A Conversation with Spencer Kobren: A Guide to Preventing & Treating Hair Loss

Spencer Kobren on The Michael Peres Podcast
In this episode of the Michael Peres Podcast, Mikey Peres and Spencer Kobren discuss what hair loss is, who it affects, proven treatments, what one can do to treat and prevent it and what does the future hold for the industry.

In this episode of Spencer Kobren’s “The Bald Truth”, various methods and medications for combating hair loss are discussed in depth. The episode highlights:

  1. Finasteride (Propecia/Proscar): Originally developed to treat enlarged prostate glands, it was later discovered to have a side effect of hair growth and was subsequently approved by the FDA to treat androgenetic alopecia (male pattern baldness).
  2. Minoxidil (Rogaine): A vasodilator applied to the scalp to help grow hair and prevent hair loss caused by male or female pattern baldness. It works best in people under 40 and for those who start using it at the first signs of hair loss.
  3. Ketoconazole: An antifungal medicine shown to improve hair growth. It is also reported to have some effects on DHT, the hormone responsible for baldness in men.
  4. Dihydrotestosterone (DHT): A sex hormone that can make you lose your hair faster and earlier. It is derived from testosterone and is present in both men and women.
  5. Prostaglandin D2 (PGD2): A prostaglandin associated with dermatologic inflammation, pattern hair loss, and allergic disorders. Elevated levels of PGD2 are associated with male pattern baldness.
  6. Dutasteride: Similar to finasteride, dutasteride was initially a drug used to treat enlargement of the prostate. It is more effective at stopping the conversion of testosterone into DHT, resulting in more hair regrowth.
  7. Follicular Unit Extraction (FUE) & Transplantation (FUT): These are primary methods of obtaining hair follicles for hair transplantation. FUE was first described in 1988 by Masumi Inaba in Japan.
  8. LLLT (Low Light Laser Therapy): A modern non-surgical hair loss treatment that uses laser light to stimulate cell growth and supercharge hair follicles.

These are presented as viable options for those experiencing hair loss, however, the efficacy and appropriateness can vary among individuals, underscoring the importance of seeking professional advice for personal circumstances.

Learn more about Spencer (@spencerkobren)

Instagram: www.instagram.com/spencerkobren
Facebook: www.facebook.com/spencerkobren
Spencer Kobren: www.spencerkobren.com
International Alliance of Hair Restoration Surgeons: www.iahrs.org

Learn more about Michael (@mikeyperes)
Instagram: www.instagram.com/mikeyperes
LinkedIn: www.linkedin.com/in/mikeyperes
Facebook: www.facebook.com/mikeyperes
Michael Peres: www.michaelperes.com

About the guest

Additional Resources

The Bald Truth by Spencer Kobren

Spencer Kobren’s “The Bald Truth” is a nationally syndicated on air support group that has a 20 year pedigree. Developing a cult like status among men ages 18-35 who are seeking advice on anything from sex, to life, to hair loss; The Washington Post declared Spencer Kobren’s “The Bald Truth” a “Pulpit of the airwaves.” Tune in and see what you may have been missing all this time. It doesn’t matter if you are a hair loss sufferer. All that matters is that you may be able to find some knowledge to help out your day to day lifestyle. read more

Finasteride (Propecia/Proscar)

Finasteride is the generic name for the brand name drugs Proscar and Propecia. Finasteride was originally developed by the pharmaceutical company Merck as a drug (Proscar) to treat enlarged prostate glands. During the trials on men with prostate problems, researchers noted an intriguing side effect: hair growth. Since finasteride had already been approved by the FDA to treat enlarged prostates in men, Merck decided to pursue the possibility of developing finasteride as the first pill to treat male pattern baldnessMinoxidil, a topical liquid solution, was already on the market (see below). In December 1997, the FDA approved a 1mg dose of finasteride for the treatment of androgenetic alopecia (male pattern baldness) in men. Propecia is the first drug in history to effectively treat male pattern baldness in the majority of men who use it. read more

Minoxidil (Rogaine)

Rogaine is considered a vasodilator. While the exact mechanism of action for minoxidil (the active ingredient) isn’t actually clear, it’s believed to work by partially enlarging hair follicles and elongating the growth phase of hair. With more follicles in the growth phase, you’ll see more hair coverage on your scalp. Rogaine is applied to the scalp to help grow hair and prevent hair loss caused by male or female pattern baldness. This is the most common type of hair loss and runs in families. Rogaine works best in people with hereditary hair loss at the vertex of the scalp (the area at the back of the head, just under the crown) or for women with general thinning of hair on the top of the scalp. Rogaine has been shown to be most effective in people under 40 years old and for those who start using it at the first signs of hair loss. It won’t help people who’ve already gone completely bald. read more

Ketoconazole

Ketoconazole is an antifungal medicine that’s been shown to improve hair growth in studies. It’s also purported to have some effects on DHT, the hormone responsible for baldness in men. While ketoconazole is a safe and useful addition to a hair loss prevention stack, it’s also not a miracle hair loss cure. read more

Dihydrotestosterone (DHT)

DHT is an androgen. An androgen is a sex hormone that contributes to the development of what are thought of as “male” sex characteristics, such as body hair. But it can also make you lose your hair faster and earlier. DHT is derived from testosterone. Testosterone is a hormone that’s present in both men and women. It and DHT are androgens, or hormones that contribute to male sex characteristics when you go through puberty.

Prostaglandin D2

PGD2 is a prostaglandin that is central to development of dermatologic inflammation, pattern hair loss, and allergic disorders, such as asthma. A newly released, 2012 study showed a cause and effect relationship between abnormally high levels of PGD2 and male pattern baldness. With topical application they found PGD2 prevents hair growth, and mice who were genetically predisposed to produce higher levels of PGD2 had diminished hair growth. They additionally discovered PGD2 levels were much elevated in balding scalp versus non-balding scalp tissue. The study concluded that one of the receptors involved in production of PGD2, GPR44, constituted a precise therapeutic target for hormonal hair loss in both men and women. read more

Dutasteride

Dutasteride was initially a drug meant to treat enlargement of the prostate (benign prostatic hyperplasia, BPH) under the brand name “Avodart”. It works in a very similar way as finasteride. They are both designed to stop the conversion of testosterone into dihydrotestosterone (DHT), a hormone that causes male pattern baldness. The main difference between dutasteride and finasteride is the intensity of the effect. Finasteride 1mg blocks about 70% of DHT, whereas dutasteride 0.5mg blocks more than 90%. This means that dutasteride is more effective at stopping the conversion of testosterone into DHT. Since DHT is what causes hair loss, this results in more hair regrowth and thickening of existing miniaturized hairs compared to finasteride.

Follicular Unit Extraction (FUE)

FUE, also known as follicular transfer (FT), is one of two primary methods of obtaining hair follicles, naturally occurring groups of one to four hairs, for hair transplantation. The other method is called strip harvesting. The follicular units obtained by either method are the basic building blocks of follicular unit transplantation (FUT). Follicular unit extraction was first described in 1988 by Masumi Inaba in Japan, who introduced the use of a 1-mm needle for extracting follicular units.

Follicular Unit Transplantation (FUT)

FUT is a hair restoration technique, also known as the strip procedure, where a patient’s hair is transplanted in naturally occurring groups of 1 to 4 hairs, called follicular units. Follicular units also contain sebaceous (oil) glands, nerves, a small muscle, and occasional fine vellus hairs. In follicular unit transplantation, these small units allow the surgeon to safely transplant thousands of grafts in a single session, which maximizes the cosmetic impact of the procedure.

LLLT (Low Light Laser Therapy)

LLLT is a modern non-surgical hair loss treatment that uses laser light to stimulate cell growth and supercharge hair follicles. It helps to combat hair loss and improve the volume and appearance of hair. The therapy is painless and has no known side effects.  

Citations

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