Biohacking Baldness: The Hair Episode for Everyone – Dr. Alan Bauman with Dave Asprey – #727

Bulletproof Radio, a state of high performance.

You're listening to Bulletproof Radio with Dave Asprey. Allen is a board certified hair restoration physician and a hair transplant surgeon. And he's treated more than 30,000 patients and done more than 9,000 hair transplants. So this is a guy who knows how hair grows in every little thing. And whether you're a man or a woman, you're going to learn something amazing in this episode. Alan, welcome to the show.

Thanks so much for having me. David. Great to be here.

Do you like when people call you a hair hacker?

Oh, I love that. In fact, biohacking baldness is the name of the game today for sure.

It's true. And I've been thinking a lot about how do I do this? Because you sent a cool piece of tech to my house and my wife's like, hey, I want to use that. And she has one way thicker hair as a result of that. And we'll talk about what that device was. So there's lots of women who are really paying attention to not just the hairstyle and hair thickness and getting weaves and whatever the other stuff that I don't even know half the stuff that ladies do to their hair, but there's actually hair health aspect to it that I'm finding when I talk to my women friends. They're into it in a different way than it's not cosmetics. It's like I just want it to grow that way. And then for men, it's okay. Baldness is a big thing. Hair loss as well as hair color. And, you know, we don't want to turn gray. So what do you think? Should we talk about this for like men versus women or is this more of like a hair biology thing because men and women are different.

Well, you know, when hair loss occurs, it looks different in men and women. And so that's why there's a difference. When your wife wants to grow thicker, healthier hair, it's not because she's having a balding problem. Right. Typically, she wants to optimize it. And then when we talk about, for men, usually male pattern baldness, well, that's something that's visible from across the room and that's different.

So is the biology so similar? We can talk about the biology of hair. Maybe we'll do that first. Then we'll go into tweaks for men and women. Is that a good deal?

Yeah. So, I mean, look, genetically androgenetic alopecia is the condition that can affect both men and women. But it looks different, it expresses Itself different. The phenotype. Right. How it looks in. In a male and female gender is going to be different.

All right, so then talk to me about hair on the head. We'll talk about eyebrows and stuff like that in a bit. When it starts growing, you're young, you get this fuzzy hair. What makes it change so that it starts. Let's do. First it starts turning gray before it starts falling out for most people, let's go into gray.

Well, it can. It can. Gray hair is probably one of the things about hair that we know the least. But it's on everybody's mind. Right. Because hair color is, you know, it's a billion dollar market.

It's ginormous for men and women, even though a lot of guys don't talk about it.

And let's say, you know, a huge number of women, let's say 80 to 90% of women will start coloring, you know, by the time they exit their 20s, even into their 30s. So. And they will continue to color most of the time.

Is that to cover gray or just because they like changing colors?

Most of it is to color, cover the gray because the gray is a sign of aging and that's unwanted.

So telling all of my girlfriends that, or whatever you want to call them, not actual girlfriends, but my woman friends, you're actually dyeing your hair for gray. They'll love me for that. I always thought it was because, oh, today I'm red, tomorrow I'm blonde.

So that's mostly just a fashion component too, for sure.

Because there's gray under there.

Yeah.

Okay. And how much of your practice is. How much in your practice do you see people's hair go back to a color it used to be? When you change how their scalp works?

Well, that's something very difficult to do. But one of the things that we often do is try to optimize the health of the follicle and the health of the scalp. And sometimes you can see this miniaturization of the hair, for example, it loses pigment, it's going to lose its caliber, it's going to lose its length over time. And so when we rejuvenate the follicle, I'm not saying that we can turn gray hair back to dark. Of course not. But hair that's starting to lose its color because of its diameter, we can rejuvenate that. So that's some pretty good news. If you catch more when you get.

Thicker hair, it can be less gray. And I've seen a few supplements out there that can help hair turn Colors. There's some Chinese herbs and some copper and things. And I wrote about all those in the book. Like I said, it's very difficult to achieve. Most people end up coloring their hair if they want it to not be gray. Now, your hair, you have some pretty epic hair, which is, by the way, how it's supposed to be because, hey, I'm a preeminent hair specialist, so you better have good hair. So do you dye your hair?

No, I don't dye my hair. I've got a lot more gray over the past couple of years.

A little bit of gray. How old are you?

I'm gonna be turning 50.

Okay, so 50. And you have less gray than I do, actually, which is cool. But then again, I've got some genetics and I've had a lot of biological stress. So there's no dye at all in your hair?

No, no dye at all.

Okay. And you've got a pretty darn thick, healthy looking head of hair.

Well, thanks, because I know all the secrets.

I was gonna say that must be why. So when people get their scalp healthy underlying support system for hair, maybe they'll see a slight change in color, but basically they're going to dye it.

Yeah, they're definitely going to need. If they're going to go gray, if they're predisposed genetically, then they're going to probably have to dye their hair.

Okay. So either you own the gray and say I have wisdom, which is completely cool, or you say, I'm going to have wisdom and look like I'm 40 forever, in which case you might dye your hair. My prediction is that within 15 years we'll have the coloring thing hacked. We'll actually understand the biology of that enough that we can put melanocyte stimulating hormone into hair follicles and things like that.

I think you're right. Just like we figured out how to basically put a liquid tan in a bottle for pigment of the skin and so forth. I think that we'll eventually figure that stuff out for the hair follicle as well.

Okay. So both men and women don't want gray hair. And women will say, I dye my hair because it's fashionable. And the men that I know who dye their hair are loathe to talk about it. Why is it that dyeing hair for men is at least historically, it's been almost like shameful.

Yeah. I think the problem is that cosmetically, when guys go to dye their hair, they usually do it too dark. They're not maybe seeking a professional to help them do that. Their cosmetologist, their local licensed beauty professional is not steering them in the right direction, or they're not even asking them. So they're going too dark, it looks too weird, too unusual for whatever their age is. It looks inappropriate, so they run into trouble.

Okay, so it's not well done. But there's also something about at least. So I grew up in New Mexico, and I'm an engineer. And you're sort of like, well, how you look shouldn't really matter. So, yeah, I got a few gray hairs, but sort of, so what? It's almost like it's not masculine to take care of your hair or even to take care of your skin. So the number of men listening to this who are our age who have never used a moisturizer on their face is surprisingly high. High. Even though I will tell you, when you use a moisturizer on your face, you'll like how you look. It changes your skin, and it's healthy for you. Likewise, you take care of your hair, you feel better.

Absolutely.

So a good number of them. Now, there's articles men are dyeing their hair because they res. It helps their career because there is ageism in the workplace, and it's ridiculous because you want a few in Silicon Valley when no one's looking, they'll call a few gray hairs in the room. Because these are people who know where all the problems are going to happen.

Because they saw them before, maybe they have experience.

Yeah, experience, wisdom, whatever. But you want people who just, oh, yeah, we've seen this pattern in three organizations in our careers. So let's not go down that road. It's just the wrong road. And frankly, it should not matter what color your hair is. However, people are saying, I'd like to extend my career by 10 years. I'd like to have my hair, and I'd like to control the color. All right, so.

But I think with hair loss, it's different. You know, there's a lot of studies that show that guys get hired when they have a fuller head of hair. And there's actually some studies where they submitted the same resume with headshots with a guy with male pattern baldness and then the same guy with a full head of hair, and the guy with a full head of hair gets chosen way, way more often.

So if you're balding, if you have lots of gray hair, or if you're fat, you will be discriminated against. And it's not conscious discrimination where people are saying, I don't like bald people. It's Subtle, it's preconscious, It's a biological choice. And the person making the decision doesn't necessarily know why they're doing that. They don't even know they are doing that. They're sort of saying, I preferred this resume after I read the whole thing. And so it's really good.

I think it's hardwired. I mean, even facial symmetry, for example, registers in the beauty centers of the brain, right? You perceive that beauty, the brain perceives symmetry as beauty. So when it comes to a distorted hairline, receding hairline, your face is less symmetrical, less aesthetically pleasing. It's hardwired.

Okay. And I would imagine, although there are probably aren't studies, but I'd imagine if you're a woman who has a very thin head of hair, there's probably some subtle thing that goes on with that and it sucks. It should not be that way. However, there's a lot of unconscious human behavior that's out there, so you can hack that. And I'm very interested in what happens with what you're doing around making the scalp healthy before you go in and move hair follicles around. In your case, you've done crazy stuff to make your scalp healthy. That would apply to men and women, I'm assuming.

Well, absolutely. Well, first of all, I love my hair and I wanted to keep my hair. And I watched my dad go bald when I was a teenager in high school, and I watched him struggle with it. I didn't necessarily know what to do about it. I had not gone to medical school, I had not had any training in dermatology or surgery or medicine in any way, shape or form. But I saw him dealing with this hair loss process. And his dad, my grandfather, I'd never known the guy with hair. And so I always thought that, gosh, that's gonna happen to me. And I guess that's one of the reasons why I grew a ponytail in medical school. But yeah, I loved my hair, wanted to keep my hair. And so that kind of shaped my thinking at least, even though I didn't have the knowledge at that point of what to do about it.

So now give me the list of what you've done to your scalp to make your hair healthy. Give me the list of what you've done to your scalp to make your hair healthy.

Uh huh. So, well, I mean, for my scalp and my hair, you know, I'm a bit of a hair junkie, so I've tried just about everything. So from pharmaceutical therapy to red light, low level laser therapy, to nutraceuticals. You know, I've done it. I've had scalp treatments to. To improve the health of my scalp and. And keep the hair growing thick and strong. That's. That's what I want.

Have you ever had a hair transplant?

So I've never had a hair transplant. Not yet. I'm not afraid of one. I probably just haven't trained that guy yet.

You've only done 9,000 of them, right?

Yeah.

And I think it would be hard to do it on yourself. That mirror image thing. Yeah.

So with the mirror and the scalpel. Yeah. No, that wouldn't. I don't think that's going to work.

Let's talk about the scalp treatment specifically, because I think that's for both genders. And then we're going to get into men versus women.

Yeah. Scalp health is so important. I mean, do you know what the most commonly used shampoo is in the world? Like, the most popular shampoo, I would.

Think it would be like, geez, suave or something.

So actually it's head and shoulders.

Oh, okay. And the range is dangerous.

Yeah. So dandruff and itching happens to over 50% of people. 50% of the time. So it's a huge. It's a huge problem. And scalp irritation. Just about everybody gets some at some point.

Yeah.

And so I think it's like 110,000 bottles per minute or something are sold. I mean, that's ridiculous. Yeah. I can give you the data, but it's. It's a. It's unbelievable. Scalp health is a big problem. And we know now that there's a direct link between scalp health and the inflammation that's going on and the production at the level of the hair follicle, of the hair fiber. The hair fiber is dead, but the follicle is alive. And when there's inflammation going on in and around that area, the follicle just doesn't perform as well. So scalp health is really important.

I used to be a proud head and shoulders customer.

Okay.

When I was younger, I'd have dandruff all the time. And when I fixed my diet and I went bulletproof, I hadn't thought about dandruff in a long time, except maybe in the last 10 years. There's been two times when I had it for a little while after I ate some stuff that I was severely sensitive to. And then I would get dandruff for a week, and then it would go away. So there's like a fungal component to it, and there's all sorts of inflammation things.

Right. So we know, you know, we know now obviously the microbiome of the gut, there's now skin microbiome, microbiome of the scalp. It's just a new frontier of, of hair health that we're just starting to learn about.

Do you get dandruff?

So I have had it in the past, but trying to eat a lot cleaner and so forth and changed my diet up quite dramatically over the past couple of years.

Well, you're wearing your surgical Bauman Medical branded scrubs and they're black and I don't see any flakes. So at least today, yeah, your program is working right now. I don't think we'll get too deep into dandruff on this, but you mentioned that you're doing low level light therapy on your, on your head. What does that consist of?

So low level laser light therapy is a great technology, non chemical, non invasive way to impart energy to the hair follicles. And so years and years ago, we didn't know the mechanism. These devices were not FDA cleared, We didn't know why they were growing hair, but they were. We had big in office units, you know, there were hundreds of thousands of dollars. Patients would come in a couple times a week and sit under these big laser devices. And now obviously you can that kind of treatment in the comfort of your own home. And we've progressed over 15 or 20 years from small handheld devices to little bands to laser caps. And certainly now the devices are a lot more sophisticated, a lot more portable and a lot more powerful too.

And people who've read the blog or people who are just longtime listeners to the show understand I've really been to light therapy for almost 20 years for cognitive health, making my brain work better. And at upgrade labs we have whole body things. And I've used lasers going back almost 20 years, but a lot of it lately has been LEDs. So you can get these cheap LED kind of helmet things for your head that seem to have some effect. But the one that you sent me, the one that you make is actually laser.

Right.

And lasers seem to be way more effective.

Yeah, we think that they're a lot more powerful that the coherentness of the wavelengths and so forth of the light energy is what's really activating those hair follicles and for skin rejuvenation, wound healing, all the above. So I think you're getting a little bit more power out of those laser light emitting devices than you would out of today's LEDs. Now it may change in the future. We may get more powerful LEDs, but the lasers seem to be the workhorse for hair regrowth.

Anyway, so you have a high end cap that you make that's got more lasers in it than I've ever seen in anything else. And I'll put that thing on and I'll wear it for five minutes, which is what you recommend.

Sure.

But I noticed something in my brain as well from it, because lasers and even LEDs, the high powered ones, they penetrate through the skull and they cause changes in blood flow. So I think it's probably good for the brain.

Yeah. Are you getting like a relaxation effect or a stimulation effect?

It's a relaxation effect for me.

Yeah. That's what most patients will say too.

Okay. So you put this laser cap on, you're getting thicker, healthier hair. And that's by the way, what Lana used. And she's literally her hairstylist. People are saying, what's going on? You have this huge new wave of 2 inch long growth. And it's because she's. Dave, what's that thing? And I said, oh, Alan sent this to me. I'm going to go interview him for everything that there is about hair. And so she basically stole it. And I would say she lets me use it, we'll put it that way.

Right, right. Yeah. Well, yeah, there's a funny story. One of our patients was in a relationship and he had the laser and his, I think it was his girlfriend or fiance or something. Anyway, they broke up, she took the laser.

Oh, no.

And boy. So not only was he crying about the breakup, but, you know, now he's going to lose his hair also, you know, everybody's crying when that happens.

Got it.

So, yeah, the turbo laser cap is what we sent you.

Okay.

And that's, that's the latest and greatest device. It's got the most coverage for sure.

It's not cheap, to be perfectly honest. Like, those are what, about like five grand or something?

Yeah, that one's a 50, $200 item. It's on the high end for portable lasers, but. But it's going to cover a lot more areas.

It's the highest end one that I've. And the laser density, just the number of lasers on that is insane. So this is a thing though that do, like, are there providers who have one that like, are the hairdressers who use them on multiple people or do people just have them at home?

No, these are home units. So patients will take them home and they'll use them five Minutes a day is the recommended treatment time. It's got great coverage. If anybody's ever seen a picture of the turbo laser cap, it really treats from the hairline all the way through to the nape of the neck. So it really covers a very, very large area. And it's got over 300 diodes and they're all, like you said, all lasers. So it's a lot of power right there.

Yeah. Very different than the little LED caps. But I would just say, in my experience, red light definitely grows hair and putting on the head's a good thing. Is it going to be enough if, say, someone hasn't started losing their hair, they're saying, oh, I'm 25, and this is, I guess a question more for about men. But okay, I'm 25, maybe I'm seeing a little bit. Maybe I'm just detecting something going at the crown of the head. Do they. If they just start using red light and washing their hair with the right stuff, is that gonna be enough to stave it off for a while?

So laser therapy does work well to block the effects of male pattern and female pattern hair loss. It definitely optimizes the follicle for sure. The main problem, though, and we'll talk about this with all the non invasive therapies, is that you need the follicle in order for any of these non invasive treatments to be effective.

So if the follicle's died, it's too.

Late if the follicles. Yeah, it can be beyond repair, let's say, you know, you're not gonna have an effect there. So if you already have a receding hairline and you're hoping that the laser is going to grow back the hairline, well, that's really not going to happen to you.

So how would you get a new follicle there?

Well, in those cases, we have to transplant for sure.

And so transplant. I remember I first read about these probably when you first started doing this in 25 years ago. I'm like, that seems so painful. They're going to take a big strip of skin and just move it and staple it onto your forehead. That's not something I would be interested in doing. But in the course of preparing for our interview and all, I didn't understand that you can actually move a single follicle at a time.

Basically, yeah. So this is not a pluggy, painful, ugly looking procedure anymore. We're going to move literally down to as little as a single follicle to recreate a 100% natural result.

You're Basically taking follicles that don't fall out with male pattern, balance things from the side, and you put them where the things that are already dead are, and then you keep them alive by doing the things I should have done when I was younger. That we didn't. That didn't exist.

Well, the transplanted hair is pre programmed. Pre programmed to live forever. It's not going to be affected by the male pattern hair loss process. It's not going to be affected by your hormones.

How does that happen? How does it get pre programmed?

Is that just from where it grows, where they're located? Yes. So the. So the viable donor zone, which is where we're going to take the hair from lives around the sides and the back of your head.

Okay.

So the occipital zone, right by the occipital bone. Those hairs in men and women are relatively permanent. They're not affected by male pattern or female pattern hair loss. So when we take those follicles and we put them in the new area, the area that used to have hair, they will live and grow forever.

Oh, that's pretty cool. So they won't be affected and as long as you have, I suppose like chemotherapy or something would affect them.

Correct, but other than. Right. Not male pattern hair loss.

So toxins could affect them.

Sure.

The normal hormonal stuff wouldn't.

Right. If you were, you know, stuck on a desert island and you're starving, you know, if there's a high degree of inflammation, you have an autoimmune disease or something like that, it could affect those follicles. Chemotherapy, obviously, and other things that are going to knock out all the hair globally, that would be a problem. But the male pattern and female pattern hair loss, it's relatively permanent.

Okay.

Which is good news. But you still have to protect the other hair. So that's where the other therapies come in.

Okay, so, and full disclosure here, I said, all right, Alan, I want to know about this because when I wrote Superhuman, I had not ever colored my hair at all. And I talked about, look, I've held the line compared to everyone in my family pretty darn well from the mitochondrial perspective. The problem is that even though I think my mitochondria are doing pretty well, based on all the evidence I have and all the stuff I've written, I manage my hormones reasonably well. But I used testosterone pellets, and pellets are really convenient. But I noticed after about six months of pellets that my hairline had receded, which pissed me off because I've used testosterone since I was 26, for more than 20 years because my body didn't make it. I had less testosterone and more estrogen than my mom. So bioidentical levels, no problems with my hair from it. But then I used the pellets. And I'm not saying pellets cause hair loss. They don't for most people. But for me, whatever that combination was with my pathways, it did that. So I'm like, all right, Alan, we gotta hack this. And he's like, come on in. So you guys are gonna see in the video, if you watch this on YouTube or if you just go to the Dave Asprey page, I'm actually gonna get some of my follicles moved from that amazing, immortal hair zone into the front. And you're gonna do the work for me for sure. So I'm gonna take one for the team. And also, if you're a guy who's saying, oh, that's interesting, but I would never do it. I would never talk about it. I'm like, yeah, I'm hacking my hair. And I'm totally, totally cool with that, because I'm gonna live to 180. And when I'm 180, I'd like to have hair at least as thick as yours. I'd be fine with that.

Well, you deserve to have a thick, full head of hair, as does everybody.

I'm not doing.

For.

I'm 47, right?

Oh, you're doing okay.

But I think I definitely. My forehead's gotten a little larger, and I'm like, screw that noise. I want to have the hair like I had when I was 30. So I'm going to do that.

Right? So we do know testosterone in the body gets converted to dht dihydrotestosterone. And that's the trigger for the miniaturization and the weakening of the hair follicle.

Well, it's a trigger, right? And I think that the DHT myth. And it's not a myth, because DHT buildup does cause hair loss, but that DHT is a bad form of testosterone. It's the myth because DHT is an important signaling metabolite. And if you inhibit all DHT in the body, bad things can happen to your hormones. In fact, that's one reason I've never taken minoxidil or finasteride. Sorry. Finasteride. Yeah. I was like, I'm doing this backwards because some number of people who take it orally, it kind of chemically castrates them. Like, all their hormones stop working. And they don't get it back, and they call it post finasteride therapy. But I'm considering doing it topically instead of orally. And that's something that you do you make it, or do you just prescribe it? How does it work?

So we prescribe it. We work with a compounding pharmacy that makes a very clever mixture of topical finasteride for the scalp.

Okay.

And so theoretically, that should avoid this large amount of finasteride in the serum, in the bloodstream, where you don't want it, which you don't want. Right, Exactly. But it will still have that activity at the level of the scalp. And so we've seen some very nice results with topical finasteride.

So you can put that on topically and it's probably safe.

Well, the data shows that we're getting some hair growth and fewer incidents of side effects than you would if you were taking it systemically.

Got it. So that's something I would not take systemically. I'd rather be bald. But topically, I think that the ROI is there. Like, the risk reward looks like it's pretty good.

And for your listeners, keep in mind that 98% of patients on oral finasteride don't have any kind of side effects. So you have to make that option and be aware that there are risks and rewards, like you said, and make the choice.

And also, if you're already on it and you aren't having massive sexual side effects, like no erections whatsoever, then great, you dodged that bullet. I just don't want to play with that, given my biology. And I did not start out with a good biological template, having weighed 300 pounds, autoimmunity, et cetera, I don't know if that's something that I wanted to do.

Right. Well, the good news today is that there's so many other options besides finasteride to really impart more strength and health to the hair follicle all the different ways that we talked about.

What about minoxidil? This was originally a heart drug, right?

Sure. So minoxidil was an oral pill for blood pressure originally, and those patients started growing hair on their knuckles now, but they noticed the increase in hair growth all over the body, and they figured, well, one man's side effect is another man's indications. So that's how Rogaine was born, essentially.

And you can put that on topically as well.

Yes. So the main issue with Minoxidil, or at least in the Rogaine and the generic Rogaine varieties and even the online pharmacies is that it's going to be a pretty greasy, gooey, sometimes very irritating, messy protocol.

So you keep your hair, but you have greasy hair?

Yeah. Greasy scalp or even, worst case scenario, some kind of irritation or inflammation. So we've got kind of a fix for that, too. Working with a compounding pharmacy, we create a different version of minoxidil that has a different variety of ingredients to make it penetrate better, make it less greasy, less gooey to avoid some of that inflammation. And that's formula 82M.

Okay. That's something that you make. And I haven't tried any of this stuff. I'm just going to try this stuff. So, like, hey, I'll just jump in with both feet. So I'm going to move my immortal hair from the back of my head to the front of my head or more. You're going to do that? But I'm asking you to do that right after the podcast, actually. And then I'm gonna try whatever goop you think I should put on there after I read the ingredients and make sure that there isn't something in there that I just wouldn't put on my body. All right. And I think you formulate pretty effectively. And then I feel like I'm well versed on the nutrients that support hair. For instance, collagen. I've lost track of the number of times people say, dave, I eat your bulletproof collagen. But the big problem is I have to go to the hairdresser and dye my roots a lot more often because my hair is growing a lot faster just from having nutrients to grow. Hair is important.

Absolutely.

But then there's other things that biotin and just all kinds of herbal things that affect hair. You also make hair supplements. Basically. What are the hair supplements that you've found, or at least things like biotin or zinc or what are the things that people need to take to have healthy hair?

So I think most people know that biotin and zinc is gonna help with hair. Unfortunately, there's not a huge amount of data in the clinical literature, but biotin has been shown to improve keratin production, which is basically that hard dead protein that your fingers and nails or their fingernails and hair is made of. A lot of that information is actually in the veterinary medicine literature for race horses and such to show that biotin supplementation improved with hoofs, hoof strength and things like that. Of course, if you, if you're investing in thoroughbreds, you want good hoofs and such. So fingernails have been shown to improve in thickness when you're on biotin. And certainly we've measured really nice improvements with biotin supplementation in the office. So we prescribe a super biotin.

Yeah, there's. It's funny you mentioned racehorses. I don't think that hair loss is a big issue, but hoof matters.

Yeah.

The low light, low level laser therapy was pioneered on racehorses. And the first device I bought for that, this is before it was allowed by the FDA for any human use. I just bought one designed for racehorses and I used that on myself and it worked so very well. And now you can clearly get human grade lighting systems.

Oh, yeah.

So I love it that you're going back to that research because, hey, if you have a million dollar horse, you're going to measure what works. And it's that idea of measuring what works that's now carried through into humans. And so you've measured what works with these topical preparations, you've measured what works with light therapy on the brain or on the brain on the head. And what other things are going on with hair that maybe people don't know about? What are the secrets?

So probably one of the most exciting therapies that we have is platelet rich plasma that come of age really within the recent years. That's really the workhorse of regenerative medicine. And I know you've heard about that in terms of sports medicine for joints and even for wound repair and skin rejuvenation. And we've leveraged those platelet rich plasma treatments and the growth factors that they provide for better hair regrowth.

Okay. I've had stem cells, my own stem cells. Harry Adelson and Amy Killen, who've been on the show. Yeah, for sure did those. And friends of ours. Friends, of course. In fact, you went to school with Harry. Right.

We did the first stem cell certification program through the American Academy of Anti Aging together. So I've known Harry a long time. Excellent work that he does. And we have many mutual patients.

And he's got a new stem cell documentary that just came out. I was just there for the premiere. I'm in it.

Awesome.

And what he and Amy did was they did inject some stem cells and probably PRP up there, but none of the work that you do. And so I think it helped, but I don't know that it was enough given that I already had dead hair follicles in the front that probably died a while ago.

Right. So. Well, there's some nuance to applying prp, making sure that we're using the right number of platelets per microliter. For example, there's a sweet spot. 1.5 million platelets per microliter is what we think is the right amount. And then in the field of regenerative medicine, it's not just the cells and the signals, but also scaffold. So what are the scaffolding components that we can use in conjunction with prp? So not all PRP is really created equally. And I guess that's what I've noticed over the past six or 10 years, is that PRP is now available everywhere. And, you know, many of your local dermatologists and so forth may think that the skin PRP that they're using to reduce wrinkles and improve skin tone can be used on the scalp, and they may not be getting as powerful a result as what we can get here.

I would say they probably aren't. In terms of what you're doing is yours is very specialized, not just prp, but you're doing a lot of other things that go way beyond that. We just toured the facility, and you have these six different rooms full of all the latest robotic toys, all the cool stuff. But PRP is in the corner of one of the rooms because it's kind of one of the many things that are part of making your hair grow bad.

Sure. Well, we have a PRP room over the room. That room is specifically for prp, but you may have noticed that there are centrifuges in every room. Because we spin PRP on every hair transplant patient, Every procedure that we do, we're going to use PRP in a number of different ways, not just for hair regrowth, but also for wound healing and things such as that.

Okay, so I'm going to get more PRP that you've just basically specified, how it's going to be to support the growth of the hair follicles that you move.

Exactly.

Okay, that's pretty exciting in terms of all these other things that are out there. Stem cells, exosomes, stem cell juice, and things like that. Usefulness for hair. I know the FDA is now talking about regulating those things, even though they're all over the place.

Sure. So you can use adipose tissue, for example, and harvest the mesenchymal stem cells in a small liposuction procedure and use that for hair regrowth. There's some interesting data on that.

Read Superhuman if you want to get the details on all that. There's a whole chapter on what's going on with stem cells. So it's possible to do that.

But now we think that the latest and greatest, really, exosomes, which are these little packets that cells use to communicate with each other, can do the work that the stem cells were doing without having to use the cells.

That's really cool. I call them stem cell juice because stem cells secrete exosomes once they go in there. So if you don't get the stem cells because a regulatory body said you weren't allowed to use your body's own cells on yourself, I'm not sure how that works, but that's the current state of things, at least in the U.S.

Well, there's certain regulations in the U.S. on what you can do to those cells that you harvest, let's say out of the body, what you can do to them. So if you minimally manipulate them, use them in the same surgical procedure, same day, then you can, you can. But if you want to try to avoid that more invasive procedure of stem cell, then exosomes might be. Yeah, a nice solution for that. And growth factors today are being bioengineered. So they're bioengineered growth factors that we can get right out of the laboratory that, with these cells, these mesenchymal stem cells have been manipulated in a certain way to produce a secretome, which is that balance of different types of growth factors, different ones that have different activities at the level of the scalp, let's say. And we can apply those directly to the scalp during a procedure, during a PRP micro needling. And you can even get that off the shelf and go home with that.

Alan, someone came to you tomorrow, maybe me, with a million dollars and said, I want a perfect head of hair. Cost is no object. What would you do?

Well, so truly, that depends upon what we're starting with.

Okay?

Right. Because if someone is coming in with a pretty decent head of hair to start with, then we can help protect it and enhance it. Right.

Let's give you a little bit more data.

Okay.

It's a guy, and he's got a little bit of hair loss, but, you know, not tons. You know, I'd like to keep it. It's a different. It's different if someone comes in with no hair at all, like my dad. Yeah, that's. That's a different scenario. But so someone who hasn't, someone who's fighting the good fight and is given up some ground but is still keeping it going, and this is a man. At this point, I think the answer might be different for women, but it's like, look, I got all the money in the world. I want all the hair in the world. Hook me up. What would you do?

So what's possible? So the first thing we would do if someone came in is find out what their goal is. And if they have, let's say, a goal to restore their teenager hairline, that might not be such a great idea, because we want the hairline to look normal and natural. So we have to choose a hairline and a shape and a design. If we're talking about restoring a hairline, we have to restore something that looks normal and natural that's not gonna draw attention to itself as something that's bizarre or crazy. Okay, but let's say we've chosen a hairline that's lower than what he has right now. We wanna turn the clock back a little bit. We have to do two different things. There's two battles to fight at the same time. There's, of course, the restoration. We gotta turn the clock back a hair. We have to reframe his face, but we also have to protect the other hair that he has. So the transplant process might ensue. We're going to do follicular unit extraction. That's the minimally invasive style of harvesting. We've got some new technology that allows us to take the follicles one at a time without trimming them.

What is that? Is it like a little melon baller? Like, how does this actually work?

A melon baller? No, no. I've never heard it quite described like that, but you will find out that it is the use of a very, very small microsurgical instrument that's kind of round in shape, but it's more like. Imagine trying to remove a palm tree from your backyard and putting it into the front yard. So you have to kind of carve around the root and then lift the tree up and put it in its new location. So we're gonna do that one at a time for either a single hair follicle or a group of two or three hair follicles.

So how big of a chunk of root does it take to go with the hair?

So it could pull a hair out? It's extremely tiny. So the good news is that this is not your father's hair transplant. This is not a row of plugs which contain 30 or 40 hairs. This is not going to be a painful process. So under local anesthetic, we're going to literally make a scoring incision around each and every follicle that we're going to harvest each graft, and that incision is literally less than a millimeter. So it could be 0.8 millimeter tool that's being used. So it's very small. And then that follicle or that graft is going to get plucked out of the scalp.

Okay. And so you're going to spray me with lidocaine. It'll be numb. You're going to do these little.

Well, guess what? It's going to be an injection.

You're going to inject. I'm fine.

Yeah, it's going to be injection lidocaine. But you're not going to feel it.

Got it.

You're not going to feel that.

And so then you're going to do that, and then you're going to. When you plant it, do you have to make a little incision for it or how does that work?

Yes. So the incision or recipient sites, which is where they're going to be implanted, is based on the design that you and I create together. So we'll actually work on that shape and design.

You get to pick one.

Well, you're not really picking, but we're going to work on it together. That we're at least looking at the same end goal, let's say.

Okay, I really like Wolverine. And, you know, he does that thing where he, like, shaves his chin and then has that cool beard. The mutton chop thing. I want to do the reverse. So my widow's peak comes down to my eyebrows. Could I do that?

Yes. Eddie Munster. Yes. That would look great on you, Dave.

The real question there is, can you plant those hair follicles anywhere you want?

Yes. We can sort of use chest hair.

I could do that.

We can use chest hair.

Okay. I'm not going to do any of that, but just because they will grow anyway.

Any follicle that we use can be planted anywhere. As long as the skin bleeds in that zone. Yes. It will live and grow forever. So I did have a YouTube celebrity ask me for a lightning bolt shape on his forehead. We declined. Yeah, we declined. But he did convince me to transplant a few hairs into his hand.

All right. How far forward would we move my hairline?

That's an excellent question. So if you look in the mirror and you raise your eyebrows, you will see where that hairline used to be, where the wrinkles stop and the smooth scalp begins. That's the anatomical location that you used to have. And you never had a super duper low hairline. But we can obviously check photos from years ago to determine that. So we're probably gonna move that hairline about a finger's breadth or so. Okay.

Not that much.

So, you know, but that's just, you know, we can decide what we want, you know, what would look appropriate. And the great thing is that when you and I work together on that design, it's done with a pencil. So we can draw it in, we look at it a couple different ways, left to right, so forth, take a picture of it even. And then if we want to see what it would look like with a lower hairline, we can erase it and draw it in again.

All right.

And once we decide, then we'll execute.

We have to get some photos of that. That's going to be cool.

Absolutely.

All right. And then what about things like peptides? I know you can speed surgical healing with red light and with peptides with ozone. So are there specific peptides that you use in the practice?

So what's old is really what's new again. So my story about peptides goes back to 1999. In 1999, we were using copper peptides to help wound healing and stimulate hair regrowth after hair transplant surgery.

Wow.

So it's been a long, long time with copper peptides. And that was basically like a blue looking solution. It came with a whole take home kit of gauze and sprays and gels that people would use after their hair transplant procedure. Of course, in those days, we had a row of stitches in the back of their scalp that they needed to heal. So the wound healing was a little bit more traumatic. Obviously, since FUE follicular unit extraction, the technology has changed dramatically and the wound healing takes much less time, very little discomfort. In fact, we don't even prescribe Schedule 2 narcotics anymore for years now. You wouldn't need it.

Yeah. I'm looking at this as a pretty minor thing where it's gonna take a good amount of time, but it's a bunch of tiny little things. Given that I inject myself with peptides just about every day, I'm like, this isn't really on the scale of crazy stuff like having my bone marrow taken out. I'm like, this is a walk in the park.

Right. So many of the peptides that you're probably already using are gonna be helpful for wound healing and recovery from this process.

They're not a standard part of what you do.

Not every patient wants to do peptides. Obviously. They're, you know, can be cost, but you're willing to. Absolutely. We're on top of that. Yeah.

Things like, I'm guessing BPT157 and then GHK, the copper.

Copper. GHK, yeah.

Are there other ones that are useful?

There's Thymosin Beta TB 500. Yeah. Which is one that we're looking at. So, again, the. The data is very preliminary at this point, but stay tuned for patients who want to try it. We talk about risk, benefit, and if they want it, then we do it. Growth hormone. So growth hormone will not grow your hair back, contrary to popular belief. But it can be used for wound healing and recovery after surgery.

Okay, got it. So if you were like a Hollywood star and you had to look really good faster, you might get another. It's only seven days of healing anyway, so you might get in.

Yeah. Actually, most people's concern is not necessarily that healing time, but it's the haircut that's required for large sessions of hair transplant. So we have some new ways to kind of avoid that. Now for people who don't want to look dramatically different, like, you know, you have a short haircut, you're not going to look much different immediately after the procedure.

I was loving it when we talked about doing this, guys like, oh, the size of it have to be short. I'm like, that's awesome. Because last year for Burning Man, I went to the hairstylist place across the street from Bulletproof Headquarters, and I'm like, hey, I need a CEO Hawk. And like, what's that? And I said, well, I'm a CEO, but I'm going to Burning Man. I want a mohawk. So I have to be able to look like a CEO and have a mohawk at the same time.

Perfect. And so the CEO Hawk is exactly the haircut that I'm gonna give you.

For the hair transplant. It's like short on the sides, basically, and normal on top. Right. But not as high as a mohawk. So that's actually becoming in fashion anyway.

Absolutely. And it's because everybody's getting hair transplants. No, I don't. I don't really know. But yeah. So we call that a wide shave, and that's the most efficient way to get the most amount of hair in the least amount of time. Access to all the donor zones. Some of our patients have previous old style harvesting, so they have maybe old linear scars. So we've developed a new technique that allows us to take the hair without trimming it.

Oh, interesting.

So this is called a no shave, or here at Bauman, we call it a VIP fue procedure. So it's long hair, no shave preview hair transplant.

Wow. So you got to work on your marketing because VIP Fu. Everyone knows what that means. I'm just kidding. So VIP for you. That's what it means.

Fue.

Fue, yeah.

FUE and follicular unit extraction. You know that's the term.

Right?

So vip.

Very important person.

But, you know, that's. This method allows us to take the individual hair follicles, so while they. Well, the hair does. Okay, so that's the caveat. Right. After the. When we harvest those follicles, they have the long hair attached. And then when we implant them, you can actually see the hair immediately after the procedure. So that helps cover some of the crusting.

Okay.

But then also, those hairs, they're gonna shed. So in about two weeks, the follicle shuts down, those hairs are gonna shed, and then they're gonna regrow at the regular time, about four months or so later on. So you can kind of a fun process.

You can only do that for a little while.

Right.

Okay. And just. In other words, you get two weeks of that, and then you don't see.

The hair for a while. The major benefit is not that, you know, oh, my God, you're gonna have that hair instantly because obviously it's temporary. But the cool process. The cool part of the process is that you don't have to dramatically change your hairstyle.

Okay, that's interesting. But, yeah, I would have no need for that.

Right. You have short hair. That's not for you.

You can totally do that. Wow. Okay. I'm. I'm intrigued that all this is possible, because I still had kind of this idea that, you know, they just take a big chunk from the backhead, move it to the front, and that's gone. Correct.

That's not what we do anymore.

One of the things that fascinates me about biohacking is just the speed of exponential change in what we can do with medicine. Where do you see hair transplants 10 years from today?

So I think, really, hair restoration, first of all, you're right. Has changed so much just within the past five or 10 years, going from such an invasive process to something minimally invasive, and I'm really proud to be a part of that. Minimally invasive. You've been a leader on that, pioneer on that. But I really see the medical management of hair loss as be the key location that a lot of changes are going to be made. So being able to track your own hair over time, because, as I said earlier in the discussion, you can lose 50% of your hair without it being noticeable to the naked eye. And your best chance at preserving the hair, you have is before those follicles have kind of kicked the bucket, so to speak. So the ways that we measure and monitor hair loss, for example, in the clinic, using a hair check tool, which is a non invasive way to measure how much hair is growing in a given area of scalp, and some of our new microscopes, which can immediately assess density and hair caliber without trimming any hair, is going to give you a metric of whatever you're doing, whatever you're trying to do to hack your hair. You're going to know the response if you give it enough time. So let's call it three months. You come back, we're going to be able to tell you exactly how your hair is changing and how much and where. So whatever hack you want to do, you know, and this is often a discussion I have with my patients. You know, they're very aggressive in new technologies and we may not have a lot of the published scientific research on much of this set in stone yet. There's maybe some inklings towards this, that or the other never is. But so we want to know and remember individualized, personalized medicine. Your response may be different than the next guy, may be different than the next woman. So how do we know what's working on you? And it's this follow up measurement, this follow up protocol. But what I see changing in the future is you going either taking some kind of device home with you that will help you track your hair, or visiting someone in your local neighborhood who can actually do that measurement for you, or have someone even in your house, like your wife, could literally hold this device up to your scalp and get a measurement.

So it's kind of like a blood pressure measurement for your hair.

Exactly.

How many women get hair transplants, not counting eyelashes and eyebrows?

So even though through the door, which we see about 1,000 patients per year, it's about 50% men, 50% women, almost equal in consultation. But many fewer women are good candidates for hair transplant surgery. And this is typically because, well, number one, they're realizing that, I would say the women are a little bit more proactive than the men in terms of their health. And so they're feeling that changes in their hair maybe more quickly. They may notice that their ponytail volume is changing or that they're having sets of shedding.

Having a baby will trash your hair like no one's business, right?

Absolutely. So it could start even after puberty with birth control. It can start with having children or around the time of menopause, or even a crash diet can change your hair.

Yeah.

For sure. Or changing your work schedule, like staying up at night and things like that.

Okay, let's talk about.