Why scalp tension does NOT cause hair loss

Timestamps
00:00 Sup chooms!
02:55 Description of scalp tension/bludflow theory
04:56 Objection #1: Pattern of scalp tension is wrong
11:17 #2: Blood vessel anatomy is wrong
12:46 #3: Scalp vascular network is redundant
14:48 #4: FUT would cause hair loss
16:16 #5: Decreased scalp bludflow is a consequence of AGA
19:46 #6: Botox data does not prove the bludflow theory
21:55 #7: Scalp message doesn’t increase bludflow
22:48 #8: Bludflow theory debunked over a century ago
23:56 #9: Minoxidil doesn’t work by increasing bludflow
25:18 Conclusion

Linked videos

Sources
1. Osborn D. INHERITANCE OF BALDNESS. Journal of Heredity. 1916;7(8):347-355. doi:10.1093/oxfordjournals.jhered.a110746
2. Orentreich N. AUTOGRAFTS IN ALOPECIAS AND OTHER SELECTED DERMATOLOGICAL CONDITIONS. Annals of the New York Academy of Sciences. 1959;83(3):463-479. doi:10.1111/j.1749-6632.1960.tb40920.x
3. Nordström RE. Synchronous balding of scalp and hair-bearing grafts of scalp transplanted to the skin of the arm in male pattern baldness. Acta Derm Venereol. 1979;59(3):266-268.
4. Goldman BE, Fisher DM, Ringler SL. Transcutaneous PO2 of the scalp in male pattern baldness: a new piece to the puzzle. Plast Reconstr Surg. 1996;97(6):1109-1116; discussion 1117. doi:10.1097/00006534-199605000-00003
5. Shoemaker JK, Tiidus PM, Mader R. Failure of manual massage to alter limb blood flow: measures by Doppler ultrasound. Med Sci Sports Exerc. 1997;29(5):610-614. doi:10.1097/00005768-199705000-00004
6. Poster Presentations. Int J Trichology. 2012;4(2):131-152. Accessed December 21, 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3500072/
7. Tellez-Segura R. Involvement of Mechanical Stress in Androgenetic Alopecia. Int J Trichology. 2015;7(3):95-99. doi:10.4103/0974-7753.167468
8. Shon U, Kim MH, Lee DY, Kim SH, Park BC. The effect of intradermal botulinum toxin on androgenetic alopecia and its possible mechanism. Journal of the American Academy of Dermatology. 2020;83(6):1838-1839. doi:10.1016/j.jaad.2020.04.082
9. Zhou Y, Yu S, Zhao J, Feng X, Zhang M, Zhao Z. Effectiveness and Safety of Botulinum Toxin Type A in the Treatment of Androgenetic Alopecia. BioMed Research International. 2020;2020:e1501893. doi:10.1155/2020/1501893
10. Deng Z, Chen M, Liu F, et al. Androgen Receptor–Mediated Paracrine Signaling Induces Regression of Blood Vessels in the Dermal Papilla in Androgenetic Alopecia. Journal of Investigative Dermatology. 2022;142(8):2088-2099.e9. doi:10.1016/j.jid.2022.01.003

Sup Chums how y’all living hope everything is Nova and you’re all having a preme week so you Chums obviously don’t need me to tell you that the hair loss industry is one of the biggest scam Industries to have ever existed navigating the internet for quality hair loss information can feel like a Jungle

Sometimes there’s dangerous misinformation about hair loss and scam products and programs around every crevice you see that is why our mission here at the Hair Cafe Institute of scientific research at K Moren is to show people what the actual scientific consensus is by breaking down and presenting data in an understandable

Manner this is the best way for aspiring hair loss witchers to learn how to defeat the slap head curse once and for all that means being able to identify what works what doesn’t work and what is just a Flatout scam anyone who has dipped their toes into researching hair

Loss witchery will inevitably encounter many scams while they’re on the path but the most common scam by far in the hair loss industry is what is known as the scalp tension Theory much like Satan the scalp tension theory has many names but on this channel it is officially known

As the blit flu Theory so henceforth that is what I will call it so the blit flu Theory it is the foundation of virtually every scam product or program that has ever existed about hair loss no joke you look up virtually any fraudulent product or program that

Claims to stop hair loss almost all of them will claim that they work by improving boot flow to the scalp so if the boot flow Theory could be classified as a monster from The Witcher it would be a drowner or a Necker since you can’t walk 3 feet without stumbling over one

And it feels like every time you kill two of them four more pop up to take its place it is not only a false Theory but it is also an incredibly obnoxious one and one that I have debunked many many times on this channel in fact and I

Don’t mean to toot my own horn here but my video where I respond to what I’ve learneds video titled what I’ve learned in Rob England debunk is probably the most thorough scientific dismantling of the whole scalp tensions scalp massage blood flow Gallia abine neurotic nonsense that has ever been done by

Anyone in human history or at least in the hair loss industry I wish that video got 10 million views frankly because it contains the most irrefutable evidence ever presented that debunks every talking point ever made about scalp tension in case you haven’t seen it yet I will link that video below along with

Some other videos that debunk the blfu theory that I’ve done in the past so I was hoping that video would silence the debate about this subject once and for all but looking back I can understand why it didn’t because the video is pretty long-winded and admittedly

Sometimes it takes me a while to get to the point so I thought for this video I would do things a bit differently and just list all the reasons why the blue flow/ scalp tension theory is wrong and I’m going to do so by using evidence-based scientific data to

Demonstrate why it is wrong even at the theoretical level every point I make will be timestamp below for ease of access or if you want to skip ahead to a point you’re more interested in hearing and of course as usual I’ll provide a list of references in the description

Section below if you want to do the research yourself but before we dismantle it completely let’s quickly go over what the blue flow/ scalp tension theory is supposed to to be the idea is that the fundamental cause of male pattern baldness is scalp tension and that is because when the muscle

Surrounding the scalp as well as the connective tissue over the skull called the Gallia aptica ense it causes the arterial branches of the scalp to get compressed which starves the hair follicles of the blood supply needed to keep them alive the original blood flu Theory just claimed that the lack of

Blood caused hair loss but once the actual science behind hair loss showed us the importance of DHT and genetics the theory has had to be modified multiple times so that con artists could continue to Market their grip to consumers in order to account for the actual science and to give the Blu

Theory the veneer of legitimacy in recent years the Blu Theory proponents have claimed that the scalp tension concept is directly related to dht’s proven role in causing hair folicle miniaturization they claim that because low blue flow causes a low oxygen environment in the scalp the lack of oxygen creates an environment where

Testosterone is more likely to be converted into DHT which then goes on to destroy the hair follicles some of the through proponents even try to account for the genetic inheritance of hair loss by saying that scalp tension is due to the skull shape and it’s the skull shape

That is inherited and that this therefore causes scalp tension that leads to hair loss so the Blu Theory it’s kind of like the Doppler from The Witcher that is constantly changing forms it is difficult to Vanquish because when you debunk it in one form it reappears in a different form since

The BL flu conspiracy theorists they like to constantly change the goalpost and speaking of goalpost I actually did a video about the skull expansion theory that I’ll link below in case you haven’t seen it yet but I am definitely not going to let them get away with their

in this video I have had years of experience debunking this stupid obsolete Theory and I can assure you that it is no match against my silver sword coated in snake oil Venom that’s right jumes it is time for us to kill the bloodflow theory once and for all

And burn it with the igny sign so it has no chance of scamming any hair loss sufferers ever again so let’s go over this point by Point number one the pattern of scalp tension is wrong if you’ve ever fallen into the scalp tension rabbit hole then you’ve probably

Seen this image it is a figure taken from this paper here published in 2015 looking at it you might think at first that if that figure is showing the pattern of scalp tension in the human scalp it matches pretty well with the common pattern of male pattern baldness

And that can’t be a coincidence right so the way this image is passed around the hair loss forums you would think it is an actual measurement of scalp tension in a real living human being but you would be wrong what this actually is is just a computer simulation of a SC thus

It is just a prediction of tension on the scalp using a computer model it is not an actual measurement and is not even a good computer model worse than that it is highly oversimplified as a model it is just a two-dimensional model which wouldn’t correlate well with a

Scalp since a scalp is of a three-dimensional proportion comparing this picture to a human scalp is like comparing a square to a cube or a cube to a tesseract it is only superficially similar this computer generated image here doesn’t actually show any scalp tension it is just to predictor based on

A lot of assumptions and it isn’t validated by any actual measurements in humans also even if this diagram was truly a diagram of scalp tension it doesn’t account for the fact that androgenic alopecia doesn’t always progress in this typical Norwood pattern there are people who have androgenic alopecia who have diffuse thinning or

Even retrograde alopecia where they will lose their hair first in the areas which according to this diagram have the lowest amount of scalp tension which wouldn’t make any sense if scalp tension were a positive factor in causing hair loss and that’s even a assuming this diagram is accurate at all which is far

From verified another problem with this model is that the pattern of scalp tension is expected to be the same in all men specifically men with balding and men with completely normal hair the authors of the study actually point this out they say quote probably the mechanical variable is not too different

Among all men it is unlikely that the mechanical variable can trigger the early development of baldness itself unquote so really this pattern doesn’t explain anything about the mechanism of balding it has to be due to other factors like the effects of DHT and the hair follicle which are genetically

Programmed to miniaturize and die out furthermore we know for a fact that where a hair follicle is located on the scalp has nothing to do with how fast it miniaturizes we know this because of research done by Dr orri in the 1950s who is the doctor who performed the

World’s very first hair transplant back when he did his research the scalp tension theory was taken more seriously since it wasn’t until the 1970s when we discovered the importance of dhts role in causing hair loss so to test this Theory Dr orri first extracted hairs from the aspal region which is now known

As the donor region of the scalp to the front balding region of the scalp and those hair follicles survived but what’s even more interesting is that he also did the opposite of that he extracted balding hairs from the temporal regions of his subjects and transplanted them to

The areas of low scalp tension in the back and aital regions of the scalp and the hair follicles continue to miniaturize at the same rate as if they had never been moved at all thus Dr orri concluded that there was donor dominance in androgenic alopecia which was called alopecia prematura back

Then based on this finding he was able to conclude that quote the pathogenesis of common male baldness is inherent in each individual hair follicle probably each individual follicle is genetically predisposed to respond or not to respond to androgenic and or slash or other influences that inhibit its growth on

Quote he even specifically addresses the scalp tension Theory by saying quote this study would seem to few theories of the pathogenesis of ordinary human baldness based solely on The Chronic activity of the scalp muscles via branches of the facial nerves that lead to shearing stresses in the dermis of

The scalp and consequent esea unquote when he is talking about esea he is talking about low oxygen levels in the scalp from low blood flow the research was further verified by Dr Nordstrom in the 1970s who extracted balding hairs from a patient’s scalp and then transplanted them to the patient’s arm

And once again there is no change in the rate of hair follicle miniaturization it continued to miniaturize as if it were still on the scalp Dr Nordstrom concluded quote the male pattern baldness process of the hair follicle is not reversed by a change in its location on the human body unquote that is

Because what causes these hair follicles to miniz in these specific locations has nothing at all to do with scalp tension it has everything to do with genetic determinism instead during the embryonic stage of development humans who inherit the androgenic alopecia Gene will have hair fogal that have a Gater density of

Anen receptors as well as more 5 AR activity and thus more DHT the hair follicles with the most an receptors and 5 a activity will for most people be located on the temporal region as well as the crown of the scalp which is why most people will start losing hairs in

Those areas first as I explained earlier though there are exceptions to this pattern which is why some people with androgenic alopecia will lose hair first in areas that supposedly have less scalp tension as we see in people who have diffuse thinning or retrograde alopecia now a common Counterpoint you hear from

Scout tension conspiracy theorists is that genetic determinism can’t be everything because hair transplants can Minze over time too what these dorks are forgetting though is that in men with androgenic alopecia the donor hair is not immune to DHT it is just more resistant to DHT than hair on the top of

The scalp if you look at people who have extremely aggressive Anri alopecia like people who are Norwood sevens they’ll have just a very small ring of diffuse hair around theirin SCP so hair transplant recipients who have extremely severe hair loss will have hair extracted from outside their donor area

Because the donor area is just too small to meet the demands of a hair transplant that requires several thousands of graphs even that tiny bit of donor hair can still thin as you see in people like Prince William who has diffused hair loss even in the tiny bit of hair he

Still has around his scalp that is why doctors will still prescribe finasteride to hair transplant patients because having a hair transplant will not prevent non-donor hair from from falling out and since even donor hair isn’t completely immune to DHT not using finasterid can still cause donor hair to

Fall out of course I went over all of this in much greater detail in another video titled why hair transplants last forever and I’ll link that video below but I just wanted to summarize that point before moving on number two the anatomy of the scalp blood vessels wouldn’t be affected by scalp tension

Even if it did exist out of all the points I have ever made in previous videos this one is probably the most daming of all to the blood flow Theory proponents because it shows that even if scalp tension was occurring it wouldn’t make any difference for hair loss whatsoever because anatomically the

Scalp vascular networks are not obstructed by any human tissue if you look at any human anatomy chart that examines the blood vessels responsible for delivering blood to the scalp and the hair FAL you will see that the blood vessels lie above the scalp muscles and Gallia auroa in this figure here you see

All blood vessels that supply blood to our scalp run over not under the muscles of the head and in this figure here you see that the major blood vessels run just under the skin in a layer of fat that lies over and not under the Gallia auroa similarly for fans of the theory

That Dental malocclusion pinches the superficial temporal artery between the Jawbone and the skull a CAT scan of the superficial temporal artery shows that it does not run in the mandibular joint it instead runs above the joint as you can see here and I made a video about dental malocclusion recently which I’ll

Link below so factors like tight scalp muscles or a tight Gallia auroa or even Dental malocclusion wouldn’t matter at all because the blood vessels lie on top of these tissues so they can’t be obstructed by them furthermore even if the blood vessels could be obstructed it still wouldn’t matter which leads me to

My next point which is number three the scalp vascular network of the human scalp is redundant so obstructing the arteries doesn’t matter have any of you guys noticed how some people or maybe even yourself have a bulging artery that you can see under the skin of your temples that’s called the superficial

Temporal artery and it is one of the only arteries that can actually be seen Under the Skin hence it’s name well this is one of the arteries that provides blood to the scalp but some people don’t like the way this artery looks under the skin and because of that there is a

Fairly popular cosmetic surgical procedure where patients who don’t like the way the artery looks can have it ligated which means it is surgically tied off completely now you may think that this surgical procedure could cause hair loss since the superficial temporal artery supplies blood to the scalp but

It turns out this is not the case and the surgeons who perform this ligation surgery even make note of this as you can see here this is because the scalp blood supply is redundant there are actually 12 arteries supplying blood to the entire scalp six on each side so if

The blood supply gets cut off from one artery it will just increase the blue flow in the other arteries so the overall blood supply in the scalp is still exactly the same to give you a picture of this just imagine that your scalp is a tank of water and the six

Blood vessels are pipes that are pumping water into the tank so if you to plug up one pipe then the water pressure would increase in the other pipes and the overall water supply will be the same and that is because the pipes just like our scalps blood vessels are all

Interconnected the blood supply of the scalp is very redundant and it is very extensive which is why scalp wounds bleed so much when they’re injured this is what makes the whole scalp tension SL BL flu Theory so horrendously flawed it’s the fact that even if our scalps

Were tense it would have matter to the blood supply to the scalp at all the only way you could actually be able to reduce blood flu to the scalp would be to tie off all six of the arterial branches on each side of the scalp and

If that happened then hair loss would be the least of your worries because your scalp skin would also Slough off and die and you’d be looking at your bare Gallia auroa which wouldn’t be a pretty sight number four if scalp tension caused hair loss then fut hair transplants would

Also cause hair loss so for those of you who don’t know what an fut hair transplant is it is basically the uglier more brutal form of hair transplantation surgery that is usually used for larger procedures since it is cheaper than the Fue method which extracts hair Foles individually and charges per hair

Follicle the reason why I say it is brutal and uglier than an fuee is because the fut surgery requires more recovery time postop since the way the surgery is performed is that the surgeon will literally remove a sizable strip of meat from the donor region of the scalp

And then harvest the hair fals from that strip of Flesh in order to utilize the hairs for hair transplantation surgery since surgeons will literally remove a strip of Flesh that can be a couple of centimet wide as well as 30 cm long that means that in order to close the wound

The skin has to be sewn tightly back together with stitches which means the skin would be pulled together even tighter than it already is so if the scalp tension Theory were true then we’d see evidence by now that fut surgery accelerates hair loss it is the oldest form of hair transplantation surgery

After all however there is no published evidence that fut transplants cause accelerated hair loss in the donor region compared to Fue transplants which do not involve the creation of a large scar some people may argue this by saying that hair transplants actually do miniaturize but that is something I

Already addressed in point number one and it is just due to the continued progression of androgenic alopecia in the donor area number five any decrease in the blue flu in the scalp of bald men is a consequence not a cause of hair loss so at this point you may be asking

But given isn’t there evidence that there actually is reduced flew in the scalp of baldman well back in 1996 Dr Goldman published this article here in the article he took nine bald men and nine men with normal hair and he found that there was Lower Blue flow and lower

Oxygen levels in the bald regions of the scalp versus the hair growing regions of the scalps in baldman Dr Goldman speculated that low oxygen levels in the balding areas inhibited Aroma tase so that more testosterone was converted into DHT however people who read this paper treat this as a proven fact fact

That low oxygen increases DHT the reality is is that this was just speculation and has never been proven as a matter of fact the weight of evidence shows that decreased blood flow in balding scalps has been shown to be a consequence and not a cause of hair loss

Each hair follicle is basically a miniature organ with its own blood supply as you can see in this figure right here so if you lose hair follicles from androgenic alopecia you will also lose the blood capillaries that Supply blood to the follicles and blood flow will go down but that still makes the

Question which comes first the decreased blood flow or the hair loss well fortunately we have this very recent article that directly addresses this question right here in the study the investigator showed that one of the results of anic alopecia is a loss of the capillary blood vessels that supply

Blood to the hair fals and can you guess what causes these blood vessels to regress Chums that’s right it’s the trash hormone DHT the study goes into the various signaling Pathways involved but the bottom line is that this destruction of the hair follicles blood vessels is a Downstream effective DHT a

Major implication of This research is that it is very important to start finasteride or dutasteride early because the loss of blood vessels happens early on and when it happens miniaturization may be inevitable this is why I always say that the earlier you start treatment the better your results will be and I

Talk about that in my why finasterid stops hair loss forever video which I’ll link below but anyways the investigators they conclude quote in summary this study reveals that anen receptor mediated paracrine signaling mainly TGF beta signaling from dermal papula cells induces the regression of blood vessels

In dermal papula at the early stage of hair follicle miniaturization and the pathogenesis of androgenic alopecia and sustains the notion that early anti-androgen therapy is better than late an androgenic alopecia treatment unquote so this means that the decreased oxygen levels found in the Goldman study are actually due to the destruction of

Microscopic blood vessels by DHT and it has nothing to do with scalp tension at all and if you think that the study implies that we should try to increase blue flow in order to counteract this problem it won’t work because we are dealing with the actual destruction of

The capillaries no amount of increased blue flu will overcome that problem the only way to prevent this destruction is to treat the underlying cause DHT and the only way to treat that is with five air blockers like finasteride or dutasteride in fact if anything hypoxia meaning low oxygen levels is actually a

Stimulant for hair growth low oxy triggers signaling Pathways that induce the anen grow phase of the hair cycle in fact there’s even a hair growth stimulant on the market today called stoan that works by this very mechanism so even if scalp tension actually caused low blue flow and low oxygen levels in

The scalp which we’ve already shown that it doesn’t then that would actually promote hair growth rather than inhibit it number six Botox Botox it is the ultimate trump card of the blue flu Theory proponents there are several studies showing that injections of Botox into the muscle mus surrounding the

Scalp can cause hair growth in subjects who have androgenic alopecia the most recent and largest study so far is this one here in this study 63 subjects with andretic alopecia received either Botox injections or Botox injections plus finasteride hair counts improved in both groups over 12 months with slightly

Better Improvement in the combined Botox plus finasteride group versus Botox alone these subjects received a lot of Botox there were 30 injection sites in each subject including the frontal muscle temporal muscle icular muscle and a cpal muscle the subjects got Botox injections every 3 months so everyone

Knows that Botox relaxes muscles so is this the final proof of the scalp tension Theory not so fast jumes in this article here 18 men received Botox injections not into the muscle but directly into the scalp this was an intradermal injection not an intramuscular injection and yet these

Men also got hair growth from Botox not only that the study found that Botox decreased TGF beta 1 which is a NE negative growth factor induced by DHD in the hair follicles so Botox in this study cause hair growth by biochemical mechanisms that have nothing at all to

Do with muscle relaxation so I’m sure someone is saying right now but Kevin that was an intradermal injection not intramuscular injection so why does a study matter if we’re talking about scalp tension well it matters for two reasons one is that it has been shown that Botox can cause hair growth by a

Mechanism that has nothing to do with muscle relaxation the other reason is that there is no reason to believe that 30 injections of Botox into muscles just stays in those muscles and never reaches the scalp drugs diffuse from the muscles into the skin and the drug hangs around

For a long time which is why you don’t need to get a botox injection every day to combat wrinkles so it is extremely naive to think that these intramuscular injections right next to the hairline don’t actually have any direct effect on the hair Foles bottom line is that the

Botox data does not show that scalp tension has anything to do with hair loss number seven scalp massages don’t even improve blood flow to the scalp to begin with so we’ve already been over in part five why increased blood flow doesn’t actually promote hair growth and we’ve also explained in part two and

Part three why blue flu isn’t even restricted to begin with but even if scalp tension and low blue flu caused hair loss scalp massages wouldn’t work because massages don’t actually increase blue flow blue flow it can be measured using an instrument called a Doppler ultrasound and this instrument was used

In this study here to assess changes in blue flow with forearm and leg massage regard regardless of the technique used or the size of the muscle massage had no effect on arterial blood flow as shown in this figure here this was true whether you massage the small muscles of

The forearm or the large muscles of the leg so the research suggests that even if scalp tension inhibited blood flow and caused hair loss which it doesn’t scalp massage wouldn’t work anyways and would be a complete waste of time number eight the blute flu theory was debunked

Already over 100 years ago in fact back when we were still fighting World War I the bo flu theory was a major theory for hair loss and just like today scammers took advantage of people who were desperate to save their hair in those days all men wore hats and it was

Thought that the tight headbands of these hats caused constrictions of blue flow and that this was the cause of hair loss however a pioneer of hair loss research named Dorothy Osborne back in 1916 published this Landmark study that not only showed that hair loss had

Nothing to do with BR flow but she also for the very first time showed that it was an inherited disease she found that the pattern of hair loss did not match the location of the hatbands she also showed that hair loss is a genetic trait fast forward to today and we now have

The advantage of molecular genetics and molecular biology to work out the mechanism of androgenic alopecia and we now know that the central mechanism is indeed androgenic androgenic alopecia is caused by the trash hormone DHT but even over 100 years ago Dorothy osbor knew that the blood flu theory was utter

number nine bonus track minox is a vasod dilator but that’s not how it works for hair loss okay so that pretty much sums up why scalp tension and bl flu have nothing to do with hair loss but literally every time I have ever made a video about the bfu theory I

Always inevitably get at least a few comments from people who say things like but K what about minoxidil it works to grow hair and improves blood flow it is a vasodilator so that proves the blood flow theory is real so haha okay minoxidil is a vasodilator but look at

This list of vasod dilators there are 34 vasod dilators on this list can you guess how many of these 34 vasod dilators work as hair growth stimulants it’s exactly one minoxidil none of the others do anything whatsoever for hair growth if improving blue flu cause hair growth every single one of these drugs

Would cause hair growth because like minoxidil they are all vasodilators when minoxidil was developed as a blood pressure medication it came as a complete surprise that one of its side effects was hair growth because no other vasod dilators caused hair growth the reason Min oxidal causes hair growth has

Nothing at all to do with its effects on BL flow the actual reason monox works is unknown but most researchers feel it works by opening a specific potassium ion Channel and that this is what stimulates hair growth so the effect is a biochemical effect on the hair focal

Not an increase in blue flow so I think that about does it I’m sure this video won’t actually convince the most extreme blue flow Fanatics because their views are unalterable and this is more like a culture War battle for them at this point but I still nevertheless hope this

Summary lays to rest once and for all the scalp tension nonsense and that this video will be a good reference for you when scammers try to convince you that scalp massages or any other gimmick designed to improve blue fluid to the scalp is the answer to all of your hair

Growth prayers so with that I’m going to go ahead and close shop for today and I’ll see you all next time my fellow hairloss witchers God bless