Experiencing Hair Loss? You Might Not Have Enough Blood Flow In The Scalp, Says An M.D.

Facial plastic surgeon & hair restoration expert By Patrick Angelos, M.D.
Facial plastic surgeon & hair restoration expert
Patrick Angelos, M.D., is a double board-certified facial plastic and reconstructive surgeon whose primary surgical interests include hair restoration and facial plastic surgery. He is certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology.
Experiencing hair loss? Try increasing blood flow to the scalp, says an MD
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DHT (a hormone derived from testosterone and thought to contribute to hair loss for some) can cause inflammatory damages to the circulation, and that can deprive hair follicles of blood and vital nutrients. But even though it appears that blood supply keeps follicles happy and healthy, there is still some controversy on whether diminished blood supply is actually responsible for hair loss. 

Here's what we know. 

A few Japanese studies have found that young men with male-pattern baldness had more than two-and-a-half times lower scalp blood flow than in normal controls. Other theories say that when there are no hair follicles in the area, some of the blood supply goes away. And we know bringing in new follicles can increase the blood supply. Other researchers, including some at Massachusetts General Hospital, have grown hair faster and thicker in mice that were given proteins that promote new blood vessel growth.

Research has also found that identifying and adding growth factors that stimulate blood vessel growth can help with hair follicle vascularization, promoting hair growth and increasing follicle size

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So does blood supply diminish after the hair is gone? Or is it the lack of blood supply that causes hair loss?

Certainly, where there's more hair, there's more blood supply, and even when new grafts are transplanted into areas that don't have good blood supply, blood supply does increase. It's even been found that blood supply will increase in scars or skin grafts with no hair. These areas have been implanted with new follicles that survive, so scalp circulation changes are not fully understood.

It's also theorized that muscle tightness in the scalp can potentially contribute to hair loss. This is especially common in people who have issues with dystonia (a muscle contraction disorder) and other conditions such as temporomandibular joint dysfunction. More commonly known as TMD, this condition causes clenching and grinding of the teeth at night, which can lead to chronic tension in the forehead and scalp muscles. The theory is that all that tension can contribute to hair loss, and that may relate to a decrease in blood flow and circulation. 

Preventive measures. 

Understanding your genetic risk is a big part of prevention. Identifying and treating that early may help you have better results in preventing the progression of hair loss. Along those same lines, if you think you may be at genetic risk, then evaluating and treating any hormonal issues or imbalances that might be affecting or accelerating hair loss may also help you early and in the long run. 

Other ways to help prevent hair loss include having good hair care and hygiene habits:

  • When washing hair, massage your scalp, rinse well with cold water, and avoid pulling back on your hair because that can put traction on the follicles. The same goes for combing. For men, it's less stressful on the follicles to wash and comb your hair forward, toward your face, instead of toward the back of your scalp and neck. Also, long hair weighs more, so on its own, it can put more traction on the follicles. 
  • Regularly brushing hair, however, is actually good for it—brushing massages the scalp and helps improve blood flow and circulation. Brushing your hair once a day, especially with a brush that can stimulate the scalp, is almost as good as shampooing your hair. That's partly because brushing can help remove dirt from the scalp. It's also important to keep your combs and hairbrushes clean. 
  • The condition of your hair should also be in balance—not too oily, not too dry. Also avoid overuse of a hair dryer on your hair—that can make it weak and brittle, which can lead to more hair loss.

While the information I've shared is fairly comprehensive, understand that there may be many reasons why you're losing hair. For some people, it's a matter of changing habits or early intervention to prevent hair loss in the first place. It is most beneficial to take a comprehensive and individualized approach to hair restoration.

Adapted from The Science and Art of Hair Restoration: A Patient's Guide, by Patrick Angelos, M.D. Reprinted with permission from the author, copyright © 2020.

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