14 Hair Myths: Let the myth-busting begin!
Today I’m going over some popular hair loss myths that I recently covered over on the channel.
Debunking hair loss misinformation is a topic that’s really important to me because nothing’s worse than putting your hair regrowth hope into the latest, greatest potion, only to find out you’ve been sold a worthless bag of magic beans.
And there is a lot of misinformation out there. It often seems like every other week there’s a new piece of hair growth lore making the rounds. It’s a bit like whack-a-mole – as soon as one is debunked, two more seem to rear their ugly heads on TikTok. Some are new, some are oldies that social media has resurrected, and some even have a grain of truth spurring them on.
- Does wearing a hat lead to baldness?
- Should I rub onions on my head?
- Is mom really to blame for all my hair loss woes?
- Let’s bust some hair myths!
- Wearing hats causes baldness
Fiction: This one has been around for a very long time, and I’m happy to say it’s false. Top-down pressure on hair follicles is usually not too problematic. It’s actually the pulling motion of tight hairstyles (ponytail, braids, hair extensions) that can lead to hair problems like traction alopecia.
But what’s behind the persistence of this myth? Well hats are often worn by people trying to mask hair loss, so what we see is a correlation between the two. People have a bad habit of associating correlation with causation – men who wear hats have hair loss so therefore hats must cause hair loss! But correlation doesn’t equal causation and this association is patently false.
There are two very small exceptions, however:
- if hats are worn really tight (uncommon) they can put pressure on the hair follicles.
- allergic reactions to dyes in the hat can lead to inflammation and subsequent damage.
But rest assured, if you love a good hat, it won’t make you bald!
Love a good hat? Good news, it won’t make you bald!
2. Shaving will make my hair grow faster and thicker!
Fiction: Wouldn’t that be nice? I wish it were that simple!
But you know the adage: if it sounds too good to be true…
A shaved head will grow out exactly as it did before, not faster or thicker.
Though shaving your head can help remove damaged hair, it does nothing to help (or hinder!) the underlying mechanism of hair growth. Hair growth happens at the base of the hair follicle (root), located 4-7 mm below the skin surface. Think of the root as the regenerative brain of your hair; it’s where all the hair growth action happens! Your razor doesn’t ever get close.
If you’ve been shaving trying to speed up hair growth, put your razors down. This one belongs in the false trash bin.
3. Losing up to 100 hairs a day is normal!
Fact: Imagine looking down at the shower drain and seeing a clump of lost hair strands after a shower or waking up to hair fall on your pillowcase. The emotional reaction makes it easy to assume that something is wrong with your hair.
But contrary to popular belief, shedding up to 100 hairs per day is completely normal. Remember that we have about 100,000 hair follicles on our heads and our hair is always cycling through various phases of growth, with about 90% of hair on our heads in the anagen (or growth) phase at any one time.
Why do we notice hair fall more in the shower and after a long sleep? Because hair that falls out and is disconnected can stick around on your scalp until you thoroughly wash or your head hits the pillow. Hair can be sticky, and the effect is even more pronounced in people with long hair or who shampoo infrequently.
But don’t worry. A clump of hair in the drain isn’t a sign (on its own) that there’s a problem.
4. Stress does NOT make your hair fall out
Fiction: Ok, so I just finished telling you that it’s completely normal for everyone at every age to lose up to 100 hairs per day…
BUT some people experience periods in their lives where they shed A LOT more than that. It’s called telogen effluvium. And - you guessed it – it can be brought on by stress.
Bad viral infections (like Covid or the flu), major surgery, pregnancy, and serious emotional stress (like a death in the family) can trigger this type of hair loss, usually about 6 weeks to 3 months after the stressful event. Chronic everyday stress (work, relationship) can also trigger telogen effluvium but it’s not as common.
Interestingly, stress can also make other hair loss conditions worse, such as alopecia areata (my autoimmune condition) or trichotillomania (the irresistible urge to pull out hair from scalp, eyebrows, face, and body). That’s because stress increases levels of the hormone cortisol in the body which can disrupt hair growth.
The good news? This type of hair loss is usually temporary. In most cases it will grow back.
Stress CAN cause hair loss (telogen effluvium). The good news? It’s usually temporary.
5. Onion oil is my new baldness miracle cure!
Fiction… mostly: Remember I said some myths are rooted in a grain of truth? This is one of them, but don’t run to the grocery store just yet!
Yes, onions are rich in sulfur and have some antimicrobial and anti-inflammatory properties that, yeah, could possibly support hair health, and a 2002 paper did find that when tested on patients with patchy alopecia areata, onion juice used twice a day seemed to result in significant hair regrowth. But a huge caveat is that this was NOT tested on the most common type of hair loss, androgenic alopecia.
Contrary to what you might have seen on TikTok, onions, onion juice, and onion oil will not cure your baldness. A lot more research is needed to definitively say whether onion juice really does help with hair growth.
Please don’t rub onions on your head.
6. Mom is to blame for my hair loss
Possibly, but it’s not that simple: I wish it was that simple – really, it would make it easier to predict and determine risk if inheritance was that easy. But male pattern hair loss (androgenic alopecia) is ‘polygenic’, meaning more than one gene is involved in inheritance. At last count we were up to 63 genetic loci that could influence hair loss. Out of those, only 6 are on the X chromosome (the chromosome that is associated with many inherited mutations and diseases that affect mostly men).
The X chromosome does play a big role in androgenic alopecia inheritance. One of the 6 loci (a specific allele for the AR gene) on the X chromosome is highly associated with male pattern baldness. European men who carry the allele are 2 times more likely to experience hair loss than people without. This contributes to the anecdotal similarity in hair status observed between some men and their maternal grandfathers and uncles.
But it’s just not the whole picture. The remainder of the loci are on the non-sex chromosomes (called autosomes), which means they can be inherited from mom, dad, or both.
Add in epigenetics, which is how your behaviors and environment can change how your genes work, and epistasis, the ability of one gene to influence the expression and activity of another, and hair loss inherence gets very sticky very quickly.
7. Men who are bald have more testosterone
Fiction: But we get the appeal.
A really popular, long-running theory out there is that bald men have higher levels of testosterone, which makes them more masculine, with increased sex drives.
Why the persistence of this myth? It has to do with a study from 1960 where a Yale doctor, named James B. Hamilton, studied twenty-one boys who were undergoing castration. He found that the complete lack of testosterone resulted in no signs of male pattern hair loss as the boys aged. But keep in mind that the study was an extreme example. A complete lack of testosterone (and castration) is NOT the norm.
We now know that people with even low levels of testosterone can still go bald, and that’s because it’s not the amount of testosterone circulating in the bloodstream that dictates baldness, it’s how your body processes the testosterone and how it reacts to the by-products.
Genetics dictate how sensitive a person’s hair follicles are to DHT and whether they’re prone to hair loss. Genetics can also dictate how much 5 alpha reductase (the enzyme that converts testosterone to DHT) a person has - higher levels of the enzyme potentially mean more DHT.
DHT levels, 5 alpha reductase activity, and hair follicle susceptibility are much more influential than testosterone levels.
Though this myth persists, high levels of testosterone do not predict hair loss. DHT levels, 5 alpha reductase activity, and follicle sensitivity are all more important.
8. Both men and women can experience baldness
Fact: Yes! Men and women both experience androgenic alopecia, aka “male pattern hair loss” (or “female pattern hair loss”)
Though the underlying genetics and cellular causes are the same (with the addition of Poly Cystic Ovary Syndrome – PCOS – thrown in the mix for women), the patterns do differ.
For men, we classically think of the Norwood-Hamilton scale with frontotemporal recession and crown thinning (though there are many more clinical variants!).
For women, the classic androgenic pattern is classified by the Ludwig scale. The frontal-most hair is typically preserved but there is central thinning and widening that occurs along the middle part.
Keep in mind that men and women can also go bald from other hair loss causes, such as the auto-immune type, alopecia areata.
9. Shampoos and conditioners are terrible for your hair!
Fiction: This one is experiencing a renaissance with the all-natural and no hair washing movements and I think it’s another case of correlation/causation bias.
Like we mentioned earlier, people often see hair shedding in the shower. For people with long hair it can be really significant because of tangles – day’s worth of hair! So, a false association can happen. You see hair in the shower, therefore something in the shower must be causing it.
There’s no doubt that over washing your hair can lead to dry hair textures, dandruff, and skin irritation, but not washing your hair can have serious consequences – it can make the scalp less healthy, lead to clogged/inflamed/ingrown hair follicles, or bacteria/fungal overgrowth. And those last two? They can lead to hair loss. Which we’ll talk about in our next myth…
The recommended frequency of hair washing is still debated, but most experts recommend washing every 2-3 days. Those with oily hair should be washing more frequently.
Shampoos and conditioners can also be a great way to apply topical products that complement medical therapies, such as caffeine and saw palmetto (included in our upcoming Feel Confident shampoo and conditioner), which both support hair growth. Visit feelconfident.com to sign up for the latest updates!
Inexpensive Prescription Hair Loss Medication Delivered To Your Door.
10. Gel, wax, and other styling products do NOT cause hair loss
Fiction: Don’t throw your styling products away just yet, but yes, the wrong styling products, over-styling, and product build-up can lead to breakage, clogged follicle, and – potentially – hair loss.
The high alcohol content and corrosive chemicals used in some styling products can dry out the scalp, reduce sebum production, damage the hair shafts, and lead to irritated, flaky skin. But the clogged hair follicles are where the damage comes in. Clogged hair follicles can trigger folliculitis, a bacterial or fungal infection of the follicle, and chronic folliculitis can lead to hair loss – temporary or permanent.
Ingredients to avoid in your hair products: formaldehyde, fragrance, isopropyl alcohol, phthalates, mineral oil, petroleum, propylene glycol, parabens, silicones, sulphates, sodium laureth sulfate, sodium lauryl sulfate.
11. Being in an air-conditioned room causes hair loss
Fiction: People online have postulated that air conditioning dries out the scalp, leading to irritation and hair fall.
But most of these claims are made by sites pushing their own products to combat these “ill effects of air conditioners”.
There is no data to support this claim. In fact, the American Cancer Foundation promotes head cooling as a therapy for chemotherapy induced alopecia.
Keep cool this summer! There’s no need to be afraid of your air conditioner.
12. Massaging the scalp reduces hair loss
Factual…but preliminary: A 2016 study on 9 Japanese men, found that hair thickness seemed to increase with 4 minutes of standardized scalp massage per day for 24 weeks using a scalp massage device. They showed that stretching forces resulted in changes in gene expression in human dermal papilla cells.
Another study in 2019 on 327 survey participants, looked at the effects of standardized scalp massages on self-assessed androgenic alopecia sufferers. Participants reported an average daily massage effort of 11-20 min, with a mean adherence of 7 months, with almost 70% reporting hair loss stabilization or regrowth.
So, what does this mean for you? While not a replacement for medical intervention, some preliminary research does seem to support the use of scalp massaging for reducing hair loss. We’ll keep our eyes on this one and see if it goes anywhere!
13. Use of minoxidil increases hair loss
Fiction: Minoxidil, in its topical form, can lead to early shedding, but that’s not hair loss. It’s a temporary process that lasts about 3-6 weeks. It occurs when the hair follicles transition from the resting phase (telogen) to the growing phase (anagen). The shedding can be a good sign, and it should be noted that oral minoxidil does not cause shedding as often as topical minoxidil. The general recommendation is to keep applying the minoxidil despite the shedding.
Still have questions? My YouTube channel has an extensive library on minoxidil and oral minoxidil. Visit my channel and check them out!
14. All hair loss is permanent
Fiction: We saw earlier with telogen effluvium that all hair loss is not permanent.
Even androgenic alopecia can be partially reversed when medical intervention happens at an early stage. Minoxidil, PRP, micro-needling, and low level light therapies can all help with regrowth and finasteride can help prevent further hair loss. Even more hair therapies are likely on the horizon.
So that ends our latest round of hair loss myth busting. If I’ve convinced one person to stick the onions back in the fridge then I’ve done my job!
If you want to learn more about hair loss, we have a whole library on YouTube covering that topic and many, many more.
The content of this newsletter is for entertainment and educational purposes only. This content is not meant to provide any medical advice or treat any medical conditions. Patients must be evaluated by an appropriate healthcare provider on an individual basis and treatment must be tailored to meet that patient’s needs. Results and particular outcomes are not guaranteed.