The Prostaglandin protocol

I will first explain the four angles that need to be taken care of to create regrowth. People usually obsess over one factor and then get disappointed when that alone isn't enough. Funny enough my good friend hellouser even posted about a rational, scientific approach like that on the public forums once after we had discussed it on PHG.

Overexpression of PGD2 in bald scalp

You probably know that Androgens, especially DHT are the "main culprit" for hairloss. Well, it's just the tip of the iceberg. People who are genetically prone to hairloss trigger an inflammatory reaction chain when Androgens dock to their scalp receptors. If left untreated the skin will express more and more PGD2 which leads to the actual hairloss. Even worse, not only will you lose your hair but the skin itself starts to genetically change and overproduce PTGDS. This means if a zone such as your temples for example have been slick bald for a while even anti androgens won't be enough to regrow hair in that area.

So we have to take care of that nasty PGD2 production. In the past people tried COX1/COX2 inhibitors because that basically removes it right? Well, it didn't work out. People actually lost more hair because when you snip the chain that high you also remove the beneficial PGE2 prostaglandin chain. COX inhibitors should thus be avoided. 

I suggest picking one of these solutions to fix the PGD2 problem:

• Use a PTGDS inhibitor to break the conversion of PGH2 to PGD2. These are still somewhat exotic and expensive, thus not really feasible at the moment.
• Block the receptor that PGD2 binds to. It's called the CRTH2 aka the GPR44 receptor. This is currently the best and cheapest solution.

Underexpression of PGE2

So we now know that our scalp is turning PGH2 into PGD2. This also means it's creating less of the beneficial PGE2 which is crucial for hair growth. Why PGE2 above PGF2a? Because PGE2 is even strong enough to protect hair from radiotherapy. And if that's not enough for you, it actually turns into PGF2a afterwards. People have been experimenting with Bimatoprost in the past but since it's both weaker and more expensive it makes little sense to use it over real PGE2. Especially when PGE2 gives you the benefit of both.

Here are some of the solutions we can use to solve this problem:

• Use a PTGDS inhibitor so less PGH2 converts to PGD2. As said before this is expensive so not very feasible.
• Activate the PGE2 receptor with things mimicking its structure. Ricinoleic acid in Castor oil for example activates one of the three PGE2 receptors while real PGE2 activates all four. If you're tight on money it's definitely something to consider.
• Apply exogenous PGE2 to the affected scalp area. This is the best and cheapest approach. By delivering real PGE2 we activate all four receptors and the skin will catalyze it into PGF2a afterwards.

By the way, substances expressing PGE1 such as Minoxidil and Miconazole should be used in the morning while you use PGE2 in the evening or vice versa. The problem here is that both are beneficial for hair but they antagonize each other. By waiting at least a few hours between using both you can get the benefit of them combined.

Mechanical wounding/needling

We adressed the Prostaglandin imbalance which is the main lock on our hair follicles. Now, actual hair growth also has a myriad of small factors which can be extremely beneficial or extremely bad. People usually get lost in focusing on one of these by-factors which aren't a huge deal but certainly something that should be adressed if possible. Some of the smaller growth factors are VEGF, the FGF's, the EGF's etc. Some of the positive growth signals are WNT, SHH, etc. And some of the negative signals are DKK-1, TGF-beta2, etc. We can actually influence almost all of these and more towards an hair-growth-optimal state by physical wounding. The least intrusive and the one we have the most studies about is called "Dermaneedling". You are basically creating small wounds with needles in your skin which triggers wound healing in that area. Exactly this wound healing overrides many of the negative signals, increases the positive ones and releases and enormous amount of growth factors.

People on the hairloss forums have tried Dermarolling with some success. It actually paid off on its own with some rare people so there is definite real life proof even apart from the studies. Dermarolling is the cheaper, easier and less effective cousin of Dermaneedling. You are basically using a roller with needles attached and as the name says you roll it over the area to penetrate the skin with the needles. The problem with that is that the motion of rolling the needles creates wounds which are more akin to small tears instead of punch wounds. It's also a lot more painful from my experience. Personally I use an eletric Dermapen called the "Derminator" from Vaughter Wellness which is the cheapest one I could find. It does an amazing job. Shout out to Sarah Vaughter, love your products.

This section is still a work in progress

Lack of progenitor cells

This section is still a work in progress