Historical & Persistant Myths about Hair Loss

Myth: Wearing hats cause hair loss.

No. It doesn't. This is probably one of the most persistent myths. Like many of the myths, it probably started with valid observations but with invalid conclusions. The idea that 'wearing a hat causes hair loss' probably originated in the military. Young men entering the service were required to wear hats and soon showed signs of thinning hair or going bald. But the two events are simply related to (due to) serendipitous timing. The ages that young men enter the military are also the same ages that male pattern hair loss becomes apparent.

Myth: MPB is caused by plugged pores

Wrong. The idea that plugged hair follicles cause hair loss is a long held myth perpetuated by the many companies exploiting hair loss myths in order to sell bogus hair products. The hair follicle is deep in the dermis of the scalp. Not even scrub brushes and abrasive cleansers will 'clean out the hair follicles'. So, if any company is claiming that their product unplugs follicles, you can be assured that the claims for the product are fraudulent. It's more likely that they're implying that their product will clear the opening on to the skin through which the hair shaft grows. Which is fine, but what they don't tell you is that the follicles don't get obstructed and that 'plugged pores', whatever they define that to be, has nothing to do with MPB.

In regards to the "dirty scalp theory" of MPB, there is no credible rationale to it at all. If this 'theory' had any credibility, you would expect a decreasing incidence of MPB in today's population as compared to past centuries, since it has become routine for many people to bathe/shampoo on a daily basis as compared to earlier times, when bathing would be a weekly or even a monthly event. But, there is no evidence to suggest that the incidence of MPB is declining despite the fact that we are 'unplugging our pores'.

Myth: Poor Blood Flow Causes Pattern Baldness

Wrong. This myth has been used to sell hair loss products as bizarre as devices that allow you to hang upside down to potions that 'increase the blood flow to the scalp'. MPB is not caused by poor or decreased circulation.
If poor circulation caused MPB, there would be no explanation for the hair loss of MPB to occur in a symmetrical pattern. Instead, balding would occur in accordance to the areas of coverage of the various arteries to the scalp, which just doesn't happen.
Furthermore, hair follicles would never be successfully transplanted, if MPB were due to decreased blood supply, since the transplants are used to fill in the balding areas affected by MPB.

All organs and tissues require proper circulation to maintain their health and all portions of the scalp receive large amounts of oxygenated blood. In fact, 20% of the output of the heart goes to the head, so the scalp is highly vascularized. Numerous studies have shown that the vascular supply to the balding scalp is just as good as the vascular supply to the non-balding scalp.

Myth: Male pattern baldness is caused by skin mites

There's no relationship between MPB and mites of any kind. Skin mites are just as numerous in the scalps of men who aren't balding as in men affected with MPB.

Everyone has literally millions of skin mites on their bodies. They're as ubiquitous as dust mites are. Under a high power microscope they appear very menacing, in fact, not unlike Godzilla. But they're harmless. The truth is they have formed a symbiotic relationship with humans ever since there were humans.

Myth: MPB can be prevented or improved by good nutrition

That'd be nice, but it's just not true. There is no known connection between nutrition and MPB. Poor nutrition neither causes nor exacerbates MPB. Subsequently, there is no scientific evidence that there are any specific nutrients and/or vitamins that will prevent or reverse MPB. Preventing or reversing MPB is much more complicated and much more difficult than correcting a nutritional deficiency due to faulty dietary intake.

Which is not to say that nutritional deficiencies can't cause hair loss or poor hair growth. The cells that comprise the hair follicles in the scalp are some of the most active in the entire human body. Those active follicles require a constant supply of nutrients, vitamins and minerals. So, it only stands to reason that there are many causes for poor hair growth or even hair loss due to dietary reasons. For example, patients who have protein deficiencies, either because of malabsorption or because of lack of intake, can present with poor hair growth and even hair loss. Patients with iodine deficiency can have the coarse hair and hair loss of hypothyroidism. Biotin deficiency can cause poor hair growth. Iron deficiencies are often overlooked as a cause of hair loss, especially in women. Etc.

Myth: Bald men are sexier.

The belief that baldness makes you more virile than a man with a full head of hair is without scientific foundation. In fact, many well-designed studies show that a good head of hair rates high on the list of 'physically attractive' features for men and women. An article entitled Psychologic and Sociologic Dimensions of Hair: An Aspect of the Physical Attractiveness Phenomenon (Patzer, PhD, Clinics in Dermatology, vol 6 no 4; pp 93-101) concludes "Since hair is one determinant of physical attractiveness, the importance of hair can be expected to increase in our society for two reasons: (1) it's importance is consistently and frequently promulgated through powerful forms of marketing and mass media and (2) there is growing emphasis to increase physical attractiveness through a younger appearance."

Myth: Oily skin causes hair loss.

Not really. Some people just have more active sebaceous glands than others do, so the skin on their faces and on their scalps is more 'oily'. But there is no relationship between an oily scalp and MPB. Whereas, it is true that DHT will concentrate in the sebaceous secretions, because DHT is fat soluble, the DHT in the sebaceous secretions is not the cause of MPB. The sebaceous glands are superficial to the hair follicles, and the DHT in the sebum does not affect the hair follicles, which are deep in the dermis.

Myth: Sebum causes MPB

There is a relationship between sebum and DHT, but not between sebum and MPB. DHT is found in the sebum in a high concentration because DHT is soluble in fatty substances such as sebum. But the sebaceous glands are superficial to the hair follicles and the DHT in the sebum does not affect the hair follicle. Damage due to DHT occurs at the base of the hair follicles, where testosterone is converted into DHT via types 1 and 2, 5 alpha- reductase enzymes. Routine shampooing or otherwise removing sebum will not prevent or reverse MPB.

Myth: Hairs shed in the shower is an accurate measure of the degree of shedding.

Wrong. There are a number of reasons why the number of hairs shed in the shower is not an accurate measure of shedding. Normal shedding of scalp hair is 50 to 100 strands per day. You will lose some of these on your pillow at night, some into the air as you perform your daily routine, and, of course, when you shampoo your hair. When the end-telogen hair shaft become wet and soapy, they also become more adhesive to your fingers and are easily extracted from the scalp. Since the hairs accumulate at the drain, the total number of hairs appears exaggeratedly increased. The less frequently you shampoo the greater the total number of telogen hairs that will accumulate and shed when you do shampoo again.

In the normal scalp, approximately 10% of the hair follicles are in various stages of the telogen phase. During the telogen phase, the hairs are easily extracted with a quick tug, of the hair shaft. Only about 1% of the telogen hairs will fall out with no encouragement. That's because the telogen phase lasts ~100 days and only those at the end of the phase fall out without any assistance. The other 90% of the hairs not in the telogen phase are mostly in the anagen phase and are strongly anchored in the dermis of the scalp. Anagen hairs cannot be pulled out of the scalp with a simple tug.