Hair Regrowth Update and FAQ

Family portrait 2011 — the “before” shot

Top of head July 2015

In April I wrote about how I’ve been using a scalp massage technique to thicken my hair and advance my hairline, and shared progress pictures. Understandably the post generated a great deal of interest. Rub your head and grow your hair back? Get your hair back without drugs or surgery? Sounds impossible, doesn’t it? Another hair regrowth scam?

I was skeptical too. Rob from perfecthairhealth.com introduced me to the technique, and it took a few email exchanges to convince me to try it. The basics of the system are as follows:

1. Twice a day, morning and evening, massage your scalp using deep, intense pinching, pressing, and squeezing, for about twenty minutes. Your scalp should feel a little sore at the end of the massage, but you don’t want to break the skin.
2. Adopt (or continue) a highly nutritious anti-inflammatory diet (low grain and sugar, plenty of vegetables, fruit, fish, poultry, meat, etc.) — more or less a paleo diet.

Why does it work? Is there any science to back it up?

1. Rob was inspired to try this technique after reviewing this study by Henry Choy (Hong Kong University). Though the study has not yet been replicated (as far as I know), Choy’s results were impressive. 100% of the subjects regrew 90%+ of their hair. Choy describes the technique as “detumescence therapy.” According to Choy, bald and balding people have more “dome shaped” heads due to thickening of the scalp on the top of the head. The massage therapy thins and reshapes the scalp, expels trapped sebum, increases blood flow to hair follicles, and releases trapped DHT (which causes the hair follicle to miniaturize and become inactive).
2. Rob has written an eBook which expands on Choy’s theory, and adds his own ideas about scalp calcification and diet. Soft tissue calcification (which is implicated in many diseases of aging, including heart disease) can occur in the scalp, and the intense massage process can help break up tissue calcification (which blocks nutrient supply to the hair follicles). In terms of diet, Rob recommends paleo both because such a diet tends to push to immune system towards a less inflammatory state (chronic levels of skin inflammation can contribute to hair loss), and also because foods like organ meats and bone broths provide high levels of certain amino acids which may encourage hair growth. He also discussed the role of thyroid health in relation to hair loss.

Personal Hair Regrowth Update

In my earlier post I detailed my own hair loss chronicles, and shared my experience using the massage technique described in Rob’s eBook. Since then I’ve been continuing the massage technique, but not as strictly. On average I probably do the head massage about five minutes in the morning and ten minutes in the evening. My hair is continuing to thicken and advance, slowly but noticeably.

My scalp no longer gets “greasy” after the massage sessions — I believe that I expelled any excess sebum within the first few months. My scalp feels much thinner, looser, and more flexible than it did when I first started. I am still experiencing what can best be described as “adult cradle cap” — excess dead skin accumulating on the top of my head that needs to be scraped off. I assume this is in reaction to the intense stimulation of the scalp skin, but it could also be a side effect of increased blood flow, old material deep in the scalp being expelled, or even some kind of stem cell activity or other hair growth factor related to the reactivation of the hair follicles. I don’t have dandruff as long as I “scrape off the gunk” and keep my hair and scalp clean (I use just water or a very gentle, “no bad stuff” shampoo).

In my earlier post some readers were critical because my “before” and “after” pictures were taken from different angles, with the “after” shot taken from further back and thereby making my hair look fuller. I’ve tried to correct that with the following “same angle” comparison:

July 2014 vs. July 2015

Overall I would say at this point I’ve regrown about 80% of my lost hair (if you include thickening on top of my head), and about 50% of the previously totally bald areas grown in at least partially. Much of the regrowth is hard to see, but I feel it when I run my fingers through my hair (verified by my wife and a few curious friends).

This isn’t as dramatic as the results of Choy’s study, but I’ve definitely regrown a lot of my hair! Frankly I’m amazed it works at all.

Readers of my earlier post have been curious about various aspects of the technique. I’ve tried to condense some of the frequently asked questions below.

F.A.Q.

1. Did your fingertips get numb?

At times they did. Using my nails more (trimmed short, just long enough to dig into my scalp a little) helped relieve pressure on the fingertips. So did using altering the angle so that I was using the finger pads more than the fingertips.

2. Did you use any special oils, like emu oil?

No — too messy for me personally. Emu oil may have a mild anti-inflammatory effect, but there isn’t much evidence that it helps regrow hair. It probably can’t hurt though!

3. What is the “correct” massage technique?

Choy’s paper describes “pressing and kneading.” Rob’s eBook focuses on “squeezing and pinching.” My guess is that the exact technique probably doesn’t matter a great deal as long as you are going really deep, almost to the point of pain, to loosen the scalp, break up calcification, and stimulate blood flow. Really get in there! What you don’t want is friction on the surface of the scalp; go deep instead.

4. When will I see the first regrowth?

Probably after about four months, though you’ll notice your scalp feels looser after only a few weeks. Readers who have been using the technique from Rob’s eBook for more than four months — when did you first start to see results?

5. Will I lose more hair before regrowing new hair?

Possibly. I didn’t experience this, but others have. Shedding may occur from follicles that are already undernourished and partially miniaturized. For some, this possibility might pose enough risk to want to avoid this technique. You could always wait until you’re completely bald — then try the technique risk-free!

6. What about supplements?

I take some supplements on an ongoing basis, including vitamin D, vitamin K2, cod liver oil, and chelated magnesium. I didn’t add anything new when starting the massage technique.

7. What if my scalp is too tight to pinch?

Try pressing and kneading, using both hands if necessary, until your scalp gets looser.

8. Would a wooden massager, brush, or electric contraption work just as well?

I doubt it. To generate enough force and really remodel your scalp tissue, direct pressure from strong hands and fingers are your best bet (and your hands and fingers WILL get stronger if you practice the massage technique daily).

9. Can the massage cause headaches?

This didn’t happen to me, but it’s conceivable that increased blood flow and vasodilation could cause a headache. Since the massage is generally relaxing, a vasoconstriction headache (the type brought on by stress) seems unlikely. To prevent a vasodilation headache, adequate hydration, salt intake, and possibly coffee could be helpful.

10. If the scalp calcification theory is correct, why do hair transplants work?

A reader wrote to both myself and Rob with this question. I didn’t know anything about hair transplants, but here is Rob’s response:

Many years ago, a big research paper came out about hair transplants. Scientists took thick healthy hairs from non-bald regions in the back of the scalp and transplanted them to balding regions. These hairs continued to grow normally for the duration of the study, and so scientists concluded that these hairs would continue to grow in perpetuity because they were protected, for reasons unknown, from MPB.

This paper became the basis of support for all hair transplant surgeries, but there were significant flaws with it. The problem: the study wasn’t long enough.

Transplanted hairs weren’t tracked over a series of hair cycles, but rather for relatively short periods of time. During this time, it was concluded that these hairs weren’t miniaturizing at the same rate of other hairs in the same region, so these hairs must be protected from MPB. This turns out to be a false conclusion. In actuality, the transplanted hairs begin to miniaturize and eventually fall out, but the process takes a long time because the transplanted hairs are so healthy to begin with.

The reason why is just as the book argues: they’re transplanted into regions of the scalp suffering from fibrosis, calcification, excess sebum/dandruff build-up, plus a host of other epigenetic changes to collagen structures. As you know, the conditions for MPB are present years before the symptoms (hair loss) begin to show. So, we can assume that if these conditions precede hair loss, then it must also take time for thick healthy transplanted hairs to miniaturize after being moved to a relatively more calcified region in the scalp.

Anecdotally, I’ve worked with a lot of people with hair transplants. Of the group who received them 5-10 years ago, almost all of them claim that most of their transplanted hair is already gone. I have a friend with a hair transplant who’s experiencing the same problem right now. It’s one of those weird cases where the science doesn’t add up with the anecdotal evidence.

To make matters worse, all hair transplant surgeons are aware of this. It’s why they ask you to go on finasteride and minoxidil after a transplant (in hopes that some of the conditions to the scalp will be addressed). They also ask you to join a hair club, and some now even mandate massages to promote elasticity (you can find YouTube videos of doctor demonstrations on this).

In regards to hair transplant surgeons being aware of these issues, Rob followed up with a link to this article, which includes the following passage.

“Micrograft survival rates in hair transplantation have been frequently described in private conversations by hair transplant doctors as variable at best. References in medical literature may grossly underestimate the prevalence and magnitude of poor growth. This is probably because most hair transplant surgeons arc concerned that publication of a significant incidence of poor growth would reflect negatively on their practice.”

11. Do headstands help?

I’ve been doing headstands for years, partially because I thought it might prevent hair loss. It may have helped, but headstands on their own didn’t help regrow my hair. I still do headstands for general health, and in addition I also twist and rub my head on the floor (or mat) while inverted, to make my scalp more flexible and to apply more pressure. No idea if it helps, but it feels good and may be synergistic with the massage technique.

12. Has this technique worked for many people outside of Choy’s study?

Many of Rob’s eBook readers have sent in before-and-after pictures, and Rob (with their permission) has forwarded some of those pictures to me. The results are impressive: significant regrowth with several men regrowing all of their lost hair (at least as much as you can tell from a picture). I hope that some of these gentlemen will grant Rob permission to use their pictures in the next edition of his eBook.

Still, we’re far from this being a “proven” technique. Anyone who is trying it now is an early adopter/experimenter. I salute you — together we are forging the way for potentially thousands of people who can use this simple technique (along with patience and persistence) to regrow lost hair!

If you’ve been using the technique for five or more months, please write in and share your results (with or without pictures).

13. How important are diet and general health to the hair regrowth process?

Since Choy’s study doesn’t mention diet or nutrition at all, and all of his subjects experienced hair regrowth, I can only assume any dietary changes are less important than the massage process. Personally I did not modify my diet at all, but I was already eating a low-grain, low-sugar, high-nutrient diet before I started.

Still, why not take the step of improving your diet if you choose to embark on the hair regrowth journey? It can’t hurt, and it may help other issues related to poor diet and/or chronic systemic inflammation, including asthma, insulin resistance, and heart disease. Even if you don’t go paleo, or maybe don’t eat meat at all, you can still take steps like cutting out baked goods (like bread), sweet drinks (too much fructose), and more than one drink a day, while at the same time increasing omega-3 intake, water, and nutrient dense foods.

14. Are you planning any video tutorials, eBooks, or other hair regrowth products?

Not at the moment. Rob and I have discussed working together on something (in very vague terms), but for the moment I think Rob’s current eBook is a great product.

If you are already experimenting with the massage technique, let us know how it’s going. I’m especially interested in people who have been using the massage technique for five or more months. Is it working for you? Did you get discouraged and give up? Do you look like Fabio now? Please share below, and as always please be polite and respectful towards other commenters.

Update:

Some readers have requested more pictures. Here are my most recent progress pictures from August 15, 2015, right after I cut my hair.

Hair regrowth progress as of August 2015.

Update Sep. 2015: Rob has recently taken his eBook offline because the amount of time he was responding to email became unmanageable. I proposed that he make it available as a free download, but he felt that would be unfair to his customers who had paid large amounts on the sliding scale (so please don’t ask me to send it to you). While the eBook is no longer available, the “how-to” is all contained in this post, the original post, and in my responses in the comments.

Update Oct. 2016: Good news — Rob has updated and relaunched his eBook. The new version includes a number of before/after pictures (my own included) as well as the most recent research studies in regards to scalp massage and hair regrowth. The new video is extremely comprehensive and includes examples of pinching, pressing, and stretching the scalp. You can purchase the new edition of Rob’s book at http://perfecthairhealth.com/

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