What's That Rash? – "Which Hair Loss Treatments Actually Work?"

ABC News | Feb 18, 2025

Episode Overview

This episode of "What's That Rash?" tackles one of the most common and often confusing health questions: which hair loss treatments genuinely work? Responding to a listener's query about the effectiveness of treatments frequently promoted online—like LED scalp massages and high-frequency wands—the hosts break down the science of hair growth, the causes of hair loss, and the evidence behind popular therapies. Together, they separate fact from fiction, helping listeners make informed choices (and potentially save a lot of money).

Key Discussion Points & Insights

1. Understanding Hair Growth and Loss (02:12–05:29)

• Hair Growth Basics:

  • Hair grows from follicles in the skin, influenced by blood supply, hormones, and other body factors.

  • Notably, hair can store absorbed toxins, such as mercury, acting as a biological footprint (02:12).

  • Hair cycles through phases:

    • Anagen (growth, lasts years).
    • Telogen (resting, about 15% of hairs at any time).
    • Hair is lost when follicles spend less time in growth and more in resting.

    “When you are losing hair, the anagen phase, the growth phase, becomes much, much shorter... your hair cannot keep with that loss, and the follicles shrink.” – B (03:28)

• Hair Miniaturization:
  Even before hair is lost, follicles can shrink, producing finer, thinner 'baby hairs' (04:02).

• Types of Hair Loss:

  • The most common is androgenic or pattern baldness (male or female).
  • Other types: autoimmune (e.g., alopecia areata), drug-induced (e.g., chemotherapy), fungal, and more.

2. History and Social Context of Baldness and Remedies (05:29–08:09)

• Ancient Remedies:

  • Historical ‘cures’ date back to Julius Caesar, including strange concoctions like “ground up mice, horse teeth and bear grease” (06:08).
  • Ancient and early scientific theories attributed baldness to everything from helmet-wearing to “dryness of the brain” (06:53, 06:56).

• Infection Myths and Realities:

  • In the late 1800s, some believed baldness was microbial, leading to recommendations like boiling combs (07:27).
  • Modern science: Fungal infections can cause some hair loss, and antifungal therapy may help in those cases (07:27–08:00).

3. Which Treatments Actually Work? (08:09–11:47)

• Diagnosis First:
  Always identify the cause of hair loss—alopecia areata, hormonal, stress-related, etc.—as treatments vary accordingly (08:18).

• Evidence-Based Treatments:

  • Minoxidil (topical foam/cream):
    • Improves hair growth modestly by increasing blood supply to follicles.
    • Requires lifelong use; stopping it results in resumed hair loss.
    • Regrown hair is often thin, and results can disappoint (08:51).

      "If you stop it, you go back to losing your hair. So it’s a lifelong therapy." – B (09:18)

  • Finasteride (oral, for men):
    • Blocks DHT, the hormone responsible for follicle damage.
    • Risks include possible erectile dysfunction, so benefits and side effects must be weighed (09:39).
  • Platelet-Rich Plasma (PRP) Therapy:
    • Involves injecting concentrated platelets from your own blood into the scalp.
    • May stimulate short-term growth, but no stronger evidence than minoxidil/finasteride (10:17).
  • Hair Transplantation:
    • Surgically moves follicles from less DHT-sensitive areas to balding zones.
    • Can be effective but extremely expensive; does not address the root cause (10:38).

      "It can work quite well in some people, but you're not actually doing anything about the cause..." – B (10:44)

• Pattern of Hair Loss:
  Not all follicles react equally to hormones, explaining the typical distribution of balding (11:08–11:20).

• Trends in Baldness Acceptance:

  • Increasingly, men embrace shaved heads and beards as an alternative to costly interventions.
  • However, recent years see medical tourism booming for hair transplants (12:03–12:25).

4. Unproven and Dubious Treatments (12:32–13:24)

• LED “Lasers,” High-Frequency Wands, Scalp Massagers:
  • Marketed heavily online, sometimes claimed to deliver clinic-level results.
  • Insufficient Evidence: Studies are small, few, poorly-controlled, or lacking placebo comparisons.

    "The studies are not good... very few studies comparing them head to head." – B (12:54)

  • How might they work? Theories involve increasing blood flow to follicles, but real-world clinical effect remains unproven (12:43–13:24).
  • Low-Level Laser Therapy could theoretically help by reducing inflammation but still lacks strong supportive data (13:01–13:24).

5. Consumer Advice and Key Takeaways (13:39–14:26)

• Be Skeptical:
  Acne clinics use regulations to vet before/after photos; hair clinics do not always.
• Get a Proper Diagnosis:
  See a dermatologist—hair loss could be caused by treatable factors (e.g., fungal infections).
• Don’t Waste Money:
  Many ‘miracle’ products and online therapies aren’t supported by good evidence.

  “If it looks too good to be true, as listeners to What’s That Rash? know, it probably [is].” – B (14:20)

Notable Quotes & Memorable Moments

• On new fad treatments:

  "If you see a young man with a full head of hair, I just don't think the control over the photographs that can be used in hair loss clinics are as tight as they are over, say, plastic surgery..." – B (13:39)

• On ancient cures:

  "Cleopatra’s baldness remedy... ground up mice, horse teeth and bear grease." – C (06:08)

• On lifelong commitments:

  "It's not huge. And sometimes people are quite disappointed... and if you stop it, you go back to losing your hair." – B on minoxidil (09:08–09:18)

• On diagnosis:

  "Step one, don’t assume that it’s male pattern hair loss or female pattern hair loss. Find out what’s causing it... it could save you a fortune." – B (13:59)

Timestamps for Key Segments

• [02:12] – Biology of hair growth explained
• [04:02] – “Miniaturization” of hair and stages of follicle loss
• [05:29] – Historical approaches to baldness and their follies
• [07:27] – Fungal theory and real infection-driven hair loss
• [08:18] – The importance of diagnosis
• [09:08] – How minoxidil and finasteride work (and their limitations)
• [10:17] – Platelet therapy and hair transplants: mechanisms and costs
• [12:32] – Discussion of LED, laser, and “wand” treatments
• [13:39] – Consumer warnings and steps before starting any treatment

Final Advice

• Don’t be taken in by glossy ads and miracle claims. Get a specific diagnosis of your hair loss before investing in any treatment.
• Minoxidil and finasteride have some effect but require lifelong use and can disappoint or cause side effects. Platelet therapy and hair transplants are expensive; their benefit varies.
• Cheap gadgets and new therapies lack scientific support. Always consult a specialist before spending money.

Tone & Reassurance:
The hosts balance detailed scientific explanations with warmth and humor, making complex medical concepts easy to digest. Listeners are left empowered and a little more skeptical of the hair loss industry’s grand promises.