AMA #63: A guide for hair loss: causes, treatments, transplants, and sex-specific considerations

**Peter Attia** (0:10)
Hey everyone, welcome to a sneak peek, Ask Me Anything or AMA episode of the Drive podcast. I'm your host, Peter Attia. At the end of this short episode, I'll explain how you can access the AMA episodes in full, along with a ton of other membership benefits we've created. Or you can learn more now by going to peterattiamd.com/subscribe. So without further delay, here's today's sneak peek of the Ask Me Anything episode.
Welcome to Ask Me Anything episode 63 I'm once again joined by my co-host, Nick Stenson. In today's episode, we cover all things related to hair loss. While hair loss is not a direct threat to lifespan, of course, it certainly can be a relatable topic when speaking about aging, and one could certainly make the case that it factors into health span and quality of life. It's also a topic I get asked about a great amount through you, the listeners and also my patients. In this conversation, we talk about hair loss primarily as it relates to aging, which is a type of hair loss that is called androgenic alopecia. This is the most common form of hair loss for men, certainly, and it also plays a significant role in hair loss for women. We describe the differences, of course, between men and women because they have a very different pattern of hair loss, and obviously somewhat different etiologies. We talk about when the right time to start treatment is and what the breakdown of various treatments are. We cover everything from the pharmacologic uses of minoxidil, finasteride, dutasteride, spironolactone, ketoconazole shampoo, low-level laser therapy, and PRP injections. We then get into the two schools of hair transplantation, talking about the pros and cons of each. We wrap up the discussion by trying to provide guidance on how to decide which option is best for someone losing their hair. Again, male or female, and recapping the differences between the sexes in regard to this. We offer some guidance on what to look for when choosing a specialist or team for treatment. Finally, I want to note that this is an episode that is available in audio only, as we were not able to record this one in video. So without further delay, I hope you enjoy AMA number 63

**Nick Stenson** (2:32)
Peter, welcome to another AMA. How are you doing?

**Peter Attia** (2:35)
Good. Yeah. Thanks for having me back.

**Nick Stenson** (2:38)
Always happy to have you back. So a lot of times on our podcast and AMA, we're getting into topics around lifespan, health span, but today is a little different. In a way, we're talking about a subject that doesn't really relate to either lifespan or health span. However, it's one of the most common questions. Not only are we asked about through the podcast and the website, but I know it's a question your patients ask you a lot about as well, which is the topic of hair loss and what you can do about it. So we decided to pull all these questions together and through this, we're going to talk about the various causes of hair loss, options available for people to either slow the rate of hair loss, or even what they can do once they experience it. We'll look at various treatments, and then at the end, summarize those into kind of how people can think about what's best for them. We'll also talk a little bit about what to look for and how people can find a good specialist if they need to go down that route. Lastly, I will say that through this conversation, we will look at hair loss and how it relates to both men and women. So with all that said, I think we can get started, but we should say, I think this is a topic you've never personally thought about, correct? Because how old were you when you started shaving your head?

**Peter Attia** (3:57)
I shaved my head when I was 22 or 23 years old, 22 actually, and it was a dare. My then-girlfriend's dad got dared into shaving his head at work. And I was like, that actually looks pretty cool. And he's like, well, you should do it too. And so we went out back and he clipped all my hair off and I never once grew it back. So yes, as we were going through this and the preparing for this, there were a lot of questions that I also had about when an individual is losing their hair, what do they notice? Do they notice the actual loss of hair density visually? Is that the first sign? Or do they notice hairs falling out on their pillow or their drains? I never experienced anything like that because of what's noted.