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Myths, Folk Tales, Urban Legends and Scams About Hair Loss

November 2007

Do you avoid stepping on cracks in the sidewalk? A lot of adults do, even though they know it is silly to believe that to "step on a crack will break your mother's back." The dire injunction against stepping on sidewalk cracks is learned from other children during your childhood. Even though there not a shred of evidence that a mother's back was ever broken because her child stepped on a sidewalk crack, the myth has staying power to persist through generations of children and to make adults wary about where they put their feet.

Unsubstantiated claims upon our intellect can be categorized variously as myths, folk tales and urban legends. They can persist for years without any evidence that they are true; some may even appear too fearsome or too good to not be true.

Unsubstantiated claims that are made with the intent to deceive, and to profit from the deception, are purposeful scams. The scam (called "quackery" when it is a medical scam) offers something that the willing victim hopes is true-such as a "cancer cure" or a "sure-fire cure for baldness". Hair loss and hair restoration are subjects of numerous myths, folk tales and urban legends. They are also a lucrative market for scams that play upon fears of hair loss and hopes for restoration of lost hair.

Hair Loss
Hats and hair loss. Wearing a hat does not cause baldness. One of the most persistent myths about hair loss is to blame tight hat bands. Supposedly a tight hat band constricts blood supply to the scalp, thereby removing the nourishment that hair follicles need to produce hair. While this may appear to be reasonable, it is not; a hat band cannot substantially constrict the scalp's copious blood supply.

A cause-and-effect relationship between hat-wearing and hair loss could easily be presumed when a man who regularly wears a hat or cap suffers hair loss over a period of years. However, the real cause of a man's hair loss is almost surely androgenetic alopecia-an inherited predisposition for male-pattern hair loss (see Hair Science: How and Why Hair Grows). Hat-wearing and progressive hair loss are simultaneous but unrelated events for the man with androgenetic alopecia.

How can we be so sure that wearing a hat does not cause hair loss? The proof is seen in men who have undergone hair transplantation to restore lost hair. The transplanted hair is taken from an area of the scalp that is unaffected by androgenetic alopecia. After transplantation with these unaffected hair follicles, the man can wear a hat every day for the rest of his life with no loss of the transplanted hair.

While wearing a hat does not cause hair loss, a form of hair loss called "traction alopecia" can be caused by constant, strong traction exerted on hair. Common causes of traction alopecia are (1) long-term corn-rowing or tight braiding of hair, and (2) too-tight attachment of hair pieces or hair-weaving to existing hair. Traction alopecia causes hair loss by physical damage to hair follicles and surrounding tissue (see Physical and Chemical Damage of Hair).

Poor nutrition and hair loss. A person's nutritional status has no relationship with androgenetic alopecia, the most common cause of male and female pattern hair loss. Androgenetic alopecia is an inherited predisposition to hair loss; nutritional status does not turn it "on" or "off" and does not affect its course.

Hair loss associated with poor nutrition is an indication of severe nutritional deficit. One of the most recognizable of these conditions is kwashiorkor, caused by severe protein restriction. A typical victim of kwashiorkor is a child with distended abdomen, scrawny body and limbs and scruffy-looking hair. The hair is easily pluckable: a patch of hair can be pulled out with a tug between thumb and forefinger. The hair loss associated with kwashiorkor is an indication of hair's sensitivity to protein loss due to disease or protein restriction due to malnutrition. Iron deficiency also may be associated with a diffuse form of hair loss. Conditions that may cause iron-deficiency anemia and hair loss include diet severely restricted in biologically available iron, diseases of iron metabolism and blood loss due to recognized or unrecognized bleeding (for example, consistently heavy menstruation).

Zinc deficiency is a relatively uncommon cause of hair loss, usually associated with a medical condition that disturbs zinc metabolism.

Hair loss due to nutritional deficiency can usually be corrected with proper medical treatment. The physician hair restoration specialist will recognize and diagnose such conditions based on a prospective patient's medical history, physical examination and laboratory tests. Hair transplantation is not warranted when hair loss due to nutritional deficiency is medically treatable.

Overly frequent shampooing and hair loss. Hair loss is not caused by hair washing, whether the washing is frequent or infrequent. The notion that hair washing causes hair loss may be prompted by the number of hairs found in the drain after shampooing. However, shampooing does not loosen growing hairs from the scalp. Hairs that wash out with shampooing are those in telogen (resting) phase, which would soon fall out in any case.

Hair loss is caused by clogged pores. This myth implies that failure to shampoo often enough, or failure to use the "right" shampoo, leads to build-up of body oils, dead skin cells and dirt on the scalp. This supposedly leads to "clogged pores" which are the cause of hair loss. This myth is kept alive by marketers who would sell you the "right" shampoo for unclogging pores. Unfortunately for this myth, the truth is that hair follicles will produce hair whether the scalp is newly clean or in need of a wash.

Severe fright can cause one's hair to fall out. Hair loss caused by severe fright-as in a "haunted house"-is a persistent folk tale. There are no proven examples recorded. There is no known physiologic mechanism by which such hair loss might occur. The same is true for tales of hair turning white overnight after a frightening experience. Almost everyone knows someone who knows someone who knows about a person whose hair turned white overnight-an urban legend

Hair loss can be caused by thinking too much. The "egghead" scientist or intellectual of comic books and cinema is the archetype bald genius. Why are genius and baldness linked? This is never explained, but there is a persistent (and quite false) belief that "thinking too much" can overheat the brain and cause baldness. One is hard put to find examples of the bald genius in the real world. The figure persists in our imagination because it has value in the fictional worlds that entertain us.

A Potpourri of Tales You May Have Heard
Eating bread crusts can make your hair curly. A good tale for mothers to use, to discourage food wastage. Children hear it from their mothers and tell it to their children when they become parents. While there is no evidence to support the tale, it is one of those tales that seems utterly benign.

If you pluck a gray hair, two will grow in its place. This myth is an anatomical and physiological impossibility. One hair grows from one hair follicle. Remove the hair and the follicle will produce another single hair, whether the plucked hair is pigmented or gray. It is hard to guess the origin of this myth. It may, however, discourage purposeless plucking of gray hair.

Nostrums, Potions, Lotions and Secret Remedies for Hair Loss
Hair loss, like other cosmetic changes in appearance, can have psychological and emotional effects of varying intensity. Some people regard hair loss as an unwanted indication of premature aging; some believe hair loss changes the character of the image they wish to present to others; some find they cannot accept hair loss for reasons associated with their business, occupation or profession. For whatever reason, many people find hair loss to be unwanted and unacceptable.

Millions of men and women have hair loss. Many of these may be willing to try any remedy that promises to stop falling hair or stimulate growth of new hair. As might be expected, the presence of a large market for hair-loss remedies attracts a host of marketers who offer a multitude of hair-loss cures-lotions, potions, creams, ointments, herbal concoctions and "secret formulas". All promise results and often offer "money-back guarantees".

Like myths, folk tales and urban legends, hair-loss remedies often make unsubstantiated claims that do not stand up to critical analysis. The marketer depends upon a potential customer's hopes for help outweighing questions about effectiveness and safety of the product.

What questions should the potential customer ask? Here are three that are useful for critical analysis of claims:

  1. What evidence is offered for the product's effectiveness and safety? The highest level of evidence for effectiveness and safety in the United States is approval by the U.S. Food and Drug Administration (FDA), based upon clinical trials of good design, carried out in statistically valid numbers of patients over a statistically valid period of time. Only two pharmaceutical products have met these criteria in the United States for the treatment of androgenetic alopecia: (1) minoxidil (Rogaine®), a drug applied to the scalp, and (2) finasteride (Propecia®), an orally administered drug. (see Hair Science: How and Why Hair Grows for discussion of how these drugs work). Beware of "evidence" in the form of purported testimonials from satisfied customers ["I tried Brand X and had new hair in 30 days-A.K., Columbus, Ohio"]. Testimonials usually cannot be verified, and even if true they would be evidence of a single person of unknown age, sex, hair loss type and experience of side effects.
  2. Does the product claim to be based on a secret or ancient formula? The "ancient" and "secret" formulas have been relied upon by medicine pitchmen dating back to the traveling medicine shows of the 19th Century. They were bogus then and still bogus today.
  3. Does the marketer claim that the product is one that "THEY" are trying to keep you from knowing about? This is one of the surest indications of outright quackery. It preys on the hopes and fears of people who are looking for a cure, and who may have been disappointed by products they tried previously. Some infamous quacks who made such claims include so-called "cancer clinics" that operate out of the reach of U.S. law. The "THEY" who purportedly are trying to keep this miraculous cure out of your hands are the usual suspects relied upon by quacks-the medical profession, the FDA, and the pharmaceutical industry.

Healthy Skepticism is Good for Your Health
The philosopher George Santayana said: "Skepticism is the chastity of the intellect." Skepticism is also good for your health and your pocketbook. While myths, folk tales and urban legends are often harmless, they can create confusion in one's thinking unless critically analyzed. Unsubstantiated product claims can be harmful, and should be subjected to critical analysis.