Balding? Check Out My Interview with a Bosley Expert

It’s funny. With all of the stuff I’ve blogged about over the years, one of the first things people have always consistently asked me about is my balding.

When I first designed the blog, I included my shiny dome in the header as a way to lighten the mood and differentiate me from all of the more “serious” business blogs out there. I never knew that announcing to the world that I was balding would be such a big deal. People want to know when I first realized I was going bald (around 21), if I tried any drugs like Rogaine (I didn’t – just some hair thickening shampoo that did nothing), and if it was a hard decision to decide to start shaving my head (it wasn’t – just picked up some clippers one day and never looked back). Personally, I now prefer the clean-shaven head look to when I had hair, but I know a lot of people who understandably don’t want to give up on their hair in their twenties.

So when the folks at Bosley, the famous hair restoration firm, contacted me about doing a blog post a few weeks back, I decided I’d be fun to do an interview with one of their hair loss experts and post it for everyone*. My questions are in bold, with the answers listed out below. This is officially my first post in the balding category. Enjoy! There’s certainly a TON of good info in their replies. If anyone has any other questions I’d be happy to follow up with them. I just asked what I thought would be the most common balding questions that people would have.


What factors contribute to who goes bald and who doesn’t? Is it 100% genetics, or are there some controllable factors that come in to play, such as stress level, weight, diet, exercise, etc?

Hair loss or baldness is a genetic trait, but how much of it is genetic, varies from one individual to another. Hair loss with genetic predisposition is called “androgenetic alopecia” or “male pattern baldness”.

Factors such as a person’s activities, diet, medications, natural hormones, pregnancy and childbirth, use of birth control pills, improper hair care and certain diseases can contribute to hair loss, but these factors may affect an individual more than another. While chemical treatments, pollution, hair-styling products and blow-drying have not been found to directly cause hair loss, they can dry and weaken hair, increasing breakage and perpetuating hair loss.

The lack of good blood circulation to the scalp may also contribute to hair loss. When the hair root is well supplied with blood it is stronger and less susceptible to the shrinking effects caused by hormone DHT (dihydrotestosterone). Good blood flow strengthens and rejuvenates the small blood vessels in the scalp. Stronger blood vessels Increases the longevity of the hair follicles specially in thinning areas and encourages hair growth. Finally, you cannot fight the effects of aging. As you age, your hairs tend to break more easily, and hair follicles do not grow as much hair.

I first noticed my hair thinning and my hairline receding around age 21. Is there an average age that most people start balding? Does it generally happen at the same rate, or does it take 10 years for some and 6 months for others? Again, are there any controllable factors or is this all genetics at play?

People start balding or suffering from hair loss at different ages, and at different rates from one another. So there are no set rules in balding. According to Medem Medical Library’s website, male pattern baldness affects roughly 40 million men in the United States. Approximately 25 percent of men begin balding by age 30; two-thirds begin balding by age 60. There is a 4 in 7 chance of getting the baldness gene. But there are rare cases where men start losing hair in their early 20s, and even before they turn 20.

In women, hair loss usually begins at menopause. Although hair loss in females normally occurs after the age of 50 or even later when it does not follow events like pregnancy, chronic illness, crash diets, and stress among others, there has been rare cases reported, in which hair loss affects women as young as 15 or 16.

The balding process and rate vary with each person. Whether it is slow or rapid, the individual would usually notice. Hair loss tends not to be something people ignore.

Factors such as a person’s activities, diet, medications, natural hormones, pregnancy and childbirth, use of birth control pills, improper hair care and certain diseases can contribute to hair loss, but these factors may affect an individual more than another. While chemical treatments, pollution, hair-styling products and blow-drying have not been found to directly cause hair loss, they can dry and weaken hair, increasing breakage and perpetuating hair loss.The lack of good blood circulation to the scalp may also contribute to hair loss. When the hair root is well supplied with blood it is stronger and less susceptible to the shrinking effects caused by hormone DHT (dihydrotestosterone). Good blood flow strengthens and rejuvenates the small blood vessels in the scalp. Stronger blood vessels Increases the longevity of the hair follicles specially in thinning areas and encourages hair growth. Finally, you cannot fight the effects of aging. As you age, your hairs tend to break more easily, and hair follicles do not grow as much hair.

What solutions are out there (besides shaving your head like I do)? How does Bosley hair restoration compare with drug solutions like Rogaine? Does the best solution depend on how far along one is in the balding process (just losing a few hairs vs. fully bald for years)?

Bosley offers the only permanent and the most cosmetically significant solution to hair loss- surgical hair transplantation. For those who are not ready or suitable for hair transplantation, Bosley also offers other solutions that can help in your fight against hair loss.

One non-surgical approach is the Bosley LaserComb. It is the only FDA-approved medical device that emits controlled laser energy to stimulate hair follicles and promote re-growth. Treatment with a Bosley LaserComb is most effective on individuals with very early-stage hair loss where hair restoration surgery is not indicated.

Another is the Bosley Professional Strength- It is a complete system to help prevent hair loss and restore thinning hair – in 5 simple daily steps. Offered in Men’s and Women’s formulations, Bosley Professional Strength contains ingredients that nourish and invigorate the scalp and hair, creating the perfect environment for the growth of thick, healthy hair.

Bosley also offers Propecia- an FDA-approved tablet taken once a day, available by prescription only. Propecia works to inhibit the formation of the DHT hormone that weakens hair and halts its growth. It is not approved for use by women and must be taken on an on-going basis to maintain its benefit. Propecia may be purchased from the Bosley Store with the appropriate prescription which you can get during a Bosley consultation.

Finally, one can achieve an instant cosmetic fix to hair loss, through hairpieces and toupees. Bosley does not offer this. The cost varies according to type and quality, and the price of a high-quality hair system and maintenance may often be greater over time than both surgical and non-surgical options.

Rogaine is best used to slow balding and retain what hair is left on the head – but Rogain is not considered a viable solution for those looking to restore hair on the top of the head or at the hairline. It does not cure baldness; while it can delay the loss of additional hair due to androgenic alopecia, any hair retained or regrown with Rogaine will be lost within a few months after the drug is stopped. The manufacturer Johnson & Johnson would tell you that their product is not effective in the frontal area, which is the area of most concern to most patients, especially the frontal hairline. They claim that approximately 8-10% of users achieve cosmetically effective growth and another 20% get vellus (or peach fuzz) growth.

Bosley hair restoration is a permanent and relatively simple procedure that actually restores hair. It achieves a natural look. The Bosley hair transplant procedure takes hair follicles from the very back and sides of the head and artfully transplants them to thinning or balding areas. So we can take hair from where you have more than you need (the back of head) and put it where you need it more (front of head). It’s the ideal solution to baldness because it uses your own hair.

Bosley hair transplants can help people experiencing virtually every level of hair loss, at any age (over 21) depending on whether the patient has enough hair in the donor area. First we would determine which class of hair loss a patient is in. Class 2 is characterized by the beginning of a receding hairline and a “widow’s peak” on the forehead. Class 3 patients exhibit a more significant decline in hair above the temples as well as receding from the forehead. In Class 3 Vertex, hair loss is starting to become significant on the crown. Class 4 hair loss may become more noticeable on the crown or patients may have significant hair loss above the temples and/or front anterior areas. Class 5 hair loss approaches significant levels with most hair loss occurring on the top of the vertex and crown. Hair transplantation for this Class and higher Class levels may require more grafts to provide coverage and density. Class 6 patients show major hair loss, but still have areas with donor hair available. Transplanting this hair can still have excellent results. Class 7 patients show the most significant loss of hair. There may still be sufficient donor hair for transplantation; however, results may be limited.

Hair restoration at Bosley is a relatively simple outpatient procedure. Many of our patients go to work the very next day. And side effects of hair transplantation are almost minor. Infection occurrences after a hair transplant procedure are rare. In the very few cases where infection does occur, it is often due to the patient’s failure to fully follow post-operative instructions. Even when infection occurs, it generally is easily treatable with antibiotics, which can be prescribed by the physician.

Any more details you’d like to add about Bosley?

Why choose Bosley Medical for hair restoration, you may ask. Bosley distinguishes itself with two key factors: Experience and Natural Results. Bosley has been a full-time hair restoration practice since 1974. Bosley has performed more hair transplants than any other medical group in the world, more than 200,000 procedures to be exact. Bosley has restored hair for patients from all 50 states and more than 67 foreign countries.

Every Bosley physician is required to be actively licensed in the state in which he/she practices, and a member of one or more professional associations. Before joining Bosley, all of Bosley’s physicians have had years of training and experience in their field. Finally, Bosley follicular-unit techniques result in a hair restoration so natural that we challenge you to tell the transplanted hair from the non-transplanted hair.

*The folks at Bosley kindly asked that I include the following disclaimer: Please keep in mind that hair loss and its treatments are medical considerations. And with everything of the medical nature, you and your readers should seek the opinions of your qualified physicians.

13 comments on Balding? Check Out My Interview with a Bosley Expert

  1. Neville says:

    10 years ago I wouldn’t have even read this post, now I’m thinking, “Hmmm, I should pay attention!”

    My friend actually got this done. He was pretty much completely bald on the top of his head and shaved his head to “cure” the problem. I believe the full procedure took a few months…but now he actually has a full head of hair, goes for haircuts etc.

    I almost didn’t recognize him after seeing him with hair (I’d never met him WITH hair).

    • Adam McFarland says:

      I remember you mentioning to me that your friend had a good experience with the procedure. It’s awesome to hear…just in case I change my mind some day 🙂

  2. Tim says:

    As another male who is, or should I say was going bald, this is an interesting article. I took the plunge and tried generic rogaine just under 6 months ago and am astonished at the results, it really is working! The main problem I think most people have is they don’t stick with it, I noticed literally NO change for the first 3 months. It is also not always convenient to apply rogaine twice/day. That said it is pretty cheap, I just bought a 6 month supply for $22.95. A friend sent me a picture the other day of me from about 4 years ago and I have a LOT more hair then I did then, the before and after pictures are very obvious.

    My head has a funny shape, I’m not going down without a fight!

    • Adam McFarland says:

      Haha that’s great to hear that Rogaine is making that big of a difference. I also had no idea that you could get it that cheap.

      • Tim says:

        The name brand stuff sold in local stores is grossly over priced, I get a yearly supply for about the same cost of a single month. I’m totally cool not seeing full page ads in male magazines and prime time commercials on TV and saving the difference. Interestingly, when I was researching this the main reason the new foam came out is because the patent expired on the liquid and it was Rogaine’s best way to maintain supremacy in the market place.

  3. Rob says:

    Very interesting article Adam – thanks for sharing. While it’s not something I’m presently worrying about, I have done in the past and I expect I will need to in the future.

    Two years ago I met up with a close friend I was at University with after not seeing him for a year and he showed a bald spot by lifting up some hair in the middle of his head. He was scared, had always been a very hairy person – back hair, hairy arms, thick hair on his head etc. Six months later it had all gone. Everything except eyebrows and eyelashes, though they’re much thinner than they once were.
    He was diagnosed with Alopecia Universalis, and told it was possibly due to stress (he’s just finishing up a Physics Ph.D in record time). It’s now a year or so down the line and he’s back to being his old self, very happy etc. He needs to wear hats more than most to keep warm, but apart from that he’s fine. He also said it’s amazing the different treatment he gets now – lots of girls want to feel his head, give head massages etc (he doesn’t complain!) but some people treat him as if he’s a dangerous skinhead. Always good to go out with him for drinks though – his Alopecia and size get him to the front of any queue with ease!

    • Adam McFarland says:

      Wow that’s a crazy story. I’ve heard of alopecia but I didn’t realize it could come from just stress at such a young age.

      • Rob says:

        Yup, he was 23 when it started. Apparently it may come back at some point in future, and I think he was hoping for that at one point, but now he says he’d be quite happy if it never came back. Saves on razors anyway! Oh, and looking at some recent photos I took last week I was wrong – his eyebrows and eyelashes are totally gone too, they just took a little longer.

  4. Rob says:

    Also, I have a question:

    What are the most important proactive things we can do to mitigate hair loss? Ie. before it’s even started, should we be caring for it in a specific way, doing certain head massages, taking certain medicines etc.?

    • Adam McFarland says:

      Good question Rob. I’ll see if I can get the Bosley rep to jump in and answer it.

      • Adam McFarland says:

        Got an email reply from Bosley:

        “Hair loss that is caused by medicines, stress, lack of protein or iron, or hair care may be prevented. Avoiding certain medicines, reducing stress, getting adequate protein and iron in your diet, and using hairstyles that do not damage your hair may reduce or prevent hair loss. If hair loss is caused by a temporary situation such as medication, stress or insufficient iron, the hair loss will stop when its cause ends. Hair loss due to infection may require oral antibiotics or antifungals. For all of the causes, early treatment works the best.

        Unfortunately, inherited hair loss (androgenetic alopecia or male pattern baldness) cannot be prevented. However, many treatments are available.”

  5. nethy says:

    I always thought the picture was a nod to Seth Godin.

    http://sethgodin.typepad.com/head-clickme2.gif

    • Adam McFarland says:

      Haha nope. I don’t think I had even heard of him when I started my blog. I do have a lot of respect for Seth, and a lot of people I know are huge fans, but I’m more of a casual fan. For some reason I’ve never been able to stick to reading his blog (subscribed/unsubscribed a few times) and his books have never grabbed my attention enough to get me to read them. From time to time though he’ll say/write something that really interests me.

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