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The Peter Attia Drive

#316 - AMA #63: A guide for hair loss: causes, treatments, transplants, and sex-specific considerations

The Peter Attia Drive

Peter Attia, MD

Health & Fitness, Medicine, Fitness

4.77.3K Ratings

🗓️ 9 September 2024

⏱️ 21 minutes

🧾️ Download transcript

Summary

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In this “Ask Me Anything” (AMA) episode, Peter dives deep into the topic of hair loss, exploring its relationship with aging and its impact on quality of life. The conversation focuses on androgenic alopecia, the most common form of hair loss in both men and women, and covers the differences in patterns and causes between the sexes. Peter delves into the right timing for treatment, breaking down various options such as minoxidil and finasteride, low-level laser therapy, platelet-rich plasma injections, and more. Additionally, Peter outlines the pros and cons of the two primary hair transplantation methods and concludes with practical advice on selecting the right specialist or treatment team for those facing hair loss.

If you’re not a subscriber and are listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or our website at the AMA #63 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

We discuss:

  • The impact of hair loss on emotional health [2:15];
  • The prevalence, patterns, and causes of hair loss in men and women [5:15];
  • The genetic and hormonal causes of hair loss, and the role of dihydrotestosterone (DHT) in androgenic alopecia [8:45];
  • The visual differences in hair loss patterns between men and women, and the importance of consulting a specialist to rule out non-genetic causes of hair loss [13:30];
  • How genetic predisposition influences the risk of androgenic alopecia, and how early detection through diagnostic tools and blood tests can help manage risk more effectively [16:45];
  • Ideal timing for starting treatment: why early treatment is crucial for effectively managing hair loss [19:30];
  • The various FDA-approved treatments for androgenic alopecia, their mechanisms, and additional off-label treatments commonly used to manage hair loss [24:30];
  • Topical minoxidil—the most commonly recommended starting treatment for hair loss [30:15];
  • Oral vs. topical minoxidil: efficacy, ease of use, and potential side effects that must be considered [33:45];
  • Finasteride for treating hair loss: efficacy, potential side effects on libido, and the need for careful PSA monitoring in men to avoid missing early signs of prostate cancer [37:15];
  • Other effective hair loss treatments for women: boosting hair density with spironolactone gel and ketoconazole shampoo as part of a comprehensive strategy [41:30];
  • Low-level laser therapy: effectiveness, costs, practicality, and a comparison of in-office treatments with at-home devices [49:00];
  • Platelet-rich plasma (PRP) as a treatment for hair loss: potential effectiveness, varying protocols, and significant costs [53:45];
  • Hair transplant for advanced hair loss: criteria and considerations [58:00];
  • Types of hair transplants: follicular unit transplantation (FUT) vs. follicular unit extraction (FUE) [1:02:00];
  • The financial cost of hair transplant surgery, and what to consider when seeking affordable options [1:06:15];
  • The potential risks and downsides of the various hair transplant procedures [1:09:30];
  • Post-procedure care for hair transplants and whether the procedure must be repeated periodically [1:16:30];
  • Combining different hair loss treatments: benefits, risks, and considerations [1:18:30];
  • Emerging hair loss treatments with limited data [1:21:00];
  • Key considerations for selecting the right treatment plan for hair loss [1:22:00];
  • A summary of the different considerations for men and women facing hair loss [1:24:30];
  • Practical advice on selecting the right specialist or treatment team [1:26:15]; and
  • More.

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Transcript

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0:00.0

Hey everyone welcome to a sneak peek ask Ask Me Anything, or AMA episode of the Drive Podcast.

0:16.0

I'm your host, Peter Attia.

0:17.7

At the end of this short episode, I'll explain how you can access the AMA episodes in full,

0:22.3

along with a ton of other membership benefits we've created.

0:25.4

Or you can learn more now by going to Peteratia MD.com forward slash subscribe.

0:31.0

So without further delay, here's today's sneak peak of the Ask Me Anything episode.

0:37.0

Welcome to Ask Me Anything, episode 63. I'm once again joined by my co-host Nick Stenson. In today's episode, we cover all things related to hair loss.

0:48.8

While hair loss is not a direct threat to lifespan of course. It certainly can be a relatable topic

0:54.2

when speaking about aging,

0:55.8

and one could certainly make the case

0:57.6

that it factors into health span and quality of life.

1:00.3

It's also a topic I get asked about a great amount through you, the

1:04.9

listeners, and also my patients. In this conversation we talk about hair loss

1:09.9

primarily as it relates to aging, which is a type of hair loss that is called

1:14.8

androgenic alopecia. This is the most common form of hair loss for men,

1:19.6

certainly, and it also plays a significant role in hair loss for women. We describe the differences

1:26.8

of course between men and women because they have a very different pattern of hair loss and

1:30.8

obviously somewhat different ideologies.

1:33.4

We talk about when the right time to start treatment is and what the breakdown of various

1:37.5

treatments are.

1:38.6

We cover everything from the pharmacologic uses of monoxidyl, finasteride, spironyl, ketocontol chuteinazol shampoo,

1:46.9

low-level laser therapy, and PRP injections.

...

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