What’s Going On Under the Scalp

  • Testosterone isn’t the direct culprit—it’s actually its potent byproduct, dihydrotestosterone (DHT).
  • The enzyme 5‑alpha reductase, present in skin, scalp, and prostate, converts free testosterone into DHT.
  • In genetically predisposed individuals, DHT binds to hair follicles, blocks nutrients, and causes follicles to miniaturize until they stop producing hair.

Often Overlooked: Thyroid Hormones

⚠️ While DHT is the main driver behind male pattern baldness, another underappreciated factor is thyroid hormone imbalance, especially T3 and T4.

  • Hair grows in three cycles: anagen (growth), catagen (transition), and telogen (shedding).
  • T3 and T4 extend the growth phase. Low levels accelerate shedding and shorten growth time.
  • See this study for more.
  • Supplements like Nutrafol work largely because they support thyroid health (iodine, selenium, etc.).

✅ Tip: Ask your doctor for a full thyroid panel (T3, T4, TSH) to rule this out.

The Stress-Hormone Connection (HPA Axis)

Hair loss isn’t just about DHT or thyroid issues — it’s also deeply affected by your body’s stress response system, called the hypothalamic-pituitary-adrenal (HPA) axis. This system helps regulate cortisol (your main stress hormone), testosterone, thyroid hormones, and insulin — all of which impact hair growth.

  • Chronic stress increases cortisol, which triggers shedding and shortens the hair growth cycle.
  • Stress can raise DHT sensitivity and reduce conversion of thyroid hormone (T4 to active T3).
  • Lack of sleep, under-eating, and overtraining also disrupt hormone balance and slow regrowth.

When your body is stuck in a stress response, it deprioritizes things like hair, skin, and digestion — which is why stress-related hair loss is common, even in healthy people.

Lifestyle Tips That Help

  • Sleep 7–9 hours every night
  • Eat regular, balanced meals (don’t skip meals)
  • Limit alcohol, caffeine, and sugar
  • Exercise moderately, but avoid overtraining
  • Practice simple stress relief: walks, breathwork, journaling, or prayer

Managing your stress and restoring balance to the HPA axis is one of the most overlooked — but effective — ways to support hair health. Lifestyle matters just as much as products and prescriptions.

>Evidence-Based Treatment Options

1. Ketoconazole Shampoo

Used at 1–2% concentration, ketoconazole shampoo not only fights scalp fungus and inflammation but may also disrupt local DHT activity.
✅ Study on ketoconazole effectiveness.
Use: Twice weekly, leave in for 3–5 minutes.

2. Oral 5‑Alpha Reductase Inhibitors

Finasteride (1 mg/day) blocks DHT production. Widely prescribed and effective.
Dutasteride is stronger but less commonly used due to limited long-term studies.
✅ These are prescription-based—talk to your doctor or primary care provider.
👉 If you’re local, go see my friend Johnny Evens at Ouachita Medical Center – North Monroe, or your preferred PCP.
View providers at Ouachita Medical

3. Minoxidil (Rogaine)

Increases local blood flow but does not treat DHT.
Best used alongside other therapies. If you stop, minoxidil-dependent hairs will fall out again.

4. PRP Injections

Platelet-Rich Plasma is extracted from your blood and injected into the scalp to stimulate follicle activity.
✅ Read the study
✅ Available at Inject Beauty – right across the street from our barbershop. Free consults offered.

Other Tools & Techniques

  • Hair Transplants: Our partner IdealofMeD in Turkey offers Swiss-quality results at a lower cost.
  • Scalp Micropigmentation: Cosmetic tattooing to darken thinning areas – coming soon to our shop (license secured).
  • Strategic Haircuts: Let us help you style around a receding hairline or crown thinning.

Realistic Goals & Mindset

Most treatments stop further loss. Regrowth is a bonus.
Drop the ego—1 in 3 men deal with this. 9 out of 10 guys mention it in our chair. Let's fix it.

What You Can Do Right Now

  • Start using 2% ketoconazole shampoo.
  • Talk to your doctor about finasteride.
  • Book a free PRP consult at Inject Beauty.
  • Plan a transplant with IdealofMeD.
  • Ask us about scalp micropigmentation or haircut options that work with your current hair pattern.

Let’s Talk About It

If you’re dealing with hair loss and want options, come sit in my chair. I’m happy to talk over lunch or during a cut. You don’t have to go bald—unless you want to.

Last updated: July 11, 2025