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The Science of Healthy Hair, Hair Loss and How to Regrow Hair

Episode 119 Apr 10, 2023 2h 17 insights
In this episode, I explain the biology of hair, hair growth, why hair growth slows and what causes hair to stop growing and/or “fall out.” I discuss the essential role of hair stem cells and other supporting biological factors for healthy hair growth. Then I describe various approaches (mechanical and chemical) to slow hair loss by increasing blood flow to hair stem cells, including minoxidil, tadalafil, PRP, microneedling, Botox and ketoconazole treatments. I also discuss how age-related hormone changes cause hair loss and explain the effectiveness of treatments such as caffeine, saw palmetto, growth hormone, finasteride and dutasteride. For all hair growth options, I describe potential side effects, how soon to expect results and the amount of hair regrowth to expect and I highlight effective combination treatments for hair regrowth even in hair “dead” (bald) zones. For many listeners, thinning, brittle hair, or pattern baldness are a source of anxiety and stress. This episode explains the mechanisms underlying hair regrowth tools and the science behind them so that you can evaluate potential treatments and associated side-effect profiles and select the best one(s) for you. For the full show notes, visit hubermanlab.com.
Actionable Insights

1. Combine Microneedling & Finasteride

Combine microneedling with finasteride for the most robust and impressive hair regrowth, as this combination is far more effective than either treatment alone and can even recover ‘dead zones’ of the scalp.

2. Start Finasteride Low & Slow

If considering finasteride, begin with a very low oral dose (0.5-1 mg/day) or topical (1 ml of 0.25% solution once per week) and wait at least 25 weeks to assess results before increasing, as effective doses are low and side effects increase with concentration.

3. Manage Psychological Well-being

Actively manage your psychological well-being, as stress and anxiety can negatively impact both hair coloration and growth rates, while hair loss itself can cause significant anxiety.

4. Optimize Sleep for Growth Hormone

Aim for regular bedtimes and avoid eating for two hours before sleep to optimize the natural release of growth hormone, which is a strong accelerator of hair growth by extending the anagen phase.

5. Improve Insulin Sensitivity

Combat insulin resistance through regular cardiovascular and resistance exercise and maintaining a healthy body fat percentage, as insulin sensitivity is crucial for IGF-1 activity which promotes hair growth.

6. Consider Myo-Inositol for Insulin

Take 900 milligrams of myo-inositol before sleep to improve insulin sensitivity, which supports IGF-1 activity for hair growth and can also aid sleep with minimal side effects.

7. Check & Supplement Iron Levels

Have your iron and ferritin levels measured (women: 25-100; men: 30-150) and supplement if low, as sufficient iron is vital for the anagen (growth) phase of hair.

8. Use Topical Caffeine Ointment

Apply topical caffeine ointment about three times a week to the scalp to stimulate hair growth and maintain stem cell populations, as it can be as effective as minoxidil with fewer side effects by indirectly stimulating IGF-1 and reducing cell death.

9. Apply Ketoconazole Shampoo

Use a ketoconazole shampoo (at least 2% concentration) two to four times per week, leaving it on the scalp for three to five minutes, to maintain hair and increase hair thickness by mildly reducing DHT and disrupting fungal growth.

10. Use Minoxidil Consistently

If using minoxidil, start with the lowest effective dose (e.g., 0.25 mg oral or 5% topical once daily, left on scalp for 3-5 minutes) and be prepared to use it for life, as cessation typically leads to loss of gained hair.

11. Boost Scalp Blood Flow

Increase blood flow to the scalp through methods like massage, red light therapy, or low-dose tadalafil (2.5-5 mg), as enhanced circulation delivers vital oxygen and nutrients to hair stem cells, slowing hair loss and extending growth.

12. Consider Saw Palmetto Supplement

Take 300 milligrams of saw palmetto per day, divided into two or three doses, to weakly inhibit 5-alpha reductase and reduce DHT, which may help maintain existing hair and potentially stimulate some new growth with few side effects.

13. Practice Yoga Nidra/NSDR

Engage in yoga nidra or non-sleep deep rest (NSDR) sessions, even for just 10 minutes, to greatly restore cognitive and physical energy, which supports overall well-being that can indirectly benefit hair health.

14. Hydrate with Electrolytes Daily

Dissolve one packet of Element (electrolytes without sugar) in 16-32 ounces of water first thing in the morning and during physical exercise to ensure proper hydration and electrolyte balance for optimal brain and body function.

15. Botox for Scalp Tension

Consider Botox injections into the scalp, performed by a skilled professional, to relieve scalp tension and improve blood flow to hair follicles, though treatments must be repeated and efficacy for hair loss is still being studied.

16. Consult Medical Professional

Always consult with a medical professional before starting any hair loss treatments, especially prescription drugs like finasteride or dutasteride, to ensure proper dosing, monitor side effects, and evaluate individual response.

17. Avoid Mother’s Father Myth

Disregard the myth that you inherit your balding pattern solely from your mother’s father; while genes influence predisposition, the pattern of androgen receptors on your scalp is more complex and not directly predictable from one relative.