E102 - How to Stop Your Hair Loss Before It's Too Late (Full Guide) | Dr. Raghu Reddy

35:14There's no reason why. So the reason why a lot of men come to us for beards now is they've got a full head of hair, but they don't feel fashionable enough. And it's a cultural thing. I think, I mean, from what I gather, you're not considered an heir to one of the royal thrones unless you have a great beard in the Middle East. And I didn't realize there's so many heirs to the throne there. So we get a lot of clients from that part of the world suggesting, listen, I'm a potential heir. make my beard as perfect as possible. And that's coming from the same area? Logic is the same. Could you technically transfer pubic hair?

35:55I wouldn't recommend that. Why? Because it would just come out? Texture is different. Makes sense. I think the cycles are different. Texture is different. So I think I've tried body hair in the past. The feedback has been the texture doesn't look the same. And I think the shedding is a lot higher. So I think the feedback I got was two to three years later, they become even finer. Potentially the purpose of body hair is different to scalp hair. But then we've transferred some hair from the beard to the scalp. That works. Okay. So if you are a big beardy man, you can move to the side. Within reason.

36:36I mean, you don't want scarring on your face either. That's true. You don't have unlimited access as well. Yeah. Within reason. this episode is brought to you by whoop the all new whoop is here the only wearable that turns your health and fitness data into personalized guidance now seven percent smaller with 14 days of battery life i've been wearing whoop since 2021 and i've been wearing it every single day it's a device which i have used to improve my training improve my sleep and stay away from things which are definitely not good for me. It has been a game changer. Now, Whoop includes a heart screener with on-demand ECG readings, so you can check in on your heart anytime and share results with your healthcare provider.

37:20It also includes a health span, a new feature that demystifies the aging process and shows how your daily habits impact your pace of aging, as well as hormonal insights for personalized guidance throughout your cycle or pregnancy. It's the only wearable that gives you a truly comprehensive view of your body, designed to help you improve your performance, longevity, and overall health. So you can join now at joinwhoop.com forward slash first things thirst to get your first month for free. Let's get back to the episode. So for, I mean, the thousands of procedures you've done, for any of the ones that maybe didn't come out as well as you'd expected, what would have been the reason behind that?

38:02Is certain people's bodies just bound to reject the transplanted hair? It shouldn't happen, you see. I think, again, probably these things may be early in my career where I, again, I started off doing a lot of corrective procedures where people had strip surgery in the past or plugs. And one thing I learned was when there've been multiple surgeries to the scalp, every time you go puncture the skin, it recovers, puncture, recovers, the blood supply diminishes over a period of, so when I look back, I think the ones where the growth hasn't been exceptional has been ones where people have had repetitive work, five, six, seven procedures.

38:48Still the yield is there, let's say, but not 85, 90 % yield, maybe 50, 60 % yield. That is a failure, I mean, I think. But were the patients unhappy? No, because I think from what they'd seen, this 50, 60 % retention was better than the older surgeries. So then you realize, okay, you pick your battles. There are some clients where you counsel them extensively. You had seven surgeries before. Chances are your scalp is very tired. Exactly. Tired, fatigue. The blood supply is not the best. so if you're happy accepting a 50 60 percent yield we go forward yeah there have been scenarios where the patient's happy but i wasn't you know it actually looks a bit asymmetrical i can do a better job give me an hour and we've done a few of those so this is this is after after i look a bit closer and you know what i'm quite obsessed with super obsessive it's a it's not a great streak.

39:54It's got a downside, the obsessive streak. But when it comes to surgical work, it works. It works exceptionally well. I see no one actually, they come for follow-ups. Give me an hour. I just need about 30, 40, 50 grafts to adjust it a bit. So, that's something we do it. Not an issue. The other things where I've never seen an infection as such, there have been an odd instance where this is a really good story a client of ours was dating a very young lady and after the surgery

40:40I think she pulls all the graphs out so this is one scenario where I realized that you know what actually they do come off a lot easier so this is one occurrence I think she I think I think they were they were being a bit intimate and and he said I never initiated but there's two sides to the story obviously but that's one scenario where it was it wasn't a great outcome I think we had to revisit that and again we had a client to knock this scalp as he got into the cab and probably three four hundred grafts popped out but fortunately he came back in this amount we have to take more out they were dead again what we realize is they don't last long outside the body maybe 20, 30, 10 seconds they're dead so when you were putting it in the Petri dish there was fluid in there exactly okay interesting that'll be quick yeah I remember I think I went to Dubai shortly after and I jumped out of a plane skydiving did you?

41:41and I was thinking this is probably not the most sensible of ideas it's because of all the wind wind is okay wind is okay but helmets Yeah, yeah. So there's a few people cracking jokes, but. So I think when clients pick the surgeries, most of them pick the dates around their lifestyle. Yeah. Either a ski holiday or a summer holiday. And the consensus is you can wear ski helmets, but I suggest them wear the ones with vent two weeks after or four weeks. Four weeks is much safer. I think for me, it would make, if I'm going to do it again, it would be more suitable to around the wintertime. because if I was to do it in the summer and I was going to be in Dubai or somewhere hot, I'm probably going to be sweating a lot more often.

42:27So it's harder to keep cool. And then secondly, the chance of me being exposed to sunlight is going to be a lot higher. I don't know how bad sunlight is for it. Sunlight is bad. Okay. Sunlight on balance is bad because again, we see a lot of clients where the scalp is really damaged. So one thing I've learned is the scalp hair is exceptionally protective. So there's a medical reason for someone to get a hair transplant. So this is not the hair, this is the scalp. The scalp is exceptionally damaged because of sun. Yeah. And I think one thing we realize is faces you can see, early signs of sun damage, and it's changing into something a bit more sinister.

43:10You can pick up a lot quicker. But back of scalps, it's a bit slower. Yeah. so we've seen a lot of scenarios right so you know what actually I don't think there's I mean they come for consultation then we realize you know what you need some help here so I think my advice is wear a cap midday sun wear a cap yeah always safer this is after no matter whether you get a transplant or not if you lack hair on your scalp the best thing to do is protect it sunscreen cap midday sun yeah okay After, I don't think three, four weeks max, you can expose it. Sensible, sensible sound. Yeah. Okay. Let's talk about finasteride, papetia, because I mean, that is something which, again, I get asked a lot.

43:57And I remember before I started taking it, I did a hell of a lot of research into it. And to be honest, I ended up just scaring myself more than anything. Because realistically, if you think about it, if somebody has a good experience of something, they don't really feel the need to leave a review exactly they're just like oh cool yeah it works fine but when someone has a really negative experience about something for example it could be you know uh traveling whether it be a airbnb or a hotel if they have a bad experience there's a lot of emotion attached to that and they feel the need to to write it on the internet so all i was seeing was basically a load of people getting the negative side effects and probably a lot of people who were just psychologically uh damaging themselves like it was a big placebo because for example if if you take something where a potential side effect could be you losing your sex or not being able to maintain an erection then you know if you're about to get intimate with someone and all you're thinking about is not getting hard then you're probably not going to get hard like you need to be relaxed so i was like you know what especially because if i was going to make this investment with the procedure, I'm willing to do anything on the side to maximize the effectiveness of the procedure.

45:19So I started taking it. And I mean, to be honest, I didn't really experience anything. I think to begin with psychologically, I was probably just expecting something bad to happen. So some bad things happened, but then I kind of got myself out of that train of thought and then everything was fine. And obviously I go to the gym, I eat well, my testosterone naturally was pretty high so you know everything was was sweet but for people that have taken it or are considering taking it what percentage of those people are really going to experience some side effects percentages are hard you see i uh literature states around 1%, 1 to 3%.

46:07But I think reality in my practice, it's a lot lower. So I do a few things, you see. A, when you meet someone, you talk to someone, you do an assessment, you know what their personality is. Someone's reasonably comfortable, has a good lifestyle, sleeps well, sleep is key here, and then vitamin D is key here. If you have vitamin D deficiency, then Chandu Zha, you will get side effects. so I think in a way I'm a bit more cautious to prescribe it to everyone so the first phase is they make sure the parameters are all there like a naturally relaxed decent level of testosterone vitamin D decent levels of vitamin D so in my practice maybe I must have done maybe 20-30 thousand prescriptions and I've had probably 6 or 7 clients come back and say they don't like the side of it But then the key thing is everyone gets side effects in the early phases.

47:07There is some drop in DHT. The percentage-wise, it depends. Some people experience 50 % drop in systemic DHT. Some people a lot less. I was feeling something in my balls to begin with. It was like a little... Yeah, I think the logic is you're probably producing more semen. So the logic is to ejaculate more often. Yeah. um so um yeah so i think if you plan it well to start with a smaller dose let's say a 0.5 milligram every other day but what i see is most clients get transient side effects excuse me in the early phases you see a big chunk of clients having side effects and then a month two months in naturally to as well yeah yeah for me i was doing one milligram a day and i was like i need to make sure i take this daily i thought like there was a few days where i missed it and i thought i completely missed messed up the whole you know you're okay yeah i think minoxidil is a bit more critical because the blood supply sorry the half life is a lot shorter finish right even a week two weeks you should be fine yeah because now it's i've got very much uh sort of casual approach to it where i will each each of the pills is one milligram okay i usually just i bite off a half and then like a day or two days later i have the other one but i need to have it like on show on my counter otherwise i forget to take it yeah and then obviously if we go into extended periods of time probably not ideal although it's it's very it's interesting to observe because i may have forgotten to take it with me or run out and a week goes by or two weeks go by and i don't really think i see any it's not like oh everything's coming out um so you know obviously i don't want those periods to be for too long um but yeah i'm i'm i think since the procedure itself i've been fairly consistent with it okay okay but the question for me now is do i continue to take it or should i look at alternatives especially when it comes to maybe i think having kids yeah something you need to take into consideration there?

49:20Again, the literature states, you need about 300 pills a day for three months for any amount to be transferred through your semen. 300? Pills a day for three months. That's what the literature states, animal studies, okay? So they're giving some animals to be one student. Exactly. But I think our logic is chances of conception every cycle is 10%. It's not high it's only 10 percent um and then you you the added stress like oh my god i'm taking a pill yeah so what we suggest is probably if you're taking a finished right maybe six to eight weeks off it's out of your system if you're taking due to stride probably six months off due to stride you should be fine but again nothing to suggest you should stop yeah what so so you stop you wait that period of time, then you try to have kids?

50:16About six weeks. Just the safest period. It's out of your liver, out of your system. Yeah. But the half-life in reality is a lot less than that. Yeah. It's out of your system a lot quicker. Is there any, apart from that, is there any benefits of taking it? Finestride? Yeah. If you look at Finestride, most men by the age of 65 have an enlarged prostate. Yeah. So they take five milligrams every day. And if you look at a cross-section of men, they say their sex lives have improved on finestrite. You have a big prostate, obviously you have issues with urinary retention and erections, but then you shrink the size of it, the sex life blossoms.

50:58So I think the sexual side effects are overstated. But what I do realize is young men are under a lot of duress now. I think it's okay. It's never been this. I mean obviously I'm talking in terms of out of context here as we speak there's so many wars happening now suddenly but I mean the feedback I get is in probably human history it's never been this, you can't plan your life now, back in the day young man means go to war you're dead by your mid 20s but now you can construct your innings but then also you're getting a lot of feedback from people you rarely met in your life So I think they're under a lot of duress.

51:43Young men are under a lot of pressure.

51:48But I think, A, as long as your sleep is good, your diet is good, you work out, I doubt you get any side effects. Besides, you can stop the medication. Side effects are gone. Yeah. What other alternatives can people look into? So, again, what we started about 12 years ago was to try and find means where clients had side effects on oral medication. So we've got a few topicals, about six. So there's one with the, it's got Finistrite and Minoxidil in it. It's a small dose of Finistrite as a spray. It's not as effective as the pill, but the side effects are next to nothing. Very manageable side effects.

52:35So this, you would spray this on the scalp? Four to six sprays twice a day. Okay. Do you need to massage it in? Massage it in for a minute. Okay. Again, and then there are some clients who don't want Finestrade at all. We've got, again, minoxidil with fewer products that help penetrate it a lot better. But why would people not want topical Finestrade? I think it's a difficult one. Just because it's the stigma attached to it. They think, I don't want that anywhere near me. Exactly. Exactly. I think they are worried about potential side effects. But also what we realized is adding dutasteride to the mix.

53:20What's dutasteride? Dutasteride is, again, a 5-alpha reductase inhibitor. It's one that reduces DHT. So finasteride reduces DHT in the scalp somewhere between 10 % to 20 % based on the dosage. but dutastride reduces DHT by 90%. It's phenomenally effective. But the side effects are slightly higher as well. Okay. So as a cream, because the molecular weight is a bit heavier, we hardly see anyone complain of side effects. So what we've done is we put men who had side effects on oral finastride. We tried topical finastride. they say, for some reason the molecule, I don't want to be associated with it.

54:06Then you switch to topical dutastrite, they say, wow, I don't feel anything. So it's a bit heavier product, so the absorption is not the greatest. So we recommend using a derma roller. We've got a few media, it's liposomal, so the absorption is a bit better. I'm looking forward to trying this because I've not done anything topical. I think you should. So you could argue combining both would give you even better results. Exactly. So take your probably, I mean, every other day of 0.5 milligram finnestride if you can. Try the topical. Which one would you suggest for me to take? I think for you, I'd probably start with the topical dutastride.

54:46Yeah. And then let's say on the hierarchy of things, if you see what the management structure is, dutastride is the strongest. And then you have oral dutastride is the strongest. Oral finnestride comes in next. And then oral minoxidil is getting a lot of traction. Because what we realized is there's an enzyme called sulfyletransferase, which is not widely, which you need for the topical minoxidil to work. Not many men have the active metabolite in the scalp. So we realized oral minoxidil works a lot better. Fewer side effects. We see some men complaining of some fluid retention around the eyes.

55:26Very rarely. but topical comes in after all the topicals comes in after yeah because monoxynol is the is that the foam spray for the actimol the idea behind because I never actually I don't think I went forward with ever trying it just because of the just the inconvenience you're having to do it and the fact that if you miss it then the effects the shedding but there's a shedding could it be even worse after you've used it We don't know that, you see. I think the problem is you start at 20, let's say. Your tissue quality is exceptional. You stop at 40. Then obviously you manage to retain all your hair and then you see shedding.

56:10But then the question is, would you have lost all of them anyway had you not used it? So it's difficult. I mean, you start at 26 months, you stop at, let's say you're 21. Then I think you can correlate. I don't think the loss is greater. But 20 years down the line, the tissue quality has changed. Obviously, you might see a bigger loss. But the key thing with minoxyl is you do see some shedding initially. So all the minoxyl is doing is it's increasing blood supply to your follicles. So the antigen phase is prolonged. So the longer you use it, your hands in the antigen phase, the minute you stop it, they say, oh, okay, let's go back to our antigen phase.

56:47And so you say blood supply is the key here. so that's one of the reasons why the crown tends to be the first thing to go because it gets the least amount of blood supply one could argue but i think it's a bit more complex than that okay so would it make sense if i was to get a 15 to 20 minute head massage every day that could help potentially there's some evidence to support that so so again this is some i mean you've touched an important subject here. So what we suggest to our clients is there are a few things one can do without medication whatsoever. If you notice early signs of shedding or you don't want to experience any shedding, not to wash hair with hot water.

57:33Luquewarm shower is advisable. Heat is not your greatest friend when it comes to hair. And then hardness as well. So especially in London, the water is really hard. So water softener makes a big difference in the background. and then a sulfate free shampoo. Anything organic without sulfates does the job. And then your supplements. I'm a big fan of vitamin D with K2 and then walnuts or Brazil nuts. They have enough zinc, selenium, manganese, all these trace elements which you need for your vitality. Obviously a good protein diet. Again, you're big fans of sleep. I mean, it's one of those things, such an understated thing in the game young men don't sleep in now especially with all these electronics technology yeah i notice um a lot of people in dubai in the middle east complain about the water there's something in the water which causes the hair to fall out or thin i don't know i don't know if it's the thinning of the hair itself or the shedding but a lot of people in Dubai, especially it's women who are complaining about this because women are washing their hair every day.

58:47They put these filters in the shower head to try and minimize it. So I do know that is an issue. So if anybody's listening, maybe look into the type of water that's coming out of the shower head and address it either with a filter or wash your hair with mineral water instead maybe. Your hair is an option. I think it's great for your skin health as well, soft water. hard water is not your best trend it comes to skin health what about greying of the hair because this is something which I mean I'm soon going to be 35 there's some greys coming I mean thankfully I don't know why not on the top on the side I don't know if that's just the thing that happens I'm glad because I get it cut short on the side but I was speaking to someone and I get my blood work done quite regularly and my copper is consistently low.

59:46Now, that's not because I'm not supplementing on top of that. I think my body just has an issue absorbing copper. And he said there was a relationship between copper deficiency and premature graying of the hair. Is that true? Partially right, yeah. Partially right. I think your hair's losing your melanocytes, the pigment. Again, is this genetics, is it lifestyle? we see premature grain genetically there is a small genetic preponderance for that but predominantly lifestyle predominantly lifestyle and poor diet plays a big part I didn't realize that you had copper deficiency well okay is there anything that can be well it's getting better now so I have my supplements from Bionic so they I get my blood tested they then put together the specific formula based on the blood work and then I have, it's addressing the deficiencies which I have.

1:00:41And then those deficiencies might change over time, which is why my formula changes over time. But even with the supplement, the extra copper I'm getting in the formula, it should theoretically be higher. So what I'm doing on top of that, which I realized I was never doing before, was having organ meat. Organ meat's packed with those nutrients, particularly copper. So I'm now supplementing with the organ meat you've got kidney, heart, literally liver, everything. But it's very hard to see if that is making a difference or not. Yeah, it takes time. It takes time. So two questions. If you have gray hair, a gray follicle, can you reverse the graying or is that gray forever?

1:01:29Not yet, but there is some potential breakthroughs happening in front as well. I think they're working on an enzyme called catalase, which can repigment. I don't know where they are with the product, but I think the science is there to reverse the graying. And if there was graying in potential follicles, which could be transplanted, if you were to transplant a gray follicle to the top, the top's going to be gray. It would indeed, yeah. So this could be a problem. I need to wait until I keep this brown if I'm going to be doing a part two. But even if you transfer a pigmented follicle, like a darker follicle, it turns gray eventually.

1:02:13Okay, yeah, well, true. So maybe I'll just have to accept the fact that I might be a silver fox when I'm older. Another thing, if, let's say, for example, you had the perfect formula of everything, topically and orally, can you regrow hair?

1:02:34Um, regrowth, how do we address this? So the way hair thins is, you have thicker hair, which is three, four, five follicles, becomes thinner. On a basic level, let's say the threes and fours become ones and twos. And then they become even thinner. And then it turns into skin. So if you catch it at a stage where you're earlier in the cycle, let's say the ones and twos are there and you catch it early, try your DHT blockers. which is finished right, this right, and maybe minoxidil, and your diet improves, your sleep improves, your vitamin D levels corrected, and you're of a certain age because tissue region rates better when you're younger.

1:03:17We have seen some reversal of thinning. But I don't think you ever get it back to before you lost it. But you can see significant changes, significant changes in reversal of miniaturization. Because I've seen some people claim that their hair has like, they've seen hair growth and I'm like, I'm pretty sure that's not possible. Once it turns into skin, no. But having said that, I think there was a recent study where they found a molecule which works on the metabolic pathway. And in animal studies, they've shown that even if it's torment follicles, white skin, they've reversed it. So we might be having a different conversation in a couple of years.

1:04:00What about things like PRP and stem cells? So the PRP, I mean, you're probably going to do a better job of explaining it. That's when you would inject plasma? Plasma, exactly. You draw your blood out, take out the plasma. PRP, my gripe is we've had PRP for nearly 20 years now. and if something's that good, someone should have come up with a more consistent study. What bothers me is that there hasn't been any big study, consistent study. For example, we have studies on finestride, effectiveness of finestride, effectiveness of minoxidil. But PRP, it's hit and miss. And my take on this is if you're having like a post-stress shedding like telogen effluvium, I would steer clear of PRP.

1:04:53But then everything's perfect effect you just want an addendum where you want a little bit of uh i think the trauma helps this little micro needling without a shadow of a doubt and gentle trauma helps so i suspect what the prp is doing is region with the trauma might be helping um the growth factors in prp question depends on what kind of prp one's injecting and stuff but on the face it's really effective. So what we do is occasionally a-listen. The hair might work, might not work. Dermarol a bit apply on your face. It's really useful. It gives you a nice glow and very hydrating. Stem cells, a difficult question.

1:05:38This is in the early phases. In the early phases, but then there's been a lot of misconception. You see, Some people are selling PRP, our stem cell. Some people are using exosomes, like exogenous. So exosomes are messenger cells that communicate. They're saying they are stem cells. The nomenclature is flawed. I think my understanding is we did a study about seven or eight years ago where we took some of the fat cells, spun it around. It's a reasonably decent study, and we thought we'll inject it, A, pre-transplant, to see if it makes a difference. or inject it into the scalp and see someone who's thinning it makes a difference.

1:06:17I don't think the outcomes were exceptional enough for us to warrant proceeding with it. But I wouldn't be surprised if you maybe take stem cells from your bone marrow, iliac crest, or one of those regions. Early days, early days. So it would need to be your own stem cells? That's what I would have thought so, you see. I think there are some practitioners using new stem cells. I see it's in Dubai now. Yeah, yeah. Rejecting IV for tendon repair and stuff. Again, my understanding is very limited. I need to delve a bit deeper into it. Yeah. I guess it's a question of ethics as well, because a lot of these procedures and the people that are making money from PRP and stem cells or whatever, they're obviously going to say, yes, this works.

1:07:02That's a difficult one. You're right. So, you know, people who, these practices or individuals who are very good at marketing, you know, they will convince people to part with a lot of money and in reality the outcome is still pretty it's either unknown or just doesn't work but i've been in this situation before where you know you are losing your hair and it feels like the most important thing in the world you do anything to get your hair back so you're willing to do whatever or spend whatever to to to get it back and i would imagine a lot of people are probably doing that just wasting their money i think you hit the nail on the head i think clinics that are purely making their money out of PRP, they're obviously, they scream loud about it.

1:07:48But we don't offer PRP as a, I mean, I don't think it's cost effective. Obviously, that is an option. I say, listen, would it work? The social contracts are important, you see. If someone comes in and says, you know what? I looked like this before, what will I look after? But PRP, you don't know. You can't, you can't. These contracts are really important. People judge you. by what you do. And I think with transplants, there's consistency. Medication, there's some level of consistency, but obviously the risk is a lot lesser. But with injectables, we don't know yet. So you have your own practice.

1:08:24I do indeed. Yeah. And you've had that for how long? Post-COVID. What's it called? It's Restore Hack Clinics. It's 107 on Holly Street. Okay. And I mean, what does the future look like for you? I know you've done so many procedures, you probably get to the point where you're like, I can't do anymore. No, I'm really passionate about it, you see. But I think the physicality, because I operate 10 hours a day. And I mean, recently I've had a bit of a frozen shoulder. So I can't, you know what, actually I'm getting on a bit now. Obviously I work out every day. It does help sauna every day. I don't know, good or bad, but it does help.

1:09:02So post-work, I stretch, posterior chain workout, sauna, watch my sleep, live like an athlete. My alcohol consumption is Saturday night, maybe a pint or two, as low as that. But still, I'm realizing, you know what, actually, no matter how well you look after yourself at a certain phase, no wonder all these footballers after 30 don't get any contracts. so I think the future is if I find someone ethical, conscientious who's passionate about this I think there's room for a lot of young doctors to jump into this game you need a young body for this so you would coach or train people? Yeah, I think that's the aspiration where obviously I've had private equity take a keen interest in what I do but But I think the ethics doesn't add up.

1:10:01Their vision means mine. My vision would be, let's say, if I have four or five ethical doctors, it takes time. Maybe a couple of years of hands-on training. And then I think the markets are there. Fortunately, I'm quite lucky that clients that I worked on 16, 17 years ago are still referring to friends. So online game is a nightmare. We've never advertised it. It's very difficult. Yeah. You find people like me. They were a man. A word of man. In fact, you're the first person, Mike, who's ever admitted to something done. Yeah. Yeah, because I remember you said you had done procedures on quite a lot of famous people.

1:10:39Yeah, yeah. But they'd said, like, you can't talk about this. Yeah. Yeah, yeah, yeah. Which, I mean, I guess still quite a lot of famous people are coming to you and they... They do. They do. To be fair, they do refer. I think they, I'm very grateful that for the love in the sense that it's never stopped. They keep referring, they keep referring. And one thing is that gives us a lot of pride is the results look so natural that, I mean, some of the people are in the media every day and no one's picked up on it. So it's incredible. So that's testament to how far we push the boundary. Yeah, but you're not allowed to retire if I want a second transplant.

1:11:21I'm going to pull you out of retirement and be like, look, you need to do it. Maybe I'll go part-time. That's the thing, because nobody knows my hair more than you do and the procedure that has taken place. So I would be very concerned if somebody else was doing it. There are some challenges, like the curls and stuff. You have to make sure the curls are matching your other day. You need to give me a heads up before you retire. I'll book in for the last session. Maybe I'll go part-time. Or maybe I could be a fitness instructor. Influencer. I think definitely the content game is where it's at. The education, content creation.

1:11:59I mean, the sky's the limit. I think you could have your own certification of surgeons. It's high quality, you see, because one of my colleagues, she's an assistant. He's a lot younger than I. And he was the one that introduced me to YouTube about a year ago. Yeah. And since then, I haven't watched any TV. It's all YouTube now. There's so much information. you've got to filter out a bit high quality information but I think probably that's the way forward you're right so I guess for people who are thinking about this who are experiencing hair loss is there a step by step procedure they should go through especially for those people who are in their teenage years or early 20s and they're starting to experience it instead of rushing straight in for a transplant it's like okay should I get a consultation first should I start trying some medication first like because I mean obviously there's the concern of them not wanting to leave it too late to the point that you know they just it's harder and harder to actually get a good result I think the key message is seek help early meet ideally meet the surgeon that will be performing the surgery I would never advocate surgery for anyone under 30, ideally.

1:13:20Late 20s, someone that's got a lot of common sense, who understands the long-term implications, yes. But seek medical help. Earlier, the better. But I think we have so much information now, so many high-quality professionals in the game. If you catch it early, and I mean, as we were suggesting, being an 18-year-old bloke is a nightmare. Especially in the sexual marketplace, it's a nightmare. And then on top, you lose your hair. It becomes much harder. So I probably advise this, probably a dermatologist, so even your GP. The other thing that's worth mentioning is there's a genetic test, a DNA test one can do early on.

1:14:07If you've got a 30, 40-year battle, it gives you a breakdown of what might work for you what might specifically work for you so my routine now is obviously caffeine cream has come quite on top of is that within a shampoo or separate no it's a cream because you need to leave it on for a while okay so there are a lot of firms that are doing caffeinated creams i mean i use something from inkey less easy as my part of my protocol along with the topical dutertebride and minoxidil. Yeah, so what is your protocol then? Because you've had do you, once upon a time you had a bad procedure which got you into doing this in the first place?

1:14:48I was a junior medic and had a really bad procedure. I think maybe 10-20 % grew and then I had so much shock loss. Quite a bit of thinning behind. It's one of those things, if you have a bad knee or a bad back you you learn so much more about it don't you so i mean i i got quite obsessed back then and part of the journey was a i thought the surgery was bad and then you realize no the surgery is quite simple once you know the science it's a practitioner's because it's something only marathon runners need to do what i do sprinters this is not a game for sprinters so it takes time patients and sometimes as I said someone like yourself split it why spend 20 hours or rush through take your time so I think that helped me being in the other end of a bad surgery you become a bit more conscientious you care a bit more and then everyday you focus a bit better so my protocol now is a I tried oral minoxidil they didn't agree with me I do similar like you oral finish tried if I remember I keep forgetting but the topical didistride has been a game changer for me I use a 0.5mm derma roller once a week very gently so just going very gentle don't traumatize too much very gently and only once a week I don't use more than once I don't think there's any evidence more than once a week helps too much trauma is bad people use 1.5mm bigger bigger derma rollers.

1:16:27I don't think they're great. 0.5 is enough, sufficient. And throw away the derma roller every six or eight weeks. I think they start... They start shearing after. This is to improve blood flow. Circulation. So I use caffeine cream on the spray and I remember oral fitness. Just like you. Got a pill cutter though. I don't think biting is... Well, because sometimes you end up getting three quarters and then it just disappears or crumbles away. But the good thing about Dubai is you just get that over the counter. You don't need a prescription. Oh, is that so? Okay. Dubai is great. The amount of things you can get over the counter, even contact lenses.

1:17:12You can go over there and just get daily contact lenses. But here in the UK, you have to get a proper prescription for that. But I think you can fill something in online. like super drug for example a lot of pharmacies are doing it that way where you fill in the questionnaire they ship out the medication be it Finistribe, Minoxid, even Dutistribe it was expensive though I remember that it was more expensive than Dubai it's a lot cheaper now because I remember I don't know when the patent for Propecia came off it was all Propecia before like 50 quid a month and now Finistribe is like 10 a month maybe under and if you split it into two, three months, it's much less, you see.

1:17:56What was that about? The patent. The patent. So I think Merck held the patent for... So only they had a monopoly. Only they had a monopoly for a long period of time. I think maybe the patent expired six, seven years ago. Since then it's become generic. Okay. Become a lot more acceptable, a lot cheaper. Okay. So you don't hear so much about side effects now. when Merck held the patent there were side effects I mean people were screaming about day in day out now I think it's probably died down a bit it's funny I think there is a remedy out there like a combination of something whether you rub it or consume it I think it exists it's just a matter of time of us experimenting and figuring it out so i mean hopefully you're the one that discovers it it'll be very uh very wonderful uh in many ways but i think the way we look at science is we learn something new every year so i think a few years ago there was this logic of a product which blocks dht attaching to the hair follicle what a great concept um lab studies were phenomenal but then in reality didn't work as well.

1:19:15And then there was the study which showed dextrose, topical dextrose, really helps hair. And then... So just like sugar? Sugar, exactly. And then there was a study which showed hair follicles have smell receptors. So things like rosemary oil, sandalwood, caffeine, the smell of coffee helps a little bit. So you're right, in some ways, let's say we add all this information together, and one product and I think one and done I'm pretty sure started 16, 17 maybe a couple of sprays every night you forget about your hair loss forever I'm sure there's some tribes in the Amazon or whatever indigenous ones they all have full head of hair so they're doing something so I was traveling around Peru and I nobody's lost hair there then I started talking to them they chew on that saw palmetto okay and I'm convinced that's probably one of the reasons why Propecia came into, became a bit more acceptable.

1:20:16So they chew on, I think, from a young age, they chew on so-palmato. So none of them are lost here. And besides the water, it's very soft over there. Yeah. And sun. Yeah. And probably better organic food. Mm-hmm. And I suppose, like anything in life, isn't it? I think the simpler you keep it, the easier it is. The more complexity you add to life, the more stresses. Yeah. I'm sure the acid-free radicals don't help. Yeah. awesome where can people find you if they want to learn more or maybe book in a consultation so we are based at 107 Harley Street the website is restorehackclinics.com but

1:21:02the other site is drraguredi.com you can see all the transformations there exactly that's what sold me exactly thank you very much man And I appreciate that. And hopefully a lot of people listening get some sort of benefit from it. Pleasure. Absolute pleasure.