Our own Dr. Ben Behnam recently joined Dr. Gillian Lockitch on her Growing Older, Living Younger podcast.  Dr. Lockitch is a former Medical Biochemistry specialist, professor, researcher, and international speaker.  Her popular anti-aging podcast features practitioners and experts on mental and physical health, nutrition, personal care, fitness, and other areas that help people learn about how they can age youthfully.  In case you missed it, here’s a summary of the informative discussion.

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Hair is an Important Aspect of Our Image

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Dr. Lockitch: Today’s quote is from actor Larry David, who said, “Anyone can be confident with a full head of hair, but a confident bald man; there’s your diamond in the rough.” That got me thinking about why our hair is such an important aspect of the image that we present to the world. Two things came to mind.

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1. Hair is a constantly renewable resource, which means we can experiment to create the look we desire, knowing that if something doesn’t work, we can try again. We can cut our hair short. We can grow it long, color it, streak it, curl it if it’s too straight, or straighten it if it’s too curly.
2. First impressions of someone’s age is influenced just as much by the state and the quality of their hair as by the state of their skin. That’s probably why hair loss and thinning are frequent concerns that people express when they’re asked about aging.

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We all know people who are gray or balding in their 30s, while others have a full, healthy head of hair in their 70s like me. Are we destined to follow the same hair growth and loss patterns as our parents or are there things that we can do to prevent thinning hair?

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Miniaturization of the Hair Follicles Causes Balding and Thinning

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Dr. Behnam: First, you must realize that everyone is different. Hair follicles typically sprout out slowly, and hair comes through the scalp.  When we’re young, our hair grows long fairly quickly.

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But, as we get older what happens is something called miniaturization, where testosterone bonds the hair follicles and prevents the hair from having that thick caliber to it. Miniaturization means that the hair caliber thickens. As the caliber of hair thickens, the hair itself shrinks and thins. The thinning is what gives the appearance of hair loss in both men and women.

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Usually the hair is in a couple of different stages. About 95 percent of the hair is usually what we call the antigen phase, which is called the growing phase.  Five percent is in what’s known as the telogen phase, which is a resting phase. Hairs in the telogen phase are typically the ones that fall out.  Sometimes the ratio shifts if there is a certain type of hair loss, such as alopecia areata. Typically, that’s true for most people, though.

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Genetics Play a Significant Role in How Your Hair Ages

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Dr. Lockitch:  Do genetics play a role in hair growth?

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Dr. Behnam:  Genetics is absolutely a component in hair growth. I have a lot of patients who say, “Well, Doc, my Mom and Dad both have great hair.  How come I’m losing my hair?”  It’s possible that both your Mom and Dad have certain hair loss genes you inherited.

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Dr. Lockitch:  One of the really interesting things that we’ve learned about genes and genetics is the power of epigenetics. Are there things that we can do to change the genes that control hair growth to make them work more efficiently or restore our hair to how it was when we were younger?

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Major Stressful Events can Trigger Hair Loss in Genetically Predisposed People

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Dr. Behnam:  As of now, we can’t alter our genetic make-up. However, your genetics only predispose you to hair loss. Other components and factors also play a role. Stress plays a major role in accelerating your genetic hair loss. I have patients, for example, who are in their early forties and have amazing hair. They will probably keep their hair unless something happens that triggers hair loss.  Major stressful events or traumatic events will accelerate underlying hair loss. One example is a 41 year-old guy who has great hair and all of a sudden loses his job, loses his house, and gets a divorce. Two years later, loses half of his hair. What happened? He was always genetically predisposed to losing his hair, but he never had those life stressors.

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Hormones Also Contribute to Hair Loss

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Dr. Behnam:  Hormonal imbalances also contribute to hair loss.   Imbalances that are typically seen in patients include:

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• Exogenous testosterone (artificially elevating your testosterone level)
• Thyroid disorders (Hypothyroidism, Graves Disease, etc.)
• Estrogen (Too low or too high)
• Progesterone (Too low or too high)
• Vitamin D deficiency
• Iron deficiency

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Although we are all genetically predisposed to hair loss, environmental factors play a big role.  In the majority of cases I see, a combination of the two typically causes hair loss.

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Diet and Nutrition Affects the Quality and Structure of Your Hair

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Dr. Gillian Lockitch:  Can we talk a little bit more about diet, nutrition and hair loss?  Tell me a little bit more about nutrition and the importance it plays in the quality and the structure of our hair.

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Dr. Ben Behnam:  I discuss nutrition a lot with my patients.  You are what you eat.   Let’s say you want to build a house. You have all the construction workers there. They’re ready to go, but you don’t have any bricks. Can you build a house? No, you cannot. Nutrition is the same concept.  If you don’t have some of those essential amino acids or vitamins, you cannot produce hair.

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When it comes to your hair, there are four pillars of nutrition:

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• Iron
• Vitamin D
• Collagen
• Protein

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I recommend at least 80 milligrams of iron for women. Vitamin D is also very important, so I usually recommend 2000 milligrams. That’s really critical. I’m a big fan of collagen; honestly I really don’t care where you get the collagen from. Collagen powders are key. You can also buy collagen tincture liquids. A lot of patients say that a few months after adding collagen to their diets, their hair starts to grow better.  Lastly, studies show that increasing your protein uptake helps. For example, eating more fish and chicken is great. Avocados and cashews are wonderful too.  We also find that adding more protein powder to your diet gives your hair a lustrous look.

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Not all Protein Powders are Created Equal

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Dr. Ben Behnam:  There are two types of whey proteins:

1. Whey Protein Concentrate
2. Whey Protein Isolate

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Whey protein isolate is what people take for muscle building. It’s the most popular type of whey protein.  It’s actually bad for your hair. The reason why is because it increases the testosterone level in your body.  Whey protein concentrate does not increase your testosterone level, and is good for hair. So we always try to switch patients from isolate to concentrate.

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Common Myths about Hair Loss Debunked

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Dr. Lockitch: What are the most common myths about hair loss?

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Dr. Ben Behnam:  Myth #1:  People always say, oh, I heard that hair loss always comes from the Mom’s side, not from the Dad’s side. Well, that’s not true. Hair loss comes from both sides.

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Myth #2:  People often think they can stop their hair loss medication after six months.   Unfortunately, hair loss is one of those things that once you start on a protocol or regimen, you have to do it forever. The reason is that you’re constantly at war with your testosterone.  If you’re not doing anything to prevent testosterone from causing miniaturization of your hair, guess who’s going to win?  So that’s a very common misconception.

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Women Have a Different Hair Loss Pattern Than Men, But the Cause is the Same

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Dr. Lockitch:  What about female hair loss?

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Dr. Ben Behnam:  As with men, testosterone plays a big role in female pattern hair loss.  Women experience a different pattern of hair loss than men.  Typically men will start to lose hair in the widow’s peak and the crown area.   Women usually lose the top of their scalp between the front and the crown area.  The number one pill that women take for hair loss is Spironolactone, a testosterone blocker.

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Not All Alopecia is the Same

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Dr. Gillian Lockitch:  I know a couple of people who developed alopecia areata in their teens. What do we know now about alopecia?

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Dr. Ben Behnam:  The word alopecia is a very generic term.  Male and female pattern hair loss is also called androgenic alopecia. Alopecia areata is a different type of alopecia.   My twin brother and I have alopecia areata. Both my first cousins have it, so it runs in my family. I got it when I was 34 years old. Alopecia areata is an autoimmune condition where the body attacks the hair follicle that prevents the hairs from growing. The treatment goal is to reduce the inflammation, which we often do by injecting steroids.

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Some People Experience Alopecia Totalis, Complete Hair Loss

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Dr. Lockitch:  Can alopecia areata occur as total hair loss?

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Dr. Behnam:  Yes, alopecia totalis, also known as alopecia universalis, occurs in some people and is difficult to treat. Fortunately, a medication called Xeljanz is now available.  It’s an oral pill that helps patients with aloepcia totalis or universalis.   Honestly, it works. The problem is that in the United States the medication is only approved for rheumatology, not for dermatology. The majority of alopecia cases experience hair loss in patches, though.

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Beware of Styling Habits that Can Cause Hair Loss

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Dr. Gillian Lockitch:  I had mentioned that one of the wonderful things about hair is we can cut it, we can dye it, we can tint it, we can do all sorts of funny things. Are there any common mistakes that people make that cause their hair loss to get worse?

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Dr. Ben Behnam:  I always say the less you play with your hair, the better.  It’s best to avoid:

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• Tight braids or anything that pulls on your hair
• Heat from hair dryers
• Hot oil treatments
• Hair dye
• Hair bleach
• Brazilian blow-outs
• Aggressive brushing

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Covid Infection Can Cause Hair Loss

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Dr. Lockitch: You mentioned to me when we were off air that a lot of people ask about Covid-induced hair loss and whether it really happens.

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Dr. Behnam: We see a lot of Covid-induced hair loss in our clinic.  Like childbirth and other events that put stress on your body, Covid causes something called telogen effluvium.  If you remember what I said at the beginning of the show, when there aren’t any interruptions to your hair growth, 95 percent of your hair is in the antigen phase and only five percent is in a resting phase.  If you go through a traumatic, stressful event like hospitalization or giving birth, the ratio shifts from 95 percent of your hair in the antigen phase to 50 percent.  That’s why people can lose up to 40, 50 or 65 percent of their hair in just a few months.  It’s shocking because many of those patients had a lot of hair before.

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To Preserve Your Hair, Live a Healthy Lifestyle

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Dr. Lockitch:  For our audience members who are interested in living young as they grow older, what key takeaways would you tell people about their hair?

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Dr. Ben Behnam:  People can deal with their hair issues by using medications or choosing a healthy lifestyle.  Adding Vitamin D and iron, using whey protein, and eating a healthy non-processed diet will not only help your hair.  It will help give your hair a much more youthful appearance.  It will also contribute to your overall health.

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Dr. Lockitch:  As you contemplate your roadmap for healthy aging, be sure to discuss your intentions with your medical or other qualified health practitioner.

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Getting Older, Living Younger Podcast

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To hear the full podcast, tune in to Dr. Lockitch’s Growing Older, Living Younger segment.

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About Dr. Ben Behnam

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Dr. Ben Behanam is a board-certified dermatologist, hair specialist and co-owner of Happy Head hair loss solution.  His well-known practice, Dermatology and Hair Restoration Specialists, is located in Los Angeles, California.

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Over time, Dr. Behnam realized that many men had side effects from the most common hair loss medication known as Finasteride. In 2020, he launched an online telemedicine company called Happy Head that allows easy access to patients across the country to a new formulation of topical Finasteride, which has potentially lower side effects than the oral version. Through this platform, he has helped numerous men and women retain and grow their hair.

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For more information about Dr. Behanm or your hair loss options, visit us at Happy Head.