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Peter Attia MDPeter Attia MD

#43–Alan Bauman, M.D.: The science of male and female hair restoration—how to protect & restore hair

Original release date: 3/4/19 In this episode, Alan Bauman, certified hair transplantation surgeon and hair restoration expert, discusses both male and female pattern hair loss, the science behind what drives it, and what that tells us about prevention and restoration. Having treated over 20,000 patients, Alan shares his invaluable insights into what works and what doesn’t in terms of the non-surgical treatment options. We also go into great detail about the more invasive approaches like PRP, and of course, hair transplantation, a procedure which Alan has refined over the years into a proprietary method that seems to produce unbelievable results. Additionally, Alan provides tips for maintaining scalp health, which is vital for hair growth, as well as the importance of choosing a hair specialist who has the tools, expertise, and patience to develop a compassionate and encompassing approach to hair restoration. We discuss: -Alan’s unique path, and how he became interested in hair transplantation [7:15]; -The prevalence of hair loss, types of hair loss, and the different patterns in men vs. women [15:45]; -The role of genetics in hair loss, and when does it start [19:00]; -Female hair loss: the role of hormones, pregnancy related hair loss, and what it means to have thinning and shedding [22:30]; -Primary drivers of male hair loss, finasteride as a treatment, and the potential side effects [26:15]; -Common treatments – Proscar, Propecia, Rogaine, and more – how they all came about and what you need to know [29:45]; -Primary drivers of female hair loss, potential treatments, and the different types of hair follicles [33:15]; -What are some of the unproven/snake oil methods of hair treatments being pushed to the public? [37:15]; -Preventative steps to take if you’re worried about future hair loss [42:00]; -Medications that may negatively affect hair quality [45:30]; -The importance of seeing a hair specialist [47:15]; -Impact of scalp health and inflammation on hair growth, how to pick and apply shampoo and conditioner, and how to avoid and treat hair breakage [50:15]; -Treatment options – finasteride, minoxidil, laser caps – how they work and what you need to know [57:15]; -PRP treatment: How it works, details of the procedure, and Alan’s proprietary protocol [1:11:45]; -The hair transplant procedure [1:29:30]; -Risks involved with a hair transplant procedure [1:44:00]; -Is a donor hair susceptible to the forces of the implant site that caused the hair loss? Can a hair follicle grow anywhere on the body? [1:47:45]; -Age appropriate procedures, how far the field has come, and why Alan loves his work [1:51:45]; and -More. Show notes page: https://peterattiamd.com/alanbauman/ About: The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 10 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more. Peter is the founder of Attia Medical, PC, a medical practice with offices in San Diego and New York City, focusing on the applied science of longevity. The practice applies nutritional biochemistry, exercise physiology, sleep physiology, techniques to increase distress tolerance, lipidology, pharmacology, and four-system endocrinology to increase lifespan (delaying the onset of chronic disease), while simultaneously improving healthspan (quality of life). Learn more: https://peterattiamd.com/ Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on: Facebook: http://bit.ly/PeterAttiaMDFB Twitter: http://bit.ly/PeterAttiaMDTW Instagram: http://bit.ly/PeterAttiaMDIG Subscribe to The Drive: Apple Podcast: http://bit.ly/TheDriveApplePodcasts Overcast: http://bit.ly/TheDriveOvercast Spotify: http://bit.ly/TheDriveSpotify Google Play: http://bit.ly/TheDriveGooglePlay

Peter AttiahostAlan Baumanguest
Jan 8, 20201h 55mWatch on YouTube ↗

Summaries, chapters, transcripts, and FAQs on this page are made by uListen, not YouTube.

At a glance

WHAT IT’S REALLY ABOUT

Dr. Alan Bauman Explains Modern Hair Loss Treatment and Transplant Science

  1. Bauman says hair loss affects roughly 80 million American men and 46 million women, is about 98-99% genetic in men, and is more multifactorial in women, involving pregnancy, PCOS, menopause, medications and scalp health.
  2. He describes a layered non-surgical toolkit: finasteride as the primary option for men, compounded minoxidil formulas, low-level laser caps, and scalp care, with the aim of protecting follicles before they miniaturize past the point of no return.
  3. He explains his PRP protocol, which uses a dual-spin process, monocyte-rich concentrate and platelet counting, and which he says lasts about 10 to 14 months in most patients.
  4. On the surgical side, he traces the shift from large linear strip scars to follicular unit extraction, discusses donor sources like the beard and body, and stresses setting realistic expectations about density and natural-looking results.
  5. Bauman criticizes how hair loss is often handled by general dermatologists and urges patients to seek a full-time hair specialist who takes objective measurements.

IDEAS WORTH REMEMBERING

5 ideas

Act early, before follicles reach the point of no return

Bauman says once a follicle miniaturizes into a vellus hair, nothing he knows of can revive it, so treatment aims to protect and enhance existing follicles.

Hair loss in men is overwhelmingly genetic and DHT-driven

He cites 98-99% genetic causation, many genes involved, and a roughly 90% chance of looking the same or better on 1 mg finasteride over about five years.

Women's hair loss is more complicated and often mismanaged

Women can lose about half their hair mass before it looks thin from across the room, and factors like pregnancy, PCOS, menopause, and medications play roles, with finasteride off-limits in childbearing years.

Compounded minoxidil and consistent use beat off-the-shelf products

Bauman says over-the-counter minoxidil is greasy, hard to apply and often used once a day, while compounded versions with tretinoin and a mild steroid penetrate better and are applied twice daily directly on the scalp.

PRP quality depends on preparation and patient selection

He emphasizes red-cell removal, high platelet concentration and monocytes, and says PRP can't revive dead follicles but can mitigate loss and boost volume in thinning zones by 20 to 50%.

WORDS WORTH SAVING

5 quotes

Wishing and hoping is not a strategy.

— Alan Bauman

The hair follicle is an organ. It's a self-determining organ.

— Alan Bauman

I can't put back a full head of dense hair for you, but I can make you look like you have a full head of hair.

— Alan Bauman

Whatever kind of hair loss you have, male, female, the idea is that you got to take action soon to protect the functioning of the follicles before there's that point of no return.

— Alan Bauman

In women, there's no socially acceptable option for female hair loss, and so it can be much more devastating, for sure.

— Alan Bauman

Prevalence and genetics of hair lossFemale pattern hair loss, pregnancy and PCOSFinasteride and DHT blockingCompounded minoxidil formulationsLow-level laser therapyPRP preparation and efficacyFollicular unit extraction vs. linear strip harvesting

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