Dr. Melissa Anzelone: EPISODE LINK

TRANSCRIPT:

COLLEEN: Welcome back to Hot Flashes on Cool Topics. Today, we have on Dr. Melissa Anzalone, and she is the Senior Director at Nutrafol. Welcome to the show.

DR. ANZELONE: Thank you so much. I’m so happy to be here this morning Um, it’s really to have a dialogue about, you know, this really, I think, important topic, menopause and hair, right? And kind of what that looks like.

COLLEEN: You know, women are going through so much when they’re in menopause, you know, our bodies are changing, our, you know, anxiety and our mental health and our hot flashes. And now we have to deal with the issue of hair thinning for a lot of women. What let’s start with a simple question. What is happening to our hair during menopause?

DR. ANZELONE: Yeah, it’s a great question. So basically we’re seeing a decline in estrogen and progesterone, right? We’re not going to have cycles. We’re not going to have babies and then because of that basically the hair doesn’t stay in the growth phase for as long as it used to so If you’ve ever been pregnant, right, been pregnant, pregnancy hair is the best hair because estrogen and progesterone are so high and then the opposite happens in perimenopause, menopause. So kind of without those hormones, the hair doesn’t stay in the antigen or the growth phase as long. So it kind of quickly moves through the growth phase and says, “Okay, well, we grew for awhile, perfect. And then kind of sheds or just stops growing. So that’s kind of the option on that side. And then from like a testosterone point of view, I always think of like estrogen and progesterone as these like chaperones for testosterone, like testosterone to me is this like unruly child on the playground, right? He’s going to swing the swings and smack the kids and do things he’s not supposed to. So without his chaperones,
without estrogen and progesterone, he can be bad. And the way he likes to be bad in the body is turn into DHT, this hair harming hormone. So estrogen, progesterone, aloe, the unruly toddler that’s testosterone becomes unruly, turns into DHT and that’s going to cause like a wider part or recession like here or here. Unfortunately that’s the thing that the DHT likes to do the hair.

BRIDGETT: So what is something that Nutrifol can do to help women in perimenopause or menopause and they start to notice hair shedding and they’re taking the shower  And you’re like, what is on my fingers? What is something that a person could do if they wanna reach out to Nutrifull and say, maybe they can help. Maybe there’s something there that could help me.

DR. ANZELONE: Yeah, so really for peri -post menopause, the best formula is our women’s balance. So that’s to have two ingredients that are specific to women 45 ish, right? And older. So we’re going to take care of that DHT problem with something called salt palmetto. That’s going to block that DHT so it can’t harm the hair. And then we’re going to really focus on stress, right? Because as we change, as we maybe send our kids off to college, right, or wherever we’re doing life, you know, our stress hormones probably through the roof, right? That’s it’s causing all that shedding. So that’s an ingredient that’s really going to help to reduce those clumps, reduce that shedding overall. And that’s something too.

BRIDGETT: I know that I was looking at Nutrafol website and there’s so many different factors that can contribute. So you said stress and then the hormones shut down. Are there other issues as well that contribute to this?
DR. ANZELONE: Yeah, there’s basically like six things that are gonna affect your hair. And we break it down like that because we want to really be comprehensive. We don’t want to overwhelm people, right? And be like, oh my gosh, look at all these things that affect your hair.
We just want to really point out the problems so we can be that solution. So it’s really stress, hormones, nutrition, aging and environment. So all those things are coming together to impact your hair, which is great. If we know that, then we can really have an ingredient for each one of those things.

COLLEEN: Can we dive a little bit into that because you do divide them up and stress is not age -related. You can have stress at any age, but of course, when you’re going through menopause and you don’t have estrogen or progesterone and the crazy child testosterone is running through. I was reading on your website that stress can actually prematurely shift out of the growth phase for your hair and into the rest phase. What exactly is the rest phase for your hair?
DR. ANZELONE: Yeah, that’s 100%, right? So similar to how estrogen progesterone keep the hair in the growth phase, stress hormone or cortisol want to pull it right out. So when we’re stressed, right, whether we’re actually really in danger, or, you know, we just missed a deadline for work, the body responds in the same way, right, it increases our cortisol. And then that takes our hair from the growth phase, and puts it into that rest or catagen phase, almost like a pause, right, the body says, Okay, we have more important things to do right now, and grow hair, right? Let’s get her out of danger. Let’s make sure she’s okay, right? Make sure she hits this deadline or is on time for something. You know, a modern society. Most of the cortisol spikes that we see every day aren’t things that are gonna really harm us, right? They’re just more so, you know, things that we’ve agreed to and maybe aren’t aligned with. But really that cortisol is a pause button, takes it out of the growth phase and puts it into that resting phase.

COLLEEN: One of the second ones and lifestyle we can get to after is aging and your scalp loses collagen. It’s not enough that our faces are losing collagen, but now our scalps are losing. Can you talk about that?

DR. ANZELONE: Yeah, absolutely. I think sometimes especially if you have longer hair, we we don’t really think about our scalpless skin, right? Like it’s just kind of the place where the hair comes out, right? Maybe it just is, you know, really not in our mind unless it ages, right? Or unless it’s causing like a problem. So, I mean, I can tell you this is what I do all day every day. I don’t really think about it, right? So, it’s like it’s covered over at a site out of mind, but It’s just like the skin here, right? Except it has a whole bunch of little follicles, right? Little holes that the hair comes out of. So yeah, unfortunately, ooh, as early as 25, we start to see the body.

COLLEEN: That hurts.
DR. ANZELONE: I know, I don’t know what to say it. I was like, oh, 25, that’s like a baby. But yeah, the body starts to break down the collagen in our face and in our skin, right up here, and say, okay, you know, I don’t think she’s using this. Let’s take it and put it somewhere else, right? Let’s put it in the joints. Let’s put it in the muscles, ’cause really that’s a priority for the body. And we start to see that change when estrogen starts to change a little bit. So we can see that, you know, even as early as 25, 30, 35 is like that sweet spot where it really is starting to change. So again, once we lose that, I’ll call her executive director that is estrogen, that executive director keeps the collagen here once that starts to go down, then the body says, okay, we don’t have a boss right now. So we’re gonna take that collagen and put it somewhere

BRIDGETT: Yeah, you know, I we’ve heard that or I’ve heard that a lot that and you mentioned that earlier that when your body Does it need your hair? You don’t have to have your hair to live So it’s going to another part of your body But mentally a lot of there’s such a connection especially with women with their hair and they’re just you know It’s just your overall mental Well -being there’s that connection. They always call it the crowning glory, you know, things like that of your body. What can women, if they want to contact Nutrafol, what can they expect a consultation to look like?
DR. ANZELONE: Yeah, so probably the best way to kind of get in touch with our brand is actually to go to our website and go to our provider section. So we retail to physicians, dermatologists mostly, and they’re probably your best resource. Then they can recommend and monitor you right on the product as like an advocate really to really maximize your hair health.
BRIDGETT: I mean, it is, you know, it’s not just for menopausal women. That’s what we focus on on the show, but it’s available to, is it everybody over 18? I couldn’t quite remember what that was

DR. ANZELONE: Yeah, 100%. So really anyone of our 18 can take it. And then we have different formulas based on lifestyle and age.
So we have a women’s formula that kind of hits our women 18 to 44. We have a vegan formula. That one’s nice because it has no biotin. If you’re averse to that. It also has smaller capsules. So that’s a nice think too, if you’re not a big pill person. Then we have our Women’s Balance, which is our peri – post menopause.  And then we also have a men’s version too. So those are kind of our main vitamins. We’ve done a lot of research and development over the years. So we’ve kind of expanded on those foundational products too. And we’ve looked at supportive products like we have a probiotic cutely named our hair biotic huge fan of that one and we have a topical line as well right the serum as well as a microbiome line so we’ve done a lot of research that’s for sure I’ve seen I’ve seen it all over the seven years I’ve been there so it’s really cool to really learn and evolve and really help people right that’s what we got to this business.

COLLEEN: Another thing that we hear a lot is that not only are women’s hair, not only is the hair thinning, but it’s changing texture. Why is it,
what is happening? Why is that, why is the texture changing?

DR. ANZELONE: Yeah, I love that question. So it’s really interesting seeing the texture of the hair and then seeing what causes that.
So if I were to hold like a microscope up to my head, I could actually see the follicle, right? So the follicle is the little hole that comes out of my scalp, right? And then below that is kind of where the hair starts. So underneath the scalp, the little root hair is there. The follicle is the little hole and then we see really the strand, right? We don’t see any of that hole because we can’t see our own scalp. And then we can’t see, you know, the root underneath the scalp. The follicle or the little hole shape determines the texture of your hair. And when I learned that, I thought that was the coolest thing. And it’s interesting. Yeah. So Colleen, for you, your follicle or the hole is more oval shaped like this. And that’s what makes your hair curly. mine is more circular like this. There we go. So that’s what makes my hair straight. The shape of that follicle is determined by the elasticity of your collagen. So as we start to lose that collagen, right, from our scalp, because the body is prioritizing other things, the shape of that hole changes. So then the hair actually changes in texture.
COLLEEN:  That’s so interesting. What role does genetics play? Because you know, a lot of people will say, oh, if your father had hair problems, then you might have, like, is it a paternal maternal? Does it, what role does genetics play?
DR.ANZELONE: Yeah, so I think they’ve done a lot of different research. I know that the traditional way to look at it is your maternal grandfather is going to determine if you’re sensitive, right and if you were going to be Someone who has hair thinning or someone who’s going to be bald There’s definitely some truth to that. I think that there’s also some environmental piece that they don’t necessarily consider, right? So there’s definitely a genetic component. You’re gonna see it in men really, really easily if you have someone who’s thinning at 18, 20, 25, right? That’s not somebody who should be sensitive to DHT. That person’s too young, But unfortunately, their genes have said, “Hey, the receptors that are around your hair, they’re going to be really sensitive to DHT. Whenever you make DHT, all the DHT is going to do is bind there and shrink your hair.” But I’m a huge believer of there’s something we have to do to kind of like turn on those genes.
I don’t know about you, but any teenage boy ever met doesn’t have the best diet, right? So I think that people who are eating high carbs, that is a perfect way to turn on those DHT sensitivity genes. So say if I’m 16, right? And I can maybe speak to this, this is how I ate when I was 16, right? Chili cheese, Doug, French fries, a whole bunch of junk. No matter what it is, I got to get in my mouth and eat as fast as I possibly can. And a lot of the things are processed and fried and carby. So I think even though there is such a genetic component,
it’s very easy to turn those genes on based on what you’re eating. And then everyone has a different threshold. So maybe I can have 100 chili cheese ducks until my genes are turned on to save my hair. Then maybe Bridgett can have five, and then that’s her threshold to say, “Okay, now I’ve turned on those genes.” I think there is a component to it, but I really do think that if we can control our environment as much as we can, we’re going to prevent from those genes from turning on.

BRIDGETT: So if somebody does start to take the neutral product that is really designed best for them, how long can they expect to, will it take for them to start to see results? Usually like three to six months is that sweet spot. That’s really what we saw in our clinical studies. We really pride ourselves on having that science and having that kind of proof behind our product. So that’s really kind of what we saw in the most cohorts. Where do they, is there a particular spot where it starts to show up sooner are like on the part or around the face?
DR. ANZELONE: Yeah, I’d say for women, definitely the part’s gonna get like skinnier. And then these areas are not only super sensitive to DHT, but they’re also sensitive to stress hormone. So if you see like a woman starting to recede here, usually that feels really well.

COLLEEN: Oh yes, I see that when I look in the mirror, When you lose hair, can you make new hair or do you have pretty much tapped out in the hair making by menopause?

DR. ANZELONE: So it really depends on if the follicle is still like viable, right? So that little hole that’s in our scalp, it just has to be open and it has to have a little hair root, right underneath the skin. So an easy way to tell that is actually go to a dermatologist. They can hold that microscope up to your head. heads called the tricoscope, and they can actually see. Okay, what’s your follicular density? How many fogals are still there in that area? And do they look viable, right? So it looked like there’s a little hair in there. So that’s the technical way to do it. The way to do it, just if you’re looking in the mirror, if you see skin that’s shiny, that is likely no longer viable. When DHT binds to your hair enough, it says, okay, shrink the hair, shrink the hair, and then it says, oh, okay, this must be what she wants. So I’m gonna keep doing that so much so that the body covers over the follicle with skin that doesn’t create hair anymore. So I just like to reference Mr. Clean as It was crazy DHT sensitive, right? How shiny his head is, that shiny area, those are all follicles that have been covered over with skin that doesn’t create hair anymore. So do you want to just kind of look in the mirror if you see any shiny spots? That’s kind of where, you know, you wouldn’t be able to kind of produce more hair.

BRIDGETT: Well, that is so interesting. Okay, now, now I’m going to be like, We’re just going to be looking at her so shiny.
I thought my skin was so shiny, but now I’m just closed that follicle up. I know I’m always looking here.

COLLEEN: I’m like, bangs. And then you don’t have to worry about it.

DR. ANZELONE: That’s really smart. I had to go back to the bank life. It’s so much easier, but, but I digress.

COLLEEN: So also dryness is an issue for a lot of women. Number one, what can we do? And I would ask a second question with that, are there shampoos and conditioners, are there certain ingredients we should avoid for dryness or menopausal hair thinning?
DR. ANZELONE: Definitely. Yeah, so dryness is interesting because like the executive director, Astrogen, controls everything, right? So the Astrogen is going to control the moisture that’s put into your hair. It doesn’t so much control the oil, that’s more of a testosterone DHT thing, so we still can get moisture there, but yeah it’s just really gonna stop putting that moisture into the hair. Hyaluronic acid is really good to keep moisture and both the skin and the hair, and we do have that in a rough formula, And then as far as like shampoo conditioner,
a lot of dryness can also come from the health of the scalp. Right, not to be gross, but on the scalp here, on our skin live a lot of little critters. Yeast, fungus, bacteria, the body is just kind of a big petri dish, right? And what we want to do is make sure This little ecosystem up here only includes good yeast and good bacteria, right? so Looking at that. That’s our microbiome of our scalp So we want to make sure that the microbiome has good players only Because it starts to have bad players. You’re gonna get dryness Itchiness flakiness and that’s really going to affect the quality of the hair overall So we do have a line actually that helps with that our microbiome excuse me line can really help to make sure that environment is really healthy that it has the right good bacteria good yeast and good fungus so that the hair can grow properly. Looking at things you should avoid there are a lot of those things I’m sure you guys have heard of sulfates, right? Those are the agents that lather the hair. We like to see bubbles. I think as Americans, that seems to correlate with cleanliness, but really what it correlates with is, right, that’s going to really dry your scalp and your hair. Any synthetic fragrance, I know it’s a huge, huge, huge carostats, a rivi fan, before I worked for those products smell amazing, but they’re so bad for you. Um, so anything with a natural fragrance is definitely something you want to gravitate towards.

BRIDGETT: When you’re on the order of that as the number of times you should wash your hair, because I’ve heard. Everything I’ve heard you can go several days without washing or wash every day. Is there anything, anything there that has helped?

DR. ANZELONE: Yeah, yeah, it’s a good question. I think that for us, we would suggest daily use, but with a product that doesn’t really strip your hair, I think there’s a lot of harsh products out there, and then they’re not really focused on that microbiome. They’re just almost focused on clearing out everything. There should be no organisms, there should be nothing in your But that’s like not human, right? So like if you’re stripping it that much, it’s almost like you’re you’re kind of bleaching the floor, right? You’re just stripping everything away. And it’s,
you know, it’s not like that, right? The scalp is a dynamic system. It’s living. So we want to make sure that if we are washing every day, which is our recommendation that we’re using something really gentle, that’s That’s not only stripping, but it was adding nutrition to the hair adding good bacteria to the hair

BRIDGETT: You know when you brought up bleaching, you know You were saying the bleaching the hair and I know all these companies will sell this like in between a wash Use this purifier or whatever it is, but with hair color and just chemical treatments How much of a factor does that play into hair shedding?
DR. ANZELONE: Yeah, it’s a great question. So I personally have jeans that say when you turn 20 years old, your hair should be gray. I was like, mom, thanks. Cool. So that was tricky, because my hair, this is my natural color, it’s very dark. So get that like skunk, right? Kind of look. I don’t think I was ready for at 20 years old. I don’t think I’ll be ready for it now. But thinking about that, right? I’ve been someone who’s dyed their hair my entire life, right,’cause I didn’t want that aesthetic yet. I think there are a lot of oxidants in color, right? Things that are gonna damage the hair and the scalp. But for me personally, it’s a trade -off, right? So I make sure to take my neutrophil with all the antioxidants in there, right? I treat my scalp really well. So I try to offset the oxidants that come from color because, you know, are they damaging? 100%. But, you know, for me, like I said, that’s not a trade -off I’m willing to accept. So I want to be dark as long as I can. So I feel like if I can do the supportive treatments, then you know I can keep up with my color. Yeah I’m hearing it from you it makes me feel a little better about this because you know you’re somewhat in this line of work and it makes me feel better about doing that so as long as you’re balancing it out and it’s also a mental thing it’s like what how are you gonna feel the best and if that’s what you feel best is having your hair a certain color, then I can understand why that’s important, you know. Definitely.

COLLEEN: I wanted to ask also about some of the ingredients that are in neutral products and like ashwagandha,
they’re all natural ingredients, but ashwagandha I know is really helpful for stress and it just seems like stress is such a big factor at any age with, um, your hair,but can you talk about some of the other natural ingredients that might be in the women’s products that would be helpful?

DR. ANZELONE: Yeah, definitely. Yeah, so ashwagandha is probably probably one of the best known ones. I think was that going with peltro? Excuse me made that super popular with like goop and things like that Yeah, so then we also have so palmetto So cell palmetto is going to be key for preventing that conversion of testosterone to DHT. So it basically blocks that creation and also blocks the binding of that DHT to the actual hair folliclel, right? Because there’s two places where our hormones can get us in trouble, the creation of them, right? So we’re going to block that from being created. And then we don’t want the DHT to actually bind to the endrogen receptor that’s right next to the hair follicle. So we’re going to block it in two ways. We’re going to make less DHT. And then once it comes, tries to bond, we kick it off with that cell palmetto. So that’s really, really key, I think, for any point in a woman’s life, especially peripose menopause. That’s one of the major players. We also have curcumin, so curcumin is going to be that antioxidant that helps to support our metabolism because our metabolism is so key in breaking down our food to the point where we can get energy and then we can also get hair. I used to make a silly analogy that you’re going to turn your hamburger into hair, whether that’s an impossible burger, right? Or like a beef burger. You’re going to break down that hamburger and make it into hair somehow. So really our metabolism needs to be at a certain speed to do that. So curcumin is going to help to do that. It’s going to help to make sure that we stay at that speed. So we have enough energy and raw material for hair. And then we also have in like our main synergy and complex something called tocatrinols. This is a fancy word for vitamin E, another great antioxidant. This is going to help to combat any environmental damage, like hair dye, like pollution, like tequila, right, All the things we’re doing and not doing, so that’s going to be really, really key too. And then we have, you know, other supportive ingredients, you know, like collagen peptides and things like that, which.

Collagen peptides are so key for both aging and nutrition, right? We talked about what happened so early in life, taking that collagen out of the skin and the hair and then the component of nutrition right if I’m eating that hamburger or a chili dog or whatever processed food I should be eating the body’s not going to prioritize the hair right it’s gonna say okay first we’re gonna put it in my heart we’re gonna put in the muscles we’re gonna put in the brain oh and then if there’s any leftover maybe the hair can have it. So not only is the collagen peptide providing nutrition, but so is our eating, right? So put a little plug in there. I used to do a lot of nutrition counseling in my past life. So I think especially for our menopausal, You know, hitting those macros of proteins and fats As someone who lived through the 90s,
right? We’re told that fat’s completely evil I think that was one of the worst things they could have told women ever So But it but it is you know, you look at the things the trends that have gone through the different decades and What that’s done to our body.

COLLEEN: And then is there anything, is there anyone that should really be cautious? Like if you are taking a certain medication or anything, is there any contraindications? Yeah, that Nutrafol could, you know, be a contraindication of.
DR. ANZELONE: I think the only thing that we stand on as a brand is, um, blood thinners. So we just caution anybody who is on blood thinners that they just talk with their doctor. There is a slight blood thinning effect of both the vitamin E and the curcumin. So we just don’t want to have an additive effect right if someone’s on that.

COLLEEN: Well that’s key and it’s important to know as well. I was also curious about dry shampoo. It’s such a popular thing but is it really good for your hair to put dry shampoo in?

DR. ANZELONE: I mean, it’s someone who has a lot on their head right now. Going to be real about that. Yeah, I would say no, because a lot of those come with a fragrance. So with that, you’re going to have endocrine disruptors, so any fragrance that’s synthetic is actually going to mess with your hormones because they’re considered xenoestrogens. So fragrances are super, super similar chemically to estrogen. So we don’t have to put any fragrance on our body, especially our hair. It works in our scalp because that’s super absorptive. So I’d say from like a scent point of view of a dry shampoo, even opt for like something that’s like scentless, doesn’t have a propellant. Right. You can spray that stuff on there forever, but that propellant is super toxic. I haven’t transitioned, but I’m trying to, just like a cornstarch. That’s super innocuous, right, and not going to hurt you, and that’s going to absorb the water. I mean, the oil as well as the dry shampoo won’t smell nice, and we’ll take a little more effort, but definitely healthier for you.

BRIDGETT: Yeah, I’ve seen that especially when traveling if you want to travel with dry shampoo There’s a brand that it is more of a powdery Cornstarch type because I know a lot of I don’t know on the plane You can’t like bring they don’t like aerosols or anything like that.
So I’ve tried it.

DR. ANZELONE: Yeah, you’re right It takes a little bit of getting used to and brushing it through there and getting it just right so

COLLEEN: I would have one little request if there’s any way you can make a Nutrafol product to get us rid of chin hairs.

BRIDGETT: That was going to be a question. It is of mine. It’s like, you know, if you take this, will you see hair where you don’t want it? Yeah, hair where you don’t want it.
DR. ANZELONE; Yeah. Yeah, that’s a great question. So the interesting thing about DHT, right? So This is the thing the testosterone is turning into all the time, but then especially peripostmenopause. So DHT is going to bind to the hair and thin the hair on the head, but then it has the opposite effect on the face. So it’s going to stimulate if you’re sensitive hair growth on the face. So DHT here, thinning, DHT here,
more hair. So we can claim that as a brand, but if you block DHT mechanistically, you’re gonna see more hair here and less hair here.
So that may be a benefit of blocking DHT. Can’t claim it as a brand, but I can talk about mechanisms all day. So there’s that. And then as far as like growing hair where you don’t want it, all the hair follicles that are on the body, everywhere, right, your arms, your hair, your legs, your skin, your face, like here, all those hair follicles can’t be stimulated outside puberty usually. So, they have kind of this one period where they’re super sensitive. That’s when the hormones are super high, right? 15, 16, 17. You get your adult hair. That’s it. There’s really nothing that can stimulate these follicles usually. These follicles up here, these are super sensitive to everything. So, these ones can be manipulated very easily And that’s great because that’s what we do, right? We give them nutrition. We protect them from stress. We protect them from our own hormones. And they say, oh, wow, that’s nice. Okay, we’re going to respond. Whereas other body hair,
it’s just kind of done. They don’t really care. They’re like, we’ve grown, we’ve done our thing. Of course, there’s exceptions to that, right? These one -off follicles that are here that are sensitive to DHT when you get older or a lot of people will lose hair in places. So that’s generally how it goes. The follicles of the body can’t be stimulated anymore, but the ones on the head are very easy to manipulate. And we use that to their advantage, right, to help them grow. Yes, well, that’s that’s a relief. Yeah, I know that’s so we just have to block all DHT COLLEEN: Thank you for coming on the show. We appreciate it and thank you for all you’re doing to help women and their hair thinning problems Thanks so much.

DR. ANZELONEAbsolutely. Thank you