Eva Proudman [00:00:04]:

So I was a diabetic and my diabetes was out of control. And I was offered serious bariatric surgery to put my diabetes into remission. I was basically given a very stark choice at the age of 40 because of my genetic inheritance and the type of problem I had. My professor said to me, I give you six months before you have a fatal heart attack or a stroke unless we do something drastic. And at that point, I’d got a ten year old son, so I would do anything.

 

Kevin Rolston [00:00:52]:

Welcome to HairPod, the podcast where you get to hear real people talk about their hair journeys. I’m your host Kevin Rolston, and each week I get to interview people from different walks of life whose lives have been touched by hair loss in some form or fashion. Many of our guests have experienced hair loss themselves and found a way to get their confidence and their hair back. For this episode of Hairpod, I get to talk to Eva Proudman, a trichologist from the United Kingdom who also has experienced hair loss herself. We’re going to find out about her own personal hair story, and you’re going to learn a lot of great information about hair loss, hair shedding, hair thinning, and the myriad of causes and treatments available for these conditions. There are so many different possible causes of hair loss, from genetics to diet to stress. And I am excited to dive into all these different topics with Eva. Hair loss can have a massive impact on our lives.

 

Kevin Rolston [00:01:46]:

Sometimes we have to change our lifestyle and be open in trying solutions we never thought of before or even knew existed. We aren’t taught about hair loss, and finding trustworthy sources is a real challenge. It’s hard to know what is actually effective and what’s going to work for you. So having clear, science-backed information is critical to determining your path forward, or you could end up wasting a lot of time and money. It’s a journey, and people like Eva have made a career by guiding people through that process.

 

Eva Proudman [00:02:20]:

Trichology is the study of anything to do with the hair, the scalp, and as far down as your chin. So this little box of our anatomy, that’s what we specialize in. We diagnose any of the disorders that you can have hair-wise, scalp-wise, and as I say, as far down to the chin. And the way I got into trichology was that I used to own, many years ago now, the largest hair extension company in the UK, we used to export to 40 countries. All of our products were about education, no damage to hair, very ethical. And I was asked by the Teenage Cancer Trust in the UK if I would have a meeting with them to talk about how we could possibly provide hair extensions for younger people post-chemo so they could get their wigs off. The last thing you want to do if you’ve been through chemotherapy is wear a wig or wear a hat because it reminds you of treatment. So we developed a program called hair in recovery and we trained a special network of salons to use these super fine micro bonds.

 

Eva Proudman [00:03:26]:

We subsidized the hair and the service to make it affordable. And we launched the program and it’s still running today. The company that I left still run it, which is great. But at that point, I realized that my passion was hair loss, not hair fashion. And so I sold my shares in the company and I trained to become a trichologist. And that’s what I’ve been doing ever since. And it’s the best job in the world.

 

Kevin Rolston [00:03:54]:

It sounds like you’re in it because it’s rewarding and you feel like you’re truly helping people. Is that right?

 

Eva Proudman [00:03:59]:

Every day is a delight. You know, hair loss is a big taboo, really. People still don’t openly talk about it in the UK. It’s very badly signposted. It’s not something that our national health service specialize in. And very often people feel they’re on their own. It’s vanity. There’s nothing that can be done when, in fact, hair loss is very emotional.

 

Eva Proudman [00:04:22]:

It’s not about how it looks, it’s about how it feels. And it can affect your self confidence, it can affect your mood, it can affect your social life. Very, very often. There are a lot of things that we can do to improve the problems that we find. And very rarely do we find that we can’t treat something. And there’s this big misconception that if your hair is thinning or you’re losing it, it’s because of your age, your medications, the menopause, all of those things kind of get thrown at people that this is why it’s happening. And I find in clinic, I’ve got nine of them across the UK, I see 250 patients a month. There aren’t many people that we can’t treat and improve.

 

Eva Proudman [00:05:07]:

There are some conditions that are permanent scarring conditions, where we can’t recover the hair. But again, we tend to have a network of specialist people that can provide very specialist cosmetic solutions that are not necessarily full wigs and look really natural and are comfortable to wear. So, yeah, it’s really, really rewarding.

 

Kevin Rolston [00:05:29]:

So what you’re trying to do is help somebody find their best solution.

 

Kevin Rolston [00:05:34]:

And if you can you want to.

 

Kevin Rolston [00:05:36]:

Provide a more natural solution for the people so that a wig or something of that nature is not the end all, be all for everybody.

 

Eva Proudman [00:05:44]:

Absolutely. And the priority is if we can restore the health of the scalp and the hair, and we can get that hair to grow better and thicker. That’s the ideal. That’s our goal. That’s where we aim. If we treat and we get some improvement, but it’s not enough for the individual patient, then we can look at other interventions from there. But the baseline is we accurately diagnose what the problem is, we will treat it accordingly. And our treatments are very holistic.

 

Eva Proudman [00:06:14]:

We look at the whole person. So your hair is very much affected by your diet. What you eat really affects your hair. It’s affected by your hair care, the products you use, how often you wash the hair, how often you wash the scalp. Stress is an issue, diet is an issue, medications can be an issue. But there again, there are conditions like thyroidism, where if you’ve got a low thyroid function, you can find your hair is slow growing, it’s dull, it’s brittle, it will shed. If you’ve got an overactive thyroid, it will shed like mad and thin. But when they are medicated and you get that thyroid stimulating hormone into a good mid range with medications, those things go away and the hair should return to normal.

 

Eva Proudman [00:07:01]:

And if it doesn’t, then there are lots of things we can do, whether it’s with blood tests or from an examination, we can add things that will get that hair to recover. So there’s lots and lots of areas that we work in.

 

Kevin Rolston [00:07:19]:

It’s encouraging to hear that there are just so many options and approaches to restoring the hair and scalp to its healthy state. As Eva points out, its not really about your hair so much as how you feel about your hair. Knowing that there are options is a huge relief. What trichologists do is so in depth, so personalized, and requires such a vast amount of knowledge in so many different areas.

 

Eva Proudman [00:07:47]:

I did a three year training course with the Institute of Trichology, and every month I did clinical hours. And you’re taught to do what we call a differential diagnosis, which is a combination of asking your patient what is it they are feeling.

 

Kevin Rolston [00:08:04]:

Which is a what?

 

Kevin Rolston [00:08:04]:

I’m sorry, you said it’s a combination.

 

Eva Proudman [00:08:06]:

To give you their symptoms.

 

Kevin Rolston [00:08:08]:

Can you tell me?

 

Kevin Rolston [00:08:08]:

You said it was a combination of something. What was it a combination of, Eva?

 

Eva Proudman [00:08:12]:

So it’s a combination of asking the patient what they are experiencing, seeing and feeling, and then having a look with what we call a trichoscope. It’s like a microscope for the scalp and looking at what the clinical signs tell us. And we then work out what the condition is from what we’ve been told and what our clinical evidence is. And generally what we find is if you see your hair falling out a lot, so there’s an increase of hair fall when you wash it, or you brush it and it feels thinner, or if you’ve got long hair, it’s gone ratty on the ends of. Generally, it isn’t always what you think. It’s not hair loss. It can be a disruption to the growing and the shedding cycle. It’s called telogen effluvium.

 

Eva Proudman [00:09:00]:

Telogen is the natural shedding phase. Effluvium means you’re doing too much of it. And there are lots and lots of underlying causative factors, and when we identify those, we can normally correct them. You can get that growth cycle to go back to normal. The shedding reduces to normal range and the density comes back into the hair, because you haven’t actually lost any. It’s just turning over too quickly. If somebody feels their hair is just disappearing gradually getting thinner. And it might be in a pattern for ladies, generally, through the centre scalp, the parting in the middle gets wider.

 

Eva Proudman [00:09:38]:

You can sort of see in, see and feel more scalp. The crown sits open. It could be something like an angiogenetic alopecia, female pattern. And again, we can manage female pattern very, very effectively. And whilst we’re on the subject of ladies, they tend to be sort of more complicated than the guys. We have a more complicated sort of background. Our physiology is more difficult. So we see ladies with multiple conditions, and again, you’ve got to treat all of them in the right way to get the best results.

 

Eva Proudman [00:10:11]:

You then get the autoimmune type conditions, so you can see things like the patchy circles of loss. That tends to be a condition called alopecia areata. It’s where the immune system is misfunctioning and it sees the hair as a foreign object, it breaks it out at the root and leaves those circles. It leaves all of the follicles behind so the hair can regrow. And what our job is is to try and stimulate the hair to regrow and to distract the immune system from attacking. And those immune attacks tend to be caused by huge amounts of inflammation in the body. So we work to reduce that. It can be sort of high levels of emotional stress, it can be low stored vitamin and mineral levels.

 

Eva Proudman [00:10:57]:

And again, we would work to investigate all of those and to correct it. And then we move on to the worst kind of hair loss, which, again, is autoimmune. But unlike the areolators, where the hair can recover, it’s what we call a scarring condition. The immune system doesn’t attack the hair, it attacks the growing unit. It’s called the pilosubaceous unit, and it attacks it underneath the scalp and it leaves permanent hair loss. We can’t regrow it. Once that hair’s gone, it’s gone. And an ever-increasing popular one we see in clinic is something called frontal fibrosis and alopecia, or FFA for short.

 

Eva Proudman [00:11:36]:

What you notice, particularly in ladies, is the hairline is receding. You’re losing hair in front of the ears, you can lose it behind, and it can progress all the way back to the crown. And you can lose that whole frontal section of your hair. At the back, it still looks perfect, but from the front you’ve got loss. You tend to find that you lose the outer third of the eyebrows, you can lose body hair. The scalp can have sensations. It can be itchy, creepy, burning. And again, what’s happening is there’s a huge amount of inflammation causing that immune system to attack.

 

Eva Proudman [00:12:12]:

And we have treatments that we use to reduce that inflammatory attack, to stabilize the condition, to retain the hair that we’ve got. So we work in very different ways and all of those things can exist together. Sometimes I’ll see a patient and I think, blimey, that’s five things we’re dealing with. That’s a big ask, but we work through it and we deal with it. Other times I’ll see a patient and it’s easy peasy. They’ve got an itchy, flaky scalp. I look at it, it’s seborate dermatitis. Good treatment, shampoo, frequency of washing, you can manage it really well.

 

Eva Proudman [00:12:47]:

So all day. And what comes into clinic is different all the time, which is what makes it such a fab job, because you never know what you’re going to see and it keeps you on your toes. You’ve got to be a really good detective.

 

Kevin Rolston [00:12:59]:

Yeah, I bet. And thats my question, is, how hard is the diagnosis? You talk about so many different things that can cause hair loss. Can you look at someone or is.

 

Kevin Rolston [00:13:10]:

It, sometimes I hear stories of doctors.

 

Kevin Rolston [00:13:12]:

That try to diagnose an ailment in our bodies and theyre guessing and theyre trying to figure out what it is. So as a trichologist, is it often easy to diagnose whats causing the hair.

 

Kevin Rolston [00:13:22]:

Loss or do you have to try.

 

Kevin Rolston [00:13:23]:

A lot of different remedies a lot of times before you get it right and figure out what truly is causing it?

 

Eva Proudman [00:13:28]:

So there are some conditions that are easier than others. The diagnosis isn’t necessarily the difficult bit because we spend three years studying, we do two years of clinical mentorship so that we know what we’re doing. We do continuous professional development. So we’re always looking at research papers, we’re attending seminars, we’re looking at all of the current evidence that’s out there and we’re lucky we get an hour with a patient. So we listen very carefully to what they’re seeing and feeling. That starts to give us the clues to what it could be. And then we put our expertise into that examination and once we know what it is, it’s then about what’s causing that and how we treat it most effectively. And so there are some things that are in every condition, whether it be a psychological one or a medical one, you will find that practitioners will have a first line treatment.

 

Eva Proudman [00:14:27]:

Something they try is their go to that for 80% of people it works for. And then they’ll have a second and third line treatment that sometimes they have to add in because the patient’s a bit more complicated. So it’s about getting the balance right of your treatment. For that individual a common treatment is depleted stored vitamin and mineral levels. For general health we have one level and as long as we’re in those ranges our body functions we’re okay generally, but the hair needs a very very different range. It’s the second fastest dividing cell in our body, but it’s non essential. So we have to make sure those stored levels are right. And some people will absorb really well from their diet.

 

Eva Proudman [00:15:12]:

They’ll have great diets, they’ll hold them and life is great for them. Other people might have a restricted diet like a vegan diet for example. And vitamin B twelve is crucial to hair growth and hair health. But it’s only in animal based products so you’d need to be supplementing it. So we might put a b twelve supplement in. But again, plant based diets aren’t great at holding iron. So we might put an iron supplement in and some people might need them for four to six months and they’re good to go. Other people might have more of a leaky gut or an absorption issue and they need to take them longer term.

 

Eva Proudman [00:15:50]:

So again you’re working with everybody as an individual because our tolerances and our abilities are all different.

 

Kevin Rolston [00:16:01]:

There’s so much information and technology available to help trichologists diagnose and treat some of these conditions. I know firsthand that it can be a little bit daunting to try to navigate all that on your own. Whether your hair loss is caused by hormones, diet, immune function, or something completely different, figuring out the root cause is the first step in knowing what type of treatment to pursue. One thing we can all take control of right now to slow down hair loss, is our diet. So I asked Eva more about how nutrition and hair health are connected.

 

Eva Proudman [00:16:41]:

The first thing the hair looks for is protein. And every day it says to the body, can I have a quarter of whatever you’re having now? The problem is, if you don’t have enough protein, it manages every single essential cell, and our very clever bodies will take all of that for the essential cells. And your hair can end up with nothing from its nutrition. And not all proteins are equal. So let me give you some examples. So if you were having an egg for breakfast, you’d get about 8 grams of protein out of that egg. And it’s what we call a complete protein. It’s got everything in it that you could possibly want.

 

Eva Proudman [00:17:20]:

If you decided that you would have just toast. You won’t really get any protein because there isn’t anyone there, and it won’t give you the things that build protein, the amino acids, and it’s those amino acids we need. So the sort of best foods to eat are your offal, red meat, eggs, chicken, fish, turkey. All of those things are fantastic. Most of them are complete. And when I say complete, it’s about the amino acids. So our bodies use 23 every day, and we can make all of them except for eight. They’re called the eight essential, and you can only get them from complete proteins in your diet.

 

Eva Proudman [00:18:01]:

Again, the hair needs all eight. It would do. It’s complicated. So those sort of foods, I’ve just said, great, get those in your diet every day. Try to have protein at each meal. Try to have it in the morning, at lunchtime, in the evening. The hair likes that consistency. Keep it well fed.

 

Eva Proudman [00:18:20]:

Dairy is good to include. And then you come down to your more sort of plant based. Your nuts, your beans, your legumes, they do have proteins in there, but it’s volume. So 100 grams of chicken, about 25 grams of protein, 100 grams of chickpeas, 8 grams of protein. So you can see when you’re advising somebody, you need to give them some ideas and some guidance on what to choose. Seeds shouldn’t be overlooked. Things like sesame seeds, chia seeds, sunflower seeds, on average, a teaspoon of those added to a salad or into a yogurt or onto a cereal. 5 grams of protein.

 

Eva Proudman [00:19:00]:

So you can sort of really work to choose the foods you like, but to make sure you get enough of them in the right proportions, that’s the best thing I can suggest for your hair and then your plate. So make protein, your biggest portion. Then your brightly colored fruit, vegetables, little bit of carbs, little bit of good fats. That generally is a balanced diet, and the hair will be happy with that. So will your body.

 

Kevin Rolston [00:19:27]:

Would a trichologist sit down and give you a diet that is good for hair health?

 

Eva Proudman [00:19:32]:

We do. We advise on what to try and include, what the best foods are, what they’ve got in them. We do study nutrition as part of our qualifications, so we’re not nutritionists, as in, you come to us because your gut doesn’t work at all, but we know what foods are good for you, what they’ve got in them, how the gut works with it, how you absorb what they give. And so, yes, in my clinic, I have a reference sheet for proteins. There’s lots of things on there, and they’re all counted to make it easy for my patients to be able to go and say, I’m going to have an egg. I know an average egg’s about 8 grams of protein, so I know I’ve got another 42 to get in that day.

 

Kevin Rolston [00:20:16]:

What are we consuming that would be bad for our hair health, whether it be foods or other substances we choose to put in our body.

 

Eva Proudman [00:20:23]:

Yeah, so bad things are sort of processed foods. So when foods are processed and fast foods, we tend to use oils in there that are nothing potentially friendly. They can affect cholesterol and those sorts of things. We tend to put a lot more salt and sugar in, and if you have too much salt, it can build up around the follicle, it can cause the hair to shed, you can get a sodium build up. Too much sugar can imbalance what the body’s trying to do. So you want to try and be as much as you can. A cook from scratch, use fresh ingredients, type of person, the odd takeaway, the odd hamburger, the odd kebab, no big deal. But if that’s what your diet consists of, a, your body’s not going to be great, but your hair certainly isn’t, because those foods just don’t give you what you need to get all of those processes working most effectively.

 

Kevin Rolston [00:21:19]:

We’ve talked about the food you consume, but you had mentioned stresses and personal traumas that can affect hair health. Is it ever a good idea to incorporate some form of therapy to try to relieve some of the stresses? And maybe you have traumas that have happened in your life. Could that be impacting your heart health? And is that sometimes a recommendation from a trichologist?

 

Eva Proudman [00:21:42]:

Absolutely. Sometimes I will refer to a therapist. It could be a psychiatrist or it could be what we call psychodermatology. And they are a branch where they understand everything to do with the hair and skin, but they understand the psychology of it. So there’s a condition called trichotillomania, which is where you pull your hair out. You’re constantly pulling it out. Sometimes you don’t even realize you’re doing it. I’ve had patients sit in front of me and I will say, have you stopped pulling? And they’ll say, oh, yes.

 

Eva Proudman [00:22:13]:

And they’re twiddling and pulling and licking the hair in front of me. They don’t know they’re doing it.

 

Kevin Rolston [00:22:17]:

Wow.

 

Eva Proudman [00:22:18]:

And they need help. I can give them distraction techniques, things like have a fidget toy, something that’s nice to touch and keep your hands busy, stop it touching the hair. But very often those kinds of conditions have started with something that’s much deeper psychologically. So they need help to break that cycle. And it’s no good saying, oh, well, just jump from the pulling bit and give you more hair, because if we give them more hair, they’re going to keep pulling it out. And the more you pull it out, you can get permanent hair loss. So we very much work on that. We help patients think about how to manage stress and anxiety.

 

Eva Proudman [00:22:56]:

The top of the list is always meditation and yoga, and they’re great, and they work for lots of people. But there are people like me that if I sit and meditate, I’m not meditating, I’m thinking, I need to do that. I’ve got this to do. I may as well be sticking a pin in my eye, because I just don’t relax with it. And so a tip I give to my patients is, do the thing where you empty your head and you lose time. So we’ve all got things we like to do where you think, I’ll spend 20 minutes doing that. You look at your watch and you go, my goodness, I’ve been there an hour and a half, didn’t realise I’ve been doing it for me. Put me out my greenhouse or the garden, I can lose all day.

 

Eva Proudman [00:23:34]:

And I’m not thinking, I haven’t got that noise in my head. For some people, it’s reading, it’s walking, it’s brushing the dog, it’s baking, it’s cleaning. Doesn’t matter what it is. The thing that gives you that downtime and you feel your shoulders relax, that’s what helps to relieve stress. And anything that works is the right thing for you.

 

Kevin Rolston [00:23:54]:

I’m assuming, obviously, sleep is a big part of this as well, that you need to do the standard at least seven to 8 hours.

 

Eva Proudman [00:24:00]:

Yeah. With the hair being the second fastest dividing cell, it needs good quality sleep because it regenerates when you’re sleepy. So again, people with poor sleep patterns or very limited sleep, again, that can be an issue in affecting the overall health of the hair.

 

Kevin Rolston [00:24:17]:

Great. Eva, your own hair journey. How did you diagnose, what situation did you go through?

 

Eva Proudman [00:24:24]:

So I was a diabetic and my diabetes was out of control. And I was offered serious bariatric surgery to put my diabetes into remission. I was basically given a very stark choice at the age of 40 because of my genetic inheritance and the type of problem I had. My professor said to me, I give you six months before you have a fatal heart attack or a stroke unless we do something drastic. And at that point, I’d got a ten year old son, so I would do anything. And he said, I recommend this bariatric surgery. And we said, okay, that will do it. So referred to the bariatric surgeon.

 

Eva Proudman [00:25:08]:

You’re assessed psychologically to make sure you’re not some kind of feeder. That even if they do the surgery and you’re still going to eat sugary food and put your sugars out of control. I had the surgery and from the moment I came round, we did a blood test. I’ve not needed metformin or insulin since the surgery puts it into remission. But I always tell myself it’s only in remission whilst I manage it. And what the bariatric system does, it resets the endocrine system and you’re just able to manage it also makes you drop weight really, really quickly. In a space of four years, I put on ten stone in weight. Ten stone is what, less than I weigh now? So there was another whole me.

 

Eva Proudman [00:25:54]:

And so I lost that weight. And the trauma of the surgery, the weight loss, I lost 50% of my hair. It literally came out in handfuls.

 

Kevin Rolston [00:26:03]:

Wow.

 

Eva Proudman [00:26:04]:

And I’m really lucky. I’ve got very thick hair, a lot of it, but I know how it feels. And when you see that hair in your hands or your shower, your eyes and your brain say you’re losing your hair, it doesn’t matter how much I knew the science that it was an imbalance and that it would go back. And you feel terrible because you don’t feel like yourself. And when people say, but it looks fine, you feel even worse because you think, well, nobody believes me. And so I had that for about nine months before we got the growth cycle to normalize. I was eating normal meals again. I was holding a normal weight.

 

Eva Proudman [00:26:38]:

My body was recovery. But I still have to have supplements every day. I have b twelve injections. I have had an iron infusion in my time because my levels were very low. But I work really hard and my mantra is I eat my protein. I eat my good green ripe orange vegetables. I have a few carbs and I have a little bit of fat. And I do cheat.

 

Eva Proudman [00:27:01]:

I’ll have chocolates. I’ll have a cake. But I have it very much in moderation. Gotta live because that’s what I have to do.

 

Kevin Rolston [00:27:13]:

It’s nice to know that there are practical, tangible changes you can make in your daily life that could benefit your hair and scalp health. Of course, we all feel better when we eat healthier. And Eva is right. Balance is important. It is essential to feel good about ourselves and enjoy little pleasures in life, even when we are dieting or trying to change habits. Hair loss is hard enough to deal with on its own hair loss is hard enough to deal with on its own. It’s been an enlightening conversation with Eva Prabin. Her passion, honesty and expertise are admirable and I feel like I’ve gained some valuable insights into understanding and managing hair loss.

 

Kevin Rolston [00:27:52]:

One thing that really stood out to me is how important it is to see hair loss from all angles, whether they be physical or emotional. Finding support and seeing a hair specialist could make a huge change in your hair loss experience. As weve learned, theres just so many options no matter where you are in your hair loss journey. For more inspirational stories and words of wisdom from people who have been through hair loss, make sure to subscribe to the show on your favorite podcast app. Thanks for listening to another episode of Hairpod. Check us out at Hair Club on Instagram or search Hairpod on Facebook to continue the conversation. If you know someone who could benefit from hearing this episode, we would love it if you would share it with them. If youre enjoying the show, consider leaving us a rating and review on Apple Podcasts or your favorite podcast app.

 

Kevin Rolston [00:28:40]:

We also have a website. Check it out by going to podcast dot hairclub.com. were here to build people up and share real stories so people experiencing hair loss feel a little bit less alone. And when you share, review, and subscribe, it helps us do just that. So thank you. Until next time.