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Posted on Wednesday, April 28, 2004 - 08:35 am:   Edit Post Delete Post

Has anyone else read S. Foote's theory of MPB? I really gave it a good look over yesterday and found it very compelling. Basically he proposes:

a. DHT is really produced to stimulate and aid the transport of lymph from the extremities of the body (the skin). He hypothesizes it does this by increasing the rate of the rythmic contractions that occur inside the lymphatic vessels. In his opinion this is the primary physiological action/purpose of DHT.

b. Hair growth patterns are directly influenced by fluid pressure levels in and around the tissue matrix supporting the hair follicles. He calls this "contact inhibition". High pressure levels retard hair growth while low pressure levels promote hair growth. This, he proposes, is an evolutionary trait that was evolved to aid the body in temperature regulation.

c. DHT, by directly lowering tissue fluid levels, also lowers tissue pressure levels. Thus, this has the side-effect of promoting body hair growth. This is particularly noticeably in males, who have higher levels of testosterone than females. He points out that beard, armpit and possibly pubic hair growth occur over areas of the body that have very dense lymph drainage vessel coverage.

d. Finally he claims DHT creates the "opposite" effect on the scalp areas where MPB occurs due to a hydrodynamic back pressure effect that occurs. Thus his claim is that basically MPB is in reality a side-effect of minor edema of the scalp.

e. But, he goes further and relates all of this to an increased risk of auto-immune disorders in females (since they have lower levels of DHT). He goes on to explain that drugs that "inhibit" DHT would induce the same conditions in those males who take the drugs to treat MPB. He has actually taken this argument so far as to have contacted the drug manufacturers and asked them to refute this possibility! All have declined to do so to date...very interesting. One actually sent him a letter thanking him for pointing this out.

Well, that's about as far as I understand it. The reason I'm posting this here is that he believes Tom's exercises would be beneficial most likely due to increasing the lymph drainage in the scalp (since muscle motion in an area promotes lymph transport in the same area). He also states that ice treatments (frequently used to treat all types of swelling) would be beneficial as well - though very inconvenient!


Tom Hagerty
Posted on Wednesday, April 28, 2004 - 10:04 am:   Edit Post Delete Post

You can see a more detailed exposition of this theory by clicking S.Foote.

S.I.Foote had a website that I had on my links page for a while. His site disappeared from the Internet a few months ago. If it's back on line again perhaps someone will notify me.

Posted on Thursday, April 29, 2004 - 09:49 am:   Edit Post Delete Post

Today I searched Kevin McElwee's site and found his opinion on Foote's theory. I post it below. It was in fact his answer to a similiar question on Foote's theory asked by a "Tom H." there about 2 years ago. Does anyone here know who that "Tom H." might be??

Kevin's answer follows ==>

It's a complex hypothesis and I found it difficult to follow his train of thought.

Overall I found the ideas rather doubtful. Contact inhibition works well enough in the petri dish, but in the body it's not that simple - plus the dermis through which the hair follicles grow is largely collagen and cell contact is relatively limited. If cell contact inhibition worked in the way Stephen thinks it works the hair follicles would go through one complete growth cycle and never re-enter anagen again. Hair follicles produce a wide range of enzymes including collagenases capable of modulating the skin - they don't push through dermis so much as drill a hole using the enzymes to digest the tissue in the way.

Inflammation, fibrosis and scar tissue can be a part of androgenetic alopecia but it is not necessarily present in all affected hair follicles or from person to person. Whilst the jury is out on how significant the fibrosis is in inhibiting hair growth, my personal feeling is that it is not the dominant factor.

I would think fluid pressure in the skin would vary significantly from day to day with intake of water, salts, expiration/excretion rates. Blood pressure would largely determine extravascular fluid pressure and I am not aware of any studies that have shown any relationship between blood pressure and hair loss although a few such studies have been done (the studies did not demonstrate any relationship).

The failure of scalp reduction to work is largely due to stretch back of the skin (and also if done badly can lead to tissue necrosis) and it is rarely offered because the graft transplant technique is easier to conduct and involves much less risk to the patient. Minoxidil is an antihypertensive drug but there are other antihypertensive drugs that have no apparent effect on hair growth. I agree that androgens can reduce autoimmune activity but I think their action is more likely to be in the core lymphoid organs on the cells themselves rather than in the periphery through anything like fluid pressure.

Stephen may not be selling a product, but from correspondence it seems he has a conspiracy theory against the hair industry to promote. I decided not to enter into further dialogue with the guy.
Kevin J. McElwee - The management - keratin.com

Tom Hagerty
Posted on Thursday, April 29, 2004 - 01:28 pm:   Edit Post Delete Post


I'm the Tom H. who asked Kevin several questions about Steven Foote's theory. You can see from the passage you quoted that Kevin has a good background in biological science and that he expresses himself well.

One sentence I didn't understand though - "I agree that androgens can reduce autoimmune activity but I think their action is more likely to be in the core lymphoid organs on the cells themselves rather than in the periphery through anything like fluid pressure."

Does Kevin mean by core lymphoid organs lymphoid cells or lymphocytes? His last phrase probably refers to interstitial fluid - the fluid that surrounds the cells.

By the way, Kevin does not think the scalp exercises will have any effect on halting hair loss or in promoting the growth of new hair.

Posted on Thursday, April 29, 2004 - 05:16 pm:   Edit Post Delete Post

Tom H.:

Thanks for clearing the Tom. H mystery up! As for your question obviously I can't speak for Kevin but I will share my take on what he meant by it.

Foote argues that DHT promotes an increase in the rate of lymph transport which, if true, would have the beneficial effect of bringing pathogens more efficiently to the lymph nodes for destruction. Thus Foote is really assigning his speculated reduction in autoimmune activity levels (when taking DHT inhibiting drugs) to their undesired side-effect of reducing lymph transport rates. In simple terms Foote believes the pathogens won't be transported to the lymph nodes as efficiently when DHT levels go down due to the usage of DHT inhibiting drugs.

Kevin states that he believes the reduction of autoimmune activity levels is most likely due to DHT (androgens in general) affecting the cells of the lymph nodes directly. In other words, it's not the rate of transport of the pathogens to the lymph node cells that matters but the effectiveness of the lymph node cells in handling the pathogens. Kevin's really arguing here for some kind of DHT (androgen) receptor mechanism in the lymph node cells that activate them in some way to more efficiently handle pathogens.

There could be several variations on this theme but that's the basic difference. Hope that clears it up. (To me they both seem to be way out on a limb on this one!)

As for your SE's - clearly they do work for some people. The problem with them is that they don't seem to do so consistently. Exercise in general doesn't consistently provide results to those who do it - but we all know it works when done right!


Tom Hagerty
Posted on Friday, April 30, 2004 - 08:08 am:   Edit Post Delete Post


Both Foote's boldly stated theory and McElwee's more humbly stated theory lack substantial evidence as far as I can determine. I like theoretical reasoning, though, even if the theories are out in the stratosphere. Theoretical reasoning keeps your mind alive. But critical and skeptical thinking has to keep a tight rein on these flights of imagination or you become a wild man with wild ideas.

If you read the four theories that I give in - My Approach - as to why the scalp exercise will (hopefully) stabilize hair loss and grow new hair, you'll detect that I give them with some ironic humor. I think that there is some theoretical basis why the scalp exercise works in a percentage of people, but it's too technically complex for the average reader to understand. Biochemical jargon is a turn-off for most people - it puts them to sleep. I don't want people to go to sleep while reading my pages.

I don't think this is condescension to what I think the average reader will understand. I respect the average reader and try to write the best prose I can to keep this reader interested and maybe stimulated to give my approach a try. I honestly believe these foolish-looking movements of the scalp eventually produce results for some people.

Posted on Friday, April 30, 2004 - 08:23 am:   Edit Post Delete Post


Anonymous me again - I guess I'm a little hair happy this week. Since I wrote the reply above last night, I've thought of a possible explanation for why Tom SE's work (when they do). It's the obvious one, but unless I'm wrong I haven't read anything from Tom about it. So here goes:

a. The SE's, when done properly, induce cellular damage in the hair follicles of the dermis (most likely vellous hair follicles since they aren't as deep in the dermis). Therefore the more "vigorously" the SE's are done the more likely this is to occur. In other words it's more of the intensity with which the SE's are performed that determines their success rather than their duration, though both matter.

b. Like everything else in the body once some damage has occurred a healing process commences. This would most likely involve the release of hair growth factors (e.g. cytokines). This has a documented analog in skin-burns (chemical or sun). The skin on the scalp, once healed from the burn, usually has regrown hair over the damaged area. This hair growth is usually temporary in the case of burns.

c. But why is the hair growth following burns temporary? The most likely answer is the documented effects of DHT. (I mean if there wasn't any hair on the scalp in the area before the burn, presumably it was lost due to DHT.) Now, DHT would then still be present after the release of the growth factors had stopped (i.e., once the healing response was finished) and then the action of the DHT starts to become apparent again.

d. Tom's SE's follows the same pattern except that he stresses the SE must be continuously performed (i.e. forever). Why? Because if stopped our old friend DHT will still be there to commence the miniturization process all over again!

So, if this is correct a "permanent" solution to hair loss involves two things:

1. Finding something that lowers the dermal DHT levels.
2. Inducing controlled cellular damage in the hair follicles such that the necessary hair growth factors are released in the healing response.

If these two things are accomplished it would make sense that the hair growth would then be permanent. Well if the going rate of a "penny for your thoughts" counts on this board - I guess Tom owes me about 5 cents by now!


Tom Hagerty
Posted on Saturday, May 01, 2004 - 04:25 pm:   Edit Post Delete Post


I just don't see how the scalp exercise could damage cells in the hair follicles or in the dermis surrounding the follicles. When you do the scalp exercise, the scalp slides over the pericranium. This is the fibrous membrane covering the cranium. It's possible for the scalp to slide over this membrane because there is a loose layer of tissue called fibroareolar tissue attached to and under the galea. In other words, there is no movement, or very little movement within the dermis itself when the exercise is done. Movement or the heat generated by movement might, however, cause the minute amount of cellular damage you're talking about.

I know that minute cellular damage or irritation like that caused by cayenne pepper can stimulate the growth of hair, at least temporarily. Kevin McElwee talks about this. Perhaps there is some heat and therefore cellular damage in the area of the follicles if the scalp exercise is done rapidly.

You wrote, "The skin on the scalp, once healed from the burn, usually has regrown hair over the damaged area. This hair growth is usually temporary in the case of burns."

In cicatricial alopecias there is no growth of hair if a thermal burn is third degree. You're talking about a less severe burn though.

All this is interesting stuff how cellular damage and irritation causes histamine release and therefore possibly stimulates cell division in the hair follicles.


Posted on Wednesday, May 05, 2004 - 09:14 pm:   Edit Post Delete Post


Good points, I have nothing to reply with which I could be certain about. Today I read something else at Keving's site that's also VERY intriguing to me and I wonder if you would be kind enough to weigh in on it.

Kevin mentions human hair loss follows a seasonal shedding pattern. At first glance the numbers he gives aren't vey significant. He states that typical hair loss is 50/day but that could go up as high as 100/day during "shedding" seasons. Now, assuming during the "non-shedding" season that no net hair is lost that means the rate of new hair growth is 50/day. During the "shedding" season then there is a NET loss of 50/day. How big an impact is this? Let's do some simple math. How long would it take to lose 10% of the typical amount of scalp hair (i.e. 10% of 100,000 hairs) at this rate?

10,000/50 = 200 days

That seems to be in the range at which MPB occurs, once it finally starts, and it's around how long it would have to take to not be easily noticeable.

BUT, a seasonal shedding wouldn't go on that long. Kevin doesn't actually state how long the studies report it lasts, but I would assume no more than 3 months. But what if something is wrong with the body clock (circadian rythm) and it just keeps going?????

Just somethin' to ponder here...


Tom Hagerty
Posted on Thursday, May 06, 2004 - 01:39 pm:   Edit Post Delete Post


I've read Kevin's messages about seasonal shedding too. He doesn't think it's too significant. I haven't seen anybody report massive seasonal shedding.

Many years ago I worked around Thoroughbred racehorses. The massiveness and the rapidity of the seasonal shedding with these animals is incredible. As soon as the cold weather arrives the horses that winter at the tracks and farms in Chicago develop thick coats - really thick. As soon as May hits, these horses shed all those thick coats in a matter of weeks.

Getting back to humans, you wrote, "But what if something is wrong with the body clock (circadian rythm) and it just keeps going?????" Yeah, things do go wrong sometimes. You don't want to be around when it happens though. That's what Woody Allen said when someone asked him about his own death. He said, "I know I'm going to die but I don't want to be around when it happens."

Posted on Friday, May 21, 2004 - 03:49 pm:   Edit Post Delete Post


I think you might find this link (on a reference mentioned at Kevin's site) interesting:


Notice the last sentence in particular. I'm not trying to argue with you here, I simply value your opinion on these topics and want to share some data.

I'm starting to suspect that MPB might just be a circadian (or more accurately, a circannual) disorder. Recent findings concerning the role of previously unknown circadian photoreceptors in the human eye on regulating the body's clock are intriguing...not a smoking gun yet though. The elusive human hair cycle clock must be related to the body's master clock in some way.



Tom Hagerty
Posted on Saturday, May 22, 2004 - 09:22 am:   Edit Post Delete Post


Kevin's site www.keratin.com is a goldmine of good articles. I read the one you linked to. I'm interested in cyclic processes. When I go bicycling in Ohio this time of the year I see "dead" trees spring to life almost overnight and the brown grasses on the hills turn green. Cyclic forces are powerful.

"The elusive human hair cycle clock must be related to the body's master clock in some way." The magical thing about this is how the stem cells from the bulge area of the follicle are able to migrate to exactly the right location producing a renewed anagen stage.

Posted on Friday, June 11, 2004 - 04:58 pm:   Edit Post Delete Post

Hi Tom,

Today I'd like to continue our discussion on cyclic processes. I've been doing some research and have found something quite interesting and would like to introduce the concept to you. Where to begin???

Well, I assume you're familiar with the 24 hour "circadian" cycles we all have. When they go wrong we have problems with sleep/wake cycles. This is commonly induced from jet travels and from night shift work. It's been studied scientifically for over a decade and so by now some good treatments are available.

The real question I've been looking into is whether humans have a "seasonal cycle" (circannual rhythm). Turns out they undoubtedly do and this affects many things: weight, appetite, mood, fertility and hair growth. I'm still not prepared to claim MPB is a circannual disorder but I'm getting closer to thinking that may be the case. Why?

The big question is how does the body "know" what season it is? This is biologically important in mammals that require seasonal changes in physiology - and almost all mammals do (even those that live at the equator).

The answer is photoperiod. What is photoperiod? It's the DURATION of light received by the retina. Apparently evolution chose this environmental cue as the most reliable to determine the season since, as one researcher wrote, "it can be a hot day in December and a cool day in June". Are humans (being mammals) photoperiodic? The prevailing wisdom is maybe. See this link, abstract to article #2:

http://www.ingenta.com/isis/browsing/TOC/ingenta;jsessionid=4lff5ncfg2t82.crescent?issue=pubinfobike://sage/j329/2004/00000019/0 0000003

Finally, I'll attempt to summarize the theory. Humans are mammals and we share a common inherited biological response to photoperiod. It's been proven - in many different ways - that we have all the biological machinery needed to adapt to changing photoperiods. So why isn't it more obvious? The answer seems to be artificial lighting - perhaps even low tech forms (like candles/torches...) that go back as far as recorded history matter. As long as a certain level of light is entering the retina the body doesn't think "sunset" has occurred. This has the unintended affect of tricking the body's circannual machinery into perceiving a "permanent summer" environment. At some later point the body "photorefracts" into a fall/winter physiology. Photorefraction is a biological calendar function that starts all the processes needed for seasonal changes in ADVANCE of the actual arrival of the next season.

Overall this area is a HOTBED of well funded research and I know you'll find many things about it most interesting. Enjoy - and thanks for all that you share.


Tom Hagerty
Posted on Saturday, June 12, 2004 - 07:54 am:   Edit Post Delete Post


I wanted to read the article you linked to but got this message when I clicked on it - "Sorry, we are unable to display the page you requested at this time."

I'm interested in the synthetic environments people live in and the effect these have on their biological rhythms.

"So why isn't it more obvious? The answer seems to be artificial lighting."

A few months ago I saw a Japanese movie filmed in Tokyo. The characters in the movie all worked in large offices ablase in artificial light. In the evenings these characters went to clubs where the light was even more intense. City people learn to live in such an unnatural ambience, but at another level perhaps this ever-present illumination is taking its toll.


Posted on Saturday, June 12, 2004 - 12:45 pm:   Edit Post Delete Post


Sorry about the bad link. Try this one instead (I tested it this time):


Goto the latest issue (June 2004, Volume 19, Issue 3) and you'll find the article I tried to provide a link to above. Another good issue to look at is August 2001, Vol 16, Issue 4. This one provides some review of the topic from the point of view of general mammalian photoperiod responses.

There are many, many other articles that are related to this topic and from many different journals. It's a bit tricky to navigate your way through the maze of all the information. If you'd like some other helpful suggestions let me know - I'd be happy to give a good "introductory" list of related articles but it would take some time to compile.

This journal IS a great place to start...again, enjoy!


Posted on Friday, July 16, 2004 - 08:30 pm:   Edit Post Delete Post


Hi again. Hope you're research in biological rhythms is going well. You probably saw the post where I asked a "24-yr old Steve" about his photoperiod. He thought I was nuts. I've learned from his reply (and others elsewhere) that your attitude of condescension really is justified. It's too bad though really.

In any case today I want to share my latest findings. It's pretty much the "smoking gun" I've been looking for and it opened up an entirely new and obvious therapy (even you might agree has merit):

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1 4996107&dopt=Abstract

Give it a read and let me know what you think. But remember melatonin synthesis is directly regulated by the circadian photoreceptors in the eye. This means photoperiod directly controls melatonin secretion cycles. No one disputes this, but the DIRECT effect it could have on hair follicles was never even considered until just recently.

This is all good science but it's not quite complete yet. Another hormone, prolactin, is also known to play an important role in hair/fur growth cycles. It's exact physiological role in human hair growth cycles (both female & male) remains to be determined.


Tom Hagerty
Posted on Saturday, July 17, 2004 - 12:28 pm:   Edit Post Delete Post


You wrote, "Hope you're research in biological rhythms is going well." I'm doing no such research. You also wrote, "...your attitude of condescension really is justified." I never have an attitude of condescension to the people who post messages on this forum. I would not like a patronizing attitude in myself or in others.

I read the abstract you linked to but I don't want to pay the $29.00 to read the full text. The hypothesis that the researchers tested is interesting, but the testing as you say, "...it's not quite complete yet." That's an understatement.

In my years around various Thoroughbred racetrecks, I've seen biological rhythms and seasonal rhythms produce dramatic changes in the coats of horses in short periods of time. I'd be interested in convincing research that shows how these rhythms affect human beings. But I don't want to force what I think is the multifactorial determinants of hair loss into one theoretical mold. I prefer to stay open to a whole range of theories and not just focus on one.

Posted on Sunday, July 18, 2004 - 04:08 pm:   Edit Post Delete Post


I asked for your opinion and you shared it - thanks. Some of what you wrote surprised me but that's the value of discussing things! Skepticism is a healthy attitude in scientific or techical debates if it isn't taken to far. I respect anyone who can disagree with tact - few do it as well as you did above.

As for the theory - time will tell how close it is to the truth as more studies and data come out. So, no need for any more debate between the two of us.

Good luck with promoting the SE's.


Posted on Friday, October 01, 2004 - 12:36 pm:   Edit Post Delete Post


I promised no more debate and I plan to stick to it. Still, I know you respect Kevin McElwee. You may want to check out his site's update on seasonal shedding. He's warming up to the exciting picture that's emerging around this topic...

P.S.: I also wanted to thank you for your comment re the speed of onset of seasonal shedding in horses. It was helpful to me in my personal research. I forgot to mention that in my earlier post. Thanks again.

Tom Hagerty
Posted on Friday, October 01, 2004 - 01:28 pm:   Edit Post Delete Post


I thought Kevin McElwee abandoned his site. He no longer responds to messages on his discussion forum. Where did you find his update on seasonal shedding?

Posted on Saturday, October 02, 2004 - 08:50 am:   Edit Post Delete Post


But I don't know when this update was put out. It's definitely a revision to what was on this page no more than a year ago. I haven't seen him respond to any posts on the discussion forum either, at least not in about the same amount of time. Can you blame him?

Tom Hagerty
Posted on Saturday, October 02, 2004 - 01:15 pm:   Edit Post Delete Post

Seasonal hair shedding by Kevin McElwee is a good article, but it would take more than two paragraphs to do this topic justice.

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