Fiction
Lack of Blood Supply
Some assert that a lack of blood supply contributes to hair loss. Bald skin gradually loses some of its blood supply and, consequently, it becomes thin and shiny. These changes, however, are secondary to the loss of hair. Hair follicles are one of the most rapidly metabolizing tissues in the body; their high metabolic rate demands an excellent blood supply to carry oxygen and other nutrients to the cells. If the blood supply diminishes, the follicle cells wither and die. Growing hair requires the proper nutrition that comes with a good blood supply. When hair follicles are transplanted into skin grafts or scar tissue, both of which have a relatively poor blood supply, the presence of the grafted hair causes the local blood supply to increase.
Clogged Pores
This claim usually accompanies microscopic photographs of an empty follicle clogged with a heaped up waxy substance that prevented the hair from growing. There is no scientific evidence that clogged pores could interfere with hair growth. Common sense is sufficient to refute these claims. Why would pores be clogged on the top of the scalp and not on the back and sides? In addition, everyone has had an ingrown hair at one time or another. An ingrown hair occurs when a hair grows through intact skin where there is no opening. If a hair can force its way through skin, it can certainly grow through soft, waxy sebum at the bottom of an empty follicle. It is also important to note that the lubricants that normally coat the surface of the hair shaft are produced even when a hair shaft falls out. Since there is no hair shaft surface for these lubricants to coat, they pile up in the bottom of the follicle space. If clogged pores caused baldness, women would be as bald as men.
Lack of Air Circulation to the Head
Folklore says that men who constantly wear hats are more likely to become bald, as hats prevent air from circulating to the head. Hair follicles get their oxygen through the bloodstream, however, rather than from ambient air. Factors that affect only the exposed part of the hair do not injure the growing portion of the hair root. One exception to this is that constant traction on the hair follicles, such as from the continuous wearing of "corn rows" or very tight braids, can cause permanent hair loss. This condition is called traction alopecia, and is distinct from androgenetic alopecia.
Preventing Hair Loss
Many over-the-counter lotions and drugs claim to restore lost hair. Whether sold through drug stores, salons or mass media, most are useless. A 1989 Supreme Court decision prevents these potions from being advertised or sold in the United States as medications that prevent hair loss or promote the re-growth of lost hair; however, such claims are still made. Charlatans of every age have eagerly seized upon each new scientific wonder to profit from a gullible public. Excepting cancer and arthritis, hair restoration has been one of the most fertile areas for medical nostrums. For example, in the same year that the principle of the magnetic field was described, "magnetic" and "electric" hairbrushes for the prevention and treatment of baldness appeared on the market. Concoctions that claimed to be "snake oils" were also sold for the treatment of arthritis and baldness. In hindsight, it is understandable that an unsophisticated person, who was crippled by pain from arthritis and who lived at a time when there was no better treatment for his illness, might be desperate enough to try "snake oil" as a treatment for arthritis. However, until the Supreme Court decision banning their promotion, ads for products that claimed to be able to restore hair filled the television airwaves. Infomercials complete with real doctors, pictures, and testimonials promoted these worthless potions every day. Even today, it is difficult for the layperson to differentiate between fact and fiction when it comes to hair loss remedies. There are two FDA approved medications to treat androgenetic alopecia. Though they have limited benefit, they may be useful for many. These two medications, minoxidil and finasteride, are discussed in detail in the chapter titled "Drugs to Prevent Hair Loss."
