Monica questions:  What causes more hair loss straightening you hair with a flat iron or doing a relaxer at a salon?

Left Brain straighteners her out:

Great question Monica.  A quick answer is that Relaxers lead to more hair loss than Flat Irons.  Read on for why.  If you want some additional options to flat irons and relaxers take a look at this post we did on 7 ways to straighten hair.

How Hair Straightening Processes Work

While relaxers and flat irons can give you similar styles, they work in completely different ways.  To understand how they work, you first must know that hair is made up of proteins.  Within these proteins are chemical bonds responsible for hair strength & hair shape.  The two most important types include Hydrogen bonds and Disulfide bonds.  (There are others but Sarah’s eyes are starting to glaze over so I’ll stop there.)

Hydrogen bonds are weaker, temporary and dependent on the amount of water in your hair.  When you flat iron your hair, you remove curls/frizz by first mechanically forcing hair straight and then removing the water with heat.  It works just like an iron on clothes.  This locks hair into whatever shape it currently is in.  It works great as long as your hair stays dry.  But once hair picks up moisture from the air, it will start to revert to its more natural shape.

Hair’s natural shape is controlled more by the Disulfide bonds.  These permanent bonds don’t depend on how much water is in hair.  With relaxers, hair’s disulfide bonds get broken down making your hair permanently straighter.  At least permanent until new hair grows back.

Both relaxing and flat ironing damage hair but relaxing is much worse because it actually degrades hair proteins.

3 Kinds of Hair Loss

When you ask about hair loss you could be talking about 3 different kinds; breakage, natural, and permanent.  Since I’m not sure which you’ve asked about, we’ll look at all three.

1. Breakage:  Everyone’s hair breaks to some extent, but damaged hair breaks more.  Relaxing causes much more damage thus leading to more hair loss via breakage than flat irons.
2. Natural:  People shed just like dogs & cats.  Your hair has a natural cycle where you lose about 100 hairs naturally each day.  Neither relaxing or flat irons will affect this hair loss.  You might notice more hair loss while flat ironing but that just because you pull out hairs that would have fallen out on their own.
3. Permanent:  In this type, hair stops growing at the roots & there is not much you can do to get it to come back.  It’s unlikely that flat ironing will cause this but it is possible relaxing hair can.  If your scalp is exposed to the chemicals in relaxers for too long, it can burn you and cause permanent hair loss.  This isn’t a problem when relaxing is done by a top notch, professional stylist but if you have an amateur, look out!

For more, see this information from the FDA about hair relaxer safety.

Should You Relax?

Despite the safety concerns and extra damage, there are some significant advantages of relaxing over flat iron straightening.  These include

• More permanent
• Easier to do (if you have a stylist)
• More consistent results
• Less prone to negative humidity effects

On the other had, being more permanent might be a negative to some.

The Beauty Brains Bottom line:

Both relaxing and flat ironing damage hair, but relaxing is much worse.  However, it does give some added benefits so you might decide hair relaxing is worth extra damage.  If you don’t want to lose or damage hair, the best thing you can do is shampoo infrequently, condition each time, and don’t comb or style it much.  Of course, that severely limits the type of looks you can get so these aren’t options for most people.

What do YOU think?  Would you rather have hair relaxed or do daily flat ironing?  Leave a comment below.

Jane’s hairy dilemma: My husband and I have seen the commercials for Scalpmed, and are wondering if it really works….he’s just beginning to lose his hair, and is interested in a preventative measure. Is Scalpmed worth it?

The Left Brain’s response:
First of all, if there really was a product that worked better than the approved drugs that are on the market, don’t you think the major Pharm companies would be all over it? The fact that Scalpmed comes from “GR Hair Solutions, LLC ,” a small company we’ve never even heard of is enough to start my BS alarm bells ringing.

I see from their website that Scalpmed actually consists of several products. Two of those products, their Vitadil-5A and Vitadil-2A formulas, “contain FDA-approved formulas for hair growth” and they state that the active ingredient in both of these products is minoxidil. Ok, so far so, good. Minoxidil (aka Rogaine) is an FDA approved drug to treat hair loss. So what’s the problem?

The devil, as they say, is in the details. Apparently you can’t just buy the minoxidil treatment, you have to buy three products that come in a kit: Vitadil 5A, Nutrisol-RM, and Cortex Enlarger. Only the Vitadil 5A contain the active drug. The kit costs $160 plus about $20 for shipping for a 2 month supply. Let me crunch some numbers and see if that’s a good deal.

Scalpmed: smart shopping?

I’ll assume that all three of the products in the kit are of equal value, even though I’d expect the drug product to be more expensive. With that assumption, the Vitadil product costs a third of that $180, or about $60 out of your hard earned cash for a two months supply. That’s about $30 per month. You can buy a 6 month supply of Minoxidil on Amazon.com for $38. That’s only about $6.00 per month. So not only is Scalpmed charging you 5 times more than you should pay for a Minoxidil product, but you have to pay ANOTHER $120 for the other two products in their kit that you DON’T really need. So really you’re paying about $90 per month for what really should cost you $6.00.

Scalpmed: superior science?

Ok, clearly this is NOT a good deal. But is it possible that Scalpmed is selling some kind of special version of Minoxidil that works better? While there’s no information on their website to indicate that’s the case, the rumor on the ‘net is that Scalpmed may be combining minoxidil with tretinoin (aka Retin-A).  We have no way of knowing if this is true or not, but there is some research on the combination. According to some studies, this combination can increase penetration of the minoxidil and result in even greater hair growth than minoxidil alone. But even the best studies (like this one from Seoul National University College of Medicine) indicate that the only benefit of this combination is that a single dose of the minoxidil-tretinoin mixture works the same as a double does of minoxidil alone. So let’s say that this research works out, you could cut your minoxidil cost in half. But remember, Scalpmed is already charging you 5 times more plus the additional $120, so you’re still losing money with this product.

Finally, the other issue with the minoxidil-tretinoin combo, according to studies like this one, is that it causes scalp eruptions and irritation. So given the marginal benefit and the potential side effects, using the combination hardly seems worth it. Maybe that’s why none of the drug companies have pursued this approach.

The Beauty Brains bottom line

IF (and that’s a HUGE if) Scalpmed can produce clinical data that indicates their product is safe and that it works better than Minoxidil, then they might be worth considering. But I say skip Scalpmed, buy some Minoxidil, and tell your husband to take you to dinner with all the money you saved.

Click here to get Men’s Rogaine Extra Strength 5% Minoxidil Topical Foam Hair Regrowth Treatment

Gail’s guard is up: My hairdresser assured me that Nioxin would make my thin, fine hair stop falling out so much and appear thicker. So far it just seems finer and thinner. (She insists that I need to use the Therapy conditioner as well as the shampoo.) What do you know about Nioxin?

The Left Brain responds:
Nioxin’s line of shampoos, conditioners, and treatments is an interesting example of a cosmetic product that has a reputation for having drug benefits. If you do a quick web search of Nioxin you’ll find numerous sites commenting on its ability to slow hair loss, increase hair growth, inhibit DHT (one of the causes of thinning hair) and make hair grow thicker. As we’ve blogged before, if a product really did claim to do any of these things it would have to be a drug and would require FDA approval.

Hair today, gone tomorrow

But if you go to the source and look at Nioxin’s website, there is no direct mention of any drug benefits. In fact, they are very careful to tell you that their product is NOT a drug and that it does not grow hair. What do they say? The Nioxin story can be summarized in three basic points: 1. DHT is linked to thinning hair. 2. Nioxin helps remove DHT. 3. The Nixon system reduces the appearance of thinning hair. Specifically their website says:

9 out of 10 people perceive a thickening effect
when using the daily 3-part system.*

*Independent Market Research conducted among consumers who perceived themselves as having fine, normal to thin-looking hair.

Deciphering Nioxin’s clams

What does this mean? They’re not claiming their product grows hair or even that it stop hair loss. They’re not even claiming that the product makes individual hair strands thicker. First, they’re just claming that DHT is linked to thinning hair which is true. Second, they say their shampoo removes DHT. This is true as far as any shampoo will remove any DHT that’s present on the scalp in sebum. Third, they are claiming that 90% of the people who used their shampoo, conditioner and treatment perceived a thickening effect.

Since the 3 part system includes a leave in treatment that contains various proteins, and glycoproteins and other film formers, it’s likely that people are perceiving a thickening effect just from the ability of the product to provide a mild styling effect. In other words, if the product leaves a coating on the hair that stiffens it, it will look and feel like it has more body and will therefore be perceived as thicker.

The Beauty Brains bottom line

Nioxin, like Scalp med, is a good example of why you have to read claims very carefully so you understand what’s REALLY being said and so you aren’t fooled by what the advertiser is implying.

Tree thinks trichology is tricky: I have see-through thin, fine hair. Recently I was advised to see a “trichologist” because “hair loss is easy to prevent, impossible to reverse.” A tri-wha-huh? I’ve been talking to my dermatologist. Is a trichologist likely to have better information than a dermatologist, or is “trichologist” mostly a fancy name for “gentrified snake oil seller”? While we’re at it, what’s your take on that “hair loss is easy to prevent” statement– have I missed out on some modern miracle while experimenting fruitlessly with supplements and coating treatments?

The Right Brain responds:
A trichologist is one who studies trichology, and according to that bastion of knowledge Wikipedia:

Trichology is the branch of medicine that deals with the scientific study of the health of hair and scalp. Trichologists themselves are not normally medically qualified although members of the medical profession can undertake courses and/or careers within trichology. Trichology can be used in forensic studies of hairs to find suspects. Forensic trichology can determine the approx. age, body mass, race, and other important traits of the hairs owner.

There are several major associations of trichologists including the International Association of Trichologists (based in Australia) and the Trichological Society (out of the UK).

Is a trichologist better informed than a dermatologist? That depends. The qualifications for being a trichologist do not require a medical background. They only require you to complete a 3 to 5 years of course work. Even then, as the IAT points out:

[our] graduates are academic trichologists. They should not be confused with others masquerading as experts whose sole ‘qualification’ has been a basic introduction to hair science during a hairdressers/beauticians course, or via a course of study in elementary trichology, or the many with no formal training whatsoever. Whilst trichology remains unregulated, charlatans will continue to prosper.

As an example, UK hairdresser Phillip Kingsley identifies himself as a trichologist and while we’re sure he’s a capable hair stylist, we wouldn’t want him giving us medical advice!  Stick to advice about Ojon.

The Beauty Brains bottom line

Since just about anyone can claim to be a trichologist, be careful which one you pick. Your best bet is to find a dermatologist who specializes in hair treatment. And be especially wary of a trichologist who tells you that hair loss is easy to prevent! That’s a new one to us!

As regular readers of The Beauty Brains know, we’re always on the look out for the latest breakthroughs in the science of hair growth. So, we were intrigued by this article from Science Daily about new research showing a protein that increases blood vessel growth in skin can also promote hair growth.

In testing done on mice, researchers from Massachusetts General Hospital (MGH) were able to increase the size of hair follicles and boost total hair volume by 70%. This discovery may apply to humans as well since male pattern baldness is caused by shrinking follicles. This is exciting news for our male readers who are worried about baldness so stay tuned for more. And while you’re waiting, check out our previous posts on hair loss cures like Fekkai’s Follicle Boosting Treatment, Dutasteride, Scalp med and the Hair Max Laser Comb.

–Mid Brain

Ninon D’s delightful question: I’ve been reading an interesting thread on the Long Hair Care Forum. It seems that some of the women there are using a cream marketed to treat thrush on their scalps to boost hair growth. The mind somewhat boggles at how anyone stumbled upon this idea, however lots of the women are reporting increased growth from creams containing miconazole nitrate such as Monistat. I’d be curious to know what your take is on this - genuinely beneficial, benign or bonkers?

The Left Brain’s skeptical response:
You’re right Ninon, the idea that miconazole nitrate (the active ingredient in Monistat) can stimulate hair growth is all over the Long Hair Forum. They make several mentions of medical studies that says miconazole works, but I was unable to find any such studies. (If anyone from the Long Hair Forum reads this, please let me know which reports you’re referring to.)

Can anti-fungals help hair growth?

The only credible research on this topic that I could find comes from a report issued by the Department of Internal Medicine, Naval Hospital, Bethesda, Maryland entitled “Ketoconazole Binds to the Human Androgen Receptor.” Ketoconazole, for those of you not up on your imidazole chemistry, is another antifungal which is a cousin of miconazole. The Bethesda report says that lab tests showed ketoconazole can interact with androgen receptors and therefore can inhibit testosterone levels.

What does all this mean?

Since androgen and testosterone levels are associated with androgenetic alopecia (male pattern baldness), it’s THEORETICALLY possible that this chemical could affect hair loss. However, this test did NOT evaluate hair growth, it only showed that this drug MIGHT be involved in PART of the metabolic pathway that leads to baldness.

Furthermore, the study also says that “ the dose of ketoconazole required for 50% occupancy of the androgen receptor is not likely to be achieved in vivo…” So even if this reaction can be observed in the laboratory it doesn’t seem very realistic to expect it would work on people.

So should I put Monistat on my scalp or not?

And what about our miconazole? The researchers said “androgen binding studies performed with other imidazoles, such as clotrimazole, miconazole, and fluconozole, revealed that in this class of compounds only ketoconazole appears to interact with the androgen receptor.” So even in lab tests at high levels, miconazole DOES NOT show any effect.

The Beauty Brains bottom line

The only report I was able to find does not support using miconazole for hair growth. Of course it’s possible that there are other studies out there showing a cause and effect. If anyone comes across them, please send them to me for review. I’ll gladly revise my position based on new data. But without some kind of study and plausible mechanism, I remain skeptical that yeast infection creams can increase hair growth.

Tamara’s temerity: Hello, Brains. I continue to adore the blog. Now, I humbly come before you again with a beauty query. My question concerns the efficacy of Frederic Fekkai More Nighttime Follicle Boosting Treatment. Freddy claims the following results: “Concentrated, continuous-release dose of niacin; Increases oxygenation of the follicle; Increases energy metabolism for a more vital, fertile scalp.”

Is this all so much hype & silliness, or does this (pricey) product stand half a chance of treating thinning hair?

The Right Brain finds fault with Fekkai:
As we’ve said in previous posts about products that claim to promote hair growth, there are only two products currently proven to work and approved by the FDA. One is Minoxidil and the other is Propecia.

Another bulls#@t product?

We were all set to rip this product to shreds. But our research uncovered one small detail that lends some unexpected plausibility to Fekkai’s claims: this product contains a pair of niacin-derived ingredients, myristyl nicotinate and ethylhexyl nicotinate. It just so happens that these ingredients are very similar to ones evaluated for follicle stimulation by researchers in a 2006 study.

Can Niacin stimulate hair growth?

The study in question was a double blind clinical trial conducted by respected dermatologists. The researchers evaluated the effect of topical application of two niacin derivatives (octyl nicotinate and tetradecyl nicotinate) on 60 female subjects with Ludwig types I-III female pattern hair loss. 40 subjects received the niacin treatment, 20 received a placebo. The researchers measured hair fullness by using 35mm photography. After 6 months the study concluded that the panelists who were treated with niacin showed a statistically significant increase in hair fullness.

Does this mean Fekkai really works?

Not necessarily. While Fekkai does say their Niaplex technology is clinically proven, they don’t present any data (at least none that we could find) showing that they tested their exact formula. We can only speculate how similar their treatment is to the one tested by the dermatologists. There are at least 3 confounding factors at work here. One, Fekkai is not using the same niacin derivatives as used in the study. Two, we don’t know the concentrations of the ingredients. They might just be “angel dusting.” And three, we don’t know if the formula itself, or the mode of application, makes a difference.

The Beauty Brains bottom line

Without compelling data on this specific product, we’re skeptical that Fekkai really stimulates follicles. Still, we have to give credit where credit is due. The Fekkai product apparently uses a technology that at least has a theoretical basis for efficacy. And that’s MUCH more than we can say for most hair loss cures.

If you’re concerned about thinning hair and you’ve got 35 bucks to blow, you can buy the Fekkai treatment here. Let us know how that works out for you!

I was skeptical of this one but it was published in the peer-reviewed Journal of Cosmetic Dermatology. Researchers found that an ingredient called dutasteride significantly improves hair growth when taken for a year. Look for this to be the next hot ingredient in hair loss. The study was only on men so I don’t know if it will work for women, but maybe. It’s not quite on the market because it’s still pending review by the FDA.

-Mid Brain

One side effect of using Minoxidil (aka Rogaine) for hair growth is that it can cause hair to grow in places where you DON’T want it. But don’t fret, dermatologists are developing a next generation light treatment that stimulates hair growth without side effects.

The Beauty Brains are taking a few weeks off to finish their first book. In our absence, please welcome Mid Brain, our new intern, who’ll entertain and enlighten you with the latest news from the world of beauty science. Keep sending in your questions and we’ll return to our normal Q&A format as soon as we get back. You can also post your questions in our Forum - there are 300 Beauty Brainiacs who’d be glad to help you!

If you’re worried about hair loss, you may be interested in recent hair loss research published in the British Journal of Dermatology.  It turns out that hairstyles involving tight braiding (corn rows) or hair extensions can lead to permanent hair loss. That’s right, gone…no more…bald patches for life.  The situation is made even worse if straightening chemicals are used.

According to the researchers who examined over 2000 people in South Africa, one third of women had “traction alopecia” as did 1 out of 7 children.  And the worst part is that it’s likely that the hair won’t grow back.

What’s Causing the Hair Loss?

The Beauty Brains have previously talked about traction alopecia. It is a condition in which a constant pulling action loosens hair from its follicular roots. The hair falls out and the follicle becomes inflamed. This can lead to the follicle shutting down and a permanent bald patch.

Traction alopecia is more common among African American population because of corn row hair styles and the more frequent use of hair relaxers.  It also has become more frequent among female athletes who wear their hair in tight pony tails and nurses using bobby pins to secure their caps.

How Do You Stop This Hair Loss?

The best advice is to stop wearing these kinds of hair styles. But if you do, make sure to give your hair a “rest”. Don’t keep braids in for days on end. Don’t keep your hair in a super tight pony tail.

Admittedly, it’s a rare condition but it does happen. Treat your hair kind and you can keep it for a long time. Pull on it too much and it just might not come back.  And something like Scalp med is not going to help much.

See this article by a dermatologist at the Hershey Medical Center for more information.