yo what's up my homies so today i wanted to visit a topic that gets brought up fairly frequently and that is on the subject of caffeine and hair loss now caffeine as a hair loss treatment is not obscure there are many commercially available products such as shampoos and topical serums that contain caffeine and are marketed towards hair loss one of the more famous ones is alphazim but there are also other brands as well including head and shoulders which has a caffeine shampoo variant and one of the active ingredients in ravita which is a hair loss shampoo is also caffeine so of course it goes without saying that i am not talking about the oral administration of caffeine caffeine is one of the most uh if not the most used drug in the world and is found in beverages that almost everybody drinks including coffee tea soft drinks and it's also found in certain foods like chocolate so if oral caffeine could stop hair loss then logic would dictate that very few if any people would have issues with hair loss simply due to the fact that almost everybody consumes caffeine now it has been shown that hair loss aside caffeine despite being a psychoactive drug does have some potential health benefits including some metabolic benefits like aiding and weight loss it's also been shown to be beneficial as an ergogenic aid for certain athletes to improve sports performance and that's even thought of as having some anti-oxidative properties that could stave off the development of long-term diseases like cancer and it's also believed that caffeine consumed during middle and old age could reduce the risk of the development of dementia although further research is needed on that subject but that of course is not why you're here you're here because you want to know about topical caffeine and how it can help with hair loss well we do know through studies that caffeine can easily penetrate the skin barrier so it has been examined extensively as a potential treatment for antring alopecia and there is a fair bit of information online but what i want to examine with all of you today is a review article on those studies which was released this year in 2020 so before we discuss any outcomes of the studies let's look at the theoretical mechanism behind how caffeine is supposed to stop hair loss or promote hair growth so it's well established that androgens notably dht dehydrotestosterone are the main culprit and hair loss in individuals who have androgenic alopecia which is the when hairs of course are genetically sensitive to androgens such as the above mentioned dht the way dht destroys the hair follicle is that it disrupts the growth cycle of the hair through the inhibition of igf-1 which works as a regulator of the hair growth cycle so as igf-1 is inhibited by dht this will cause the growth phase of the hair follicle known as the anagen phase to shorten whereas the resting phase known as the telogen phase will be prolonged this in turn results in the subsequent miniaturization of the hair follicle and the theorized mechanism behind this is that igf-1 promotes angiogenesis which is increased local vascularization to the hair follicles and in absence of igf-1 there is in turn reduced vascularization which eventually kills the dermal papilla cells of the hair follicle until the follicle itself is destroyed and replaced by scar tissue now caffeine is not hormonal in any way it's not going to inhibit dht or any androgens on the scalp but as we know with other non-hormonal treatments like minoxidil or stomoxidine the inhibition of dht is not necessarily a prerequisite for the efficacy of a hair loss treatment some compounds like the above mentioned minoxidil work as hair growth stimulants uh by managing to promote the growth of the dermal papilla cells even as the dht tries to destroy them this is why dermatologists will often recommend using both a growth stimulant like minoxidil in combination with an anti-androgen like finasteride since the growth stimulant will work to promote the growth of the cells which grow hairs while the anti-androgen will stop dht from destroying the hair follicle giving the two drugs a synergistic effect well the way caffeine works is that it inhibits the enzyme phosphodiasterase which is part of the system that regulates the level of cyclic adenosine monophosphate aka cyclic amp in the cells cyclic amp is a growth stimulant among other functions and it is created by conversion of atp adenosine triphosphate to cyclic amp by substances that stimulate the beta receptors on the cells like norepinephrine and epinephrine which is basically adrenaline the enzyme phosphodiesterase breaks down the cyclic amp so a phosphodiesterase inhibitor like caffeine prevents cyclic amp from breaking down so both adrenaline and caffeine end up increasing cyclic amp levels uh though by different mechanisms that's why when you get an adrenaline surge you get all jittery and when you drink too much coffee you feel the same way it's all due to increases in cyclic amp in your cells so like i said cyclic amp is a cell growth stimulant and thus can cause hairs to spend more time in the angin phase in less time in the telogen phase at least theoretically thus that will stimulate hair growth however in vitro studies also show that caffeine increases igf-1 which like i mentioned before increases angiogenesis and thus improves blood supply to the hair follicles and also stimulates the anagen phase of hair growth so the question is can caffeine be utilized as a growth stimulant like minoxidil and can it be incorporated as part of an effective hair loss treatment regimen and if so how does it compare to an fda approved treatment like five percent minoxidil which is widely believed to be the strongest hair growth stimulant on the market so let's take a look at the in vitro studies on caffeine there are a lot of studies that have been performed and usually they are performed in a cell culture of hair follicles like for example a study performed in 2014 used hair follicles just dissected out of men with aga angiogenic alopecia that were then cultured and were then exposed to caffeine at concentrations of 10 or 50 micrograms per milliliter and the caffeine ended up prolonging the anagen phase and it increases and it also increased igf-1 expression and caffeine also inhibited apoptosis and necrosis meaning it prevented cell death and the study concluded that caffeine works by multiple mechanisms and is likely to be clinically effective and people with anginic alopecia there are a number of other studies which basically come to the same conclusion as well but as you know from watching my videos i do not hold in vitro studies in very high regard because i don't think they are necessarily good indicators of what happens in real life so let's go ahead and take a look at the in vivo studies on topical caffeine and see how caffeine works on actual human beings like you and me so my source like i mentioned at the beginning and which i'll link below is this 2020 review article on caffeine and hair loss and right off the bat looking at the authors of the study they all list that they are employees of a company called dr kurt wolff who just so happens to be the manufacturers of the famous alpescent products which include caffeinated shampoos and topical solutions marketed towards hair loss one of the researchers dr clank even appears in the commercials for it so if you live in the uk or european union you've definitely seen these ads as they market the bleeding crap out of it so this review article is essentially funded by the people trying to sell you caffeine related hair loss products like shampoos and topical solutions as we see from the alps in line of product so looking at the in vivo studies we find that like the review article they also seem to be industry funded for example the only study directly comparing a 0. 2 caffeine solution with five percent minoxidil has as the senior author dr adolf clank that's right it's the very same dude who appears in the commercials for alps and shampoo as well as other alps and related products so looking at the study it was a randomized but open label study meaning that the subjects and the investigators knew which treatment they were receiving this is a potential big issue because the people interpreting the results have a vested interest in seeing a positive outcome of their product i mean after all you buying the product is how they earn money so a blinded study would be much fairer as it would have removed the potential of industry bias but in any case in this study there were 210 males with android alopecia who were enrolled and they were given a 0. 2 caffeine solution which is the same as the commercially available alpha and topical solution and their main endpoint for the study was looking at a change in the proportion of antigen hairs from baseline up until six months versus hairs uh not in antigen phase so they basically just want to see how many hairs were in the growth phase on treatment versus how many hairs were in the growth phase before treatment so the way they assessed this was by plucking a set number of hairs from the scalp and then examining them under a microscope to examine what growth phase each hair is in now a big problem with this approach is where the hairs are coming from not all the hairs are equally as androgen sensitive although they say the hairs that did come from the frontal and occipital regions even just minor changes in the location of hair harvesting might have a big effect on the results and this is again a problem since the study is open label and the investigators may be biased in their selection of hairs so a much better way they could have done this to measure hair growth would be to use something like a phototrichogram and measure things like hair density and hair counts per square centimeter as was done with treatments like finasteride and minoxidil when they underwent the clinical trials that got them fda approved in the first place finally another uh big flaw possibly the biggest flaw with the study is that there is no control group for all we know if a control group had been used they would have had the same changes in their antigen percentage as the treatment group it makes you wonder if these parameters were deliberate in order to produce a favorable outcome for the product now unfortunately being that the study is industry funded we cannot rule out this possibility so looking at the results of the study the percentage of hairs in the antigen phase increased with five percent minoxidil by 11.
68 percent and in the group on 0. 2 percent caffeine the increase was 10.