Why do Men with Excessive Body Hair go Bald More?

A year after I wrote this post, an interesting new study comcluded that hair follicles across the body communicate with each other! Truly astounding.

Scalp Hair Loss :-( Back Hair Gain :-(

Around the year 2000, I started noticing that the vast majority of people that I saw in the gym or pool who had very hairy backs also tended to be heavily balding. If I had to put a figure to it, I would guess that 75 percent of men with excessive body hair (especially hairy backs) tend to be balding severely.

I saw a similar, but weaker correlation between those with substantial chest hair and scalp hair loss. In contrast, for those without any back or chest hair at all, the balding rate is extremely low. Perhaps less than 25 percent when it comes to young to middle-aged men. I doubt that I am off by much in both my above percentage estimates. Past studies also confirm that androgens stimulate beard growth, but suppress scalp hair growth.

Besides at the gym and in the pool, I have also noticed this trend among my own immediate family members and in-laws. My father has zero back hair and very little chest hair, but he had an absolutely stellar head of hair into his 60s. Even in his early 70s, he still has better hair than I have in my 30s. And of course I have a lot more body hair then him. My brother-in-law went bald in his 20s, and has an extremely hairy back. Same correlation with several of my unlucky friends.

Hairy Balding Athletes

When I first started noticing this phenomenon, I was a big tennis fan. The two superstars of the game at the time, Andre Agassi and Pete Sampras, were both very hirsute in their bodies. And, not surprisingly, both were balding on their scalps. Agassi used to wax his chest and back hair regularly, so some of his topless photos are deceptive.

Since retiring, balding Sampras has been rumored to have had one or several hair transplants. I would guess that his scalp would look more like his father’s Norwood 6 one were it not for the transplant(s).

Bald Man with Hairy Back
A man with excessive body hair on his back. Common sight at sporting events.

Lucky on the Scalp, Lucky on the Back

Native Americans/American Indians (who are genetically related to East Asians) have almost zero body hair. Not surprisingly, I have never seen a balding young full-blooded native American. The one native American that I did see with major hair loss was half Caucasian.

Chinese, Japanese and Korean people (all part of the East Asian family) rarely have chest or back hair, and tend to have much less balding in comparison to other races. Especially at younger ages.

It should be noted that even among Asians, there are some hirsute exceptions to this stereotype. One publicized recent case covered a Chinese girl with hypertrichosis who was raising money for laser hair removal.

Excessive Body Hair
World’s hairiest man from China. Body hair covers 97% of his body.

Finasteride Works Better for People with Excessive Body Hair

Around a year ago, I discovered a very interesting 2014 study from Japan. It concluded that people with more body hair tended to respond better to finasteride treatment for androgenetic alopecia. In my opinion, this is a fascinating discovery. Men who were “pileous” in areas other than the scalp might benefit more from dihydrotestosterone reduction.

It should be noted that very few Japanese people are likely to be very pileous or hirsute. I wish someone would do the same study on very hairy Caucasian men. I am including Armenians, Greeks, Persians, Turks, Afghans, East Indians and South Asians, Middle Easterners and so on as part of the extended Caucasian race definition here.

Many Finasteride and Dutasteride Users Have Seen a Reduction in Body Hair

Over the years, I have read countless testimonials on various hair loss forums of people who were taking 5α-reductase inhibitors finasteride or dutasteride seeing a significant reduction in body hair. People taking anti-androgens such as spironolactone and cyproterone acetate also report similar side effects.

However, to me, the surprising thing is that there are probably far more people who see no obvious reduction in body hair while on finasteride or dutasteride. I would have guessed that drastically reducing DHT levels is bound to reduce body hair in most people. Especially in those who have a ton of it to start off with? Yet, less than one-third of such hirsute people seem to see a reduction in body hair when on those drugs.

In any case, below are a few recent examples of people who noticed a reduction in body hair while on finasteride or dutasteride:

  • In an excellent recent thread worth bookmarking, HLT forum member “dnpuntold” stated: “body hair looks a lot thinner and less which is nice since I’m a freaking gorilla.”
  • On this very blog, in the comments to my post on the cost of generic finasteride, “paddy” stated: “I have been taking Propecia (non generic) for 18 yrs, I agree with the “hold the line” comment above. It pretty much stopped by hair loss when I started it. Have experienced no negative side effects as far as I can tell. But a nice bonus is that much of my other body hair (back, butt, arms, chest, etc) has thinned dramatically. Its as if it reapportioned that hair back to my head. Was a welcome side effect.”
  • Also on this very blog, in the comments to my post on dutasteride success and failure stories, six (!) people thus far have mentioned body hair reduction after taking Avodart.

Do Men with Excess Body Hair Have Higher Testosterone and DHT Levels?

One of the biggest myths ever purported in the hair loss world is that balding men are more virile and have higher levels of testosterone. This is not true.

I also do not think that balding men have significantly higher levels of dihydrotesterone (DHT) in comparison to non-balding men. Keep in mind that I have not read any data on that subject. What is true is that balding men’s scalp hair follicles are more sensitive to the damaging effects of DHT.

For me, the more interesting thing is that it seems like balding men’s body hair is also more sensitive to the effects of DHT. Albeit, in the opposite direction, unfortunately. DHT seems to make a high proportion of balding men turn hirsute and grow copious amounts of body hair.

Skepticism on the Hirsutism vs. Androgentic Alopecia Correlation

In the past, I have talked to two experienced hair transplant surgeons about this phenomenon and theory of mine. To my surprise, both have told me that they do not see such a correlation. i.e., regarding men with hairy backs and chests being much more likely to bald then men without hairy backs and chests. I remain 100 percent convinced of such a correlation.

In recent years, I have also read many hair loss forum members suggest the same thing. However, since there are always exceptions to the rule (e.g., balding Asians without hair backs), this correlation theory does not get as much attention as it should. There is always some person who will ruin a thread on this subject. Usually, by writing: “I have no body hair and am still balding. So I do not buy this theory!”

Exception: Khalid Sheikh Mohammed has more scalp hair then would be expected based on his plentiful body hair. He is still balding from behind per other photos.

Hypertrichosis (Hirsutism) in Khalid Sheikh Muhammed.
Hypertrichosis (aka Hirsutism) in terrorist Khalid Sheikh Muhammed.

Body Hair Transplants (BHT)

In the original headings for the first two sections of this post, I implied that people with hairy backs were lucky. I then added a question mark (?) at the end. I have since changed those headings due to them becoming too lengthy and confusing.

My reasoning for this ambiguity was due to two contradicting phenomena:

  1. Most people with robust back hair would probably consider themselves unlucky. Hirsutism and hypertrichosis are usually not desired by most men and women.
  2. A recent trend in the hair transplant world has resulted in many people being grateful to have more body hair. More on this body hair transplantation phenomenon below.

This trend involves moving body hair to balding regions of the scalp, and is termed as body hair transplants (BHT). I have discussed BHT a few times over the years, and will have more posts on the subject in the future.

For now, its worth noting that only certain types of body hair are usually worth transplanting. Beard, chest and back hair seem to be the most utilized, in order of importance and desirability.

Body hair will never be as good as scalp hair that is moved from the permanent donor region at the back of the head. Nevertheless, there are now 100s of video documented cases online of people who have been happy with body hair transplants.

For people with very limited scalp donor hair (i.e., those with very extensive balding patterns), robust thick back hair and chest hair might now be considered to be a lucky thing! Dr. Ray Wood’s first BHT patient video is worth watching.

Hairy Balding Women

This post has mostly focused on men. This is because I doubt that there are many women who have their backs covered with thick lengthy hair. Some women do have thick beard and chest hair growth, but this is a rarity.

It should be noted that a high proportion of balding women also complain of excess body hair. Usually in areas other than the back. Many of these women suffer from a condition called polycystic ovary syndrome (PCOS). This hormonal disorder causes women to have high levels of male hormones. Here is a good resource for such women.

Last and Definitely the Least: Ernie Primeau

In the history of the online hair loss world, there has never been anyone more insane and crazier than a certain Mr. Ernie Primeau. I briefly discussed him in a post here. Ernie holds the all-time record for number of hair loss forum and hair loss newsgroup posts. Especially in the alt.baldspot newsgroup. A record that will never be surpassed by another human being.

Even into his old age, the man is still present online and continues to promote his theory: removing all of ones body hair via plucking will regrow scalp hair!! Of course I do not believe this possibility. However, perhaps it might very well have been Mr. Primeau who got me thinking about the inverse correlation between body hair and scalp hair over a decade ago.

I am pretty sure that it was my fellow gym and pool members and family members. But my memory could be incorrect. In any event, I hope to never mention Ernie again on this blog after today.

Positive News from Shiseido, Histogen and Dr. Brotzu

We got news about three new positive developments from totally separate entities (Shiseido, Histogen and Dr. Brotzu) this past week.

Shiseido

Yesterday, this blog’s unpaid but respected Japanese correspondent “nosyu” provided us with a link to a big news story that Shiseido was commencing clinical trials in Japan in partnership with Tokyo Medical University and Toho University. Seems like the trial will entail 60 men and women and go on for up to 3 years. Another new article estimates the cost of treatment to be around $900.

Shiseido’s technology is probably identical to what the original inventor Replicel was doing in terms of autologous cell culturing and transplantation using the permanent hair at the back of a balding person’s scalp. Perhaps Shiseido might have its own improvements to the Replicel process, but that is hard to tell at the moment. It seems like one set of injections will give lifelong results!

Note that Dr. Ryoji Tsuboi of Tokyo Medical University (who will lead the clinical research work there), is also co-president of next year’s 10th World Congress for Hair Research. So Shiseido is hiring very reputable people. This development is especially good news since Replicel’s stock price and previously strong social media responsiveness have both tanked in recent months.

Perhaps this newly published video with Replicel CEO Lee Buckler was not filmed too long ago and Replicel is still continuing work in the hair department? Thankfully, Shiseido, the world’s fifth largest cosmetics company, is not letting us down. Also see my post from 2014 on Japan’s new laws fast-tracking stem cell treatments.

Histogen

To my utmost surprise, Histogen’s CEO Dr. Gail Naughton responded to some questions this week from a HLT forum member. Over the years, I have become disenchanted with this company (despite my regular coverage of it on this blog) since it seems to have been in the news for at least ten years. Numerous presentations, successful funding rounds and much media attention have still not led anywhere insofar as treatment being made available anytime soon to the general public.

Nevertheless, it is refreshing to see the CEO responding to people in person. I always found Ms. Naughton to be fairly genuine and sincere and hope that her company does end up like Aderans or Intercytex.

Getting back to the subject matter of this news item, Dr. Naughton states that Histogen’s HSC treatment will be made available in Mexico first in 2018. And they will soon be conducting a large-scale 330-person clinical trial in Mexico with a local partner. They are also close to getting a partner in China for what I assume will be human trials in that country.

The company is also planning for Phase I trials in women and Phase II trials in men in the US soon. Dr. Naughton said that higher doses are more effective per Dr. Craig Ziering’s findings. Finally, the company will most likely get more funding from an Asian partner, and will also prepare for an initial public offering (IPO) thereafter.

Brotzu Lotion

While all these new-age companies with their sizable funding rounds look into cellular biology, 81-year old Dr. Giovanni Brotzu is old school and prefers a topical product. I never wanted to cover this man’s work in the first place, but here I am mentioning him for a second time this year.

Last week Dr. Brotzu gave a detailed interview to an Italian hair loss forum team. The big news is that there is an ongoing trial using his Brotzu lotion on 60 androgenetic alopecia patients. Virtually everything he says sounds reasonable to me, although I have done very little research on the accuracy of some of the more esoteric things that he mentions that I do not understand. He does make some excuses about the lack of photos.

Someone more motivated than myself can check out the Italian forum threads on this man and see if people over there are also optimistic. I like the fact that Dr. Brotzu openly and honestly states that his product will not help regain long-lost hair. Most likely, the best case scenario is that you will only regain what you lost in the past five years. Still a great potential solution for many younger people. Dr. Brotzu has a few patents to his name, some of which include hair growth related applications.