Narrator (00:06):

Navigating the complexities of hair growth and loss can be both concerning and deeply personal. So what steps should you take? Millions are affected by hair and scalp changes every day. In a society where appearance can make or break even one day, where should you turn for informative, honest science-based information? Kimberly Vaughn's goal for this podcast is to offer informative content with the help of subject matter experts along with individuals just like you.

Kimberly Vaughn (Host) (00:41):

Hello, and thank you for joining Hair Loss Restore your roots and confidence. Today we are joined by a wonderful woman who is the president and owner of Pro Compounding Pharmacy. Pro Compounding is a customized pharmaceutical organization located in middle Tennessee. Jessica is dedicated to the art of compounding, and for over 20 years, she has been training and supporting other pharmacists across the globe in formulation development, she works routinely with providers to educate and create customized medications to fulfill the needs of each individual patient when we know that routine medications are not just getting us there. Jessica graduated from Southeastern University in 2001 with a doctorate in pharmacy and was certified in pharmacogenetics through the University of Florida. As she is herself a middle-aged beautiful woman and holds certification in hormone replacement therapy. She understands specifically the impact of hormone and hormone imbalance on a woman's life. She also understands firsthand hair loss due to personal circumstances as well as for many of those that she treats daily. So you're in for a special show today. Let's kick it off. Tell us a little bit about compounding, why Middle Tennessee, and what your operation is all about, so our listener and our audience know a little bit more about what you bring to the table today.

Jessica Patrone, Pharm D.  (Guest) (02:32):

Sure. So like you mentioned, I've been in this game a long time, probably longer than what I want to admit. I've been a pharmacist for over 20 years, 23 years, something like that now. But during that time, I've spent a lot of my career really doing formula development on the compounded side, and I think a lot of people don't really understand what compounding even is. So I'm going to start with that. Compounding is the old apothecary style of combining certain ingredients in a very customized way to achieve something that you're not going to get anywhere else. It's not going to be the same as something that you get that's commercially available or over the counter. It's also going to be more customized for your unique need. So a compounding pharmacy, previously compounding was done in a regular pharmacy, but it has become its own specialty.

(03:32):

And so the pharmacy that I have is pro compounding. We specialize solely in compounding. We compound for a lot of different specialties. So it could be anything from veterinary medications to, as Kimberly was mentioning, hormone replacement. We do a lot of hormone replacement because that's so individualized. It could be thyroid disorders, hair loss in this case, and a lot of these conditions, they all intertwine. So when you're talking about hormones and thyroid and hair loss and stress factors and nutritional deficiencies, all this can point back to the reason why something would need to be individually compounded for a specific person. So that's our focus, that's our passion. And it takes a long time for somebody to be trained and skilled to the extent that they can create these things and put these things together on a very customized basis.

Kimberly Vaughn (Host) (04:33):

That's right. Well, and Jessica, I want the audience and our listener to realize this is one of the reasons that HPI started working with your pharmacy backs quite a few years ago because we were having such a challenging time having a pharmacy that was willing to customize and be very specific on the needs of our clients. So obviously with focusing specifically in Tology and the study and the diagnosis of what is going on on the scalp as well as what is going on with the hair, whether it's slow growth, lack of growth, miniaturization or hair loss. And so that is one of the reasons that we had looked for two years to find your pharmacy. And lo and behold, here you were right in Middle Tennessee with us. But that is one of the issues is that we find that every single client that walks in our door every day and we're available and open six days a week to see clients throughout the entire United States, whether it's virtual or whether it's in our offices, is that we were not able to find the right solutions that were customized directly for their needs.

(05:48):

And so that's what's been such a great opportunity to be able to work with your team because I know you have a large team of creative formulators as well as your traditional PharmD specialty that you offer. So with talking about and staying specifically focused in hair loss, let's talk just about our usual suspects, right? I mean, I think probably everyone that's listening to the podcast is familiar with Minoxidil, familiar with Finasteride, and potentially familiar with Tretinoin, which is the active ingredient in the most famous wrinkle cream on the market today with Retin Egg, right? And Tretinoin is in a lot of other ingredient in a lot of other products. It's just probably my lack of knowledge that I'm not sure where that is. So let's talk specifically just and break these three down, and then let's also talk about the nature of the combination and the enhancement of that, and then we'll dive in from there. So Minoxidil specifically, that can be taken orally or it can also be a topical. And so when we talk about topical formulations, and let's talk specifically about when someone is applying a topical with Minoxidil and they see over the counter, whether it's Walgreens, whether it's Costco, whether it's our online friends, HIMSS and hers, and keeps, let's break down what is the difference really in a customized solution that has Minoxidil versus an over the counter product that would be purchased on a mail order subscription without a prescription and without formulation development?

Jessica Patrone, Pharm D.  (Guest) (07:41):

So I think something that a lot of people don't think about is the cleanliness of a product. And what I mean by that are you can have a drug and the drug has to be in something, okay? And the something is what we call excipients. And so depending on how it's created and how it's formulated, there could be a lot of excipients in there. And it could be an unclean product or it could be a very clean product, and there's very little. And why is that an issue? Well, potentially some of these excipients can cause irritation. They can cause buildup, depending on the excipient itself, it can alter the structure of the drug. So I would say that that's the first thing is making sure that the product is clean. The other thing is going to be the strength of the medication and making sure that you truly are getting what is labeled that you're getting.

(08:39):

So whether that's 5% or 7% or 8%, you've got to make sure that you're actually getting the strength that it says on the label. The other thing I'd say is that you brought up Tretinoin, which is retinoic acid. That is only a prescription item. Okay? So you can buy retinol like molecular retinol over the counter. You'll see that in some of the face creams, that is not the same thing as Tretinoin or retinoic acid. So Tretinoin and retinoic acid is only available by prescription, and that is typically added to a lot of formulas containing minoxidil really to enhance the response that patients have to minoxidil. So in some cases, patients on minoxidil may not respond at all, but when you add a little bit of Tretinoin to it, you can have those patients go from a non-responder to a responder, which is great. Now, when you're talking about oral minoxidil versus topical, oral is only going to be available by prescription. And does it work? Yes. Studies have shown that oral Minoxidil works, and so does topical. The differences going to be the side effects that go hand in hand with using anything oral, not just Minoxidil, but when we will start to talk about Finasteride and some of these other medications that can also be used orally, there can be side effects. And I think the world in general is starting to recognize that the less side effects and the more clean product you can give yourself, the better off you are in the end.

Kimberly Vaughn (Host) (10:14):

Oh, most definitely. And I will tell you that one of the very first questions that we have with our new clients is how aggressive you want to be and what are you willing to accept as a side effect or not with your treatments. Because we know that when hair loss goes from minor shedding to aggressive shedding from just kind of a lessening of hair growth and more hair in the shower to aggressive handfuls in a brush and a comb or on your clothing or on your sheets and pillowcases. And so that is one of the first topics that we discussed is what is your natural sense of utilizing a drug to help you move through this hair loss progression, whether it is a temporary or an acute and long-term genetic issue. And so I appreciate you bringing that up. That is very important. Now, you had mentioned with Minoxidil, you had talked a little bit about the enhancement of Tretinoin. So tell and share with our listener, why does that retinoic acid cause this enhancement, and what happens when we see this?

Jessica Patrone, Pharm D.  (Guest) (11:40):

Yeah, so Tretinoin, when you add that on board, okay, tretinoin enhances the udal response, particularly in androgenic alopecia. And really it does that by influencing an enzyme called sulfur transferase. Oh my goodness, that's a mouthful. So they've noticed that this enzyme at the hair follicle, if patients don't have enough of this, minoxidil, really doesn't work for them. So Tretinoin really enhances that. And basically, I guess you could say it enhances the sensitivity to minoxidil. Now, tretinoin, you're going to find this in several different concentrations. A higher concentration maybe 0.025%, and some of the studies out there will show that that is the correct concentration to use. I've also seen studies with lower concentrations. So really we've paired the studies with real life. And can somebody or the majority of the population tolerate a concentration of retinol as high as 0.025% on the scalp? The answer is commonly no, they can't. It really results in itching, maybe some redness, flaking, and discomfort of the scalp, and nobody wants to be trying to grow hair and scratching up their scalp all day. So what we've found is that we can get equal effects and fewer side effects by decreasing the concentration of Tretinoin to 0.01%. And that seems to be really the sweet spot in reality where patients can tolerate it. We've limited side effects. We're enhancing what the minoxidil can do, and patients still see the effect.

Kimberly Vaughn (Host) (13:38):

From it. Yes. The other thing I want to bring up because I think this is really, really important for the listeners, is that if you have any other form of irritation on the scout such as dermatitis, seic dermatitis, any form of breakouts, tretinoin can be extremely irritating to those areas. And to just get to your point, I mean, yes, it can also aid in healing, but that irritation, that itchiness that sometimes goes along with the first 10 to 15 days of application with the skin, having that barrier broken down and that exfoliation starting to take place, we have to be very, very careful with that topical. And which is the reason again, we started this discussion, is that we need to compound and customize each one of those topical products for the right skin type.

Jessica Patrone, Pharm D.  (Guest) (14:38):

Exactly. And just by nature, the drug, the way that it works, it causes cell turnover, so it causes this proliferation and differentiation in the cells. So too much of it just by knowing that mechanism of action, you can see how that could be really irritating to the skeleton of some patient.

Kimberly Vaughn (Host) (14:56):

That's right. For sure. Okay, so we had talked about Finasteride. Let's go back to that. Let's talk about a topical application of Finasteride and then oral. I think probably anyone listening to this podcast, if they've done any Googling into the world wide web, they've only seen the negatives of the side effects of Finasteride with an oral. And so that is one of the reasons that we have chosen to use it primarily in our topical combinations, in our topical formulations. Certainly, Finasteride can be used very safely in an oral suspension, but at the same time, we always default back to topical. So tell us a little bit about how Finasteride is working on the top of thecal.

Jessica Patrone, Pharm D.  (Guest) (15:47):

Okay, so Finasteride, and there's another product called dutasteride. Both of those are really good for androgenic alopecia. Let me make a point before I really dive into that. But your customized hair formula is customized for the type of hair loss that you have. Okay? So when we talk about these different hair loss formulas, if you don't have androgenic alopecia, adding Finasteride is likely not going to do very much for you at all. So we'll get to that point, that part of the conversation, I think. But Finasteride is an anti-androgen, okay? So it's going to help stop the conversion of DHT, which is dihydrotestosterone. Now there are these receptors on the hair follicle, these DHT receptors, and the hair follicle needs DHT. However, when there's too much DHT, it causes this magnetization of the hair follicle. So in those specific cases, patients can benefit from adding on something like Finasteride or Dutasteride topically or even orally to block that DHT. So we keep it really in the sweet spot of where DHT needs to be so that the hair follicle is healthy.

Kimberly Vaughn (Host) (17:08):

Right? That's right. And I'm sorry, we might have lost you for just a minute on that last, but I think the last topic is that you had talked about the benefit of utilizing Finasteride as well as dutasteride to help with that androgenetic alopecia or a GA or genetic hair loss with the miniaturization process, correct?

Jessica Patrone, Pharm D.  (Guest) (17:32):

Yeah, that's right. And we typically think of that only in men, but this happens in women too.

Kimberly Vaughn (Host) (17:38):

Yes, most definitely. For sure. Okay, great. So then now we get into the customization into that formulation piece of combining Finasteride with Minoxidil or Dutasteride with Minoxidil and then adding also in Tretinoin. So I think what would be helpful for our listeners to understand is when they see products on the market and they have a combination of all three Minoxidil, Finasteride, and then Tretinoin, what do they need to be thinking about in purchasing something like that? And just starting without a diagnosis of the type of hair loss that they have or without seeking some type of professional acknowledgment and condition source of what is going on with their hair.

Jessica Patrone, Pharm D.  (Guest) (18:33):

I think that the biggest point is a lot of, Google and the internet give us power, but it also makes us all kind of our own little doctors in some ways. And so we see a product, we see the before and after pictures, and we think that's the right product for me. But like I mentioned, there are different types of hair loss, and these medications really target very specific things and reasons why you're having hair loss. Let me give you an example, and this is a personal example. So a couple of years ago, two and a half years ago, I had covid for the first time and I lost a lot of hair. It was about 30% of my hair, and it came back, but it was not fun to lose 30% of your hair. So in January, I got COVID again, and my symptoms were a lot worse than they were two and a half years ago.

(19:23):

So I expected that there would be more significant hair loss. So I thought, I have a lab, I can develop a product that's specifically designed for this type of hair loss. And so I did and I started it. I have not only noticed any hair loss up to this point, but I've also noticed a slowing in my natural shutting. So that's an example where that was a very specifically designed formula to treat that type of hair loss. And I think that the biggest point to be made is that unless you really have a professional on board, you don't know why you're losing hair, at least the majority of the time you don't. And so these formulas can really be customized to target your specific hair loss. And I think that's the biggest point.

Kimberly Vaughn (Host) (20:14):

That's right. I appreciate that because that's exactly what takes our team time and effort and within the consultation process, making sure that we listen and understand exactly what's going on with the hair loss. So for you, for example, you had not experienced hair loss up until your first episode with COVID-19, and then you knew you didn't want to go through that again. So then as you said, you were able to almost jump ahead of that and be proactive versus reactive. And that's really what we hope that many of the listeners today are thinking is, let's get into this. Now, whether you are just seeing the early stages of hair loss, it's so much more important to start this treatment process now versus waiting until you've lost 30-50 %. Sadly, the statistics Jessica, is that someone typically does not make a stand and move forward with treatment until they have seen at least 35% of their hair loss in some even 50%, and then we're behind the curve instead of ahead of the curve.

(21:27):

So I appreciate That's such a great point. Well, let's move on. So for the listener who is not interested in utilizing a synthetic or a drug topically, then what can we do for them when it comes to topical treatment with natural stimulators and natural DHT blockers? I mean, we know the internet loves to feed us information about biotin and saw palmetto. The sad part is it doesn't always give us information about amino acids and vitamin E and arginine and citrus seine. And so some of the other areas that we can treat in staying drug-free with topical treatments, and I know HPI pushed you a little bit outside of the box because we have some formulations that are designed by our DNA genetic testing that kind of steps outside of the realm. And so we've run into some fun blockers either with odor or with carrier agents or how clean can we keep these products? And those are top of mind for us. And I know they are for your lab as well. So with talking in relation to natural topicals, tell us a little bit about how your lab looks at those formulations and why you're different than most labs.

Jessica Patrone, Pharm D.  (Guest) (22:57):

Yeah, we'll combine the two. Okay. Or we'll strictly do a natural product if that's needed. In the case of our hormones, for example, we make a really clean product. It's all plant-based, no dyes, no added fillers, nothing. And we treat hair loss products the same way, even though you might not be putting it in your mouth and swallowing it, we try to make as clean of a product as possible. And if there's a benefit in adding some natural ingredients, then we definitely include those. So like you mentioned, you've got vitamin E, that's an antioxidant. One that you didn't mention was rosemary oil. We'll put that in there. There's biotin, you mentioned arginine, which is a great vasodilator. These are all-natural products. And when you get into the world of natural products, here's a comment that I want the viewers to really understand. You're going to have a lot of junk out there on the internet.

(23:54):

And when something is not a prescription, if it's not regulated, you are really at the mercy of the company who is making it to know that you're actually getting what you're asking for. So a word of caution there when you're talking about natural ingredients that you think, okay, well, I could take arginine orally and this study or this article that I read says that I'm going to have the same benefit as opposed to using it topically. Maybe if the company who's making it is good, if the dosing is correct and the potency is there, then quite possibly. But as I said, you're really at the mercy of those manufacturers over the counter to trust them that you're getting what you're asking for. So there are a lot of natural ingredients, and we will typically incorporate those in haircare products because we want to make sure that our patients are getting what's beneficial to them. And if we can add it all into one product, and you don't have to use three or four different things, life gets in the way. I can't think of anybody that wants to swallow a bunch of pills or apply a bunch of stuff to get the same effect that they could have a once-a-day application to the scalp or even every other day.

Kimberly Vaughn (Host) (25:18):

That's right. As you sit in front of patients with your hormone therapy treatment as well as thyroid support, we hear the same thing about hair loss in the Trichology world is don't give me one more item or one more product to put on my head. If I can do this in two steps or three steps, that's great. If I can come to the clinic and have treatments performed, that's going to make me much better at where I am in this stage of my journey. And I think that the key is again, going back to formulation and why it's so important that if you are someone that has a busy lifestyle if you're seeing yourself with this perpetual hair loss and having a provider and having a support clinician compound or devise the right protocol and the right formulations for either your orals and your topicals, you're going to be able to move into that combination approach to where you're using less, you're taking less, but yet it's also being more effective. Right?

Jessica Patrone, Pharm D.  (Guest) (26:29):

Exactly. Exactly. And it's convenience is one factor for sure. I'll use Minoxidil as an example. So Minoxidil is not very soluble in a lot of different excipients. So when we increase the concentration of minoxidil five, 7%, we have to add on a lot more of a certain excipient to solubilize it. And what happens is that that becomes oily. And so whether it's having to apply multiple things or whether it's applying something that aesthetically is not pleasing and makes your hair that's already thinning, matted down, and looks even thinner just for the ultimate gain in the end, some patients may not like that. So again, when we talked about retinol and adding that on board in combination with Minoxidil, a lot of the times you can decrease the concentration of MINOXIDIL by having retinol on board and make a lot easier application and less oily, more aesthetically pleasing type product. So applying fewer things to make it more convenient versus something that's aesthetically pleasing, can be a huge benefit to a lot of patients.

Kimberly Vaughn (Host) (27:52):

And that is one of the first objections that we hear from our female population. And so because we treat so many women with long hair, with blonde hair, with curly hair, the issue is is that when topicals are applied that have an oil base or a sticky base to them, then it's very difficult to be able to move through the second morning looking the way you want it to look. I mean, versus your hair being sticky and tacky to your scalp. This is also one of the reasons with your formulations and making sure that the carrier agent or the actual base in gradient that you were talking about, that is the clean process in this combination approach is making sure that the patient and the client truly have what they need so that they can move through their day without aggravation, without hassle, and certainly without sticky gummy hair.

Jessica Patrone, Pharm D.  (Guest) (28:56):

Yeah, I don't think anybody wants that.

Kimberly Vaughn (Host) (28:58):

No, that's exactly right. That's right. Well, Jessica, you've given us so many good tips and so many important lessons on the purpose of compounding and some of the reasons why that Minoxidil, Finasteride Dutasteride Tretinoin work, that then you've also helped us understand all the areas within that natural combination approach as well, so that if there is an individual who is not interested in using some type of synthetic drug, either orally or topically that we have these natural solutions. And so that's been extremely beneficial for the listener. Maybe you can offer a little bit of a takeaway for our audience that if they're looking at what is the right solution for them and they haven't seen a professional or a Trichologist or someone to help manage their hair loss, is there, what should they stay away from versus looking for? What can we caution them on to say, Hey, be very cautious on this line of products, and it's not specific products, it's just what is it that they need to be aware of.

Jessica Patrone, Pharm D.  (Guest) (30:14):

So I would be careful that first of all, you're not taking something orally that you really don't need or that's not going to be beneficial to you. So we talked a little bit about Oral Minoxidil or Finasteride Dutasteride, even Spironolactone cetirizine. I mean, even your supplements, if you don't need them, you may not only not see a benefit but have added side effects. So I would say that the first thing is making sure that whatever you're taking is something that you actually are going to benefit from. The second thing is, when you're looking at over-the-counter products, be very careful that the quality of the product is there. A lot of natural supplements that are labeled as natural supplements are not FDA-approved. They don't go through the FDA approval process. So you're at the mercy of the company to really make sure that that quality is there. Now, when it comes to prescription items, you go online, maybe you're doing a telehealth visit, and they're prescribing based on just a questionnaire. How do they even know that that truly is what you need? I think I can point back to Kimberly's reference to DNA testing and how valuable that can be for patients because you can actually really isolate the root cause of the problem, why the hair loss is actually occurring. So my biggest takeaway is to make sure that whatever you're applying, whatever you're taking, is something that is actually going to be beneficial to you.

Kimberly Vaughn (Host) (31:59):

Right. Oh, such great information. And so I think you brought up three major points. What is the benefit of what either you're applying topically or taking orally, and is it something that your body is going to accept, two is going to use and three not be harmful or toxic to the system? Secondly, the quality of what you're using. We know that price varies all over the internet, and all over brick-and-mortar stores. Why is it important to use that quality of product? Well, you might have a bottle of a product that's either 90 mils or 90 pills. It might cost pennies on the dollar in comparison to 60 pills or 60 mils of a compounded formulated product. That is really into the nature of what your specific needs are and being able to use that product sometimes for even longer than the 60 days receives maximum benefit in those 60 days versus it taking you 180 days just to scratch the surface with a product that has so little concentration.

(33:14):

So I think that's really important. And man, I'm the first to always say, I've sure gone down that rabbit hole. Oh, it's cheaper. Oh, it's this, oh, it's easier. It's more convenient. But at the end of the day, I'm looking for results, and so I'm going to make sure I get the best results that there are possible. And then thirdly, we talked about determining what is it that you need. And yes, you bring up a good point about testing, whether it is DNA genetic testing that we can send our tests and our screenings all over the United States, right in Canada to determine what your body does need, what's the genetic predisposition of the hair loss, and make sure that we are also recommending whether it's supplements or medications topically or orally that your body's going to truly absorb. And I know that our DNA test is proprietary and a little something special, but just running traditional labs, just making sure that you're actually utilizing the natural blood labs just to measure those trace metals and minerals in the system for the cell support. So that's key as well.

Jessica Patrone, Pharm D.  (Guest) (34:26):

Yeah, and we talked about there being other influences and hair loss. In my personal example, unfortunately, I'd had the experience of losing hair, but the second time I had COVID-19. Now I was powered with information and I knew, first of all, I've got to get on this specific formulation because I need to extend the antigen cycle and I need to get on it soon because if I wait and my hair is already shedding, it's too late. So again, that's just my personal example. But when you get to the root cause of it, whether it's hormonal, like you mentioned in blood work, some of those things can be diagnosed that way, or whether it's thyroid or whether it's an elemental nutritional factor. I mean, really the DNA test is one test, but getting to the root cause of it can be hugely beneficial. Nobody wants to waste their money for three months or four months and really get nowhere.

Kimberly Vaughn (Host) (35:31):

That's right. I couldn't have said that better myself. I love it. I love it. That's great. Well, Jessica, thank you so, so much for joining us today. I know that the listener has gained so many amazing points of interest for takeaway, for knowledge, for just diving into what is taking place when, whether it's their physician or their pharmacist in the city that they live in, recommends and formulate a product for them. Hopefully, this has given them a little bit more information, and that they feel a little bit more empowered and equipped now and certainly more educated with your support and help. So we couldn't thank you enough for taking your time today, but then we certainly are just so grateful that you support HPI with all of our processes as well. So we're excited to see what 2024 brings, and we'll be sending more patients your way. That sounds fantastic. It was a true pleasure talking to you today.

(36:33):

Another great addition to Hair Loss: Restore Your Roots and Confidence. We produce these shows to bring you the best information that we have at our fingertips. During these episodes, we want to make sure that the listeners, our community of hair, hair loss, men and women, have unbiased information, and have detailed information regarding treatment solutions, and causes of all things hair loss. So we hope that you've enjoyed the show today and we hope that you've been able to deem some information from this. Please take a moment and let us know how you feel about the show Radar our show. Let us know if there are questions or topics that you would like us to dive into. You can respond directly to the links below the show. You can always reach out to us at info@hphairpartners.com. Our website is hpihairpartners.com. You can click the consultation link, which brings you directly to a consultation form, and we are happy to meet you where you are today. So without further ado, remember that this show is for you and we always want you to have a great hair day. So thank you so much and we'll talk to you soon. Bye-Bye.

Narrator (37:58):

Thank you for tuning into this week's episode. We hope you've gained valuable insights into the world of haircare and restoration. If you found this episode enlightening, don't forget to drop us a review over on Apple Podcasts. If you're eager to delve deeper into how HPI Hair partners can cater to your hair needs, why wait? Connect with us today@hpihairpartners.com and make sure you never miss an episode by hitting that subscribe button. Tune in every week for fresh and enlightening updates. Until then, here's to healthier hair and boosted confidence.