Category Archives: Superficial Temporal Artery

Ligature of the Scalp Arteries to Prevent Hair Loss

Every time that I think I have heard it all when it comes to potential hair loss cures or partial solutions with some merit (i.e., at least one reputable scientific journal related backing), something new and totally unexpected comes along. Recently, one of my blog readers sent me a link to the following interesting paper (published all the way back in 1977):

New Treatment for Seborrheic Alopecia: The Ligature of the Arteries of the Scalp

In essence, this doctor shut off (= ligature) two arteries near the face and scalp region, and lo and behold, balding slowed down in 76 percent of the 1,300 (!!) patients on whom he performed this procedure (10 percent of whom were female). Moreover, 17 percent of patients saw regrowth in previously bald regions. The two arteries that were ligated were the temporal superficial artery and the posterior auricular artery.

The below image from wikipedia commons shows the location of those two arteries (first and third arrows from the top):

Artery Ligation Hair Loss

It should be noted that seborrheic alopecia is not exactly the same as androgenic alopecia. However, the above procedure should also work for androgenic alopecia as according to the article:

“If we accept that the main androgen hormone active on the skin target cells is dihydrotestosterone, a metabolite of circulating testosterone, then the enzymatic control of the alpha-reduction
of testosterone into dihydrotestosterone is assumed by the 5-alpha-reductase. If this enzyme can be inhibited in the scalp, seborrheic alopecia will probably be reduced. One of the most powerful non-toxic enzyme inhibitors is hypoxia. Through surgery, by ligature of the scalp arteries, hypoxia can be induced in the scalp (by reducing the speed of the normal blood flow through replacing the arterial flow by capillaries and by obtaining a diminished P02 in the ligated area). By creating hypoxia in the scalp, testosterone metabolism will be reduced and the condition improved.”

Note that “hypoxia” means oxygen deprivation. Besides a slowing down or reversal in balding, the conclusion of the article also states that sebum production in the study participants’ scalp was reduced, and the condition of their hair follicles was strikingly improved (reduction in dandruff, itching and greasiness).

For myself, the worst part of slowly losing hair over the past decade has been the on and off associated itching, dandruff and sebum on the scalp. Nizoral (and probably Finasteride too) has helped me a lot in combating this problem, but some days are still annoying.

One interesting thing about this artery ligation procedure is that it reduces blood flow to the scalp. Over the years, I have read many expert and non-expert opinions that increased blood flow to the scalp can lead to better quality hair. However, it seems like normal blood flow is causing balding (in susceptible individuals) in the first place via supplying androgens to the scalp, and reduced blood flow can in fact help the hair! Who would have thought.

Finally, I should mention that the reader who sent me the link to the above study from 1977 also sent me another link from a more recent slightly related study from 2014: cessation of hairline recession following open forehead rejuvenation. I do not think that this second study entails any type of artery ligature, but have not done any research on it, nor tried to find the full study as I did for the first one. I am guessing that this new procedure does nothing for crown region balding. The surgeon (Dr. Guyuron) who is the lead author of this second study is reviewed on yelp.  Also read Dr. Guyuron’s detailed write-up on forehead rejuvenation.

NOTE: I would never ever go for such procedures and would advise readers to do the same. Very few  doctors would have done something like this just for hair loss, and the potential side effects are significant if the surgery is performed by an inexperienced person (and even experienced surgeons can have bad results). Moreover, there is no guarantee than your androgenic alopecia will be cured with such procedures. Even a slowdown in the rate of balding is not guaranteed, based on the 76 percent success rate I discussed earlier in this post. I would also like to find out how those of the 1,300 patients who are still alive feel about their procedure today and the condition of their scalp. Did they get any pain or necrosis in the long term? Was it okay to have a permanent reduction in blood flow to the scalp region for decades?