Hair Thinning, Hair Fall and Menopause with Dr. Snehal Sriram

Welcome to Manopause wise, you are going to podcast for all things evidence based in the Manopause verse. I am Dr. Sipri Patel, an MD gynecologist, a Manopause health advocate, a post-manopausal woman and the founder of Manopause wise. And I am so excited to help you join us on this journey. Whether you're a healthcare provider, looking to stay on top of the latest evidence based practices, a woman navigating your own perimenopause or Manopause journey, or a partner or family member eager to support the loved one, this series is designed with you in mind. Our mission through Manopause wise is to close the Manopause knowledge gap by bringing you the latest research, expert insights and practical advice, empowering you to make informed decisions about Manopause and perimenopause. Welcome to today's episode of the Manopause wise podcast on hair thinning and hair loss at Manopause. Today I am excited to welcome Dr. Snayhael Sridhar, a senior dermatologist and tri-collegeist with over 28 years of experience in skin and hair health. A goal-metallist in Manopause graduation and recipient of multiple prestigious awards, Dr. Sridhar is a key opinion leader in cosmetic dermatology and tri-collegey. She has led medical services for Chaya clinics across India and the Middle East and served as medical director for Chaya-Kahe clinics. Dr. Sridhar believes in a holistic, customized approach to hair and scalp health, integrating overall wellness with targeted treatments. In addition to dermatology, her areas of special interest include mind-party connections, telepathy, parenting and spirituality. And in this episode, she shares expert insights on why Manopause leads to hair thinning and hair loss. And more importantly, what is it that women can do about it? Thank you Dr. Sridhar for joining us today and welcome to our episode on this episode of the Manopause wise podcast. Thank you so much for inviting us. I'm looking forward to conveying the right information and separating myths from facts. And that's the exact reason why we have you here to provide some credible information on hair thinning hair fall because there are so many women with the same problem today and options are confusing in the market. So thank you for doing this. And let's start with the very basic question. Why do women at Manopause and Pery Manopause face hair fall and hair thinning? Why do so many women face this problem and how hormones play a role in hair health? That's an absolutely important question to begin with. There is, so let us simplify it a little more. So we have two hormones, two kinds of hormones in our body. The male hormones, what we call androgens and the female hormone broadly we would call them estrigen. So in both male and female bodies there would be estrigen and androgens. Now in a woman's body there would be pre dominant estrigen, female hormones as opposed to male hormones. So they are always in a state of balance where male hormone activity is not at any point in time taking over the functions. However around menopause and Pery Manopause stage your estrigen starts getting depleted. Your female hormone starts getting depleted and as a result there is a relative like you know the weighing scale shifts a little bit and now the Andrew general male hormone effect starts showing up. And male hormones have this weird paradoxical property. They will thin the hair on the scalp and they will increase the body here. So typically when the male hormones increase hair thinning begins and initially it is a very subtle one. It is not you don't suddenly start seeing volume. However subtle thinning begins slowly slowly slowly in city or a period of time till you start seeing that your ponytail volume is less the hair are significantly thinner. There are ideas where you can see your parting being more visible and then it goes on from there. Understand, what about you know is there anything that I can do at this stage when I'm just observing that there is no amount of thinning. Are there any kind of over the counter hair products that I can use or should I be what is like a warning signal for us to take action because as you said it's not going to bald overnight but is it important to recognize it early and what can I do if it is early enough. It's really important to recognize it early. The reason is because earlier you treat start treating hair loss the better are your chances of retaining your existing hair. See when we try to treat hair loss there are two aims of the treatment. One of the aim of the treatment is to preserve your existing hair so that it does not you don't lose hair further. And second part of the treatment is to work on the growth of the hair that you already lost. Now coming to early action what are the signs you would find that your ponytail volume is lesser. Sometimes when you tie the clips you will feel that there is a little bit of pain where you put your clips. You would see that you shed a little more hair than usual. There are other factors also that we need to watch out for. One of the factors so before I get into those factors there are three things I would really want to make it clear that hormones, while it triggers hair loss. There are other hair loss accelerating factors like nutritional deficiencies like certain physical illnesses like there are certain other drugs, other medications which can also increase hair loss. There are other psychological and mental emotional factors which would increase stress that would also increase hair loss. Why is this important because for your body your hair is not important. It is not vital. On a A to I mean I am simplifying this a little bit but on a A to Z priority your body for your body your heart lungs, liver kidney brain everything is important. Hair does not play a very vital role and it requires a lot of nutrients to grow. So if there is any stress on the body, any nutritional deficiencies, any physical illness, anything is not going right with the body. Your body will not prioritize it. So what happens blood supply nourishment is curtailed. It is like if your company is in recession you would look at shutting down the least important department. This is similar for our body. So our body does not send blood supply nourishment to the root of the hair. Now the hair which is hormonally predisposed to thinning and now it doesn't get blood supply, it will start thinning much faster. So if we start noticing hair loss we need to check for nutritional deficiencies, any other physical factors, any other illnesses or even mental or emotional stress and we need to treat those aspects also. So that's one thing that we need to understand which is other hair loss accelerating factors who existing with menopause and sometimes indirectly even connected to menopause. The improvement changes, the stress that comes in with menopause or very menopause stage will be also an indirect factor in addition to the hordes. Then so that's one thing that we need to understand. Second thing we need to understand are genetic of family history. Genetic tendencies for hair loss is pretty common. In women it is said that 30 to 40% of women would have some degree of genetic tendency for hair loss. So if you have a genetic tendency for hair loss and need not be only on your maternal side, it can be, any one it could be grandfather and could, any one if they have a history of hair loss or body. Then it's important to start working on hair loss a little earlier. Now what are the things that one can start doing? Look at your nutrition in a nice time. Nutrition is an important aspect. Your hair is a very fast growing cell in the body. It requires a lot of nourishment. It would require proteins, it would require micronutrients. It would require a lot of water. A lot of time people don't correlate the water intake with their growth. So nutrition, water intake and your lifestyle. Lifestyle in terms of working with your body and your mind. Working with your body means exercise, working on a non-sidentory lifestyle. Working with your mind would involve destressing, mindfulness, meditation, whatever works for that face in your life. So when we work with body and mind, we are getting the circulation going and we are destressing. when we are working on the right nutrition. We are feeding your hair in addition to feeding your body and when we drink enough water, water is a vital nutrient to carry the blood supply and nourishment to the roots of the hair. So when we do these three things nutrition what I take and lifestyle changes that itself will go a long way in preventing further hair thinning and also taking the other hair loss accelerating practice. Got it and I feel like these are such important pillars whenever we discuss any part of menopause or any part of health it keep coming back to the basic pillars of nutrition, exercise, hydration, sleep, stress, all of that but very often we are looking for a magic pill. We are looking for that supplement which says hair nails and something on a shelf which may be helpful. I guess because it are those supplements then do they make sense in a way considering our nutritional requirements are not always met by food would would would be something that you could recommend. Yes supplements do make sense and I do recommend different types of supplements for someone with hair loss. The reason as you very rightly said that your nutritional requirements are not always met by food because of multiple reasons one is you know it's not always like have your balance to your diet is it may not be always possible to consume that much amount of protein that much amount of micronutrient that much amount of omega 3 however there is unfortunately no magic bill a lot of in the market you find a lot of nutritional supplements which are touted as the penascia for hair loss and you and I see patients you know they will say that my friend has taken this and I have gone and I have been taking it for now six months is nothing which has happened because there is no one single nutrient which would work generally what I do is I give my patients what is called cyclical nutritional therapy I would recommend a balance of macro and micronutrients so the nutritional therapy is not say one biotein I mean biotein is really overrated work it works but it works in a limited quantum the not a magic pillow it's not like it's really not a magic one so typically I would suggest proteins amino acids omega 3 fatty acids I would suggest a combination of micronutrients even a basic ion so we find I find a lot of my patients they will say my hemoglobin is fine doctor there is no problem and then when we get their blood we find that you know they're ferritin levels which is your ion storage is low sometimes your serum ion levels are so they have what is called non-anemic ion deficiency so even supplementing ion and folic acid as basic as that becomes important and the reason why I believe in cyclical nutritional therapy because see I am if I add all the nutrients together the absorption gets affected your body will absorb what it needs and it will not absorb and that is over when you know you take high dose over nutrients so typically I would give things like say Monday and Thursday take these two pins Tuesday and Friday take these two Wednesday and Saturday so one of protein one of micronutrients I would not combine ion and calcium so if I'm giving ion and ion and folic acid and vitamin B12 on Monday and Thursday then Tuesday and Friday I would give calcium and omega 3 so generally I would really recommend getting yourself tested for nutrient deficiency especially micronutrients like iron, ferritin like vitamin B12 vitamin D3 get yourself tested possible and supplement those nutrients and then I find that when my patients are taking a one single pill I do not see that decreases unless the patient has that specific nutrient deficiency supposing you have B12 deficiency and then you are taking B12 then that makes sense but otherwise taking a valve like how we need to take a balanced diet similar to when the nutrient supplements need to be balanced and not over them I think what I would really recommend and that is what would help but that is not a substitute for healthy diet that's that that we need to really balance in terms of diet I generally would recommend that slightly lower carb carbohydrate diet with good amount of proteins omega 3 a lot of antioxidants in the form of raw salads raw vegetables fruits etc and enough that's yeah however another thing that's very important for your hair in addition to omega 3 a small amount of saturated fats so when I see you know there are patients of mine who are on diet which is really look fat diet they are looking at working on their weight or for whatever reason they've been told to take a low fat diet and then I find whatever we do the hair remains a little rough course not smooth you know that's smooth and shine would come when there is balance and especially in pettimenopausal and menopausal women I would also give ice of leavons and assuming that they do not have hypothyroidism etc then so a isoflavons are good I I I combine that with antioxidants so there are these supplements that one can really do and one can start of early so that the hair root is getting enough nutrients which which possibly every menopausal a perimenopausal woman can start off with understanding the nutrient profile starting overall healthy diet and some degree of supplementation not over supplementing but cyclically supplementing all nutrients that are needed right right and I feel like you know you mentioned biotene and it's amazing how it's it's just taken over the hair market you see so many bottles different kinds of bottles over the you know many different shells and everyone thinks it's a magic potion and this attitude I feel that you know the magic pill what is going to change my hair fall or that magic oil is there is there a place for things like like oils and is there any recommendation that that you would make too because of course like in India oiling your hair is not very uncommon or now it has probably become little less common but when we were younger we always used oil and there are a different variety of oils available and what would you what is your comments what are your comments on the use of oil for prevention of hair loss or stimulating hair loss or hair growth what do you think about it so so oiling now oiling is not bad however oiling is not going to soil now when I'm talking about oiling is not bad generally my advice to patients would be if you are in the habit of oiling do not stop oiling but if you are not in the habit of oiling then starting to oil to prevent hair loss is really not going to give you that kind of results so typically what what let's understand oiling and benefits of oil when you apply oil there are two parts of the benefit one part of the benefit is the moisturization of your scalp and second part of the benefit of the massage itself so when we massage you know there is that increase in blood circulation there is a little bit of that feel good fact some amount of destressing that happens if there is someone else who is massaging I mean not we are putting it there is that some amount of destressing that happens those are all good things now moisturization really is not an important and because none of us walk around with oil so those who are even putting oil they would put oil for an hour and then wash it off and when they are washing it off they lose two times the amount of shampoo they would normally use to wash it off so what happens the hair becomes dry again because they want the hair to be dry they don't want the hair to be oiled because a current modern standard of grooming oiling is not an acceptable acceptable grooming standard to go out if it's not acceptable you're not going to oil so you're just going to apply massage I mean the same benefit of massage you can do if you do which is dry massage or one of those peptide based hair serums or one of those red and silk procapill. You know those type of serums you apply and just massage it. It's going to do the same thing. However if you are in the habit of oily, go ahead and oil. It's not that oiling is bad but oiling is not going to give you some magic benefit. Now there are certain elements. Now since you talked about the types of oil. So there are certain which do have some issues. So one of the herbs is bringerage and there are other herbs which are associated. You know there are bramy and there is anti-oxidants and plecamlamathy etc. Those things are useful if you have dandruff. However from a hair loss, purely hair loss point of you, bringerage and so on. These are two herbs which have some degree of anti-male hormone property. That is when they get absorbed inside. Now when we put oil, it's not going to go through the cells to the root of the hair. So remember that root is quite deep. It's not just at the scalp level. So the oil is really not penetrating the root. Oil is penetrating the dead skin cells. It's a little bit penetrating the epidermis, the top level of skin. It's not going at a deeper level. So what is the method in which these herbal extracts can be introduced inside to give the clinical effect. That's a separate function of research and there are several prescription serums, even over the counter serums which do contain soparmato, bringerage, those properties and they have the formulation is made for absorption like like the formal formulation and the different types of formulation. However the regular oil does not go too deep inside. So it does not convey the vehicle. However there is absolutely no harm in oil. It's not, it's just that you know, similarly, I mean it's like there is no harm in taking that biotin supplement over. It's understanding. Not going to solve your problem but it is no harm in taking it will help to some extent. So here what I'm referring to is a balance. A balance in everything. A balance in not overdoing anything. If you are used to oiling, go ahead and oil. Don't change your habit. But if you want specific oil then go in for an oil which will have bringerage which will have soparmato because they have medically they are called DHT inhibitor. DHT is the type of androgen called dihydrotestosterone. So they will help reduce that hormone a little bit. So go ahead and do that. If you want to choose a oil you choose going for something which will contain those elements and you could use it to potentially do some extent. Like it as in it will give you some benefits. A lot of small small benefits would combine together. So instead, burden do it but that's not the panesia of your hair loss treatment. What really hair loss treatment requires is a combined like not 360 degree of energy. No one is going to solve it. Even a clinic treatment, no one treatment is going to solve it. When you take, I mean I have patients who say that you know, "Dr. Dundes, I've done this, I've done this, I've not seen results." In the very same patients, we have seen that when we do a 360 degree work where we are working on diet and lifestyle, we are working on nutrition, when we are working on the solutions and serums to apply and work internally to that patient's customized body requirements. We get very good results. Yes, I guess it comes back to, there's no magic pill and we need to look at the entire picture always for any part of health. So these are the common things that we do end up using. But would you recommend what are the kind of topical treatments, let's say over the counter, like all you said has a small role, maybe, maybe not, we don't know, but we want harm. So, you know, again, but would there be any over the counter topical treatments that someone can at least get started with before saying, "I need to see a dermatologist." Yes, there are things that you could start with. So if you start seeing thinning, you could use, so there are some peptides, peptide based serums. Specialy, there are these three peptides which are really found to have good results. One is redensil, procapyl and capexyl. There are these three peptides in that combination. A serum which would contain at least two or three percent of redensil, at least one to five percent of capexyl, you know, those type of serums and you get these OTC over the counter. So you start applying these serums. You apply it once a day at night, put about one to two ml on your scalp, make partying, put drops and massage it in. Do this daily, if possible, or at least three or four times a week. That would help. But along with starting to take nutritional supplements, cyclical therapy, like you know, check your vitamin D, take those vitamin D supplements, check your iron levels, take iron supplements two or three times a week, along with iron, take folic acid and vitamins, these supplements, take some omega three supplements and calcium supplements, at least three times a week, not on the day of iron. You take these and that will help. What if I've done all of this and I'm still experiencing hair fall? Is there a role for testing hormones considering there is, there could be a hormonal aspect as well. Yes. So the thing is a lot of hormones have closed interplay between each other. So typically I do test hormones. We have to rule out hypothyroidism. So we check thyroid hormones, we check prolactin hormone. Another very important hormone is your insulin hormone. Insulin resistance will secondary increase your male hormones. If you have insulin resistance, your male hormones will slightly increase and your male hormone effect, which is in this case the hair loss can increase. So check insulin resistance levels. Now insulin resistance is not equal to diabetes and that is something that we really need to understand because insulin resistance is kind of pre-pre-dabetic level. So you have diabetes, you have pre-dabities and then you have insulin resistance before that. So insulin resistance, there is one test called HOMIR index and I do recommend that to my patients along with of course HPA1C2 check what are the sugar level averages. So we do that check, we check thyroid prolactin and if they're not attained menopause, I also check their A-match levels. So we check these tests and then see where we are. So assuming there's no thyroid, assuming there's no prolactin level abnormality or insulin resistance, then sometimes if there is significant thinning, we do start our patients on what we call anti-androgen. Currently there is a US FDA approved anti-androgen for postmenopausal hair loss called finaxe, finasteride. So this is something which is commonly given for a little advanced degree of hair loss which is perimenopausal and postmenopausal stage. But this is not something which is over the counter. This is something that your dermatologist can prescribe after understanding and assessing your case. Right. And then of course looking at the whole picture, making sure everything has a stake in the end of it. Right. What are your thoughts about using it considering I think certain versions, certain formulations are available over the counter as well. Yes. Yeah. I mean, there's been one of the oldest remedy for hair loss treatment and it really remains effective on till date. It's quite a useful remedy. So, in a noxidil typically, how does it work? It's open up the blood circulation. So it's what medically what we call vasodilator. It opens up blood circulation and it is known to have stimulating effect for hair growth. So in fact, it was discovered when it used to be in the yesterday years, be a hypertension medicine. It's given for high blood pressure and those people were on higher dose of me noxidil tablets as tablets. They started. having increased hair growth and that's how that whole compound evolved into being made into formulations which can be applied. So typically 2% and 5% minoxidil solutions are available in most countries over the counter. Now the issue with minoxidil is only actually that two issues with minoxidil. One of the issue with minoxidil is where you cannot dissolve it in water. It's a substance which is alcohol soluble or some alcohol substitute. Alcohol free minoxidil or whatever but when you apply it it really makes you very dry, very dry and rough. So what happens is cosmetically it's not elegant. So especially women who are going to their office daily, they're not able to wash their hair daily. You know, they are not comfortable and because of that reason a lot of time, the compliance of applying minoxidil is not that good. And this is the thing that I've seen time and again except for you know those cases where the hair loss is really increased to a level where they are applying irrespective of the cosmetic look. But early cases of hair loss they are not able to apply daily because it really makes the hair very dry and rough. Now there are minoxidil formulations, newer formulations which have come out which may or may not be available over the counter in every place but it can be tried and applied. So that's one issue which is the cosmetic appeal. The second issue with minoxidil is rebound phenomenon. So if you've used minoxidil for a year or two and then when you stop using it, there is that degree of rebound hair loss that happens. So hence minoxidil if you're using you should not suddenly stop it. You keep using it for some period of time and then once you see your desired results, taper it very slowly. Don't stop using it. You need to maintain it. So you could look at like say one day minoxidil one day, the peptides are when you are tapering it off. So make it alternate days or my treatment twice a week but a little low dose you keep using so that you don't get the rebound hair loss. That's that's that's yeah I wasn't aware of that that's that's quite some information very practical and Okay so so as as my first line I have tried everything I have now used topical solutions I have tried using supplements and let's say I'm nutritionally okay. Hair fall has stopped but what do I do about the hair that's not growing back is it possible that if I've let it go for a while you know used to hair or does the follicle really died as it like is it not able to ever generate is that a possibility. So the thing is the follicle yes it can die and become very very inactive like so dormant that can't be revived back that is something that can happen however in most cases we are able to revive back the follicle. Now again the time when we start treatment is crucial here if you start treatment very late then you are not able to revive the follicle so much but if you start treatment at a little early stage where you not really gone into the irreversible irreversible damage to follicle I mean it's not become so inactive that you can't revive it. Most cases we see like I have seen personally around good 70 to 80% improvement in hair regrowth with treatment but this involves a complete treatment so use a combination therapy so typically I would use a protocol of growth factor concentrate treatment which is like an ex-generation PRP platelet rich plasma therapy. These are regenerative medicine treatment where we take your own blood in the lab separated separate into a platelet rich plasma activated create growth factor concentrate and use micro injections to inject those growth factors at the root of your hair. There are methods also which we can use the methods which are minimally invasive or non-invasive methods we work with a combination of those. That includes low-level laser light therapy that includes no needle mesotherapy treatments that includes a variety of micron edling dermat type of treatments so we combine treatments depending on what is needed for that particular patient and see really good amount of improvement. In fact these days there are new regenerative medicine treatments which are being tried one of them is exosomes exosomes are extra cellular signaling molecules so essentially one cell has to communicate with other cell so that cell will produce an exosome which is a small little extra cellular vesicle vesicle is a small it's like a signal that the cell is sending out so these days we are using exosomes for anti-aging we are using exosomes for follicle health but however it's still new and stilettarous earth stage then we use other newer factors newer growth factors lab grown growth factors these are growth factors which are in fact one of them got us every approval recently so these are growth factors and peptide combinations so they can be injected or using micro injections or micro needle treatments it can be induced inside so these are some of the treatments which can be worked on stimulating your hair growth and can be revived so what is really important is don't lose hope it can be treated it's not that you know everything is gone and you have to just reconcile to the fact that there's less hair or there is no hair right and that is that is such a big thing because hair can play such a huge role in the psyche of a woman right you were telling me about how it's such a huge impact more than skin is for a woman yeah yes it is yes it is so the thing is I mean and I hear it a lot of time from my patients also and I see it that you know they say doctor if there is something on my skin there is pigmentation there's something I can just put a concealer and I can cover but if I don't have hair or my hair is thinning, bulging and patches then I don't know what to do I mean in fact I've seen patients were just seeing that hair loss and thinning and gaps in between their hair actually can lead to depression I have seen women getting into depression because of that when I in the first concert when I'm talking and you know are we getting to a detailed history taking to understand which are the possible hair loss accelerating factors and then when you are discussing stress there are so many of my patients who commented doctor I don't have any other stress my stress is related to my hair loss so you treat my end of my stress is good well it is it completely changes the way you look just having a haircut can completely change the way you look so not having hair can cause plays such a huge role and the body is undergoing so much at that time our skin is changing so much is changing especially at very man of course for someone yes and the thing is you know it all has a compounding effect you're not finally feeling good when you see in the mirror you're not looking good that makes you not feel good you know so it kind of leads to a compounding effect and see also what has happened is over the generations hair has been to some extent you know this is at a whatever you can call collective conscious or subconscious level that collective unconscious level the subconscious level that there is that degree of association of femininity with hair typical impression of female I'm talking about not just I'm I'm talking about again at a societal conditioning over the years that is with good hair thick hair long hair silky hair you seldom see any female depiction without hair whereas for men it's a some level acceptable to have boiling that is not so in at a conditioning level for females there are no acceptable world role models for women that is so true that is so true but coming back to to using products do you think you know considering today's day and age we've also exposed ourselves not only to environmental pollutants but also pollutants in the sense the kind of products that we end up using you know to look a certain way are there shampoos or products that women should be aware of or then say okay. I shouldn't be using these in my younger years or if I've lost hair, do not use products which say x, y, z, like would there be any advice with regards to that? That's like day-to-day products and the second part is treatments that we undergo, you know sometimes says starting from the smallest things like hair color, two things like keratin and all the wild stuff that's available up there. So yeah, I should have commented on these. Yeah. So, um, looking, so basically talk about the day-to-day products. So typically we are talking shampoo, conditioning, hair mask, etc. So when we are talking about shampoo, see there are, okay, shankoos have been overrated in treatment of hair loss. No shampoo is going to treat hair loss because the hair loss is happening at hair root level, which is like deep inside, if this is the top level of skin and then you know your hair is coming out from here and the root is here. So it's too deep inside for the shampoo to really penetrate and work at the root level. So shankoos do not cause hair loss and shankoos cannot prevent hair loss to and that's something that we need to understand. What shankoos do they are the cleansers? They'll cleanse, they'll remove dirt, debris, oil, pollutants, etc. Now like like soaps and body washes, there are mild soaps and there are harsh soaps. Similarly, there are mild shankoos and there are harsh shankoos. So a milder shampoo would be a shampoo which would not deplete the scalp of all the oil which will not cause dryness of hair. So that's a milder shampoo. When milder shampoo, you can use frequently like you can use it daily or alternate day without any problems. So some example of mild shampoo has healthy shampoo. Now, sulfates are cleansers or shankoos are cleansers and sulfates inside shankoos are cleansers. So if you have very oily scalp and you are continuously using a sulfate free shampoo, your scalp oil is not going to get cleansed well and that we need to understand. Now of course from a marketing point of use, free of anything is a big marketing claim. So from that point of use, sulfate free shampoo, market is budget. So you have sulfate this shampoo which are your cheap shampoo and you have the little more expensive shampoo which are your sulfate free shankoos and in general sulfate free shankoos are milder shankoos because the cleanser, the detergent component in that is mild. However, none of them are going to cause or or help in hair loss except for a little bit psychology psychological benefit that we would have, what we call placebo effects. However, however, in general, if you are putting so many hair products etc like you know, I'm talking about products here, I'm talking about semi-oxidilose, I'm or something and if you have a head loss, you're using those products. It's a good idea to use a mild shampoo because then you are washing your hair more frequently. So you don't want your hair to come off all dry and freezing etc. And remember already the male hormones are making your hair curly and frezier, curlier, vevier. So already there is that propensity towards frizziness, dryness of hair. So in that if you use a harsher shampoo, it'll make it more dry. It's not going to get lost. It's going to make your hair a little more unmanageable or it's not going to make it look nice or feel nice. Use a mild shampoo by all mean but use it knowing that that's not your hair loss solution, that's your hair cleansing solution. That second is that's not going to prevent your hair loss. Your prevention will happen internally from your food, from your supplements, from your water intake, from your exercise, all of that. So that is something that we need to differentiate the hair cleansing products versus hair loss products. Now coming to the hair grooming methods in Goob. So we have hair color, we have keratin, cysteine, hair, Botox, etc etc. So all of them would contain chemicals and from time to time all of us use it, everyone uses it. In fact one of my patients sometimes asked me, "Doctor, I want hair so that I can use these things and you know, idea of doing to you, not to stop doing all this. I want you to give me good hair so that I can abuse my hair and live it." Typically it's like, you know, it makes your hair look more good. Yes, it is exposing the hair to a lot of chemicals so we need to create again a balance. I mean moderation. Do not go for, so for example hair color is if you are getting into hair loss but you want to color your hair, you want to cover your gray, so you want to just color your hair, that's fine. Work on root strengthening and go ahead and color choose a color which is milder, which is not just ammonia free but it may be located at PPD, paraphernalia in diamond, PPD free or PPD free colors, those are milder ones. Don't go for bleaching or highlighting. If possible, hair is damaged, please avoid that. The reason is because bleaching, highlighting, you have to remove the existing color and then put the new color. When you are covering your gray or when you are the regular hair gray coverage does not need chemicals which will take away the color from the hair. Low chemical intensity treatments. So for example rather than the actual hair straightening treatments, you could potentially go in for cysteine or keratin. It is not that it has no chemical. I mean, see imagine now keratin which is the protein of which nails and hair and the dead skin cells are made of. Now this keratin, if you apply what will happen, it's not going to stick right, it's going to get washed out. So to get stick to the hair, they have to use a chemical like formaldehyde or formaldehyde releases which will bind what the hair with that. At least for those three months that it remains, it would need to coat the hair with that. So there is chemical despite of whatever marketing we are talking about. However, if you want to go ahead and do that, do that but don't do it at a stage where you suddenly have. So I mean, you know, I tell you a typical thing that happens. Someone starts losing hair, they start feeling very bad about their hair. So typically they would go to the powder, they look at a haircut, they'll say do something, they'll say man, you're quite frizzy or a naturally because of the may not. So up to hair, what frizzy or a let's we'll do some keratin treatment. It's protein treatment, there's no problem. Do it. Go ahead and do it. Now there you expose the hair, how's chemicals? The hair root is already weak, there is no nutrition going in harmonally, the follicle is shrinking. You expose more chemicals, there is more oxidative stress and the roots actually. I mean, I've seen cases where you know, two to three months. So they said that, you know, I was still managing, but you know, just two months back, I did this keratin treatment and since then my hair is just for you. It happens because we are damaging the hair, which is already weak. So, strengthen the hair first and then look at these things. I'm not saying that you know, you don't do it at all, but make your hair root strong and then work with them. Make sense. Make sense. And I guess the other treatments are also similar as the meters, you said keratin, but I guess there's 16 and this. I mean, and there's other things. That's one of the examples I gave. You see there are different brands and different products and each one has to differentiate themselves in the market. So, you know, there would be a different name, there would be different, but in principle, these are certain types of proteins, which are coated onto hair with certain chemicals. Heat. The chemical and the heat together, we'll coat and the coating will then last for two to three months. Right. Right. I think that's the important thing to we, we want we wish to believe that it is just protein and we wish to believe that there is no internal damage being done at that time of taking the treatment, but but I guess marketing is a powerful tool and how products are marketed in them, you know, there are buyers for these things because they marketed well. That's one second thing is it looks good, not temporarily or is it looking very nice? Yeah. Yeah. But then, it's not one idea and they want the head to look So that's why they're going for it. Yeah, but there is a beyond three months what happens to my hair and what happens to me. And yeah, and I think there is just no money in liver healthy lifestyle. So that's another problem for it. So the thing is, I mean, as simple as you're taking supplements, okay, that's fine. But you look at your diet, you look at as simple as how much of water you're drinking. How much of water you're drinking? I mean, water is such a basic requirement. It's such a base level requirement, but you are not getting it. I would not have even thought about water. Like if someone told me like top five things, that's okay. You know, look at your eye. Look at the bed well. But water would have just not been one of my top five. Very important. Yes. Yes. What the environment varies from person to person, but the thing is what is really crucial. That's really important advice. So I guess we've covered quite a bit of a lot of things. Would there be anything that you would like to share with us any myths or anything that we feel we are not covered in hair especially in this age group of women? So one thing I want to really share. I mean more than a myth, what I really want to talk about is when don't lose. I mean, I have seen patients who will feel who will be very sad and you know there is that degree of sad acceptance or you know some degree of that nothing can be done to live with it. There is a degree of subtle depression about hair loss. It can be treated. That's one part. Second part is what you good hair is also what will give you good health and good life, which is all the factors. So it's not when you're treating hair loss. It's not that you are just, you know there are patients who come to me so that you know I really want to treat my hair and then I tell myself the patient is telling me that I should I be working so much for just hair it's just vanity. So I tell you that what you're doing for your hair is actually what you're doing for your health. You are taking a balanced diet, you are taking balanced nutrients, exercising and then you are doing some local treatments to make your hair better. So basically it's like this, the common sort of phrase that we use in general health is do whatever you do to help your brain usually helps your heart health as well. So similarly what you basically the hair, the skin is reflecting ultimately your internal health and by you're coming for vanity perhaps but the bottom line is you're solving a deeper problem. And that's such an important message that that's great. That's so great to hear that because we also tie like some out of shame in vanity. Like, oh should I just be doing this for my hair? That's my many more important things that I should be doing but that's a great point to bring out. Thank you so much for sharing it. One of my patients had once told me the doctor and she was really one of those patients and she told me that I she told me the doctor I don't spend on jewelry. I don't spend on too many clothes but I would like to spend on my skin and hair and she said I'm not a shimrovert I don't. And then I really learned something from that patient. I understood that you know we equate different things. I mean different importance to different parts like you know for some women. Socially buying jewelry isn't there. Don't feel very guilty about buying jewelry or buying something specific to where I'm talking about wearing. However buying I mean doing something for your skin and hair. There is that social conditioning that that's bad. I mean spending smaller amount of money for that is bad. It's just a social condition is nothing right and wrong there. I mean I was just when this patient told me this and I was just reflecting yeah that there is really nothing right and wrong. It's a perception and it's a choice that they are making. But if you look at it from that angle when I wear certain types of clothes that I would want to wear that's also vanity. When I'm wearing certain type of jewelry or I'm living my life in a particular way that's also vanity. As much as if I'm looking after my skin or if I'm looking after my hair. So true so true. But it's not like having a bypass done right. Then there's definitely you're definitely using your money well you know that that's just I'm not saying that that's a fact of course not but the point is that I guess for the general population that that can be an attitude that it's not I'm not spending on my skin. It's not superficial. It's it's a requirement that you need it. It's not a luxury. So yeah, but that's a. I mean I would say how do you want to project yourself? True true. I mean it's like you know all of us would have a different choice of clothing and then nothing good or bad. It is all dependent on how would you like to project yourself in your mind in others mind. So how would you project your hair or project your skin is also part of that? Well that is some wisdom to take away. This is where your other interests have come in right not specifically being a dermatologist and biologist but your interest in life and its spirituality and connections and mind body connections and I think that's such and that really adds value to what you have to say because it's not just tunneling down the prescription road. It's about how does one perceive themselves and yeah thank you for sharing that. So coming to the end of this episode it's been so amazing actually I can go on for another couple of hours but probably too long for you know to take away so much of your time. But if you could give us three essential tips to walk away with what is it that you would advise women just three tips on taking care of their hair and limiting hair fall or preventing it around this age of very medical and medical. So the first tip would be to start early start looking after your hair early look at your hair and see if you see anything if you feel that you know my who I had straight hair and now it's turning a little frizzy or maybe or something which if it's a sign that something is not going right and seek treatment seek consultations early start treatment early. Before you lose your hair so that's one advice I would really one one suggestion that I would really leave it out there and open second part is what I mean that's something that we had discussed balance is what is really important balance life would lead to balance of your health and would lead to balance of your hair. So create that balance you want to go in for hair grooming method create a balance moderation one if you are looking at exercises okay even exercises create a balance I have seen patients who go overboard huge amount of gym supplements lot of exercise and then what happens is exercise is not bad but I'm talking about a lot of gym supplements what happens is that a lot of anabolic proteins which are going in what happens that will increase male one that will create its own set of problems so moderation and balance is really the key one and in all areas so start early create a balance in your life see what makes you feel better and create a balance around that and the third part is really look at your hair. Really look after your nutrition and water you take water is a real. A lot of which is your omega tree your protein your iron and calcium those. Wonderful wonderful so once again thank you so much for today and we've come back with such a bag of useful information I'm sure this is going to benefit a whole lot of women who are looking at their hair thinning. and at least they can get started at home and get started with The basic stuff, let's get started with the small stuff before we reach a place where we need bigger treatments. So once again, thank you so much, let's just say now it's been such a pleasure chatting with you. - My pleasure, it's a pleasure being here. It was nice talking to you. Thank you so much for inviting me here. - Thank you. - Thank you. - All the-- - Thank you, bye bye. - Thanks again for tuning into Manipur's Voice. Stay informed, stay empowered, and I'll see you in the next episode as we continue to navigate the Manipur's journey together. If you're a health care provider interested in collaborating with us or have insights to share, we'd love to hear from you. Please email us at info@manopor'swise.com. That's wise with a set. And before we go, a quick medical disclaimer. The information provided in this podcast is for educational and informational purposes only and is not intended as medical advice. Always consult your physician or a qualified health care provider before making any decisions regarding your health or any medical treatments discussed in this podcast. While we strive to provide accurate and up to date information, this podcast does not replace professional medical consultation, diagnosis, or treatment. If you have any concerns or symptoms that require medical attention, please seek advice from your health care provider.