, but DHT and insulin both seem to inhibit the growth-positive effects of IGF-1 in scalp
- androgens increase iNOS and NO in all dermal papillae but for some reason this promotes hair growth on the face, but inhibits it on the scalp
- androgens seem to produce TGF-B1 and B2 and lots of IL-6 in the scalp, but not in the face
- something specific going on with the Wnt proteins in the scalp is at the heart of this too and I'd expect differences in levels between the vertex and occipital scalps

Its called the androgen paradox and they don't know why this happens. But more than likely the same reasons for promotion of hairgrowth by DHT on the face is the same reason why occipital hair growth is promoted by DHT, while vertex hair growth is discouraged.

Is it because of local hypoxia? Could be. Is it because the galea is tight? Might be. But we don't have proof of that. I'll believe it when I start seeing miracles on this site from "loosening" the scalp.

youngn Wed Jan 29, 2014 8:36 am

Loosening the scalp will probably not regrow all of your hair once the damage is done. The damage done to hair follicles is on a genetic level. The mutation of a hair follicle could be caused by hypoxia/tight scalp... but I have never seen a report of a Galeatomie regrowing someones hair. Just that they arrest hair loss. To regrow hair the dermal papilla needs to be re-programmed or else you will have to sustain its life by using growth agents.

Xenon Wed Jan 29, 2014 8:44 am

AS54, you have to admit, the scalp tissue is noticeably tighter in comparison to other tissues. You only have to pinch the skin to make the comparison. Perhaps pillow compression may exacerbate oxygen loss around the temples? When you consider the fact that the head is the heaviest part of the body, and further consider how much pressure it must exert on the temples when we are sleeping (for 8 hours per night), then it's probable IMO that this does contribute to temporal air loss. The vertex on the other hand doesn't suffer the same degree of head/pillow compression, so this may explain why this hair usually survives longer. And likewise with the temples, sleeping with the occipital region pressed against a pillow may be partially the cause of the bald patch.

The hair which is situated upon the occipital and temporal muscles is cushioned by a thick layer of fat, so I think that this fat and the underlying muscles acts as a cushion to capillaries, alleviates compression and allows healthy bloodflow. Perhaps this is partially the reason why hair in these areas is never lost.

And maybe this compression slows down lymph drainage, not to mention causes many more problems.

Xenon Wed Jan 29, 2014 8:54 am

P.S. I thought I'd add:

Pressure Alopecia
"Postoperative or pressure alopecia (PA) is the term used to describe a group of scarring and non-scarring alopecias that occur following ischemic changes to the scalp, with a pathophysiology similar to pressure ulcers. The condition was first described by RR Abel and GM Lewis, who presented a series of eight cases to the annual meeting of the American Dermatological Society in 1959.[1] PA typically presents with a discrete area of alopecia, usually in the occiput, within a few weeks of surgery or a prolonged period in an Intensive Care Unit (ICU). Some patients experience tenderness, swelling, or ulceration in the scalp prior to the alopecia, but in others, the alopecia may be the presenting feature."

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3500075/

I thought I'd also mention I feel tenderness on the temple which I have slept upon the most, so this may suggest that pillow compression is playing a role.

AS54 Wed Jan 29, 2014 9:05 am

Xenon, no I'd agree I have experienced the sensation of tightness in my scalp. I'm not saying it isn't what's causing the androgen sensitivity. I'm just saying we don't have definitive proof of that yet. We have a theory, and one that's yet to provide any truly convincing results. I'm not saying it isn't an intriguing theory. But talking about it and looking for evidence to support our beliefs is one thing, and I just think we need to see results before we say we've got proof.

Xenon Wed Jan 29, 2014 9:29 am

The whole issue is a nightmare to fathom. On one level I am 100% certain that too much metabolic heat to my scalp seems to trigger MPB, then when I'm in a room which is low in oxygen and high in C02 I will always feel inflammation - specifically within the balding regions.

Christ knows what the precise prob is here; perhaps capillaries become heavily compressed, and when too much heat enters them it causes them to rapidly dilate and then rupture?

Again I just do not know.

ETA: I know that estrogen helps to heal the endothelial cells, by promotion of CD34+ progenitors, which are the progenitors involved in terminal hair growth. So perhaps when capillaries (of balding men) are ruptured from the effects of blood pressure / vasodilation, they don't heal so well?

Xenon Wed Jan 29, 2014 9:56 am

Apologies for thread hijack, Slowmoe, I just wanted to post some pics of ICU patients who have suffered pressure alopecia:

Studies that help confirm my theory that balding = low oxygen + DHT - Page 2 4567782909_3a63bb9d22_m

Studies that help confirm my theory that balding = low oxygen + DHT - Page 2 4567782909_3a63bb9d22_m

Studies that help confirm my theory that balding = low oxygen + DHT - Page 2 IntJTrichol_2012_4_2_64_96901_u2

Again, the problem seems to be localized to the tissue which has been compressed against a pillow, but this does not (as far as I'm aware) affect the lower back and sides of the head where hairloss doesn't occur. So, therefore, perhaps repeated pillow compression (in the case of MPB) may also cause gradual loss of hair.

Live forever Wed Jan 29, 2014 10:13 am

I think the key part is this-
Why is it the top and not the sides.

You cannot deny the sides are looser and fattier.
But this is the case for women too in my personal experience.
You can understand and credit people for exploring the limits of these differences and trying to promote theories.

I agree with as45 that theres no real evidence of scalp loosening being the magic bullet. Although hes not saying its not something we should stop experimenting with etc.

I dont buy that this is evolution.

Xenon Wed Jan 29, 2014 10:25 am

Live forever wrote:I think the key part is this-
Why is it the top and not the sides.

You cannot deny the sides are looser and fattier.
But this is the case for women too in my personal experience.
You can understand and credit people for exploring the limits of these differences and trying to promote theories.

I agree with as45 that theres no real evidence of scalp loosening being the magic bullet. Although hes not saying its not something we should stop experimenting with etc.

I dont buy that this is evolution.

I think that it affects mainly the top (crown) because that is the position in which the ICU patients have been laying in for several weeks. Perhaps the same thing would happen if the patient had been positioned on the side so the temples where pressing against the pillow.

I do find it interesting that hairloss never occurs where the scalp muscles (and additional adipose tissue) are located. surely that can't be coincidence. it's probable IMO that these muscles / fats help to cushion capillaries and reduce friction / pressure. But that's just my opinion.

Also I know that estrogen helps to protect these blood vessels and promotes rapid repair, so this may be a key component here, whereas the properties of DHT don't seem to have the same favourable effect.

But, anyway, as you and Anthony said, all this means jack shit without sound results.

Xenon Wed Jan 29, 2014 10:42 am

One more thing; I was just reading about pressure ulcers and it said the following in regards to interruption of lymphatic drainage:

"Pressure ulcers occur when soft tissues (most commonly the skin) are distorted in a fixed manner over a long period. This distortion occurs either because the soft tissues are compressed and/or sheared between the skeleton and a support, such as a bed or chair when the person is sitting or lying, or because something is pressing into the body, such as a shoe, surgical appliance or clothing elastic. Blood vessels within the distorted tissue are compressed, angulated or stretched out of their usual shape and blood is unable to pass through them. The tissues supplied by those blood vessels become ischaemic.

As well as occluding blood flow, tissue distortion also obstructs lymphatic flow, which leads to accumulation of metabolic waste products, proteins and enzymes in the affected tissue [accumulation of enzyme 5AR?]. It is suggested that this can also initiate tissue damage, although the precise mechanisms are not fully understood "

You will note that lack of adipose tissue and musculature in the galea area would cause the tissue to be heavily compressed against the hard skull. If the scalp is already tight, then it's probable that continuous pillow pressure would cause worse probs, not to mention with lymphatic drainage.

ETA: "The most serious pressure damage usually occurs as a result of the deformation in the deep tissues near the underlying bony prominence. Because the pressures can be much higher than at the skin/support interface (Sangeorzan et al, 1989; Le et al, 1984) and because larger blood vessels are more likely to be affected, necrosis of a large volume of tissue often takes place. When the supporting structures of the skin have been destroyed, parts of the skin become non-viable and die subsequent to the primary deep tissue destruction. As the non-viable skin breaks down, a cavity filled with necrotic tissue is revealed (Fig 3)."

^^Again we find bony prominences of the forehead in many MPB sufferers. Pillow pressure + skull shearing would likely = deep tissue damage / compression, reduced blood flow and lymph drainage.

Anyway I spoke enough shit for one session, I'll leave it to you guys :p

AS54 Wed Jan 29, 2014 2:27 pm

Xenon wrote:
As well as occluding blood flow, tissue distortion also obstructs lymphatic flow, which leads to accumulation of metabolic waste products, proteins and enzymes in the affected tissue [accumulation of enzyme 5AR?]. It is suggested that this can also initiate tissue damage, although the precise mechanisms are not fully understood "

Its possible that androgen metabolites could be oxidized/reduced the other direction if they hang around too long, but typically once these things hit the lymph they aren't physically going to act on the end-organ anymore. They can't do much harm in circulation. That's why serum levels of the hormones aren't as useful as you'd think. It really requires knowing what's happening right at the follicle.

The real problem of a lymph/blood backup is the effect on local blood pressure. The pressure and any accumulated waste/proteins are going to call in the immune system. That inflammatory response is what's causing our problem. The inflammatory infiltrate and release of things like the prostaglandins at those sites is what the attack is all about. Scarring that results from this builds on the problem.

Xenon Wed Jan 29, 2014 7:39 pm

AS54 when I had chicken pox when I was sixteen it left a pretty deep pock mark on the right side of my face. Consequently beard hair never grew in that scarred patch of skin. So I wonder if the same is somewhat true for the majority of follicles where internal damage and scarring has occurred.

I also have a tiny bald patch on the left side of my head, this is a scar caused my an injury I sustained when I was a kid. Again hair never regrew there. I know this is scarring alopecia, which is permanent due to fibrosis, but whether or not this is comparable to MPB is another story.

However, all hope isn't lost... if you observe the skin where hairloss occurs, you will note that it produces both sebum and sweat. The sebaceous glands are connected to the same capillary network as the follicle, in fact the sebaceous gland is located within the follicle wall. So if the sebaceous gland is functional, then why is it that this isn't true for the follicle? I don't think that capillary loops break away from the papilla because it still produces micro-vellous hair.

So would it all simply imply that the follicle is programmed to stop producing hair?

SlowMoe Thu Jan 30, 2014 2:19 am

AS54 wrote:I hate to be a dissenting voice, but there isn't any evidence here that this is an effect of scalp tightness. We're looking at facts and making connections that aren't supported.

So the botox study where paralyzing the scalp muscles stopped loss in all and regrew hair in most isn't enough for you?

What the studies did suggest is there is a difference between the vertex/frontal scalp and the occipital scalp. That doesn't automatically assume its because the top of the scalp is tight. I'm not saying it isn't possible, but we can't just throw around the word "proof". This could easily (and likely) be a difference in receptor sensitivity in the vertex.

I never stated this as actual proof and if i did i apologize. The fact that paralyzing the scalp muscles ends miniaturization leads me to believe that the placebo effect MAY HAVE worked via decreased scalp tension.

There are other things to consider:
- local androgen levels and the specific paracrine mechanisms for type/amount of androgen synthesis in local tissues (highly variable)

Again, studies show that hypoxic environments may lead to increased DHT synthesis

- number of receptors

Once more, androgen receptors appear to proliferate under low oxygen conditions

- sensitivity of receptors (genetic)
- levels of local enzymes: 5-ar, aromatase, 3b-HSD
- mutant androgen receptors
- androgens cause an upregulation of IGF-1 in facial hair growth, but DHT and insulin both seem to inhibit the growth-positive effects of IGF-1 in scalp
- androgens increase iNOS and NO in all dermal papillae but for some reason this promotes hair growth on the face, but inhibits it on the scalp
- androgens seem to produce TGF-B1 and B2 and lots of IL-6 in the scalp, but not in the face
- something specific going on with the Wnt proteins in the scalp is at the heart of this too and I'd expect differences in levels between the vertex and occipital scalps

I think you are overthinking all of this. Tissue hypoxia can cause all sorts of problems in the body and balding scalps have been scientiffically proven to be hypoxic.

Its called the androgen paradox and they don't know why this happens. But more than likely the same reasons for promotion of hairgrowth by DHT on the face is the same reason why occipital hair growth is promoted by DHT, while vertex hair growth is discouraged.

"They" put a PERSON on the MOON what, 60 YEARS AGO? And "they" can't give a clear explanation for all of this? Usually the simplest answer is the correct one and it's blatantly obvious that the galea region is prone to poor circulation due to being the highest point on the body AND the ONLY hair bearing part of the body that becomes tight due to muscle tension. HELLO

Is it because of local hypoxia? IMO PartiallyCould be. Is it because the galea is tight? IMO, partiallyMight be. But we don't have proof of that. We have several studies actuallyI'll believe it when I start seeing miracles on this site from "loosening" the scalp.That is the thing. Everyone wants to see a magical miracle and have all their hair return. The truth is, it takes a very long time for hair to miniaturize, generally. You should expect the same amount of time for it to come back, once everything is brought into sync, IMO

AS54 Thu Jan 30, 2014 2:28 am

Not the dreaded quote-my-whole-email-to-pick-it-apart-with-red-text! Very Happy

Only kidding.

Slow, I never meant that to be a true attack. You know I'm one of the people here who isn't convinced totally. So I just made my point that we don't have proof, and even a couple of studies aren't proof. The botox study grew back some hair. I don't recall the figures exactly but I am pretty sure the regrowth rates were somewhere closer to 10%? And the studies in the OP of this thread, they show a different hormonal response to a DHT inhibitor between different regions of the scalp. Like I said, these are interesting studies. You usually always turn up some good stuff. BUT, none of these are proof of the tight scalp/galea theory. Not yet. That was my point. I know it flies in the face of where he forum is headed collectively, but we still gotta have checks and balances Smile

.

I already was with you that hypoxia can lead to an increase in DHT. But we've got to find the biochemical reason for loss on the top, but not on the back or sides. Can we show that a tight scalp is the reason for the hypoxic environment? Did the botox study show an increase in tissue oxygenation after treatment? If they did, then perhaps I'm wrong. To me, its more likely a difference in receptor distribution and local differences in responses to the same hormone. But I also realize people hate that kind of talk because it doesn't give us anything very actionable.

AS54 Thu Jan 30, 2014 2:31 am

Xenon,

Very interesting. All of my scars have tended to be on my hands or face (and I haven't been able to grow very good hair on my face ever), so I didn't really ever notice this. But it makes complete sense. And I'd agree, I don't think it means these follicles are dead. Stem cells are still present and they need only the growth trigger. But I do think a form of this same thing is happening in MPB, and scarring is impinging on the hair follicle. This is all where the immune system comes into play with this, and its where I have the least amount of knowledge and it all confuses the hell out of me.

SlowMoe Thu Jan 30, 2014 2:44 am

AS54 wrote:Not the dreaded quote-my-whole-email-to-pick-it-apart-with-red-text! Only kidding.

Slow, I never meant that to be a true attack. You know I'm one of the people here who isn't convinced totally. So I just made my point that we don't have proof, and even a couple of studies aren't proof. The botox study grew back some hair. I don't recall the figures exactly but I am pretty sure the regrowth rates were somewhere closer to 10%? And the studies in the OP of this thread, they show a different hormonal response to a DHT inhibitor between different regions of the scalp. Like I said, these are interesting studies. You usually always turn up some good stuff. BUT, none of these are proof of the tight scalp/galea theory. Not yet. That was my point. I know it flies in the face of where he forum is headed collectively, but we still gotta have checks and balances .

I already was with you that hypoxia can lead to an increase in DHT. But we've got to find the biochemical reason for loss on the top, but not on the back or sides. Can we show that a tight scalp is the reason for the hypoxic environment? Did the botox study show an increase in tissue oxygenation after treatment? If they did, then perhaps I'm wrong. To me, its more likely a difference in receptor distribution and local differences in responses to the same hormone. But I also realize people hate that kind of talk because it doesn't give us anything very actionable.

We would like to present the results of an open-label pilot study using botulinum toxin type A (Botox; Allergan, Inc., Irvine, Calif.) for the treatment of androgenetic alopecia. This form of alopecia is believed to be caused by a genetically predisposed sensitivity of hair follicles to the toxic effects of dihydrotestosterone, a metabolite of testosterone. Medical treatment of androgenetic alopecia has previously only been moderately effective using systemic drugs such as finasteride, a 5α-reductase inhibitor.1

In this ethically approved study, 50 male subjects aged between 19 and 57 years with Norwood/Hamilton ratings of II to IV participated.2 The study was 60 weeks in duration, with 12 weeks of run-in followed by two treatment cycles of 24 weeks each. Subjects were injected with 150 units of Botox (5 units per 0.1 ml saline) into the muscles surrounding the scalp, including frontalis, temporalis, periauricular, and occipitalis muscles in equally divided doses over 30 injection sites. The primary outcome measure was a change in hair count in a fixed 2-cm area using a method described by Canfield.3 Secondary outcome measures included hair loss, measured by having subjects collect loose hair from their pillow with a sticky lint roller, and subjective efficacy using a validated questionnaire. Statistical analysis entailed paired t tests of group means.

Forty subjects completed the study, and no adverse effects were reported. The treatment response rate was 75 percent. Mean hair counts for the entire group showed a statistically significant (p < 0.0001) increase of 18 percent between baseline and week 48 (Table 1), similar to the results reported with Propecia (Merck, Whitehouse Station, N.J.).1 Hair regrowth was objectively visible in some subjects (Fig. 1). Secondary outcome measures were also significantly improved. The reduction in hair loss and increase in hair count did not show a statistically significant correlation. This suggested that longer retention of terminal hairs did not account for the increase in hair count.

Table 1
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Fig. 1
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Mechanistically, the scalp behaves like a drum skin with tensioning muscles around the periphery. These muscle groups—the frontalis, occipitalis, and periauricular muscles and to a minor degree the temporalis—can create a “tight” scalp when chronically active. Because the blood supply to the scalp enters through the periphery, a reduction in blood flow would be most apparent at the distal ends of the vessels, specifically, the vertex and frontal peaks. Areas of the scalp with sparse hair growth have been shown to be relatively hypoxic, have slow capillary refill, and to have high levels of dihydrotestosterone.4

Conceptually, Botox “loosens” the scalp, reducing pressure on the perforating vasculature, thereby increasing blood flow and oxygen concentration. The enzymatic conversion of testosterone to dihydrotestosterone is oxygen dependent. In low-oxygen environments, the conversion of testosterone to dihydrotestosterone is favored; whereas in high-oxygen environments, more testosterone is converted to estradiol.4 Blood flow may therefore be a primary determinant in follicular health. Strategically placed Botox injections appear able to indirectly modify this variable, resulting in reduced hair loss and new hair growth in some men with androgenetic alopecia.

SlowMoe Thu Jan 30, 2014 2:48 am

Also, please read my email connversation with the guy that patented the botox treatment and conducted that very study:

SlowMoe wrote:Dr. Freund;
I am interested in the Botox treatment of hair loss, and was wondering what the approximate cost of the procedure was.

I am semi-retired so I am not actively doing this procedure anymore. However I can tell you how the fees were structured in the past. It takes about 100 units of Botox to inject the periphery of the scalp which costs about $350 in drug. I used to charge about $250 to do the injections. That is about $6 per unit. The fees will vary depending on whether the injector considers it a 'cosmetic' procedure (more expensive) or a therapeutic procedure (less expensive). For most people it takes about 2 treatments per year to get and maintain the effect. Hope this helps!

Thank you very much for your response sir.

I have a couple more questions...

1. Can anyone qualified to perform botox injections do this procedure or do you hold the patent for it?
2. Is this something that can be done at home using iontophoresis?

Thank you!

Anyone qualified can inject for this procedure. The Germans tried iontophoresis a few years ago without very much success. Botox, due to its large molecular size and lack of charge and polarization, doesn't move through skin well. Xeomin is much smaller but I am unaware of any data for it.

Brian, I feel as though my occipital muscles are my biggest problem, my scalp tends to stay bunched up in the back. Do you think it would be worthwhile to just do those muscles?
Also, did you get good reviews back from the customers who received this treatment.

I apologize if I am bothering you with all of these questions. It's just that I knew all along poor bloodflow was the main culprit behind balding and have been ridiculed because of my stance, now you have given me solid evidence to back my claims and I am very excited about not only the opportunity to grow my hair back without finasteride or minoxidil but also the other treatment possibilities that may be capitalized upon.

You could certainly start with those muscles and always inject more depending on the scalp laxity you achieve. The way I assess muscle contribution is by placing a hand on the top of the scalp and getting folks to wrinkle, frown, wiggle their ears etc and see what pulls the scalp.

As far as success; for those where it works - it works very well. However, it appears to arrest further hair loss in just about everybody. I will attach an abstract that I presented a few years ago which has a few pics taken about a year into treatment.

As far as blood flow you are correct. However, it is more than just follicular strangulation. The enzymatic pathway that converts testosterone into either estrogen or DHT is oxygen dependant. In areas of low oxygen such as the crown of the head DHT is favoured and we know what that does to hair follicles.

Cheers, B.

Brian, I need to trouble you for one more thing sir; do you have any literature discussing how t is converted to DHT in low oxygen environments?

It is not so much that Testosterone gets converted to DHT more effectively in low oxygen environments, it is that aromatase which converts testosterone to estradiols works much more efficiently in high oxygen environments. You therefore have the two enzyme systems - 5 alphareductase and aromatase competing for the same testosterone substrate. This paper is germane to the whole low oxygen, high DHT, no hair concept. Goldman also has some good references if you want to research further on any specific aspect. Cheers, B.

Dr. Freund:
I am getting a lot of resistance from the traditional hair loss crowd that say the old transplant experiments (Norstrom, etc) prove without a doubt that donor dominance is accurate and there is no way that loosening the scalp, or any other means of increasing blood flow to the scalp, could reverse miniaturization, and if the injections do in fact work as you rported it is by another mechanism.
They have read the Goldman findings and believe that the lock of oxygen in the scalp is caused BY a reduced number of hairs, not being the cause of loss.

Did you happen to take transcutaneous o2 readings on the scalp after performing the procedure?

Now you get an idea of what I have been up against. I did not do any oxygen measurements in the initial trial as it was a proof of concept only. The second trial would have measured many more parameters, however, funding was cut as the results were not significantly better than finasteride. From a research funding perspective the eventual commercialization potential was not there (funding for cosmetic indications is strictly based on $$ to be earned). The hair community found the concept of a pill much easier to swallow (pun intended).

Getting back to blood flow, the old research papers deal with microcirculation of the scalp and do indicate that the microcirculation does change with follicular atrophy based on tissue biopsy. In the end stage of baldness, even if you increase regional flow I don't think it is likely that the microcirculation will re-develop which is why you cannot get a shiny scalp to grow hair by any means, unless you replace the microcirculation with a graft. However, the grafting studies do not address regional blood flow - it was never a consideration. 'Donor dominance' is not nearly as clear cut as it used to be. We know that all sorts of tissues switch their genotypic or phenotypic expression based on the environment they are placed in. The most graphic example is coronary bypass. The veins used to replace the clogged arteries remain useful for about a decade at which point they have taken on the physical characteristics of the arteries they replaced, including becoming clogged. What the hair transplant guys don't tell you is that a considerable proportion of transplants eventually fail as well, which to me implies external environmental pressures otherwise you would expect a zero failure rate. You will be interested to know that the blond guy in the pictures I sent you is a failed hair transplant 12 years after plugs.

Some concepts (like the Earth is not flat) seem to take quite a while to mature. There is a guy who has been working on this concept for a number of years from an engineering standpoint. I have not communicated with David for quite a while (years) but he may have more data or ideas to offer you. http://www.malepatternbaldness.net/ , http://www.worldhairloss.org/index.php/hairloss/page2-featuredcontributors/the_mechanics_of_male_pattern_baldness

Cheers, B.

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