Hair Loss and Balding

Wed, 6/16 6:34PM • 1:01:04

Better Man Clinics 

When do men usually turn to a Dermatologist for help with hair loss? Are they usually the typical middle aged man who sees hair loss as part of aging or are you seeing men in their 20s and 30s dealing with hair loss?

Dr Kandel 

Hair loss can start as early as in the teens. But it’s not noticeable, probably until till the 20s. If anything, I actually do have a fair number of young men, early 20s, late teens coming in.  They first notice hair loss and go online and see that it can actually start that early. They usually panic and want to seek treatment before it gets to be too noticeable and other people see that they’re going bald. So I see young men as early as 20. By age 50, hair loss and baldness are usually pretty apparent.  By that point, most men already know what’s going on and they’re either on treatment or they’ve kind of given up.

Better Man Clinics 

So it would be safe to say then when men see a Dermatologist or other health care professional for hair loss, they’re really kind of in the early stages?

Dr Kandel 

Yes, as for many dermatologic conditions, people who see the dermatologist for hair loss are the one who care about their appearance and who will try to catch it very early, even if there isn’t a significant amount of hair loss yet.

Better Man Clinics 

That’s important to know because you really want to to get ahead of this right?

Dr Kandel 

Yes, it’s much easier to start with almost a full head of hair and keep it that way than to grow back a whole head of hair.

Better Man Clinics 

To what extent does genetics play in causing hair loss and baldness?  Specifically, is it true that if a man’s maternal grandfather is bald, then it is very likely he will be bald as well?  And if so, to what extent?

Dr Kandel 

Well, to a certain extent.  We know that genetics plays a big role in hair loss.  However, it is not as simple as if your maternal grandfather is bald then you’re going to be bald. Several have been found to be associated with baldness, most of which center around testosterone and testosterone receptors and how sensitive your receptors are to testosterone. Because bald men don’t necessarily have high testosterone, it’s a matter of how sensitive their scalp is to that testosterone and the byproduct (dihydrotestosterone). So basically, the chances are that if either grandfather is bald, you’re more likely to be bald. I’ve read that if your father is bald, you’re five times more likely to be bald than someone whose father is not. Several major genes that have been found to be associated with hair loss. One of these is this AR(androgen receptor) gene that is involved with the testosterone receptor. But as I said, they found now that there are many contributing factors.  We know genetics is probably the most important determinant of hair loss. We just don’t know how to accurately predict which men will develop hair loss.

Better Man Clinics 

Well, if nothing else, if your family members do all have full heads of hair, that’s potentially a good sign that you will as well.   Now, let’s take a step back, because you mentioned testosterone a few times.  Testosterone, as we know, is the “male” hormone.  It (and its derivative dihydrotestosterone) is the hormone that that gives men male qualities.  What’s that relationship between these hormones and hair loss?

Dr Kandel 

We know that testosterone and probably more importantly, dihydrotestosterone, or DHT, promote hair loss in men. DHT is basically the active metabolite of testosterone. There are different types of receptors for this hormone in the prostate and in the scalp.   In the scalp, DHT actually affects the way the hair follicles mature. During this process, each hair follicle is becoming thinner and thinner and the space between them gets wider and wider. DHT also shortens the growth phase of the hair. Normally, your hair has a growth phase, arrest phase, and then a death phase. If the rest and death phase are longer, and the growth phase is shorter, and the hair follicles are getting thinner and thinner, their eventually is more and more space on the scalp between hairs (thinning) until complete baldness occurs.

Better Man Clinics 

So DHT really plays a key role in the process of hair loss.

Dr Kandel

Exactly. And, as a result, many hair loss therapies are targeted this hormone.

Better Man Clinics 

Are there medical conditions that might predispose men to hair loss? Is the mechanism in these cases the same as in typical men’s baldness? Or is that a whole different mechanism?

Dr Kandel 

Baldness is associated with several medical conditions. These include conditions such as obesity, diabetes, high blood pressure, heart disease, and even prostate cancer.  What we don’t know is why or how they are related. Are they co-morbidities? Meaning, do they just go together? Or is it that whatever is causing the medical condition is the same thing that’s causing the baldness?  We do see that bald men have higher rates of heart disease and prostate cancer, especially if the hair loss is at the vertex crown of the scalp.

Better Man Clinics 

The connection between prostate cancer and hair loss appears to be testosterone and DHT because the prostate, like hair follicles, is sensitive to these hormones.   But with other medical problems, though, like with thyroid disorders or even lupus, what is the mechanism that connects them with hair loss?

Dr Kandel

The hair loss that is associated with these other conditions is not considered androgenic(related to Testosterone), or male pattern baldness.  Rather, it probably is more related to inflammation.  For example, we think that hair loss associated with thyroid disease is something called telogen effluvium, which is caused by stress on the body. Sometimes, when the body experiences significant stress then it shuts down functions that aren’t necessary. Hair and nails may stop growing in times of acute stress like when someone experiences a big weight loss or undergoes a major surgery.  People will notice that their hair starts falling out after these stressful events, or they notice ridges in the nails where they stop growing during that time. But hair loss in these situation is usually short lived and when the underlying strssors are attended to, the hair usually regrows within a year or so.

Better Man Clinics 

That makes sense.  If there’s a major stress to the body, it’s going to focus on what’s going to keep you alive, not necessarily things like hair or nails.. That type of hair loss that occurs from stress on the body from medical issues is not an androgenic hair loss or male pattern baldness. Women can experience that type of weight loss as well.

Dr Kandel 

Correct.  Stress related hair loss is not related to androgen or testosterone. But what you mentioned earlier, with regards to heart disease, and prostate cancer and the diabetes, those are linked with androgenic alopecia or male pattern baldness. And again, we don’t know if it’s cause and effect or just similar things that are causing the male pattern baldness. We don’t know if it’s the Testosterone thats also playing a role in the development of heart disease and diabetes in these cases or if there is another mechanism involved.

Better Man Clinics 

What about medicines? Do any medications contribute to hair loss?

Dr Kandel 

Many medications have been associated with some hair loss. But again, that would be different. Most of the medication related hair loss usually would be something would be associated with telogen effluvium, meaning that the medication kind of arrests the hair from growing.  Chemotherapy represents the extreme form of this – it can completely arrest the hair growth and make it fall out. But those are reversible. Once you figure out what the medication is and switch to a different or stop the medication, that hair will usually grow back.

Better Man Clinics 

We talked about how physical stress on the body from medical conditions can cause hair loss.  What about psychological stress?  Would your body naturally lose hair just a more mental or psychological stress?

Dr Kandel 

I think if you just have more stressful life at baseline, probably not. But significant psychological stress that translates into less sleep less and poor diet possibly can.  So I think it’s not just the fact that your brain is stressed.  Rather, I feel that other things associated with the mental stress are going to contribute to the hair loss. But again, that would be reversible unless the stress goes on indefinitely. Again, that hair loss wouldn’t the type that’s sensitive to the testosterone and DHT

Better Man Clinics 

What about diet?  There are several mentions of vegetarian diets online as possibly contributing to hair loss due to a lack of protein.  Is that a credible cause?

Dr Kandel

Diet can impact hair loss but it wouldn’t necessarily be the androgenic or male pattern hair loss. We see people who go on extreme diets or on simple vegetarian diets without really knowing where they should be getting their protein from and without taking supplements as needed. That could lead deficiencies in protein as well as nutrients like Vitamin B12 or Biotin.  That type of hair loss should be reversible by adjusting the diet and taking the appropriate supplements. So yes, diet most definitely can affect hair loss.   But, in contrast, you cannot reverse male pattern baldness simply through an extreme diet maximizing protein and the other nutrients that we mentioned.

Better Man Clinics 

Nonetheless, if I am noticing that my hair is thinning but I also decide I want to start the latest in the greatest vegetarian or vegan diet is that something to keep in mind?

Dr Kandel 

For sure. If you if you’re going to start a new diet, you definitely need to research what key nutrients you won’t be eating as part of that diet, and where you can get those comparable vitamins, minerals and amino acids that you need in your diet, especially for hair. If you’re going to do a restrictive diet, you may lose hair, whether you have a tendency to male pattern baldness or not. You would always be wise to thoroughly research if you need to take supplements and what kind of things you need if you’re going to do this long term.  Its always a good idea to consider speaking to a health care professional about the possible consequences of starting a new diet.

Better Man Clinics 

And this is an important point- your diet affects so many parts of your health. When you take on an intervention like a new diet, its always a good idea to talk to your health care provider to at least get an understanding of what you are getting into.  Now, another another risk facor we hear about with hair loss is smoking. How much does that play a role?

Dr Kandel

Honestly, in everyday practice, I can’t say that, I’ve noticed that as a contributor. Obviously, the smoking probably decreases the blood supply and the oxygen to he scalp.  I imagine that would have some impact. And it’s obviously not good for many other reasons. But in terms of genetically altering your predisposition or bringing out your male pattern baldness at a certain age, I don’t think that’s related to when you started smoking. Don’t get me wrong- its always good to try to stop smoking. There are so many other reasons why you shouldn’t smoke.

Better Man Clinics

Now we are going to go a little bit into left field with a segment that I like to call “fact versus fiction”.  I want to run some potential lifestyle factors by you to see what you think of them as a potential cause of hair loss in men.   The first think was something my mother used to tell me when I was a kid to avoid so as not to go bald when I became an adult: wearing a hat. I have seen this online as well.  I have seen a theory that maybe wearing a hat suffocates the hair follicles?  What are your thoughts?

Dr Kandel 

No, I don’t believe that wearing hats causes hair loss.  I don’t know of any evidence that hats suffocate the hair follicles or hurt them to any appreciable extent.

Better Man Clinics 

What about brushing your hair?  Some would say that if you brush your hair too aggressively, you’re going to pull your hair out that way. So you have to be very gentle with your hair when you brush it. What do you think of that?

Dr Kandel  24:39

Yeah, again, I think long term, you’re probably not going to change the outcome.   However, I do advise people who are experiencing hair loss to try not to wash their hair as frequently. I advise people in that situation to try not to wash their hair every day. Other than in the US, people in most countries in the world do not wash their hair on a daily basis. And it doesn’t really require it.  You need oil to protect the scalp and the hair follicles in the cuticle and by washing your hair daily, your are also washing away that oil.   I always say, you lose a certain amount of hair every day and it’s normal.  We all do.  But on the days that you wash your hair, you probably lose double. So if you’re doubling the amount of days that you wash your hair, you probably are doubling the amount of hair loss because obviously you are manipulating it and pulling it a little bit when you are washing your hair. It’s probably worse for women who have longer hair, because there’s a lot more pilling going on. But I think there’s some truth with men as well.

Better Man Clinics 

So just to clarify, during the hair washing process, is it the fact that you’re running your fingers through your hair and kind of pulling it? Or is it just getting water and shampoo on it?

Dr Kandel 

I think it’s mostly just the massaging and the pulling. The hairs that get pulled out are already in what we call the telogen phase, meaning they’ve stopped growing. These hairs are going to come out anyway, but they get pulled out to early in this scenario, before they can be replaced by a new hair. That makes you look like you have less hair because of the gaps when the old hair is pulled out before the new hair has time to grow in.

Better Man Clinics 

How many times a week would you recommend men to wash their hair in general?

Dr Kandel 

I would say two to three times a week is  probably more than adequate.

Better Man Clinics

What about hair products?  Does using gels and other products in your hair change affect the health of your hair, particularly with respect to the risk of hair loss?

Dr Kandel 

No, probably not. I don’t think they do. If you’re doing things like perms or like the Brazilian blowouts where you’re straightening the hair, those probably could damage the hair and cause more hair to fall out. Again, that hair would come back in several months anyway. But I think in the short term that the gels and hair products probably don’t make a difference.

Better Man Clinics  29:17

So now, we’ve talked about prevention.  Lets say a man does everything he can to could to avoid hair loss, but he looks in the mirror and notices that his hair is thinning. What can he do? I’d like to start with the simplest, most innocuous things and make our way through to more aggressive treatments. So even if we’re starting with the with super, super simple things that you can get in the supermarket, like, shampoos. I’ve heard that there’s different types of shampoo can help treat thinning hair. What’s your thought about shampoos and treating hair loss?

Dr Kandel 

I kind of scoffed at this at first, but in doing a little research, you’re right. Zinc is one of the ingredients in dandruff shampoos like Head and Shoulders.  Studies of these shampoos have demonstrated that, over a six month period, that they do increase the hair density.  When you compare these results with those of minoxidil, they are probably less than half as effective. But in somebody who doesn’t want to use minoxidil, that would be a good option. Because as you said, you have to wash your hair anyway, and why not start getting improvement. And Head and Shoulders and DHS zinc shamppos are over the counter. Another one, I think you mentioned or we’re going to mention is the Ketoconazole or Nizoral shampoo. The 1% strength version of these shampoos is over the counter, so you can buy it anywhere. And again, they’ve small trials and have shown that they do increase hair density in men over a six-month period. And so those are two things that are very easy to do. Just switch your shampoo and, you know, maybe you’ll buy yourself a couple years where it kind of slows it down enough that you don’t need anything else.

Better Man Clinics

Do we have any idea as to the mechanism behind how shampoos like Head and Shoulders affects hair loss? I know it helps my dandruff. But why would it help me get thicker here?

Dr Kandel 

Well, we’re thinking that maybe the zinc in these shampoos is some form of anti inflammatory and that maybe the testosterone is a pro inflammatory.  We also know that ketoconazole is anti inflammatory. There is also some thought that the zinc and ketoconazole may counteract the conversion of Testosterone to DHT in the scalp. These anti-inflammatory properties and impact on DHT may be behind how these shampoos help with hair loss.

Better Man Clinics 

We always hear about Rogaine as a treatment for hair loss. Is that medication over the counter or is it available only by prescription

Dr Kandel 

Minoxidil is over the counter. The trade name was Rogaine. They still have Rogaine available. Minoxidil is the generic: same thing, half the cost. They make a 2% concentration for women, but even for women, I recommend the 5% concentration because it’s obviously more effective. We used to think that minoxidil works just by increasing blood flow to the scalp because it’s a vasodilator (it dilates the blood vessels).   It brings a better blood supply with more oxygen which should make hair can grow better.  Studies have actually also shown that minoxidil also increases the length of the growth phase of hair follicles. Either way, we know that minoxidil does improve the longevity of hair.

Better Man Clinics 

And so, so minoxidil 2% or 5%. Is that a cream? Is that a gel?

Dr Kandel 

There’s a couple of versions that comes as a liquid.  All are pretty easy to put on. It also comes as a foam, which I  prefer because I feel it’s easier to kind of get it into the scalp.  The gel can be a little messy.

Better Man Clinics 

How do you apply Minoxidil?  Do you put it in like a shampoo and wash it out? Do you apply it on dry hair like a gel or hair product?

Dr Kandel 

You can just rub it into your hair and hope that it doesn’t mess up your hairstyle too much. If you have a lot of hair, the minoxidil will probably the texture somewhat. I don’t think it behaves as a gel necessarily to make it stiff. But it probably does have some look to it. The biggest complaint I get is that can cause some scalp irritation. Rarely,some people complain about their scalp being itchy and red.

Better Man Clinics 

And men can get Minoxidil in a regular supermarket?.

Dr Kandel 

Yeah, I’ve seen it in stores such as Target  and Walmart.

Better Man Clinics 

What about supplements? One that comes up a lot both by itself and also as an ingredient in shampoos is biotin.  Does that help?

Dr Kandel 

Biotin is a B vitamin which is pretty easy to ingest naturally. It is found in a lot of shampoos and other formulas but I don’t think that biotin supplements contribute much in this situation. I don’t usually recommend it for men with androgenic hair loss.

Better Man Clinics 

Another supplement I have seen with regards to treating hair loss is Saw Palmetto. For those guys that don’t know, Saw Palmetto is probably the most common supplement used by men for enlarged prostate has a modest effect. I’m assuming that the idea here is the same as the idea with the prostate: the effect on Testosterone and DHT etc.  Does it really work for hair loss?

Dr Kandel 

Saw Palmetto can have some benefit both topically and orally. I would probably not use it by itself.  I would probably do use minoxidil with maybe one of the shampoos and then add Saw Palmetto.

Better Man Clinics

Is it common to combine the various hair loss treatments for a stronger effect?

Dr Kandel

Yes, I always tell people that, as with many conditions that we treat, sometimes two, three ingredient combinations, work much better than just the one treatment alone. If you combine these three treatments, you can see better results because they are working via slightly different mechanisms simultaneously.

Better Man Clinics 

I am assuming that the over the counter options we just discussed are for men that are starting to see thinning hair and are hoping to preserve the hair they still have.  Is that right? These over the counter treatments are not for people who have full blown hair loss and male pattern baldness?

Dr Kandel 

Yes, that is true.  The initial large studies on minoxidil were geared towards preventing hair loss rather than restoring hair that has already been lost.  Actually regrowing hair in a meaningful way requires prescription medication and/or other treatments.

Better Man Clinics 

Lets talk about prescription medications for hair loss. The one that I know of is Propecia. I know about it because it is used at a higher dosage for treating prostate issues. Tell us a little bit about that and what type of man is the ideal candidate for this type of medication?

Dr Kandel

Yes. Propecia has a dosage of 1 milligram.  It is basically the same medication as the prostate version, called Finasteride, which comes in a 5 milligram dosage.  Because it is stronger, the prostate version also has more significant side effects. Both medications work by blocking the enzyme that converts the testosterone to DHT, or the active form of testosterone. The studies on Propecia are very good.  Long term data demonstrates that, after three to four years of treatment, men can increase their hair volume by 25%. That’s the upside.

The downside is that once you’ve committed to taking this medication, it’s a lifelong medication or until you’re old enough to decide that your ok being bald. Essentially, once you stop the medication, hair loss will accelerate and regress to where it would have been had you not started.

Better Man Clinics 

What about surgical options?  What can you tell us about hair transplants or hair plugs?

Dr Kandel 

Hair transplants essentially involves harvesting hair follicle units.  Surgeons used to take wedges if hair from the back of the scalp, cut it into pieces, and graft the pieces.  Now they use a more elegant approach in which they use punch grafts, each about 3-5 millimeters.  The key to these approaches is that man needs to still have hair on the back of the head from which to take grafts.  The theory is that if you transplant those hairs to the areas of alopecia that they will take on the characteristics of the back of the scalp instead of becoming miniaturized. And they’ve actually done studies and shown that it is indeed true those hairs if they take and, you know, grow, they will be safe from future hair loss. And they will not be sensitive to testosterone or DHT.

Better Man Clinics 

And what happens to the place from which you took the grafts?

Dr Kandel 

Again, you are basically taking little punch grafts, three or four millimeters in size. These tiny holes can then easily be closed with a stitch and hair will then grow over them.

Better Man Clinics

What happens immediately after the transplant?  Does the transplanted hair look natural?

Dr Kandel 

Hair transplants involves a lot of work.  Each session can involve between 800 and 1200 grafts. For a while, you do look a mess because the surgeon applies the grafts as if he or she is planting roses. They are then covered and allowed to “take”.  During this time, you have to be very careful. But the result is usually very nice.  The hair line looks more natural.  In a few months, you probably would have a hard time differentiating natural from transplanted hair.

Better Man Clinics 

So this sounds like a journey of several month. It’s not like, “Hey, I’m just gonna come in and get my hair transplant today.”

Dr Kandel 

Correct, and there is no guarantee that all of the grafts will take. Up to about 20% of the grafts can fail and you would likely have to redo those at some point.

Better Man Clinics 

And so you had mentioned as opposed to the original hair plugs, what is the hair plug versus hair transplants?

Dr Kandel 

Hair grows in hair follicle units. Typically, three or four hairs grow out of a follicle unit. So when you do this punch for hair transplants, you kind of look and see, and you get like a little collection of hair follicle units.  In contrast, for the old hair plugs,  they would take this large sheet of follicles, and then just slice it like you would a brownie, into quarters. So they weren’t really differentiating these hair follicle units, they were just making little squares and shoving them in. So that’s why the hairline never really looked natural, it looked too straight across.  If you look carefully, you notice that your hair never just go straight across. It kind of does a little zigzag. So if you transplant the individual units, you’re not getting these straight, unnatural lines that you used to see with plugs. Rather, you’re getting the natural variation that you do with natural hair. So it’s actually brilliant. And it looks great, but it’s a lot of work. It can be tedious and uncomfortable, because you do have to get a lot of pokes for the individual grafts and a longer recovery because it kind of takes a while to look good. And then you have to go in and do it again for those that don’t take. So it’s probably a year process until you really are done.

Better Man Clinics 

The other criticism of the old hair plugs and even hair transplant that I’ve heard is that it doesn’t quite look the same; it may not look quite as thick, not quite as long, kind of more looks like peach rose. But that’s not the case, right? I mean, when the if it takes, it looks like the real deal?

Dr Kandel 

It’s the real deal. Again, the issue is how much hair loss you’ve had. You know, if you’ve lost a little bit of hair, that’s easy. If you’ve lost a lot, it’s going to take a long time and money. So if you’re planning to do one session, it’s probably not even worth it. Because that would look weird if you have like, few clumps of hair. So if you are going to do it you really have to be prepared for the investment of time and money.

Better Man Clinics 

Another treatment we hear about is scalp micropigmentation. This is not the spray on hair that we used to see on infomercials, right?

Dr Kandel 

Scalp micropigmentation is essentially tattooing, permanent makeup tattooing. Its like when women get a permanent eyeliner or micro blading. So it’s a little different than just drawing a line of the eyebrow; they actually, they make them look like little hairs, so to speak. But essentially, again, if you’re completely bald, it’s going to look ridiculous. But if you’re kind of thinning, where you can see the white of the scalp, and you go in and you tattoo, the dark little lines, the I can’t tell if that’s scalp or hair, because it’s dark and blends in and it looks pretty good. Again, this is really only an option if you’re not bald, and the hair is just thinning,

Better Man Clinics 

Who performs micropigmentation? Aestheticians?

Dr Kandel 

Aestheticians perform micropigmenation.  I don’t know if they have a special license to do the permanent makeup or the microblading. But they’re essentially aestheticians and this is done like a tattoo.  Its a little more superficial than tattoo pigment from what I understand. It doesn’t last as long as a tattoo would, but it’s still semi-permanent.

Better Man Clinics 

To that point, both these last two options of the hair transplant and the micropigmentation are invasive to some extent and they can be at least semi-permanent.  However, neither a hair transplant nor micropigmentation requires a prescription or referral.  Should a guy who is worried about hair loss and is interested in a hair transplant or micropigmentation consult with a dermatologist before jumping into treatment?

Dr Kandel

I would.  Your hair loss may not be extensive to the point that you need these more aggressive treatments.   It may be wise to maybe try something beforehand to thicken up the hair. Maybe you’ll still need a transplant but maybe it’ll be much less extensive and maybe you would need fewer sessions if we can get the hair thicker in a year.  Also, you want to make sure it’s right for you.  A lot of times it’s deceiving; you may think someone has male pattern baldness, but it turns to be another, more reversible type of hair loss that we previously discussed.  Sometimes it is autoimmune hair loss or sometimes it is stress related.  In these cases, we can try different treatments and restore the missing hair. Also, in some cases, the hair loss will resolve on their own and this would all be for nothing. Its never a bad idea to confirm the problem before seeking an expensive and time consuming solution.

Also, you want to get a good recommendation for the right professional to do the procedure. It’s like with a plastic surgeon- you want someone who’s had a lot of experience doing only hair transplants, not someone who like does it once in a while. You want to make sure it’s a board certified dermatologist who’s had experience with the latest techniques, because I’m guessing some people are still doing the old block sections.  They may be less expensive, but if you’re going to make the investmen, then you might as well go to the best.

Better Man Clinics 

I think that’s such a good point. I mean, you really can’t assume that any place you walk in with a shingle is going to give you the best possible care, particularly when you’re making such a huge investment in something that’s so important to you.

Now, one last thing. I’ve seen a lot of commercials for LED light therapy. I think one of them is called Capillus. From the commercials I’ve seen, it’s literally like a baseball hat that you wear while watching TV. The hat has these light emitting diode(LED) lights that are supposed to increase hair growth.  Can you shed some light (no pun intended) on the LED hats?

Dr Kandel 

The LEDs there basically low level laser light therapy. They use these LEDs, which are red or near infrared light. We think that they may increase the circulation. I don’t think they have any effects on the hormones or the testosterone. To my knowledge, there are really no controlled studies. It’s one of those things that the literature says may lead to  some increased hair density after six months. But if I was serious about treating my hair loss, I would probably invest in one of the more respected treatments, unless I do this as an adjunct. If I had someone who was already on finasteride and using the minoxidil who wanted to try the LED therapy I would be ok with.  I would say “sure, it’s harmless, you can try the hat”. But if he wanted to invest in this versus using the minoxidil, I would say no, because the data demonstrated that the best options for hair loss are finasteride and minoxidil and obviously the hair transplant if you’re going that route.  These other options probably have some modest effect, but would not be my only sole treatment.

Better Man Clinics 

Dr. Kandel, thank you so much for providing all these insights for us. I think you provided a wealth of information to every man who is a little worried every time he looks in the mirror and hoping to not lose the remainder of their hair or maybe grow some back. It’s been a pleasure speaking with you.

SUMMARY KEYWORDS

Hair loss, hair, scalp, supplements, shampoos, testosterone, hair transplant, baldness, minoxidil, dermatologist, bald, hair follicles, male pattern baldness, wash, prostate, Rogaine, Propecia