Chapter 92
Topical Herbal Treatment
All kinds of diets and alternative treatments are touted that supposedly “cure” hair loss and leave you looking like Rapunzel, but a critical review of the literature shows that much of the data comes from shaved rodents. Even when clinical studies are done in humans, sometimes there is no placebo control group, so you don’t know whether the diet had anything to do with it. Check out the video see.nf/hairfoods, in which I describe the extraordinary case of a completely bald man who got his luxuriant head of hair back after a fecal transplant, and it also goes into detail about all the foods that, in randomized placebo-controlled double-blind trials, were shown to work against hair loss. These include the heat from half a habanero pepper a day or a teaspoon of medium-hot red pepper, daily soy isoflavones as in three quarters of a cup of tempeh or simply cooked soybeans or in half a cup of soy nuts, and the pumpkin seed oil from about four pumpkin seeds a day. Unfortunately, the supplement did not use pure pumpkin seed oil but rather a mix of vegetable powder and other ingredients, and the study was financially supported by the product’s marketing company. But it can’t hurt to eat a few pumpkin seeds, perhaps with cayenne pepper on tempeh wings.
Topical Herbal Treatment
If pumpkin seed oil is so antiandrogenic, why not just rub it into your scalp? It works in mice, but what about people in general or, in this case, women? Pumpkin seed oil was tested head-to-head against minoxidil foam; for three months, women with hair loss rubbed a quarter tablespoon of oil or minoxidil 5% foam into their scalp daily. Both treatments worked, though minoxidil worked better, even though it was also five times as expensive.
In a similar experiment, topical application of a 0.2% caffeine solution, which was about five times stronger than coffee, was compared with minoxidil 5%, and the researchers found that both worked equally well in men with progressive baldness. As in the pumpkin seed oil trial, however, there was no placebo group to ensure that participants didn’t simply improve on their own—for example, due to the influence of the seasons, since you lose less hair in spring than in fall.
If you drip caffeine onto human hair follicles in a Petri dish, it promotes hair growth, and when it was eventually tested placebo-controlled, caffeine did better in male and female hair loss. In the study with men, 85 percent were satisfied after using the caffeine-containing shampoo for six months; in the placebo shampoo group, it was only 36 percent. EGCG, one of the main components of green tea, can also promote the growth of human hair in vitro, perhaps via inhibition of 5α-reductase, and it helps mice with hair loss, but I couldn’t find any clinical trials on hair growth and green tea.
Shampoo with one percent zinc pyrithione, which is normally used against dandruff, did better than a placebo, since after 26 weeks the male subjects had denser hair, but not enough that they themselves would have noticed anything, and it worked less than half as well as 5% minoxidil shampoo.
And what about the topical herbal treatments that have been used since time immemorial?
Ginger can serve as a warning here. It has been used for a very long time in Asia to stop hair loss and promote hair growth. Search Amazon.com for “ginger shampoo,” and you’ll get almost 1000 hits. But when China’s national foundation for natural sciences examined it at some point, the researchers were astonished to see that ginger actually suppressed human hair growth. In light of that result, they suggested using ginger instead for the removal of unwanted body hair.
Polygonum multiflorum, the multiflower knotweed, known in traditional Chinese medicine as he shou wu, is a flowering plant in the same family as buckwheat that is commonly used in hair tonics. As with green tea, there are promising in vitro experiments and rodent studies, but no clinical studies in humans. Rosemary, however, has been tested.
Rosemary Oil
In see.nf/rosemaryoil I describe in detail a series of experiments in which patchy hair loss, alopecia areata, was treated with a mixture of essential oils or, less pleasantly, topical application of onion or garlic juice. For age-related hair loss, it turned out that applying a quarter teaspoon of lotion mixed with ten drops of essential rosemary oil per 30 milliliters, twice a day to the scalp, worked just as well as the drug minoxidil in men with early baldness. That amount of rosemary oil costs about a penny for a week.
Preserving Hearing
What you can do to save your sense of smell—above all, don’t smoke—see see.nf/smell. Although a reduced sense of smell can have serious consequences because, for example, you don’t notice when it smells like gas, or you oversalt your food, most of those affected are not aware of their impairment, not even when you point it out to them directly. In contrast, hearing loss is regarded as a serious disability and is among the most common chronic ailments of older adults. Nevertheless, according to a report by the National Academy of Medicine, it was for far too long “dismissed as inconsequential” in medical care.
Hearing Aids for Age-Related Hearing Loss
Presbycusis, age-related hearing loss, (from the Greek presbys, “old,” and akusis, “hearing”) affects in the United States about a quarter of those over 60, more than half of those over 70, and 80 percent of those over 80. Among 100-year-olds, more than 95 percent are severely hard of hearing. The resulting impaired communication can lead to isolation, loneliness, and depression. Or even be life-threatening, since it increases the risk of motor vehicle accidents.
Hearing aids can help, but they are used far too little—not even one in six older people with significant hearing loss uses one. The reasons: The devices are annoying, not attractive, and expensive. Unlike in countries such as Great Britain, where citizens have received hearing aids free of charge for more than 50 years, in the United States they are unaffordable for many; on average they cost 2000 to 7000 dollars, and health insurance usually doesn’t pay. Fortunately, in 2017 both parties in the US Congress passed a law that gave the FDA three years to allow over-the-counter hearing aids, which was supposed to increase competition with physicians’ offices and specialty shops and reduce prices. Understandably, the FDA missed the statutory deadline because of COVID, and because masks and physical distancing made communication even harder for the hard of hearing, the need for affordable devices is greater than ever. In part because of pressure from a presidential executive order, as of October 17, 2022, over-the-counter hearing aids are finally available.
How well do they work? Unlike “aural rehabilitation,” a set of strategies such as lipreading that turned out to be of little use in older people with hearing loss, hearing aids improve the ability of adults with mild to moderate hearing loss to understand others and manage everyday life. They are the best possible help for people with hearing loss who want relief.
With modern hearing aids, some difficulties that users had complained about have been fixed; for example, whistling due to acoustic feedback has been electronically reduced or eliminated altogether. Others, like conductive hearing loss, which makes your own voice sound different or makes you hear yourself chewing, were harder to correct. Many think hearing loss can be fixed as simply with more volume as poor eyesight can be fixed with glasses, but just because sounds are louder doesn’t necessarily mean they are clearer. Too little benefit is a main reason some people don’t wear their hearing aids. But are there benefits beyond symptom relief that could change the cost-benefit calculation?