Biohacking Baldness with Dr. Alan Bauman

In this Episode

• [02:44]Stephan Spencer interviews world-renowned hair restoration expert Dr. Alan Bauman to discuss biohacking baldness.
• [05:18]Dr. Bauman shares impactful hair restoration procedures he had done for Dave Asprey.
• [07:26]Stephan asks about using robotic and manual tools in hair transplants.
• [09:30]Dr. Bauman discusses the downtime associated with hair transplant procedures.
• [14:39]Dr. Bauman warns of unqualified surgeons offering discounted procedures abroad, including hair transplants.
• [18:12]Stephan asks about the typical price of a hair transplant procedure, which depends on various factors such as the number of hair follicles, medical diagnosis, and preoperative preparation.
• [25:09]Dr. Bauman recommends hair loss treatment for most patients, with a 90% success rate.
• [30:42]Dr. Bauman describes the benefits of TED treatments, a new technology that delivers growth factors and peptides through ultrasonic waves without needles.
• [37:41]Stephan and Dr. Bauman talk about exosomes as tissue regeneration and rejuvenation tools.
• [44:00]Dr. Bauman explains how to use ozone therapy for healing and anti-aging, including topical application to the scalp and injection into injured joints.
• [51:31]Dr. Bauman elaborates on a holistic approach to hair restoration, including nutraceuticals, micro-needling, PRP, and PDO threads.

Jump to Links and Resources

Dr. Bauman, it’s so great to have you on the show.

Stephan, great to be with you. 

Let’s talk about what the heck is biohacking baldness. Why do you need to biohack it? 

Of course, those of us who are biohackers like to change our environment, change our nutritional intake, change our lifestyle so that we can hopefully live longer, increase our lifespan, and increase our health span, which is not just the number of years in our life, but the amount of life in our years, but also to increase our hair span. That’s what we’re aiming to do: increase the amount of time that we get to spend with a thick, full, healthy, and luscious head of hair.

When it comes to biohacking, we can use these external molecules, a holistic approach, and pharmaceuticals. There are no rules when you’re a biohacker. I think biohacking baldness came about mainly through my discussions and work with Dave Asprey, the father of biohacking, who asked me to give him a head of hair that would last him 180 years.

Right. I believe he did some live-streaming while you were working on him, didn’t he? 

Well, 100%. First of all, Dave did everything under the sun to keep his existing hair. We leveraged all of these state-of-the-art treatments as well as hair transplant procedures to restore his hairline to a more youthful position, to fill in the big bald spot in the back of his crown that most people didn’t even know he had because he was maybe about six-something, and to utilize all manners and methods of healing to get him optimized prior to the procedure and to get them healed obviously after the procedure and growing quickly. 

Working with Dave has been very exciting for us in the world of hair restoration. We had a chance to meet at the American Academy of Anti-Aging around 2016 or so. I was hooked on bulletproof coffee, and we discussed hair and things like that. It’s been great to see Dave. 

We also did the transepidermal delivery system on him, which uses growth factors and peptides. He’ll throw everything but the kitchen sink at it, so to speak, because he wants to keep a good, thick, full, healthy head of hair, as most of my patients do. 

What would be some of Dave’s most unusual and impactful procedures? By the way, he was a guest on this podcast years ago, talking about many biohacking procedures and techniques that he had come across and incorporated into his lifestyle. What were some of the most impactful and the most unusual?  

One of the most impactful things is the use of red light therapy. He does use the Bauman TURBO LaserCap, a device that he says has more lasers in it than anything he’s ever seen. It’s a nonchemical hair growth device that we can prescribe and dispense to patients. It’s FDA-cleared for hair growth and has a huge amount of coverage across the scalp. It’s portable, powerful, cordless, and rechargeable. It packs completely flat for travel. 

I think it forms the cornerstone of biohacking baldness because, again, it’s a treatment you can do on your own. It’s one of the least costly treatments over time because it’s essentially a one-time cost and has zero side effects. No one’s ever had low-level laser light, photobiomodulation, or red light therapy issues. You cannot overdo it, nor can you overdo it with the Turbo Laser.

In just five minutes a day, you’ll get better hair growth. But certainly, other things can go along with red light therapy aside from the turbo laser. One of the things he did in conjunction with his procedure was using cell therapy. Obviously, we’re transplanting hair follicles, but we want those follicles to take and grow very well.

We want his existing hair to grow very well, so we utilize blood platelets as a source of growth factors. We used PDO, which is polydioxanone, and polydioxanone threads placed into the scalp to stimulate hair growth. 

We can also use exosomal therapy today. That’s a state-of-the-art cell therapy that comes from a bottle. These are exosomes that are created in laboratories today under the guidance of some very smart PhDs and so forth who curate these stem cells and put them under a specific environment so that they will release these exosomes, which contain growth factors, cytokines, micro RNA, and all of these things that are great for healing and for hair growth. We have those literally in the cryo fridge. We defrost those and can apply them directly to the scalp.

Dave did those things during his procedure, in addition to having a state-of-the-art follicular unit extraction hair transplant, essentially taking hair follicles from the back of the scalp and implanting them into the thinning or balding areas.

Is that done with a robot arm? Or do you do that by hand? 

We now focus primarily on manual extraction using much tinier instruments, which produce slightly less trauma to the scalp.

Robotic hair transplants have been a very exciting part of the practice. They were FDA-approved in 2011, and the first artist robot became available. We certainly got ours pretty soon after that, and we used it for many cases for many years. 

Before the robot was available, we used mechanized devices. The mechanized devices were handheld rotational devices, essentially ergonomic so that you could extract the hair follicles by hand. The robot was certainly helpful, but not a miracle. There was still a need for manual devices. 

Over the recent years, I would say, these manual tools have become so sophisticated that they have outpaced the robot in terms of ability and accuracy, instrument size, and so forth. While I love robotic hair transplants, the robot is the most sophisticated semi-autonomous surgical instrument on the planet, but to be honest, we don’t use it as much these days. In fact, we haven’t used it in a couple of years. 

We focus now primarily on manual extraction using these much tinier instruments that produce a little bit less trauma in the scalp. In our hands, in my clinic, that’s what we find works the best.

I’m not afraid of robots. We certainly have used it and had great results with it. But today, we use various tools depending on the patient’s characteristics, hair color, quality, texture, and whether we want to take the hair with a long hair attached and not shave any zones. The thing about the robot was that we had to shave a huge area to get the harvest done. It was not appropriate for female patients, certainly not for men who wanted to wear long hair and not have that downtime associated with it. 

Using the more sophisticated manual tools, we can rotate the instrument differently, either back and forth, with oscillation or vibration settings. That enables us to take the follicles without trimming any additional hair. It’s a unique service we can offer patients that most clinics worldwide cannot.

How much downtime do you have when you come in for a hair transplant procedure? How long do you hide under a baseball cap?

Are you talking about a normal person or somebody like Dave? Because it’s different. 

I say for a normal person like our listener. 

The normal healing time is about six to eight days. Most patients will be here with us in Boca Raton near the clinic and visiting us after the procedure for about a half hour each day. During that time, we’re applying different types of ointments and sprays. We’re doing a sophisticated scalp wash. It might be a mechanical scalp wash tool that we use for that. We’re making sure that the healing is on point. 

The patients will receive red light therapy and a variety of therapies while in the office. They might also undergo hyperbaric oxygen and other types of treatments to expedite their healing.

Now, once the sixth day rolls around, those crusts and scabs that you would see in the transplant zone exfoliate. They’re lifting off from the scalp and washing down the drain, essentially. The follicles are healed and underneath the skin, so there’s no harm once the area’s exfoliating to scrub and wash that area. In fact, we encourage that. That’s typical, six to eight days. 

Dave, with his healing regimen—he’s written books about it and produced his own movie on recovery from surgery—I think he used various tools, including ozone therapy, supplementation, and a few other things, to expedite the healing. He healed in about half the time a normal person would. 

Normally, we would see hair grow visibly between four and six months. For him, it was two to three months when the hairs started to grow, so he had some accelerated healing. Being optimized makes a big difference in terms of recovery time and also in terms of hair growth. 

It doesn’t take that much time. I guess your short answer to your question is that, basically, if you don’t want anybody to know that you’ve had this done, you will be under a baseball hat for about a week.

Okay. I remember when I had a procedure done in 2009, they took a strip of skin from the back of my head about an inch wide from ear to ear practically, and of course, I was awake for the whole procedure, and that was pretty awful. It was super painful to go through that healing process because it’s so tight back there. I couldn’t move my head down and not experience a lot of pain because it was so tight, and that was just back in the old days. 

Stephan, that’s old-style procedures. When I was in training over 25 years ago, linear or strip excision was the mainstay of therapy. That’s what everybody was taught, and that’s what everybody did. But even as early as 1999, I started to think about how we could get these follicles out without taking those big strips of skin. 

My background in endoscopic surgery and general surgery in New York led me to believe that a minimally invasive approach is preferable. We knew that minimally invasive surgeries for the GI tract, orthopedic surgery, brain surgery, and neurosurgery resulted in less downtime, less pain, quicker recovery, and fewer complications. 

We didn’t really have all the tools for follicular unit extraction as we have today. Here we are, more than two decades later. I always thought about that in those early days. There’s got to be a better way to take the follicles out. I feel very blessed that I was amongst a handful of surgeons in the world who pioneered this technology from 1999 to maybe 2004, when I designed our original instruments to help us manually extract those follicles from the scalp. 

The Bauman TURBO LaserCap is a nonchemical hair growth device.

Today, it’s a huge difference between what you had with a strip, stitches, and staples. I suggest weeks of downtime out of a physical regimen, an athletic regimen, and staying out of the gyms to avoid stretching out. That’s a common problem that we see with those old-style procedures. 

Today, with FUE, Follicular Unit Extraction, the downtime is minimal. The crusting is exfoliating in six days, but you could be back in the gym as quickly as three or four days. Sweating and running are no problem. The donor zone is almost indestructible. Don’t try that with stitches or staples in your head. 

Of course, the biggest benefit is that no linear scar is left behind, and there’s less discomfort. Most patients take two Tylenol to go to bed the first night. It’d be kind of unusual to need more than that. Some patients do, but it’d be very unusual after a day following the procedure to need any kind of pain medication whatsoever with FUE. Meanwhile, with the linear harvest, as you described, downtime is much longer and more uncomfortable.

I know there’s a medical tourism center in Turkey for hair transplants. Why Turkey? Why is it so much cheaper over there?

Medical tourism for cosmetic surgery is not something new. I mean, you’re in Miami, and you know that unlicensed dentists perform tooth extractions in their garages in downtown Miami. You don’t have to go far to find an unskilled professional. The same is true whether you live in South Florida or anywhere around the world where the labor is cheap, and there’s no governmental oversight. There’s no licensing board or safety regulations. You’re going to have many nonmedical professionals taking advantage of the situation and the desperate people out there. 

It’s pretty sad. We see what cosmetic surgery might look like. My mentor was a very prominent plastic surgeon in Manhattan, and he took care of patients in an exceptional way. He had patients who flew in from around the world to see him. But everybody knows even from South Florida, you could fly to Costa Rica and get a liposuction at half the cost. However, the problem is that the complication rate is not half or twice as much. It’s maybe ten or twenty times as much as you would normally see in a certified facility here in the States. 

I guess I would just caution patients for the buyer, beware. There are plenty of warnings out there from the conferences and clinics. The third-party regulatory bodies about destination surgeries are at a cheap price. A good hair transplant is not cheap, and a cheap hair transplant is not good. 

It might be executed, but what I see coming back from some of these places, and it’s not just those countries that you mentioned, but other places around the world where the work is not sophisticated, is that people are coming back with a straight across cookie cutter hairline. If you’re having a hair transplant, the last thing you want is somebody to notice that you’ve had a hair transplant. I’ve said on the air when CNN came to my clinic. I told them back in 2001, “Look, hair transplantation is 90% art.”

Yes, you have to have the right tools, technology, and personnel. But if you don’t have an aesthetic, artistic eye, you’ll end up with something that looks bizarre. 

For someone trying to make themselves look better, a permanently bizarre hairline is sometimes called walking wounded. Unfortunately, patients often come back from these distant locations or even local locations where things are not done so aesthetically pleasing. They’re unfixable or very difficult to fix, and, unfortunately, people have spent a lot of time and money. They’ve spent time in third-world countries. They are getting procedures and treatments and haven’t gotten to their goals. 

There’s just a buyer beware out there. There’s a reason why we are listed as one of the top 20 clinics in the world. There are plenty of surgeons around the world who operate at this level. But it does require training, expertise, instrumentation, and good-quality professionals. People have been with me for over 20 years. My team has taken over 20 years to coalesce into a symphony of detail to ensure that every patient is cared for in the best way possible.

I would caution. I want to put a word of caution: do your homework and do your due diligence. If someone’s offering you a discount or a coupon, or “you can jump into the chair next week,” I would be careful of that. There’s a reason why they’re giving you that offer or offering to pay for your travel. I mean, that’s the other thing. 

Unfortunately, if somebody is buying your tickets to Turkey included with the procedure, the government is in on it. God forbid you had a complication that might never see the light of day. I’m going to leave it there and let the buyer beware.

I understand. What is the typical price for a procedure? I know it’s based on the number of hair follicles. Could you explain how that works? 

Being optimized makes a big difference in terms of recovery time and hair growth.

Sure. We don’t discuss pricing until you’ve had a consultation, but the bottom line is that the price of the procedure is dependent, not just on the number of hairs. You’re not buying a gallon of gas here. There’s a lot that goes into the procedure, preoperatively, to prepare you for the procedure, ensure that you’re an appropriate candidate, and optimize your lifestyle, hormones, and medical conditions. “What medications are you on that could interfere with your hair loss situation? What diagnosis do you have?” 

We often have to rectify those things before starting any procedure or treatment. Then, don’t forget there are medical therapies or other non-invasive treatments that go along with the procedure to help you protect the non-transplanted hair. Costs can be significant, but remember that hair transplantation is a permanent solution to hair loss. If the follicle is dead and gone, no manner or method of mystical creams, lotions, or potions will bring your hair back. Even the best biohacks, if you will, will not work on a dead follicle, so you better have the right diagnosis before you proceed.

If someone who’s listening is interested in figuring out how much the process is going to cost, they need a detailed diagnosis, and that would start with a virtual consultation that’s easily scheduled through the website baumanmedical.com. They can make requests from anywhere in the world. We can get on a video call, Zoom, Skype, or otherwise from their home or phone. 

If you’re local to South Florida or can fly into Boca Raton, we can do an in-person consultation. We can get the AI-powered microscope on your scalp to measure your hair quality and density in every area so we know exactly how much donor density and quality you have available. Then we make a plan. The plan is going to be all-inclusive. It’s not just, “Oh, this is the price per graft.” No, that’s a crazy way to think about a hair transplant. 

It’s an all-inclusive process that we’re in lockstep with you forever because this is a chronic and progressive condition. For the long haul, you’re with me, and we don’t like to lose hair. We will make sure that you keep the existing hair growing strong, and if necessary, transplantation. If it’s required, we’ll do it, along with all the other things we mentioned today. Medications, laser light therapy, nutritional supplementation, and regenerative medicine are all parts of the practice. 

Even for patients who are not candidates for hair transplants, we can help with cranial prosthetics and medical hair systems appropriate for people with chemotherapy, alopecias, temporary alopecias, patients who have had scarring alopecia, or hair loss from wounds like military explosions, house fires, and kitchen fires. We’ve treated a huge number of those patients pro bono in the practice. It’s very difficult to say. 

Also, if you’re thinking about an eyebrow transplant versus an eyelash transplant versus a scalp hair transplant, the location is different. Maybe you need a mustache, beard, or sideburn, or maybe you’re covering a scar from a plastic surgery procedure, or you’ve had a brain tumor removed. I’ve seen a lot of those lately. You’ve had a benign brain tumor. It’s been excised, and you’re left with a big old scar. We can fix that. If you’ve had a facelift or a brow lift, we put hairs there too. 

Even for patients like yourself who have an old linear scar on the back from old-style transplants, there are a lot of things that we can do. The range of transplantation costs is huge. I encourage anyone interested in learning what they need to get a detailed evaluation rather than just an off-the-cuff number. 

Can you do those evaluations over video?

Well, absolutely. Our video consultations were super popular long before the pandemic. Obviously, with the Zoom and boom phenomenon, that number increased dramatically as people were locked down in their homes with their phones and wanted to get an idea of what it would take to get their hair completely restored.

We’ve seen a huge increase in patients inquiring about hair transplantation since video conferencing became increasingly popular, with how many users are now getting on Zoom, Skype, or Google Meetings. They’re looking at themselves on video, maybe more than they would in the mirror. I spend hours a day looking at their hairline, going, “Oh, my gosh, I don’t want to look like the oldest guy in the Google meeting. I want to look like I have a youthful appearance and frame of mind.” 

That delivers confidence. When you are confident about your hair, you look good and feel good, and that’s why people like Dave Asprey and biohackers want to not just feel good on the inside but also exude that health and vitality on the outside. It’s hardwired naturally. As humans, we want that. 

When you look at somebody’s hair density, you can tell, using a video session like Zoom, what density they have, the amount of miniaturization of follicles they’re experiencing, and all that.

Right now, we don’t have the technology to measure density accurately from a distance. However, we do have machines and portable microscopes that we often bring to consumer expos and other events. We also have them in the office, where we can do a density measurement on the spot. We take a photo that gets sent to the cloud, and then a reply comes back with the exact numbers. All the follicles are highlighted and characterized, and so forth. 

If you’re having a hair transplant, the last thing you want is somebody to notice that you’ve had a hair transplant.

We have larger devices in the practice called HairMetrix, which is an artificially intelligent powered microscope. We have the HairCam Pro, a smaller device many hair coaches use. Let’s say they’re in a salon, a medical spa, or a medical practitioner’s office that doesn’t specialize in hair restoration. It’s a smaller portable device. 

We teach and train how to use those to measure hair density, but on a video call, we’re talking about the coverage. Hopefully, you’ve sent in some photos ahead of time. If we’re talking to you virtually, we can see with your hair wet and parted a general idea of the density and the quality of the hair. We can often see, even if the hair is not wet and parted, where there’s a diminishment of hair quality because the hair will lay flat, let’s say, in the crown for many of our male patients, when the quality of the hair starts to diminish. 

Obviously, in male pattern hair loss, you can see a receding hairline, and we can talk a lot about that, how much transplantation is needed, and we can get you started on the medical therapies. We may not have such an accurate density measurement doing it virtually, but we can at least start the process. 

Then, when you came in, I had a patient today flying from Arizona for his follow-up, and we did measurements for him. We did his hair check measurements and the AI-powered microscope measurements—great improvements in medical therapies. He was glad that he came in for those measurements, even though it took him some time, effort, and energy to be here. Many of our patients will visit from afar at least twice a year if not more.

What do you typically recommend to patients in terms of preventative or maintenance-type modalities? Is it red light therapy and Propecia for most folks? Or is it more rare to recommend those?

As we said previously, it all starts with a detailed diagnosis. The medical history will elucidate the cause of the hair loss. What are the compounding factors or risk factors contributing to the man or woman’s hair situation? Once we’ve identified those, we want to minimize risks. 

Now, you mentioned Propecia, an antiandrogen therapy called Finasteride. Propecia is off-patent, so everybody uses just Finasteride, either generically or typically with a compounded version. Finasteride is important for men because it’s probably our most powerful treatment. It works 90% of the time to keep you looking good long-term. That means nine out of ten guys get a positive response from just taking a pill once a day. That’s pretty good. 

Two percent of patients might have sexual side effects from the drug, that’s not so good. We can avoid those sexual side effects by stopping the medication, which comes out of your system in about a week. Then, we can transfer that medication into a compounded topical version of Finasteride. 

Do your homework and due diligence. If someone offers you a discount, be careful.

We do prescribe a lot of Finasteride and have for two decades or more because it’s so powerful. It’s not the right treatment for everybody. If you’re disinclined to use an antiandrogen treatment, at least orally or systemically, and you’re thinking about it topically, we can start there. 

Other medications could include minoxidil, which, as most people realize, is the ingredient in Rogaine. Even though Rogaine is not so great, it’s greasy, gooey and irritating to the skin. A compound in minoxidil is usually better tolerated and has better efficacy. We can also use minoxidil orally today, which is nice. It keeps it simple and easy, not so messy. It won’t mess up your hair; it’s very powerful. Microdose oral minoxidil is a very common therapy.

A lot of our biohackers, I would say, want to stick with something more natural, maybe non-pharmaceutical, so red light therapy becomes a mainstay of therapy. We can use nutraceuticals and nutritionals like saw palmetto, curcumin, and turmeric, which decrease inflammation. Saw Palmetto affects the androgens and other nutrients like proteins. We can also use therapies such as PRP, platelet-rich plasma, and other regenerative treatments like peptides and growth factors to stimulate hair growth without pharmaceuticals. Those are some of the basics. 

I’m curious to hear what you’re taking personally. Are you taking finasteride or minoxidil orally? Are you taking peptide growth factors? 

Most people watching or listening are wondering why Dr. Bauman would need something for his hair. It looks pretty good. Well, my dad was bald before we transplanted him. We transplanted what looked like a full head of hair back for him, and my mom’s dad had a big bald spot in the back and a receding hairline. I’ve always been nervous, even before I went to my surgical residency and training, that I would lose my hair. 

My grandfather, I never met the guy with hair. I thought he was born bald. No, I’m just teasing. But I always thought, “Hey, look, this is coming for me.” I’ve always thought, “Hey, when will this hair loss situation affect me?” Certainly, I’ve seen it, and I’ve measured it.

I’ve been in quite a sack for over twenty years. I’ve used a variety of treatments, including oral finasteride, topical finasteride, and minoxidil. Today, oral minoxidil is one of the therapies I use consistently. I’ve redesigned and reengineered the TURBO LaserCap, our proprietary laser device. It sits on my bed stand. I use it for five minutes every night. 

I have not used regenerative treatments yet, although I’m signed up to partake in a microneedling clinical trial because I’ve never used microneedling. But I’ve also designed my nutritional supplement line specifically for hair. Over the years, I’ve come across specific supplements that can be helpful for hair regrowth, and that’s what you would find in the Bauman Wellness system for hair. 

Biohacking baldness helps to increase hair span and allows you to spend more time with a thick, full, healthy, and luscious head of hair. Click To Tweet

That might include collagen, peptides, biotin, multivitamins specifically for hair, probiotics specifically for hair, etc. Also, we call the ‘Zen Master,’ an ashwagandha-based product, as well as a couple of different hair care products that might reduce stress.

I have a very sensitive scalp, so the first thing I designed was a hair care product called Soothe, which is a conditioner and shampoo that decreases inflammation at the scalp level using a CBD component. Probably even more importantly, I use a shampoo and conditioner pairing called Boost, which contains an olfactory-derived compound, which is a trigger for the actual chemosensors in our scalp embedded in our hair follicle that can trigger hair growth based on odors or smells. Chemicals you would normally be able to smell with your nose can now trigger hair growth on the scalp. That’s a standalone compound that’s in the Boost shampoo. 

The BaumanMD line contains nutritionals, hair care products, a laser cap, microneedling tools, and other home-use devices. Of course, we also do things in the office, like in-office laser therapy. 

TED, which stands for Transepidermal Delivery of growth factors and peptides, is a really exciting technology that is much less uncomfortable than traditional PRP. Even though our PRP is not painful at all, it does require a blood draw and some injections in the scalp. The TED treatment involves growth factors and peptides applied with an ultrasound delivery device. 

Have you done PRP on yourself, or another practitioner did it on you?

No, I have not had PRP yet, but I’m looking forward to it. I know PRP worked great, and will certainly use it in my stack. I would not hesitate to use it. Today, I would start with the TED treatments first because I’ve seen such a great result in practice over the past year since we got one of the first devices here in North America.

What does TED stand for, and what does PRP stand for? 

PRP is platelet-rich plasma. It’s a concentrated version of platelets derived from your blood. We eliminate most red blood cells, leverage the platelets, and concentrate them to a dose of 10–12 billion platelets per treatment. We found that that’s the most effective dose, and the concentration of 1.5 million platelets per microliter gives us the biggest boost of hair growth. That’s PRP, platelet-rich plasma. 

TED is a new technology called transepidermal delivery that uses ultrasonic waves to break up the skin layer called the stratum corneum, which is the moisture barrier, and to push these larger peptides and proteins as well as the growth factors right through the skin without a needle. That’s a nice treatment. 

Even the best biohacks will not work on a dead follicle, so you better have the right diagnosis before you proceed.

Both of those take about an hour to practice. Some people will do mostly PRP. Some people will do mostly TED. Some people do both combinations. PRP, one treatment per year, is typically enough for most patients. The TED treatments require a series of four treatments once a month for four months to see the real improvements. 

PRP and TED, too, can be helpful to rejuvenate and bring a kind of youthfulness to the skin on your face. 

Absolutely. The Vampire Facelift was what the Kardashians brought to the forefront well over ten years ago. That was the explosion of PRP and all the media spas and things like that because it was a nonchemical rejuvenation. I think it was while Kim Kardashian was pregnant that she had that treatment done on her face. Again, leveraging the growth factors within the blood, within the blood platelets, is the birthplace of the popularity of PRP that you see for the skin. 

Can you use the TED, transepidermal delivery, on the skin of the face? Yes, of course. My institution has taken several classes for that.  We have an aesthetics program in the practice and our functional medicine program. The aesthetics program is designed for skin rejuvenation. We do laser hair removal and skin tightening.

We have the Morpheus and a few other different devices and tools, and that dovetails very nicely with obviously the hair regrowth treatments that we’ve been offering for over 25 years because once you get the head of hair looking great, then you start focusing on the forehead, the cheeks, and the chin and all of that business is so.

We need to have some good rejuvenation for that as well. That’s been extremely popular in practice. Blanca, my esthetician, has been super busy dealing with our male and female patients on the aesthetic side. 

Microneedling refers to using tiny needles to deliver the PRP into the skin.

Well, our PRP is injected directly into the level of the follicle. Microneedling is something we do apply right after the injections of the PRP. It’s important to understand that some people apply PRP topically and microneedle above that. That is going to have a very weak effect, typically. 

You need to inject the PRP at the appropriate depth to get the stimulation of the hair follicle. That’s what has worked best in our hands. It’s important because people say, “I got PRP down the block. It didn’t work.” “How many platelets did they use?” “Oh, I don’t know. They didn’t measure it.” “Where did they inject it?” “Well, I don’t know.” Are they scalp specialists? “No, they’re just skin specialists.” “Did you even have injections?” “No, we just had microneedling.” It’s like saying I made pizza but didn’t put the cheese on it. It doesn’t make any sense. 

The BaumanMD line contains nutritionals, hair care products, a laser cap, microneedling tools, and other home-use devices.

That’s interesting. Where does CBD come into play here? How does that help with hair loss, hair regrowth, and maintenance?

Yeah, so cannabidiol is a very, very interesting compound that’s a non-psychoactive component of the cannabis plant. We use CBD in a lot of different ways in the practice. Some interesting research in peer-reviewed clinical literature shows that CBD at certain doses can stimulate hair growth. Certain dosages have been used to fight acne and improve skin health. CBD can also decrease inflammation.

There are many good reasons why CBD and the receptors for CBD, these cannabinoid receptors in the skin, especially maybe even the hair follicle, could be leveraged for our benefit. For many, many years, we’ve used CBD-containing squalene moisturizing ointment. That’s a healing ointment for patients to use after their procedures on the scalp and the donor and recipient zones to moisturize the crusts and the scabs for comfort and exfoliation purposes and minimize the inflammation after that.

That’s been a very nice, popular treatment. Many people keep that bottle and use it as a styler afterward because it moisturizes the hair. It’s a squalene-based product, which is really nice. Squalene is a packageable compound, but it’s similar to sebum in terms of its consistency. It plays very nicely on the scalp. It’s non-comedogenic. It’s not going to create inflammation. It’s going to do the opposite. It’s going to decrease inflammation because of the CBD component. 

Now, the CBD component in the Soothe hair care line has a specific anti-inflammatory role. I think we’ll see more and more information about how CBD affects the skin and hair follicles as more research comes out. 

It seems like CBD is getting a bad reputation, maybe from the medical, industrial complex or governmental bodies, but it can be quite helpful. 

We’ve seen great results with our CBD-containing products and treatments. I would just say if the government or the regulatory bodies are skeptical of something or starting to poo poo it. I’m not telling people what to think, but you may want to take a second look at it because, so far, the government, our insurance companies, and big pharma haven’t done much to improve our health these days.

It’s more disease maintenance than healthcare.

Look, as soon as something that’s cheap, easy, and readily available with no side effects comes out. You can bet there will be a backlash from the powers because they want to keep everything patentable, pharmaceutical and regulated. You’ve especially seen this in the world of cell therapy. There’ve been actions by the government to try to shut down the use of your cells for healing, and it’s just unbelievable that that has taken place in this world. 

Leveraging our own body’s regenerative capacity is the third epoch if you will. It’s the next phase of medicine. We’re currently in the midst of a transition away from pharmaceutical interventions. 

It’s an exciting time to be alive, for sure.

 A 100%. 

Now, let’s talk a bit about exosomes. What are they? What kind of uses would you want to incorporate exosomes into healing or therapies? And are these harvested ethically or morally? Tell us more about exosomes.

Let’s start with the basics. Exosomes are little bubbles that come off cells. Almost every cell in your body can give off exosomes; every bodily fluid contains exosomes, from breast milk to saliva. Exosomes are everywhere. 

But what do exosomes contain? What we learned from cell therapy like stem cell therapy or using mesenchymal stem cells or mesenchymal medicinal signaling cells is that, when you put mesenchymal stem cells, or MSCs, into a joint that’s injured, years and years ago, when I did my stem cell fellowship. Training, we thought those mesenchymal stem cells were becoming the injured joint and repairing the cartilage that way. 

It wasn’t the case because after a while, you’d go back to that joint, and you couldn’t find those cells. The question was, in patients, let’s say you had fat transfer from abdominal fat during a liposuction into their face or hand for rejuvenation, “why did the skin tone improve? What’s going on there?” 

Those are the first things that I saw in the world of cosmetic surgery. I am interested in plastic surgery. “What was going on with these adipose transfers? Why was the skin tone improving in the face and the hands when you did the adipose?”

Some smart researchers figured out that within the adipose tissue and many other mesenchymal stem cell-containing tissues in the body, for example, bone marrow and even hair follicles and things like that, the stem cells themselves just sensed the local area and released these growth factors, peptides, and microRNA for rejuvenation into the zone.

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If you had an injured knee or joint, the cells would sense that injury and do what was required to initiate repair and rejuvenation. And so, how did they do that? What did they secrete, and how did they secrete it? 

These chemical messages that the cells gave off were contained in exosomes. Exosomes are like little bubbles. Think about them as one one thousandth size of a cell. If you were looking at the size of an old-fashioned Cadillac and then compared that to the size of a Hot Wheels car, it’s about a thousandfold difference. That’s the difference between the size of a cell and the size of an exosome. One thousandth the size of the cell.

Cells give off these exosomes under certain environments. Let’s just say you had a paper cut, and you had cut through some blood vessels there, and the skin all of a sudden is not getting enough oxygen. The cells in that local area sense low oxygen. Then, they start to secrete different growth factors through exosomes to trigger new tissue regeneration repair and new blood vessel formation.

Theoretically, if you could have stem cells in the laboratory in a bioreactor, you’d be creating millions and millions of stem cells. When you put them under this low-oxygen environment, all of a sudden, they start to release these very powerful peptides, growth factors, and microRNA that would normally tell the body to rejuvenate, repair, and maybe grow new blood vessels.

In these labs, these FDA-cleared laboratories, these researchers are now collecting the exosomes, purifying them, concentrating them dramatically, sterilizing and freezing them, putting them in a bottle, and then sending them out to physicians. 

Now, we can use exosomes topically, and this is because some guidelines have been handed down by the FDA saying that they would prefer us to use exosomes topically. What you’ve seen out there, what I’ve seen in many of these presentations and conferences in the world of cell therapy and cosmetic procedures and treatments, is that exosomes have dramatically enhanced the healing times of cosmetic surgery patients. 

They’ve healed wounds in half the time in patients who were expected to need skin grafting or some kind of invasive surgery to repair their either diabetic ulcers or blast injuries from fireworks and things like that. Topical exosome therapy has healed these wounds almost miraculously, and these reports continue to appear in the clinical literature at the conferences I attend, so we’re very excited. 

That’s how I got started with PRP. I wanted a great wound-healing treatment for our hair transplant patients. We’ve been using exosomes in practice for many years, and there have been a variety of manufacturers in a variety of different concentrations. I won’t go beyond the scope of our conversation today, but we’ve narrowed down those companies, distributors, manufacturers, and FDA-approved tissue banks that make the best exosome products, and that’s what we use on our patients topically.

We’re currently in the midst of a transition away from pharmaceutical interventions.

It’s been amazing to see for me because it’s truly leveraging the power of the stem cell without having to worry about dealing with the cells. I no longer have to take an adipose extraction on you to get those powerful cellular messages. I basically get them in a bottle, and they’re consistent. I know how many are in there, and it’s very exciting. 

Now, how do we get those into the skin during a procedure? Well, we can use it topically. As I said, we can use it along with microneedling. We can use it along with TED, the transepidermal delivery. It is a very cool way to do it. 

We’ll be at Dave Asprey’s biohacking conference in Orlando and apply the TED, which is the growth factors and peptides, but also exosome therapy directly through the skin without a needle. I’m super excited about being able to demonstrate the latest and greatest technology. 

I’m looking forward to seeing that. I’ll be at the conference. 

Cool. We’ll schedule your treatment ahead of time. For those of you who are listening out there, if you’d like a full-blown TED treatment, like more than a demo, we have some limited slots available. Of course, you can do it with the exosomes if you like. 

Awesome. I know we’re running short on time here, but I would love for our listeners to understand there are different kinds of oxygen therapies. You mentioned hyperbaric oxygen and ozone therapy earlier. What’s the difference, and what other oxygen therapies are discussed in the biohacking community?

These are very different. Ozone therapy can be applied topically to the scalp or even injected into injured joints. It creates a hormetic response, meaning that a certain amount of stress is put on the cells in that area, and then the body responds like a trigger, like a boost.

I’m not saying all patients should do rectal ozone as Dave Asprey did. Although that was one of his healing hacks postoperatively, it did seem to help and accelerate his healing process. We’re learning more and more every day about ozone therapy, whether it be topical or injected and so forth.

We can also use ozone therapy in conjunction with PRP. We mix our ozone with our PRP and inject that. You may have heard about extracorporeal blood oxygenation treatments, where they run the blood through an Ozonator and then back into the body, and that’s a pretty exciting new technology. We’ve heard a lot about that. 

I don’t perform that in practice, but there are local clinics that do that here in South Florida, and it seems to be a very powerful healing and anti-aging therapy for tissue regeneration and repair. 

That’s very different from hyperbaric oxygen. Hyperbaric oxygen, you may see these big chambers, they come in kind of a soft and hard variety. The higher the pressure inside the chamber, the more oxygen dissolved in the bloodstream. 

Instead of dissolving oxygen in the iron part of the red blood cells, if you put yourself under a significant amount of atmospheric pressure, you can dissolve the oxygen in the liquid part of the blood, which is cool. This delivers that oxygen to the wound healing areas, to an injury. 

We’ve had patients who have had a traumatic brain injury, and hyperbaric oxygen works great. We often use that for military veterans. A great team that’s here in Boca, which I’m the medical director of, for many of our patients over the years, we’ve used hyperbaric oxygen to stimulate wound healing after hair transplantation. 

It’s not as popular today because our healing is pretty quick, as discussed previously. But years ago, when patients were dealing with stitches and staples, hyperbaric oxygen decreased pain and inflammation, accelerated their healing times, and increased the wound structure and tension created by the body. We also got an acceleration in hair growth from that. 

I caution patients to remember that, as I said, the soft chamber doesn’t go as high in terms of pressure, so you need more repeated treatments. A harder chamber will give you a higher atmospheric pressure, maybe two atmospheres of pressure. That will give you a higher delivery of oxygen. You need fewer treatments that way. But I’m a huge fan of hyperbaric and ozone therapy.

Then there’s hyperoxygenation and hypo-oxygenation. A long time ago, I had one of the guys from LiveO2 on the show to talk about their device, which was interesting. Are you into that?

I’m a skier, but it’s hard for me to train when I’m here at sea level and be ready for my high-altitude ski adventures. You know that teams and different sports athletes will train at higher elevations with lower oxygen to stimulate more red blood cells to appear in their blood and carry more oxygen to be more efficient. 

Is there something to train it in hypo-oxygenated states? There probably is. I haven’t tried it yet, but I look forward to it before my next ski trip.

Awesome. One thing you mentioned earlier was PDO. Could you explain that a bit further for our listener, who’s not familiar with it?

One of the innovations we’ve made to our PRP and regenerative treatments is using scaffolding. In regenerative medicine, there’s a triad or trifecta of cells, signals, and scaffolds. Let’s say you go to a regenerative medicine conference. Everything you’re going to see on the stage and in the expo area and talk about with your colleagues will fall into those three categories: cells, signals, and scaffolds.

We’ve actually talked a lot about that today. I was one of the first physicians to use a biological scaffold in conjunction with our PRP. There were a number of different biological scaffolds. Some of them were xenografts, meaning that they came from non-human sources. For example, pork bladder matrix was a common xenograft that we used with PRP. Many people remember that as a product called ACell. We used that back in the early 2000s in conjunction with PRP. We had a very prolonged effect than just using the PRP alone. 

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Then, we proceeded to use perinatal biologic tissues. These are placental-derived tissues. These are healthy harvested placentals from placental tissues from medically screened donors. Then, those are processed in clean rooms at FDA-cleared laboratories and tissue banks and so forth and then provided to physicians who perform, for example, cornea surgery, back surgery, orthopedic surgery, cosmetic procedures, and treatments. These placental tissues can be adjuncts for wound healing and tissue regeneration repair. That’s been our mainstay of therapy. 

The PDO, polydioxanone, is a synthetic material. Many people are familiar with a long or slow-absorbing suture material called polydioxanone. If they’ve had any kind of mesh repair, like a hernia, or they’ve had a big GI procedure, let’s say a procedure in their abdomen, and the stitches needed to be there for a long time to create that repair. 

Polydioxanone was the first Johnson & Johnson product. That was a very slow-absorbing suture material that I remember from the 1990s, and it was approved about ten years prior. Today, polydioxanone is used in very, very small filaments for tissue regeneration in the skin and for wrinkle reduction. 

It can also be used to pull and tug on sagging areas, cellulite, collagen stimulation, etc. We learned about it at a cosmetic conference in the Far East. Someone said, “Hey, have you ever tried polydioxanone threads in the scalp for hair growth?” I said, “No, I’ve never heard of that before.” 

After chatting with some of my colleagues who had tried it and doing some research in the clinical literature, we decided to try it. Lo and behold, the placement of these threads in the scalp, just the threads alone, stimulated a surprising amount of hair regrowth in about the first six to twelve patients we tried.

I was demonstrating the technique at a conference at the same time they wanted to do a PRP demonstration, so I ended up having a cancellation, and we had to do the PRP and the PDO on the same patient. Let me tell you, that combination serendipitously triggered the most powerful hair regrowth I’ve ever seen from a regenerative procedure. We were super excited about adding PDO threads together with our PRP, and we’ve done so for many years. It’s been about six or eight years now, and we’ve done thousands of these treatments. 

The interesting thing is that we’ve never seen a complication. Sometimes, the threads work their way out of the scalp. You just pull them out within a minute, and they’re gone. Then, they typically were resolved on their own, but those threads stimulate a lot of hair regrowth. It’s pretty amazing. Especially in conjunction with PRP or other treatments, you can get a spectacular amount of regrowth. I found that that process has encouraged a longer, prolonged effect from just our regular PRP alone and a much stronger effect from just our PRP alone. 

PDO, polydioxanone, threads, we’ve taught a lot of surgeons how to do it now. Many physicians around North America are doing it, including those I learned from in the Far East. But it’s a very exciting technology that is a very, very low risk, low complication, very comfortable procedure to perform and has a great outcome. I’m very excited about being able to provide that to our patients.

Of course, we can always add exosomes to that if you want, and there are plenty of other new technologies, like hair follicle stem cell therapy, which is coming of age and could be added to our PRP and regenerative treatments. 

Do those PDO threads dissolve on their own? 

Yeah, they’re placed under the scalp at a very appropriate depth underneath the hair follicles. They dissolve over time. They do not create any excess inflammation. There’s no excess inflammation. If you were to biopsy it, you don’t feel them. You don’t see them. They just dissolve by themselves. They last for about six to twelve months or so before you need to do it again. 

Wow. Fascinating. Awesome. I know we’re out of time. Fabulous stuff. This was great. It’s such a holistic aspect of medicine and therapy to incorporate things like nutraceuticals and different kinds of supplementation, ashwagandha, probiotics, and all of that, and all the different procedures that you do, the microneedling, PRP, TED, the PDO threads, and all of that. 

It’s a very holistic approach. I think the hair follicle is just taking a step back, zooming out for a moment. What we see is the hair follicle is a very, very highly metabolic organ. It can be affected by inflammation, nutrient status and fuel status. Of course, it can be affected by genetics. We’ve talked about the effects of hormones on the hair follicle. 

 

It can be affected by blood circulation. Even adding things like nitric oxide into the regimen, nitric oxide boosters, I mean, all of these different things, as well as taking a lifestyle approach. If you’re dysregulated in your nutritional status, your sleep cycle, whole-body inflammation, or your gut microbiome is out of whack, you’re really going to have a hard time growing good hair. We see this repeatedly in our patients, and sometimes my colleagues will present cases at our congresses and scientific meetings, and they’re trying to figure out what went wrong with this patient.

We ask these questions about lifestyle, nutritional status, and medications that they’re on, and there’s no answer. They don’t have that information. They don’t take that kind of medical history before they get started on the treatment or procedure, and it’s sad. 

Being able to incorporate all of that and rectify those things, not just for the patient’s hair but also for their longevity, health status, overall wellness, and how they feel, man, it’s a really good feeling not just to make them look good on the outside but also to make them feel good on the inside.

If our listener or viewer wants a consult with you to get the evaluation, they may want to partake in one of your procedures. Where do they go? How do we get them in touch with you? 

Anybody out there, if you, a friend, or a family member is dealing or struggling with either a hair shedding problem or hair thinning problem, you’re seeing more scalp shining through more hair in the brush or the drain, you need to get an evaluation by a full-time board-certified hair restoration physician, and you got to do your homework. 

There are thousands of pages of information at baumanmedical.com. That’s my website. I’ve written all those pages personally over the past 25 years. If you want to ask a question, you can go to baumanmedical.com/ask and type in a question. If you have any questions, I will respond, and my team will respond. 

Suppose you would like to start a consultation process from a distance, like I said, from your home or phone, from anywhere in the world, baumanmedical.com. You can schedule a consultation. You can select a scheduled consultation, and after a few questions, we can get a handle on what’s happening. 

Even if you just want to find out more information, baumanmedical.com is a place to be, and of course, we are located right here in South Florida, so not too far from Miami or Palm Beach. It’s a sunny place, a nice place to visit and to recruit for your hair transplant procedure or other treatments. I look forward to helping you. If you are struggling with hair loss, you don’t have to. We have ways to protect the hair that you have and also restore the hair you’ve lost. It will be my pleasure to do so. 

Awesome. Thank you so much, Dr. Bauman, and thank you, listener. We’ll catch up with you in the next episode. I’m your host, Stephan Spencer, signing off. 

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About Dr. Alan Bauman

Dr. Alan Bauman is a full-time board-certified hair restoration physician who has treated over 33,000 patients and has performed over 10,000 hair transplant procedures and over 10,000 PRPs since starting his medical hair loss practice at Bauman Medical in 1997.

Bauman Medical is a 12,000-square-foot, state-of-the-art “Hair Hospital” in downtown Boca Raton, FL, located about a mile from the renowned Boca Resort & Club.

Dr. Bauman is one of approximately 200 physicians worldwide to have achieved certification from the esteemed American Board of Hair Restoration Surgery (ABHRS).

Dr. Bauman is known for pioneering numerous technologies in the field of hair restoration, including minimally-invasive FUE Follicular Unit Extraction, VIP|FUE™ No-Shave Hair Transplant, Low-Level Laser Therapy, PRP (Platelet Rich Plasma), PDOgro™, Eyelash Transplants and others.

He is a frequently invited faculty member and guest expert at numerous international scientific meetings and live surgery workshops. He has been featured in hundreds of news stories in the media. You may have seen him on NBC Today, CBS Early Show, ABC Good Morning America, CNN, The Doctors, Spencer Kobren’s The Bald Truth, Bulletproof Radio with Dave Asprey or featured in Men’s Health, GQ, Vogue, Harper’s Bazaar, The New York Times, Oprah Magazine and many more. 

Dr. Bauman was voted “#1 Top Hair Restoration Surgeon” in North America by Aesthetic Everything for the 6th consecutive year, “Top Hair Restoration Surgeon of the Decade,” and received the 2022 “Lifetime Achievement Award in Hair Restoration.” Forbes also recognized him as one of the “10 CEOs Transforming Healthcare in America.”

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