Hello, and welcome, Dr. Morgan, to the Rev Up Health Podcast. Thank you so much for having me — I'm excited to be here today.
We're so excited to hear about your new hair restoration program. Our first question: what inspired you to look at this?
What Inspired the Program
I've had my own journey with hair — nothing too dramatic — but almost every one of my patients complains about their hair, men and women. Men tend to roll with it a little better, though not all of them; some get pretty upset. For women, hair is really a big part of our identity, so it's scary when you start to lose it. That was one of my main motivations: if there's something I could add to what I already do that would really make a difference in people's hair, I know they'd be happy about that.
Who's a Good Candidate
Are there certain patients who are good candidates? It's designed for just about anyone on any journey with their hair. I was talking to a patient the other day who said, "I'm not really losing my hair, it's just always been super thin and poor quality, but I'm not shedding a lot." She's a great candidate too. We can all have healthier hair. There are a few people I'd say don't need this, but anybody who wants to improve their hair can. That was one of my biggest takeaways from my one-on-one training: it's possible to improve your hair for anyone. The health of your scalp and hair — there's room for improvement for all of us.
Debunking the Myths
There are a lot of myths that float around social media like a virus. One of my favorites to share: some messages say you shouldn't wash your hair very often — as little as possible — to keep the hair you have. That's absolutely not true. Your scalp grows healthier hair when it's clean, so we want to wash every day or every other day. For very coarse, ethnic hair, maybe twice a week at most, though I know a lot of people in that community only wash once every two weeks. The cleaner the scalp, the healthier the hair, which is reassuring.
People think washing causes trauma and makes hair fall out — they see it in the drain or hairbrush. But it's normal to lose up to 100 hairs a day, and interestingly, the hair that falls out while washing actually detached from the root about 8 to 12 weeks prior. It's a slow migration up from that follicle deep in the scalp. So the big misconception that trauma is causing your hair to fall out isn't true. I didn't realize it was that long before detaching, either.
Genetics, Male vs. Female Patterns
Is hair loss genetic — if my parents had it, will I? There are differences between males and females in where we lose. Women typically lose across the top, a widening of the part — we call it a "Christmas tree," widest at the back and narrowing forward. Picture standing outside talking to someone and the sunlight comes through and you can see the top of their scalp. Men tend to lose in the temple area and at the crown, and eventually those areas join — most of the time they still have hair growth down low. Women who are on too much testosterone, or are very sensitive to its hair effects, can start to get that male-pattern thinning through the temples, so women on hormone therapy can have male-patterned thinning.
Everyone has some genetic hair loss. Your parents may have really healthy hair but their parents may not have, so we don't know exactly how it penetrates through the genes — but likely all of our garden-variety thinning is genetic. The good news is that all of it can be prevented if we start early enough.
One of my favorite reassurances: women never lose the ability to grow hair. Once a man really lets it go and is "slick, shiny bald," that follicle is gone and you won't grow hair there — though you can recover hair around it to look fuller. But for women, even those who look really bald across the top, those follicles never go dormant permanently, and you can wake them up with the right treatment.
Stress, Shedding, and Other Causes
What else causes hair loss — stress, hormones, diet? About 95% of the dramatic hair loss people worry about is genetic — a genetic predisposition to be sensitive to DHT. DHT is a breakdown product of estrogen and testosterone; even in our natural state we metabolize those hormones to DHT. DHT causes vasoconstriction — narrowing of the blood vessels and decreased blood flow — at the hair follicle deep in the scalp, which produces a thinner, more fragile hair that's more prone to detaching and thinning.
There are a few other conditions. Sometimes you get a fungal infection in the scalp, which is patchy — losing chunks in various spots rather than the typical genetic pattern — so that's easy to figure out. And shedding happens on about a three-month cycle from the anagen (growth) to telogen (shedding) phase. It's normal to lose about 100 hairs a day, sometimes more and sometimes less. But big physical or mental stressors — or taking a GLP-1, or anesthesia — can lengthen that telogen phase so you lose more. I call it "shock shedding." Don't panic, because it will recover — you'll go back into a growth phase, and there are ways to speed that along. It's not permanent. You can see how chronic stress could cause a kind of chronic thinning.
Hair Practices That Help or Hurt
Are there practices people think help but that actually damage hair? Not a lot, actually — but keratin products. If a serum or styling cream has "keratin" or "protein" in it, you probably want to avoid overusing it. A keratin treatment can infuse protein back into the shaft and reduce frizz, but overusing these creates buildup and doesn't help the health of your hair. The health of our hair comes from the root, so we want to focus on things that increase blood flow and nutrients important for growth and collagen.
Wash frequently — at least every other day, if not every day — and wash twice. I used to think "wash, rinse, repeat" was a gimmick to sell more shampoo, but it's not; washing twice really cleans the scalp and removes oils. Then always condition to add those oils back. A lot of people think conditioning makes their hair greasy, but that's probably because they're not washing enough — introducing conditioner after washing twice is a good thing.
Coloring your hair isn't really all that damaging, though really harsh bleach processes can be. Overall, it won't contribute to hair loss or shedding. Ethnic hair with a lot of traction or braiding can cause traction loss — not from brushing, but from pulling hard to mold hair into a style. That comes to mind with athletes — softball and soccer players always wearing tight hair bands — it's more of a recession thing.
Nutrition and Labs
What about nutritional root causes? This surprised me. I've prescribed a hair vitamin similar to Nutrafol for lots of patients and they've done pretty well, but you probably don't need a big gun with a lot of different things in it. Labs are important. Thyroid and hormone health go without saying, but specifically for nutrients, the biggest things to dial in are copper, zinc, ferritin, and vitamin D.
I learned that most people are not deficient in biotin. We hear a lot about biotin for collagen, hair, skin, and nails, and it matters to an extent, but most people aren't deficient, and it can actually cause acne — and it can offset other lab markers, so we tell patients not to take it.
For the specific ranges: vitamin D at least 60 to 80 (nothing wrong with being around 100, but a minimum of 60). Ferritin about 60 to 100. Copper, ideally for hair growth, 84 to 126 — a very specific range that isn't typically drawn. It's not expensive to add copper and zinc to the normal testing, along with vitamin D and ferritin. If you're not deficient, you don't need a dedicated supplement, which can really cut down on the number of supplements — and the cost — we ask patients to take.
Other Treatment Modalities
What about PRP, peptide therapies, hormones? It could be a combination of things, which is where seeking a consultation with someone trained in hair recovery helps. Exosome therapy and PRP are similar — both injected into the scalp, sometimes with microneedling. Microneedling in the scalp plus PRP can be really helpful for a bare spot, but for overall thinning it may not be the best answer. None of it is harmful, but it's expensive, so it's about where you want to spend your dollars and custom-tailoring a program to the patient's needs.
The Medical-Grade Laser
One of my key takeaways was the medical-grade laser, which I believe is important for every hair recovery program. Combined with topical minoxidil, finasteride, or even oral medications, it's a big piece of the puzzle. It's a cap you wear just six minutes a day — more isn't better — that fits like a baseball cap, so you can wear it while brushing your teeth or meditating. They suggest using it for a lifetime; the devices I'll use have a 10-year warranty.
The medical-grade laser is different from red light therapy. Red light is like a street lamp in a dark parking lot — diffuse by the time it reaches the ground — which is helpful for scalp conditions and surface wrinkles. But to affect blood flow to the follicle deep in the scalp, a medical-grade laser penetrates much deeper and hits the level we want, so it's much more effective.
It's really about increasing blood flow and stimulating the scalp. That's why finasteride works well — it's a DHT blocker that blocks the conversion of estradiol and testosterone to DHT, which causes the vasoconstriction. So we decrease DHT with pharmaceuticals and also "turn on the hose," the irrigation to the follicle. Using both can be beneficial, but each patient gets a customized approach — some may just need a few things.
Timeline and Tracking
What timeline can patients expect? Usually within about 90 days you notice a pretty big difference, and within six months you really do — especially if you're compliant with the laser and everything else. You won't see maximum improvement for about two years, but the good news is it just keeps getting better with continued use.
There's also a microscopic camera I'm getting — I've ordered it and trained on it, and it's fascinating. It's not much bigger than a lip balm; you take pictures of different parts of the hair and scalp and can truly see the difference between healthy and unhealthy hair, plus scalp issues you'd never see with the naked eye. It's a little creepy — I thought I had a healthy scalp, and when I saw my pictures it looked like an alien. But the more you look at scalp pictures, the more you can identify issues, especially buildup from non-washing.
A Message of Optimism
What's your message for someone discouraged by hair loss who's tried everything? I came out of this training with so much optimism. The problem when something hasn't worked is that it's usually monotherapy — one thing. It's really the combination: looking at labs, using the medical-grade laser cap with or without prescriptions, and good hair hygiene should all allow you to improve your hair. I won't make promises, but I'm really optimistic. And especially for women — we never lose the ability to grow hair; the follicle may be dormant, but we can wake it up. So it's never too late.
We don't want people spending a lot of money treating "slick, shiny bald" — that process happens for men, and I can think of a few patients, like my dad, who's been that way most of his life. But otherwise, there's room for improvement.
Getting Started
What are the next steps if someone wants to get started? I'm still working on that. On my Instagram, if someone DMs the word "hair," I'm putting them on a newsletter list, and this should be up and running by June 1. I just finished the training and want to get all my ducks in a row for a seamless recovery process.
We really appreciate your time taking a moment out of your schedule to talk about hair. If people have questions, they can reach out to us. Thank you — have a healthy day.