Hair loss isn’t just cosmetic—it’s deeply personal, affecting confidence, identity, and how we show up in the world. In this episode, we sit down with world-renowned hair restoration physician Dr. Alan Bauman to unpack the real science behind hair loss and what actually works to treat it. From the biology of hair follicles and the role of DHT to the impact of stress, inflammation, nutrition, and aging, this conversation goes far beyond surface-level advice. Dr. Bauman breaks down proven, evidence-based treatments like finasteride, minoxidil, red light therapy, PRP, and cutting-edge regenerative solutions, while emphasizing the importance of early diagnosis and a personalized approach. If you’re experiencing thinning, shedding, or simply want to understand what your hair is telling you about your overall health, this episode offers clarity, practical strategies, and a hopeful look at the future of hair restoration.
The information presented in Fully Alive is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before making changes to your health regimen. Guests’ opinions are their own and do not necessarily reflect those of the podcast host, production team, or sponsors.
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The Hair Episode: What Your Hair Loss Is Telling You About Your Health With Top Hair Expert, Dr. Alan Bauman
Welcome back to Fully Alive, where we unlock the secrets to your healthier, happier, and longer life. This conversation is all about hair. We’re going to dive into it. Hair loss is one of those topics that’s often brushed off as cosmetic. For millions of people, it’s deeply personal. It affects how we see ourselves, how we show up in the world and sometimes, how we age with confidence. Our guest understands that better than almost anyone.
Dr. Alan Bauman is widely recognized as one of the world’s leading hair restoration physicians. Over the past few decades, he’s treated tens of thousands of patients and helped pioneer many of the technologies that have transformed how we prevent, slow, and even reverse hair loss. What makes this conversation especially powerful is Dr. Bauman doesn’t just look at hair in isolation. He approaches it as part of a much bigger picture. One that includes biology, hormones, inflammation, stress, aging, and overall health span.
In this episode, we’re going to go far beyond the surface. We talk about what causes hair loss in both men and women. Why early intervention matters more than most people realize and what treatments are truly evidence-based. How hair health fits into the broader conversation about longevity, vitality, and quality of life. If you have ever noticed thinning, shedding, or changes in your hair or if you simply want to understand what your hair might be telling you about your health, then this is a conversation you won’t want to miss. I’m excited to welcome Dr. Alan Bauman.
Dr. Bauman, thank you so much for joining us. You are literally one of the best in the world at what you do. You’re on the Top 20 Surgeons List. You’ve been doing this for a long time. I’m so excited to talk with you and learn from you. For our readers and audience to learn from your expertise, your wisdom, your experience. You’ve treated 35,000 patients over your career. Just a wealth of knowledge and expertise. Thank you so much for sharing that with us.
No problem, Zach. Thanks for having me. It’s great to be here.
The Path To Expertise: From Plastic Surgery To Hair Restoration
You’re the guru of all things hair. I’m excited to dive into all of that, learn from you and share that with the audience. I’d love to just start with how you get into this field. What led you to become one of the top hair restoration surgeons in the world? How did you fall in love with this and become passionate about it?
I get asked that question all the time. No one is born into the world of hair restoration surgery and certainly, I wasn’t. I was interested mostly in plastic and reconstructive surgery. That’s the first surgical stuff that I got interested in. I had a chance to observe when I was a teenager were procedures, treatments, consultations, and post-ops from my original mentor. He was a very prominent plastic surgeon on the Upper East Side of Manhattan. Basically, I got a chance to watch him operate before I could even drive a car. That was a unique experience.
I kept my focus all the way through medical school, internship, and residency. I always thought, as I said, cosmetic and reconstructive procedures. It wasn’t until I met a patient who had had a hair transplant himself personally. Essentially, I was unable to tell. He was having another procedure. Not a hair transplant. He was having a cosmetic surgery procedure. Maybe it was eyelids or something like that.
In his medical history, we could see that he had had a hair transplant. I always thought at that time, in 1990s, that hair transplants were basically pluggy-looking and painful. Why would you have that procedure? Why would you perform that procedure? I was not knowledgeable at all about hair restoration. Although, I did watch my dad lose his hair. We made fun of him.
The point was that this guy had said he had had a hair transplant. I’m looking at him and I can’t tell. I said, “Do you think you could tell me a little bit about your hair transplant? It looks amazing.” He was a layman. He told me in layman’s terms about how he searched out his physician. He was so excited that I couldn’t tell that it was a hair transplant. He explained to me the use of single follicles and the softness of the hairline. How he chose the surgeon based on the artistry and the technology. I thought to myself, “Wow, this is a lot better than I thought it would be. Maybe I should think about adding this to my repertoire.”
The one thing that I took home and one thing that settled in over that brief conversation was not just how his results looked but how he told me that the results made him feel. He shared with me this interesting story about how it changed his entire life socially and professionally. To the point where he was showing me pictures of his family telling me about these amazing job opportunities that he had. He said to me his life was never the same as it was prior to the hair transplant.
That gave him a level of confidence, enthusiasm, and just a renewed zest for life that took him through a social and professional skyrocketing essentially. From there I thought, “Maybe I should probably look into this and see if it’s something I want to add to my plastic surgery repertoire.” For long-story-short purposes, I did a lot of research and went to a lot of conferences. I traveled around the world, looked at different physicians doing different types of techniques. Eventually, I entered into a fellowship in hair restoration surgery in Long Island. It’s near where I was doing my internship residency so it wasn’t too far.
Every day that I spent looking, doing and performing hair transplant surgery during that fellowship, I knew that this couldn’t be a side thing that I would add to a plastic surgery repertoire. I felt like I had to dedicate 100% of my efforts to this. It truly needed that. The rest is history. I moved down to Boca Raton, Florida in the 1990s with my wife. We opened the office. It was a small office, single operatory, I should say. My wife answered the phone.
Eventually, we got married and built the practice from just the two of us and part-time help to what we have which is a 13,000-square foot facility on the East side of Boca Raton. It contains 35 team members, five operatories, and a full department for scalp health. It’s an exciting place to live, work, do our job and to change people’s lives just like that first patient that I ever met that I knew had had a hair transplant and I was unable to tell.
The Psychological Impact: Hair As An “Emotional Organ”
Thanks for sharing that story. I think there’s even a lot of data out there and studies that have been done that show the level of confidence that people have, for example, before and after or how hair loss or lack of hair loss affects their confidence. It can be transformative for people.
I feel like we transform lives every single day. When someone’s dealing with a hair loss issue, it could be a young man in his twenties or even later on in midlife or a woman entering menopause. We say hair is a very emotional organ because it causes a lot of distress. We don’t need to explain what a bad hair day is if it’s not doing what you want it to do. Hair loss can turn your bad hair day into a bad hair week or month or year or life. That’s not so good.
When you address the hair loss problem, even just knowing that you have an established diagnosis. You’re on a therapeutic intervention that’s going to work. We’ve tracked it. We show that it’s working. Even before you can see the full final result, your attitude changes for the better. It’s exciting to see patients’ lives changed when we restore their hair.
It’s certainly a fun practice to have. Quality of life improves dramatically when you improve your hair. I don’t know if it’s a look good or feel-good thing. The body and the mind are interacting in that way. Certainly, we’re programmed as humans to like our hair in general. To want to groom it, to style it, and use it as a sign of self-expression.
Certainly, if you’re losing it, then it can be a source of issue. It can be a source of a problem, a concern, anxiety, depression. Even like I said, these younger guys, some of them are not leaving the house without a baseball cap. Women are not going out to their regular social events without hair extensions or things like that. No matter who you are, hair is an important piece.
Thank you and congratulations on the amazing accomplishments that you’ve had thus far. Transforming 35,000 people’s lives is amazing.
We’re not stopping anytime soon.
You’re just getting started. I’d love to learn from you about the biology of hair loss for our audience and readers to learn. What’s happening at the root cause of hair loss for men and women? What’s going on inside our body? What might thinning hair tell us about what’s happening systemically? Can you break it down for us?
Root Causes: Metabolic Health And Hereditary Alopecia
The first thing to understand is that the hair follicle is a highly metabolic organ. It requires a lot of nutrients and fuel to do its business. Alopecia, which is the general term for hair loss, has a lot of different types of causes. Some of them are more prevalent than others. We see all types of hair loss in the practice.
Let’s talk first about when the hair follicle is highly metabolic, it needs good nutrients and fuels. You can imagine things that dysregulate your whole body situation, whether it’s poor nutrition or sleep, inflammation in the body. Even stress, can influence the hair follicle. Its only job is to make a hair fiber like a very tiny 3D printer.
Those hair follicles are designed to grow between a quarter to half inch a month if they’re on the scalp. They do so for at least 5 to 7 years if they’re healthy. They rest for a couple of months, then turn on, and do it all again. That cycle should repeat again and again. 150,000 hair follicles exist on the human head. That’s what gives you supposedly a thick full healthy head of hair.
If you’re, as I said, nutrient deficient, there’s inflammation of the body or even inflammation of the scalp. There can be autoimmune conditions that attack the hair follicle or if there’s an injury or trauma. All of these things can certainly impact the hair follicle function. The most common thing that we see is hereditary or genetic causes of hair loss. That’s the most common cause of hair loss.
What causes that gene to be expressed? Is there a way to combat that?
Hereditary hair loss can certainly be passed along from the mom side or the dad side along with other genes that code for hair color, quality, texture, thickness, and distribution of the hair over time. For example, we know 20% of men in their 20s, 30% of men in their 30s, and so forth, are going to experience signs of male pattern baldness.
Male pattern baldness is that androgenetic alopecia, hereditary hair loss, that is inherited through the mom side or the dad side. That is the sensitivity of the hair follicle to DHT or dihydrotestosterone. Dihydrotestosterone is the trigger that causes the miniaturization of the hair follicles over time. It causes the success of cycling to shorten so that the hair spends less time in the growing phase, more time in the resting phase until eventually the cycle ends.
Dihydrotestosterone is the trigger that causes the miniaturization of the hair follicles over time.
What does that look like? For male pattern hair loss, it’s a receding hairline. It’s thinning in the crown area. All the hair on the top of the head eventually can be affected. The speed at which that occurs is also genetically pre-programmed. You could be highly sensitive to DHT and end up going bald by age 25. Maybe you could keep most of your hair until you live to be 80 years old or 90 years old. Everybody’s a little bit different in terms of the speed of loss that occurs.
In women, hereditary hair loss is the same gene but it expresses itself a little bit differently. We see a diffused loss around the frame of the face. Remember that in men, that back and the sides area, those areas are immune to the DHT problem. They’re not going to be affected by male pattern hair loss. We see pretty much that same pattern in women where the hair around the sides and the back of the scalp stays pretty healthy and strong. Unless they’re putting extensions or doing other things to cause a different type of alopecia back there.
Women will typically go diffusely thin in that frontal zone first and then maybe eventually recede a little bit in the temple areas. It can be from exposure to androgens if you’re doing hormone replacement in women. It can be maybe natural changes in hormones and their ratios as you go through pre-menopause and then menopause.
Hair loss can happen anytime. You could undergo an illness such as COVID or another high fever or influenza episode and have some shedding that occurs 6 to 12 weeks out. Women often experience shedding after childbirth when the hormone levels crash back to normal. Weight loss is another big trigger with GLP-1 agonists or crash dieting and things like that.
That’s something to be on the lookout for.
Lots of them back there, but those are the main types of hair loss that we see in the practice.
Step one is to figure out what might be causing the hair loss.
We always recommend getting started with the correct diagnosis. You see all these TikTok trends and influencers telling you how to grow your hair with rosemary oil and all this nonsense that’s out there. Nothing against rosemary oil, but I’m not so sure it’s going to be great for your hair. You’ve got to know what the diagnosis is and how severe the situation is before you begin any kind of therapeutic intervention.
You’ve got to know what the diagnosis is and how severe the situation is before you begin any kind of therapeutic intervention.
Even if you use an FDA-approved therapy known to be a powerful hair growth treatment. If you have inflammation at the level of the scalp that you’re unaware of, those treatments are not going to work well. Some of those over-the-counter treatments like topical therapies get a real bad rep for a number of reasons. One of them is that they’re being used by people who don’t have a diagnosis. They don’t know what’s going on.
I want to come back to some of those TikTok trends a little bit. Before we do, can we just dive into DHT a little further? We need that in our bodies. It builds up in our hair follicles. Depending on how sensitive we are, that causes hair loss eventually. Can you break that down further for us and explain?
DHT is a natural metabolite of testosterone. Testosterone is going to get converted into DHT in the body on a regular basis. It’s not necessarily a high or low testosterone or DHT problem that causes the hair loss issue. It’s your sensitivity to it. It’s probably an androgen receptor genetic situation or susceptibility that we’re dealing with. In the near future, there are coming treatments that will address the androgen sensitivity and also maybe even affect the androgen receptor itself. We’re keeping a close eye on that.
It’s not necessarily a high or low testosterone or DHT problem that causes the hair loss issue. It’s your sensitivity to it.
You are correct, a DHT does a couple of things in the body, especially to men. It causes their prostate to enlarge. That’s also not so much fun as you continue to age. In fact, the most common treatment for enlarged prostate is finasteride which is the old Proscar. It is also FDA approved for male pattern hair loss. It’s approved for that because it lowers, inhibits essentially, the DHT production in the body. DHT is produced in a number of areas of the body, especially in our follicles as well. DHT can be identified essentially as the primary trigger for the male pattern hair loss and for many women as well.
The Testosterone Paradox: Balancing Hormones And Hair
If we have a higher testosterone level, which for men, we want to maintain a high testosterone level. Does that mean that we’re going to naturally be producing more DHT which could lead to hair loss? If we do TRT, testosterone replacement therapy, then one of the outcomes or side effects could be more hair loss? You see a lot of bodybuilders that have this problem because they’re boosting their testosterone essentially.
Anything that you do. It could be just optimizing your testosterone level through adding testosterone or through an injection or pellets. It could be weight training, which is going to boost your testosterone naturally. There are other herbs and supplements which have been noted to change testosterone levels. Anything you do to drastically increase your testosterone is going to increase your DHT level.
Anything you do to drastically increase your testosterone is going to increase your DHT level.
If you’re susceptible, not everybody, but if you’re one of those people who is prone to male pattern hair loss, that might accelerate the issue. Very often we see male pattern hair loss, for example, going along slowly as guys go from their 20s to 30s and 40s. If they start to decide, “I want to get on hormone optimization therapy.” They’re doing a little bit of testosterone to keep it in the normal range, not even overdoing it. What we do notice is that as testosterone goes up, so does the DHT. Their hair loss does seem to accelerate through that process. The good news is that there’s many things that we can do to stop that.
We also see that in a lot of post-menopausal women. Post-menopausal women will use testosterone replacement therapy to improve body mass, lean muscle mass, libido, brain function, and bone strength. There’s so many great benefits for women to be on testosterone replacement therapy, especially as they enter menopause. If they overdo it, that can also cause that receding hairline and loss of hair if they’re susceptible to female pattern hair loss.
It’s one of those things we have to balance a little bit.
It’s a delicate fight. We want testosterone and its great benefits but we don’t want hair loss. We have to fight back a little bit. Very often, we work closely with a number of functional medicine physicians in this regard to optimize both things. Keep the hair and get the benefits of the testosterone at the same time. I wouldn’t say it’s simple, but it’s doable for sure.
That’s encouraging and optimistic. You said the first step is correct diagnosis. We need to figure out what is causing hair loss if we’re experiencing it. It be something as simple as, as you said, our sleep, stress, inflammation or diet. Are there some people who can just adjust some of those lifestyle factors? Can the hair regrow then or maintain? Walk us through something like this, the first easiest steps up to the most significant.
All of those things that you just mentioned from sleep hygiene habits to good nutrition, especially protein intake, excellent nutrients and fuel, inflammation in the body but also at the level of the scalp. These are all important factors. Oftentimes, we can elucidate that through a medical history. When someone comes in for an evaluation, it’s not just, “Let’s look at their hair loss pattern.” Let’s take a step back first and see, “Are you well nourished? Are you dealing with a weight loss situation?” Even if you’re doing great on your weight loss medication. That still could be hurting your hair. Let’s talk about that.
Is there some gut level disruption of the microbiome or something that’s causing inflammation in the body? All of these things can impact hair growth. If you’re pushing a treatment or procedure or something to try to get the follicles to do their business better but if you haven’t addressed what I would call maybe holistic or functional issue. It’s like pushing the boulder up a hill. You’re not going to be able to do it. It’s going to be much more difficult to try to grow hair better under those conditions.
Even high stress. Take someone who is in a high stress situation, whether because of their job, economic status, whatever. Stress is a survival mechanism. Exposure to stress, especially cortisol, over the course of the day or day after day. That’s going to impair hair growth. Not only impair hair growth, but it may also change the stem cell population that produces the pigment in your hair. Anecdotally, we see patients who have gone through stressful situations end up going gray or with accelerated hair loss.
We talk a lot about stress management in Bauman Medical because it’s important to get that on point. One thing plays into another. If you’re not sleeping well, your chances of being more stressed out and metabolically dysfunctional are much greater. It’s a domino effect. We do the best that we can to address those things. As I said, work with local functional medicine physicians and people that optimize health to address those things if need be for our patients.
Finasteride: Dispelling The Myths Of Side Effects
I want to ask about finasteride because that’s a popular treatment or can help by reducing the DHT in your scalp. If you take oral finasteride, then it’s going systemically throughout your body. Can that lower your overall testosterone levels in your body then? Is it better to just use a topical finasteride? I’ve also heard that finasteride is small enough. If you put it on topically, it still could become systemic because it’s going to cross into your bloodstream. Can you break that down or dispel that myth for us?
We know a lot about finasteride. Finasteride’s been available and FDA approved since the 1990s. It wasn’t the first FDA-approved drug. That would have been minoxidil but let’s talk about the finasteride. It’s a simple and easy treatment. It has a very high success rate. What do I mean by that? If you’re on finasteride, which by the way, blocks or inhibits the production of DHT. Not perfectly because there’s a couple pathways that create the DHT. There’s several.
The 5-alpha reductase enzyme is what your body does to convert testosterone into DHT. There’s Type I, Type II, and even, I think there’s a Type III that we’ve discovered. The Type II 5-alpha reductase is responsible for the major road towards DHT. Meaning it’s the most prominent metabolic pathway to the DHT. That Type II 5-alpha reductase is what gets blocked by finasteride. DHT levels go down about 60% to 70% when you’re on finasteride at a steady state. That’s 1 milligram orally once a day.
In terms of what that does for your hair, it’s pretty exceptionally good. Ninety five percent of patients get a positive benefit from finasteride. What does that mean? That means that they look the same or better in the long run. Two out of three get some regrowth. Meaning that their hair that was weak rebounds and grows thicker, better, stronger, and visually looks better. Five out of six guys just flat out stay the same and stop losing hair. That may be because there are other metabolic pathways that are also creating DHT.
Let’s talk about what’s going on with the finasteride. If you are thinking about hormone optimization therapy or you’ve been on hormone optimization therapy with testosterone. You may want to consider going on finasteride for that reason. It will help inhibit the DHT production and therefore, protect the hair follicles while you’re getting those benefits of testosterone.
By the way, the original studies showed that you can even get an increase in testosterone when you’re on finasteride of somewhere around 16% or more. That’s probably because you’re blocking that degradation in the DHT, let’s say. I have many patients who have been on finasteride. Ninety eight percent of patients can be on finasteride without worry of having any sexual side effects whatsoever.
This is what commonly comes up in conversation. It’s like, “I don’t want to be on finasteride because it’s going to knock out my libido or decrease my ability to maintain a hard erection.” Whatnot. Those two sexual side effects, if they occur, first of all, are very rare. It’s 1.8% of our patients, 1.8% of those in the clinical trials. It matches exactly to the decimal point, versus those in placebo.
Those are mild side effects and are reversible. In my practice, I’ve never seen a patient not rebound completely from discontinuing finasteride. Meaning if they stop the drug pharmacologically, it’s out of their system in about a week. If you have the side effects, you’d be better by the weekend. There’s a lot of finasteride fear and a lot of that fear is unfounded. Finasteride can be a great treatment.
If you are concerned about oral finasteride, that systemic absorption, and that small 1.8% chance of sexual side effects which, again, is reversible. It’s a no-go for you. You can do what you just mentioned, which is topical finasteride. We’ve had great success with our topical finasteride. It’s literally targeting the follicle where the DHT has been created. There is a little bit of systemic absorption. The risks of the sexual side effects drop extremely low, almost negligible, especially compared to placebo.
Patients can do very well with topical finasteride. We prescribe a lot of it. We use 82F by Hair Science. That is a protocol that was developed by a series of dermatologists and pharmacists from South America then it was brought to the US many years ago. It’s based on the original 82M formula, which was a minoxidil formula. Topical minoxidil combo with finasteride is a great treatment option when it’s prescribed in that way. As long as you’re using a base that’s not greasy and not gooey. It’s absorbing quickly and not messing up your hairstyle. That would be good.
Minoxidil 2.0: From Greasy Topicals To Micro-Dosing
Thanks for summing that up, dispelling some of those myths that are out there. Correcting diagnosis and addressing those functional issues. Maybe an initial treatment could be like you just mentioned, an 82F topical finasteride or oral finasteride to block the DHT. What comes after that?
We also want to think about oral minoxidil. Minoxidil was the original FDA-approved drug that is available over the counter. Instilled the nastiest formulation that’s out there is the Rogaine foam. It’s greasy, gooey, messes up your hair, and all that. The solution is even worse and it causes a lot of irritation. We use compounded topical minoxidil. I would say, more prevalently, patients are opting for microdose oral minoxidil, which is a nice option.
When patients use oral minoxidil, they can have a very powerful hair regrowth effect without the risk of the side effects that come with the larger dosages. What’s important to know about that is minoxidil was originally a blood pressure drug. It sounds scary. I don’t want my blood pressure to drop. Those large doses of blood pressure medication were used to control people who had hypertension or high blood pressure. What was noted is that they started to grow hair all over the place, even unwanted places.
Upjohn, in the 1970s, decided this would be a great baldness drug. That’s how we got Rogaine, essentially. Presently, we use a compounded version of minoxidil in the oral tablet form or capsule at a microdose level. We’re getting all the great benefits of this powerful hair growth. Meaning follicles are going to stay in the growing phase longer. Remember, that’s an issue with male and female pattern hair loss. They’re going to grow thicker, darker, stronger hair which is what we want. It can fight against the effects of the DHT.
Even if you’re prone to the DHT miniaturization, you can get that minoxidil to stimulate the hair growth which is awesome. Oral daily dose of microdose minoxidil is very effective for hair regrowth without the typical side effects. Do some people try to max out on those dosages? They’ll try to go more and more and more until they have a side effect. They can get hair in places. They can get low blood pressure and headaches or dizziness. At the microdose level that we prescribe, it’s very unusual.
These can be very much a game changer, especially for even women with female pattern hair loss. As I mentioned previously, they don’t typically recede and lose the hairline until much later on. It’s more of a diffuse thinning. If we can get those weaker follicles to grow a lot thicker, darker, stronger, and longer, that’s where we’re going to see some nice improvements in their hair growth. That would be one of the next modalities that we would chat about.
High-Tech Alternatives: Laser Therapy And Peptides
What about some of the other kinds of alternative things like GHK-Cu copper peptides or red light therapy? I know you have a LaserCap that you guys have created or adapted and put together at Bauman Medical. Tell us about some of those kinds of treatments too.
A lot of patients want to add to those pharmaceutical regimens or they’re disinclined to use pharmaceutical treatment and want to go a little more of a natural route. The things you mentioned like red light therapy. Red light caps have been available for many years. Unfortunately, most of the caps that are out there in the public realm are underpowered. Maybe not even laser diodes. The consumers are being hoodwinked into purchasing these Chinese knockoffs and wondering why they’re not getting a good result from it.
Turbo LaserCap is a true medical device. It’s got an FDA clearance which means it’s proven to grow hair. It’s a cordless, portable, powerful device that you can pack flat for travel. It has all pure, overdriven lasers which means it’s delivering a lot of power to the scalp. Over 25% more coverage than any other device on the market. It covers all the way down to the nape of the neck and all the way to the front of the hairline and temple areas. That’s a great option.
Also, that’s a one-time cost. Once you own one of those good devices, like the Turbo LaserCap, which is a lifetime warranty. You’re going to have that forever. Amortized over time, that could be your least costly hair growth treatment, which is nice. Other therapies that are nonchemical and non-invasive. You mentioned copper peptides. Certainly, we love the peptides that we use in conjunction with TED or TransEpidermal Delivery. There’s a couple of ones that we push through the skin without a needle using TED. That would include a thymosin-beta4 derivative as well as the copper tripeptide and dozens of amino acids, and such.
That treatment is essentially a once-a-month treatment that you would do in the office. We can also pair that with a topical peptide solution that you would use at home morning and night. It also has PTD-DBM. nice ingredients in, what we call, the PEPgro. That’s also available through the practice without a prescription. It’s a nice hair growth treatment.
You mentioned copper peptide. We’ve been using copper peptide as a wound healing agent since the 1990s. It’s one of the most well-studied peptides on the planet for skin, for burns, and wound healing. Also, to potentially maintain the stem cell population of the melanocytes for color preservation as well as for hair regrowth. I’m a huge advocate of copper peptide for decades now. It’s a no brainer.
We used to have a kit that we would dispense to patients. It had so many different ways to put copper peptide on your scalp. It had these little foil packets with gauze and sprays. A copper peptide gel that you would put on the old-fashioned stitched area in those older outdated procedures. That was an amazing post-operative kit that accelerated healing for our patients. That way back in the 1990s and 2000s.
You’ve been on the cutting edge for a long time.
Peptides Vs. Pharmaceuticals: Finding The Right “Stack”
I would say that the copper peptide went out of favor for a little bit of time. There were other things that were happening, maybe PRP, and things like that that were coming into the practice. We didn’t focus too much on the copper peptide, especially as we went to a more minimally invasive surgical aspect like FUE or the follicular unit extraction. We’d have all the stitches and staples to deal with and such. Copper peptide faded out then came back with a vengeance to where we are.
Compare and contrast for us the difference between someone who gets your PEPgro peptide and puts that on morning and night, versus taking finasteride and minoxidil.
Certainly, patients have to find their own pathway through. Again, if they’re disinclined to use a medication or a pharmaceutical agent, then the peptides are a great stop-gap. If you were to ask me which one works better or has the lion’s share of research. I’ll always tell you the pharmaceuticals are going to be a little bit easier. For example, we can combine finasteride and microdose minoxidil in the same capsule, which is great. We get amazing results with that combination synergistic therapy by hitting the follicle two different ways.
If you want to add something more to the stack, so to speak, then laser light therapy to increase blood flow and to provide energy through the mitochondrial pathways. That’s great. Copper peptide, as we said, has good science behind it certainly as a wound-healing agent and also as a hair growth treatment. In terms of hierarchy, scalp care making sure there’s no inflammation of the scalp is foundational. It doesn’t regrow a lot of hair honestly.
Nutritional fall into a couple of categories like nutrients and fuel and then nutraceuticals, which could have a pharmacy-like effect. You’ve got the medication category. We talked about the finasteride and minoxidil topicals or orals and peptides that are in that category as well and then laser light. We get into the regenerative treatments that are in the office. That would be platelet-rich plasma or exosome therapy or using the new FDA-cleared laser in the office, the fractional laser called the FoLix. A couple of different things that we have.
Again, it goes all the way back to the beginning. What exactly are we treating? If it’s a depleted or bare area, patients need to know that all of these other things are just designed like fertilizer in the garden. It’s not going to replant your hair. You need a hair transplant if you’re severely depleted. That should be the take-home message.
The Physics Of Photons: Why Your Red Light Panel Isn’t Enough
I want to just ask a question, too, about red light therapy. People can go with the Turbo LaserCap. As you said, it’s a one-time cost. What if someone already has access to or owns a red-light therapy panel or has access to a red-light therapy bed? Are they going to get the same results as with the cap? Is it different because it’s closer?
I’m a huge fan of red-light therapy. I got a red-light infrared sauna. We use red-light for relaxation and improve blood flow. LED lights, which are what you’re talking about, in these panels are not going to deliver the same number of photons. The photon is how much power of light you’ve got. Joules per square centimeter is what we’re looking for in terms of the output. Laser output is going to be always exponentially more powerful than a diode, than an LED or light emitting diode typically.
Laser output is always exponentially more powerful than a diode.
You want to look for something that has pure lasers if you want that high power density into the scalp. The panels that you have at home are for one thing or another. They may be great for skin rejuvenation and such. They’re probably not going to be great for hair. It’s like PRP, the typical Medi Spa PRP, which is a test tube spun around in a little centrifuge. It maybe good for healing or maybe good for Kim Kardashian’s little wrinkles or whatever. That’s not going to grow your hair back.
If you’re doing a series of PRPs where you’re going, “It’s once a month for three months in this little test tube that they take.” That’s not anywhere close to the right amount of platelets. What happened is the industry and the knowledge is accelerating. For example, what is the dosing strategy of laser light therapy? We know how many joules per square centimeter. We know you need over 300 diodes, 25% more coverage. That’s the Turbo.
The next closest device, even though it has, let’s say, a couple of hundred diodes in it. If you put a power meter up to those diodes, what you find is that they’re barely putting out a fraction of the energy of what you’re getting in the Turbo. That’s the issue. It looks like it’s the same kind of device. It sounds like “We’ve got 300 diodes and the right wavelength, 650 or whatever.” It’s not putting up a power. The joules per square centimeter is much lower. That’s how much dose that you’re getting into the skin. That’s a critical step.
The same concept holds true for PRP. If you’re not getting 1.5 million platelets per microliter in your PRP, that means eleven billion platelets in about 7.5 CCs of injectable. That’s not going to stimulate hair growth. I’m sorry. It’s going to be great for your skin. It’s going to make your wrinkles look better. Maybe wound healing, but it’s not going to give you substantial hair growth. That’s why I think a lot of folks are like, when they hear something, “I got to get my PRP.”
They don’t do the due diligence to find out exactly what kind of PRP they’re getting. Worse than that, they’re not getting a measurement. That’s the other most important thing we should do. Get a baseline measurement before you have a treatment so you know what’s working and how well. If it’s a repetitive therapy like PRP, when you should repeat the treatment.
AI And Precision: Mapping The “Scientific Ponytail”
You’re doing an assessment. When you come in, you’re going to use an AI-driven microscope to do an evaluation of a baseline measurement. Is that right?
When we’re doing baseline measurements, we have a couple of different tools in the practice. We have a tool by TrichoLab. We have a Canfield Scientific HairMetrix, which is the AI-powered microscope. We have the HairCheck tool. The HairCheck tool is a physical measurement. Think of it like a scientific ponytail, if you will. We’re going to go back to the exact same area using a mechanism that maps out exactly where we did the measurement. We’re within a millimeter of the measurement zone each time you come in.
That’s important because that’s a physical measurement. It’s essentially a cross-sectional area. A lot of times women complain that their ponytail’s getting smaller. What’s happening? They may have less hair fiber or the fibers that they have are just growing weaker, thinner, and wispier. Both of those things can happen to a ponytail.
The same thing can happen if you have hair loss. Is it a density issue? Is it a hair quality issue? Is it both? The HairCheck, which is a cross-sectional area, is the most sensitive way to determine whether you’re growing more or less hair. If you’re having a shedding phase, is that a good thing if you started minoxidil or laser or PRP? Is it not a good thing? If you didn’t do a measurement before, you’re not going to know after if you have more hair.
The other thing was the density measurement with the HairMetrix. The Canfield Scientific device, HairMetrix, measures exactly how much density there is in each of those same zones. It gives us hairs per square centimeter. It also measures the thickness of each individual hair that’s on screen in the measurement zone. It gives us an average. It can tell us whether your hairs are thick or thin or very weak or basically near dead. It basically gives us this color gradation.
What do we do? We look at the most permanent and best hair, usually around the sides and the back of the scalp. We’ll compare that to the other zones that are likely to be affected by hair loss. For example, that frontal area or in the temples. We’ll look at those zones and compare. We’ll see what’s happening. Is it a hair density issue where there’s not too much hair going on? Is it a hair quality issue?
Exosomes And The Future: Growing Hair Twice As Fast
You mentioned exosomes. We’ve had Dr. Ed Park on. We’ve had another physician that uses exosomes as well. I know that’s more cutting edge and newer technology coming out. What kind of impact are you seeing with that sort of a treatment, with exosomes, or other stem cell treatments?
At Bauman Medical, we’ve been using stem cell therapies for over a decade. That would include either using a patient’s own stem cells for treatment or also using exosomes, which are essentially off-the-shelf, stem cell-derived therapy. I can tell you there are hundreds of different manufacturers of exosomes. We’ve narrowed down to several which are amazing. We use exosomes in combination with PRP. We can use exosomes in combination with the previously described TED or TransEpidermal delivery.
We don’t need any needles to deploy them into the skin. We can use exosomes to speed up the healing after a hair transplant. One of the most exciting things that we do with exosomes is that we can basically spike the graft storage solution with the exosomes. We put some exosomes in the graft storage solution. The follicles are then bathing in that exosome-rich solution. What we found is when we put those back into the scalp, they grow twice as fast as they used to. Instead of waiting six months for half of the results and the full result in a year for most patients, we can now get half of the results visible in just four months. It’s exciting.
In fact, we’re doing a study with my exo-SOAK protocol, which is what I just described. The way that we soak the grafts and do other things to them. Also doing the study with the exosomes plus the TED. We completed that study with JuveXO. JuveXO H is one of those amazing exosome products. I’m very excited about working together with them. I’ll tell you the next phase is going to be your own personalized exosome or stem cell-derived therapy. That’s the next latest and greatest chapter.
We can thank your hair follicle stem cells. We can also use some of those cells in the laboratory. Multiply them, cultivate them, and collect their secretions. We call that their secretome. That’s all the stuff that the cells secrete. Collect that and then freeze-dry it and send it back to the clinic. That process is giving us a product that we have on ice. Literally, it’s in the fridge with your name on it. It’s your treatment. We call that STEMgro. We can deploy that at your PRP. We can deploy that with microneedling. We could deploy that with TED. We could put that in with your hair transplant procedure. Using your own personalized secretome from your own hair follicle STEM cells. It’s futuristic stuff.
We’re so psyched to be a part of it. Acorn is our close partner and technology provider in that realm. Dr. Drew Taylor, an amazingly smart guy who’s developed this process. Basically, what happened is I banked my follicles in 2023 just in the hopes that we would have the youngest cells available when I get hair cloning going. We don’t have that yet. In the future, hopefully, we’ll have some hair cloning which will give us an unlimited supply of hair follicles. That would be great.
I wanted to clone, not my 70-year-old hair follicles when I needed, but my 53-year-old hair follicles from years ago. Those are in the bank. It’s only since then has he been able to develop this secretome treatment, which we’re super excited about. By the time this episode gets released, we will have clearance to be able to do the studies on the injectable version of that. Imagine an injectable exosome therapy derived from your own hair follicle stem cells that contains up to 45 times more growth factors and other proteins in PRP. That’s going to be some pretty exciting stuff.
That’s amazing. You’re describing the future. It’s here. It’s not years out. It’s happening soon.
The AI-powered research that’s being done out there in research labs is going to take us, accelerate us into the future of hair loss treatments and services. Even I think that hair loss is having its GLP-1 moment. Everybody’s thinking and talking about hair as something that can be done.
Hair loss is having its GLP-1 moment.
It seems like there’s hope.
It was taking us this long to describe the basic therapies that we offer. There’s a lot of different therapies and treatments. Designing the right treatment regimen for someone is not necessarily so simple. It’s not a cookbook. That’s why they need an evaluation.
It’s starting with that. Let’s talk about the actual hair transplant itself and go through that. I know that’s another amazing thing that you’ve done thousands of. How does that work? Who is that for? Who should be thinking about that?
The Art Of The Hairline: Avoiding The “BBL Phase”
Let’s talk about what a hair transplant is. That’s important. We’re taking hair follicles that are the many organs that produce the hair. We’re going to take the most permanent ones from the sides and the back of the scalp. We can harvest those grafts. A hair follicle graft usually contains a follicular unit, just so everybody knows it, between one and three hairs. Those are implanted into the thinning or the balding areas.
That’s very highly technical, labor intensive, labor of love, if you will. It takes about twenty man hours in a day to do thousands of follicles transplanted. It does require a team of people. Not only is it a highly technical thing, one that we’ve done close to 15,000 times at Bauman Medical in nearly 30 years. Most importantly, it also requires this critical artistic step of planning and design. Male hairlines and female hairlines are totally different. Everybody’s hairline is unique and individualized.
Unfortunately, what we’re seeing out there is a lot of work that’s being done. Every hairline looks exactly the same straight line all the way across. Too low, too angulated, and very unnatural looking. While hair transplantation is gaining popularity, it’s also going through its BBL phase, which is too much. It’s like, “Back off there. You did too much there.”
What will happen is we’ll see the pendulums swing back to something that looks a lot less artificial. The point is that we can create something with artistic intention that looks completely undetectable and natural looking. If we design the appropriate shape and we angle the hairs in the correct manner so that it mimics a natural hairline. Unfortunately, a lot of medical tourism destinations are not necessarily adhering to that.
I’m known personally for what I would consider and people say my signature is that naturalness of the hairline. It looks normal. It doesn’t look like it’s transplanted. It’s going to be thick and dense. Moving hair into that area, certainly, we’re not holding back. It’s going to look natural and normal because of its design and the angles and shapes. Literally, every hair is placed separately or differently than the one next to it. If that’s not being done, you’re going to end up with a weird outcome. That’s not good.
In our hair transplant procedures, patients are comfortable. That’s also a common misconception. People think it’s like, “Adult circumcision doesn’t sound like fun.” Hair transplants can be completely painless or pain-free if you apply the local anesthetic with some nuance as we do. We can use some nitrous oxide to keep the patient’s anxiety levels low. Keep you relaxed so you don’t feel the local anesthetic. Once the local anesthetic is in place, then you’re in the sweet spot. You don’t feel anything. You’re just sitting through the process, relaxing. Most patients tend to sleep through a couple of hours. Maybe watch some movies.
There’s harvest, there’s the design work, the recipient site or pre-made sites that I make. There’s harvesting and implantation. You have the recovery phase. It takes about six days for the crusting and the scabbing to completely go away. During which time, you can get back to exercise and activities within about 4 or 5 days. Even tennis, golf, and swimming is okay as long as you’re not creating any friction in the scalp.
The scabs and the crusts are gone. All the swelling is usually gone in a day or two, by the way. You have to wait for the hairs to grow. If you had the exo-SOAK protocol, it’s going to happen a little bit faster. If you didn’t, it’s going to take a little bit longer. The living and growing hairs start to appear. They’re permanent and forever, which is great.
You are an artist. I never thought about putting the hairs in at an angle. You’re putting them in each hair at a different angle. You mentioned watching a couple movies. How long is it? Is that a whole day that they’re there? Can you do more than one a day? How’s that going?
A typical transplant a day is about six hours in the chair. You can have a break for lunch and restroom breaks. You can get a snack, drinks, water, juice and so forth. We prefer that you don’t have a caffeinated beverage because we’re trying to keep you relaxed. As I said, most people snooze through it. Some patients are doing larger cases.
Our bread-and-butter surgery sometimes extends over two days. We can do two days back-to-back or even three days if we’re getting 4,000 or 5,000 grafts or more. Some patients want to do a lot of scalp harvesting to scalp implanting. Also, we can use beard. That may add another day to the process, potentially, where we’re harvesting beard follicles to cover the crown.
Not everybody’s a great candidate for that. Don’t forget. It’s not just scalp hair that we’re doing. We are also doing eyelashes and eyebrows. It’s very popular for women. Women who have had brow lift scars or facelift scars want those covered. Injuries or trauma to the scalp are also great candidates for hair transplantation as well.
I was surprised you said earlier that we have 150,000 hair follicles on our head. I would have guessed it’s higher. How many are you transplanting? You just said 4,000 or 5,000. That sounds like a lot. Is that typical?
A hair transplant procedure of 4,000 grafts could contain 10,000 hair follicles that were moving around because of the numbers of hairs that are in each graft essentially. We can move quite a bit of hair around. If we’re doing an eyebrow, usually, we’re working with single follicle implants. There’s even more intricacy that’s going on with the eyebrow design for both men and for women. If you look at your own eyebrow close up in a mirror, you’ll see each hair going in a different direction. That gives you some idea of how eyebrows are created essentially through this a process.
It’s a fun procedure to do. We have a great time doing it. I’m blessed with an amazing team. Many of my team members have been with us since 2006. It’s incredible to be able to provide these kinds of procedures and treatments at the level that we do. I also have an associate physician, Dr. Rose. She’s amazing. I have a nurse practitioner. She does a lot of our regenerative treatments.
I have a full-time trichologist and her team, which handles the scalp health department. We have 35 team members at Bauman Medical. It’s busy with a lot of patients every single day. Sometimes, we are doing more than one case in a day depending on how they’re staggered. It’s fun practice to have. Everybody in the practice enjoys changing lives for the better. That’s our goal.
A Student Of Nature: The Habit Of Observation
When you’re on an airplane or walking through a crowded place or at a ball game or something. Are you checking out everyone’s hair? It’s like, “That guy needs to come see me. I could fix that.” What’s your average day like?
It’s a good thing I’m not breast surgeon or that would have gotten me in trouble. I’m looking at everybody’s hairlines because that’s my job. I am a student of hairlines. It reminds me of a time when I was being mentored by my first plastic surgery mentor before I entered into a fellowship for hair. He used to tell me that I should be a student of nature. His analogy was if you’re going to be an artist and you want to know how to draw a pine tree or an oak tree. You better study what a pine tree or an oak tree looks like in nature.
His point was that noses come in all shapes and sizes. He was trying to make the point that you better know what the natural proportions are and what looks good in nature. What people like and prefer also can dictate. At that time, things were changing in the world of plastic surgery. There was a time when in the 1980s where everybody who underwent plastic surgery wanted the same type of nose. Even at present we can appreciate and want to preserve ethnic noses and things like that, even to a greater degree than we did then. His point was that you better understand all of that and be a student of nature.
Taking that into hair restoration, I’m always looking at the intricacies of people’s hairlines. If I’m in a social distance, I’m talking to you, but I’m looking at your hairline. I want to know what the shape is. Do you have a little widow’s peak? Is it very receded? Is it more flat and receded because of your ethnicity? What does that temporal point shape look like? Which is this side area. All of those things. It’s just a habit. If somebody meets me at a cocktail party, they find out what I do. The first thing they do is wonder if I’m staring at their head.
As I said, it’s fun practice to have. Most people have never met a hair transplant surgeon at a cocktail party before. That’s also an interesting discussion. As you asked me, “How do you get started in this crazy business, interesting field?” It was at a time when it wasn’t super cool. I don’t know if it is yet. At least, we’re on the way. My parents thought it was insane when I told them I was going to go into hair transplantation instead of plastic surgery. Which everybody knows what plastic surgeons do.
My dad and my mom were like, “Are you going to plugs? What?” They didn’t know that technology had progressed a little bit. Honestly, I didn’t either until I did the research. That was the barrier to entry. With social media, there’s all kinds of crazy things. Sometimes you don’t even know. Is it AI? Is it not? I see these machines coming down on people’s heads and growing full heads of hair. We don’t have that yet. That’s AI. At least, it’s an interesting concept that maybe someday we will. As I said, it’s a fun practice to have.
For those folks, the most important take-home message would be, number one, time is volatile. If you have some hair loss and you think it’s progressing, you’re probably right. It usually progresses with time without treatment. It doesn’t get better on its own like many of the things that we deal with in health and wellness. It does require intervention. Typically, if you have a health problem, you don’t necessarily want to be following the latest and greatest TikTok trend to fix your health problem.
They may have the reason or good ideas out there, but that’s not going to be the state-of-the-art medicine or let’s just say, science-based approach. That’s what we try to do in Bauman Medical. We try to stay on the cutting edge, go to conferences, and learn. That way, we can apply those therapies and treatments to help our patients look and feel better immediately by maintaining their own and restoring their own living and growing hair.
They don’t need to undergo transplantation again and again. That holds true also if they’ve had a hair transplant, to just keep the hair that they have. That’s a big part of what we do in the practice as well. We say time is volatile and get that evaluation. Many of our patients will connect with us virtually first before they even come to the office for all those fancy measurements that we do and tracking them.
“Time Is Follicles”: The Importance Of Early Intervention
I was aware that you guys did some remote assessments and things. If anyone reading this anywhere in the world could have a remote assessment done initially. Is that right?
Absolutely. This is not as I said a medical tourism destination where you’re going to be consulted on WhatsApp with a salesperson. That’s not what we do. You’re going to have a one-on-one conversation with me about your hair loss situation. We’re going to look at your biomarkers and your lifestyle factors. We’re going to figure out what’s going on. We’re going to figure out, if you’re an appropriate candidate for what kind of treatment. Is it non-invasive therapy to start the progression of regrowth? Is that going to be enough over time? Great. No problem. We can do it.
If there’s a need for transplantation, we’ll talk about it and figure out how to get you through that process in a comfortable way and in a way that gets you to the end goal. Making it look great and feeling great about it is the key. We do it also in a way that’s not going to leave you with all of those risk factors of an unknown clinic with an unknown language with a post-op care that means get on an airplane with bleeding bandages. All of that is just insanity to me. I’ll just going to leave that there.
I know you have a lot of resources on your website as well that people can learn and explore this further. Can you share a little bit about that? How can people connect with you if they want to do a virtual assessment or come in person to Boca and meet with your team?
Knowledge is power for sure. At BaumanMedical.com, you’ll find thousands of pages of information on hair loss treatments, diagnoses, conditions, and things that you should be aware of. The latest in what’s going on in the news with the latest and greatest treatments that might be coming available. Whether it’s hair cloning or some Los Angeles PP405 or Veradermic’s sublingual minoxidil or other treatments like small interfering RNA. You name it. I’ve probably got an article on that.
There’s hundreds of hours of videos that you can consume to learn about these kinds of therapies and treatments that are available and also what’s coming next. There’s also thousands of patients that you can look at who have had procedures and treatments that are similar to you and your condition, whether your age, ethnicity, hair loss pattern, or whatever. You can see the restorations that we’ve accomplished for them over the years.
You can book an evaluation. Click the button and book it. You can talk to me at any time. There is a cost for the evaluation process. That’s completely credited back to you when you undergo a treatment or procedure with us in the office. They can find me on any social media platform. We have a lot of content out there. We do feel like it’s important to combat a lot of that misinformation that’s out there related to hair loss treatments. If you’re squeezing onion juice on your head, let’s talk.
Closing Thoughts: The Future Of Hair Restoration
It sounds good. Thank you so much for sharing this with us and the amazing work that you’re doing to restore people’s confidence, identity, and self-worth. It’s making a huge difference to everyone that gets the chance to work with you and learn from you. I appreciate it. I learned a lot. I’m excited about what’s next. It sounds like if we can maybe hold onto our hair long enough, there’s going to be even more non-invasive or breakthrough treatments coming here very soon. A lot on the horizon to be excited about.
I’m very confident that we’ll have more therapies, more treatments coming soon with all the research that’s underway and things that are in the pipeline. More now than ever in the history of the practice. We’re pretty excited about that. As I said, time is volatile. If you think that you’re losing your hair, let’s have a conversation about it. Let’s get on top of it. At least, we don’t have to do anything more heroic or too heroic as time goes on. You can hold onto what you’ve got.
There you go. Thank you so much, Dr. Bauman. It’s fun to talk to one of the leading experts in the world on this subject and to learn from you. Thanks for being with us and for time for sharing this. BaumanMedical.com a great way to find you and connect with you there. I hope that people will.
Thanks so much, Zach. Thanks for having me on.
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I hope you enjoyed that conversation with Dr. Alan Bauman of Bauman Medical. You can find him at BaumanMedical.com. Their practice is located in Boca Raton, Florida. They would love to see you there. You can also connect with them virtually. They can do a remote assessment as well. We covered so much. There’s a lot to unpack there. Everything from what causes hair loss, how that is impacted by your overall health, things like stress and inflammation and diet.
Having those baseline things in place, but then what to do beyond that. It starts with getting a correct diagnosis, as he mentioned and addressing those functional issues and then usually stacking different modalities. He mentioned PRP or TransEpidermal delivery of certain peptides along with oral medications or topical medications that can be applied as well. Some of the hair transplant options that we discussed as well are the final step there.
They have much more advanced ways of doing that, including soaking the hair follicles in exosomes, which is the stem cell secretome. Even extracting your own hair follicle stem cells, growing more of those in the lab, and then reapplying them to your hair. It’s breakthrough, exciting stuff on the horizon. That’s happening now with STEMgro. JuveXO H is the exosome treatment he talked about as well. We’re on the cusp of a lot of these exciting things.
Red light therapy is another one that he mentioned. I know we’ve had several guests talking about red light therapy in the past. He’s talking about utilizing a red-light therapy laser technology that has that powerful joule per centimeter squared. That’s an important thing to look for. I hope you learned a lot as I did. Check it out if you’re interested in hair restoration or maintaining healthy hair. He’s obviously the best person to talk to out there. Check him out at BaumanMedical.com, Dr. Alan Bauman. Thanks so much for joining us.
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