Does Fungal Infection Cause Male Pattern Baldness and Heart Disease?


Quite the rabbit hole I’ve been down with my research. Does fungal infection cause male pattern baldness and heart disease? There’s an iron link to fungal infection too.

This started when a reader told me that he had started donating blood after reading this site and my book on iron.

He said that he had had seborrheic dermatitis of many years standing. (Click here if you want to see what that looks like.) It’s basically something like really terrible dandruff, but can be on any part of the body. He had tried both anti-fungal medication and topical steroids, and nothing worked. Since it didn’t bother him much, he quit worrying about it.

After his first blood donation, it started clearing up, and after his third donation, it completely disappeared.

What in the world? It turns out that both dandruff and seborrheic dermatitis are linked to a fungal infection by the fungus Malassezia. So is tinea versicolor, a skin infection; when I lived in Sierra Leone, virtually everyone had it to some degree.

In this report, we show that dandruff is mediated by Malassezia metabolites, specifically irritating free fatty acids released from sebaceous triglycerides.

Dandruff is caused by a fungal infection.

All microorganisms that invade man and cause disease require iron. (Every living thing requires iron.) Withholding iron from microbes is at the center of an evolutionary arms race. It stands to reason that donating blood can treat fungal infections of the skin by lowering skin iron levels. (Donating blood will also make you look younger.)

Shampoo that contains salicylate and ciclopirox effectively treats dandruff. Ciclopirox is an iron chelator (attaches and removes iron). So is salicylate. By attaching and removing iron, they deprive fungus of required growth material, it dies, and dandruff is treated.

Ketoconazole, an anti-fungal chemical that works by inhibiting fungal steroid synthesis, also treats dandruff.

Male pattern baldness

Male pattern baldness has been linked to fungal infection as well, and the antifungal drug ketoconazole treats male pattern baldness just as well as minoxidil (Rogaine).

Comparative data suggest that there may be a significant action of KCZ [ketoconazole] upon the course of androgenic alopecia and that Malassezia spp. may play a role in the inflammatory reaction.

If this holds true for many or all cases of male pattern baldness (androgenic alopecia), then our notions of why some men go bald (that it’s due to testosterone metabolites) may be all wrong. Curiously, folklore has it that hats cause baldness — perhaps by giving fungus a warm, moist environment in which to grow?

Male pattern baldness is also associated with heart disease. Severe baldness was associated with a 2.5 fold greater risk of death from heart disease. Huge increase.

If fungal infection in the skin causes both male pattern baldness and dandruff, then iron is implicated, because all invasive microorganisms must take iron from their hosts.

High iron (ferritin) is also associated with heart disease. The mechanism usually postulated is increased oxidative stress of the walls of arteries; iron is a very reactive metal capable of damaging biological structures.

But another mechanism might be the stimulation of fungal growth. “Occult fungal infection is the underlying pathogenic cause of atherogenesis” (from the journal Medical Hypotheses):

Atherosclerosis is the underlying cause of coronary heart disease (CHD). Atherogenesis is supposed to result from response to injury and is considered an inflammatory condition. A variety of infectious agents have been investigated as the underlying risk factor for atherogenesis, however, none have been proved to be causally linked. Also several interventions against these agents have not been proved to be of benefit in trials. The role of fungal infection, however, has not been explored in sufficient detail. Baldness particularly male pattern baldness and coronary artery disease have been linked in several epidemiological studies. There is some evidence that this type of baldness could be due to fungal infection and this link is being established even though traditionally male pattern baldness was associated with androgen effect. Seborrheic dermatitis and Pityrosporum [Malassezia] infection have been causally linked and the benefit derived from antifungal shampoo in male pattern baldness, gives further credence to the link with fungal infection. Here it is being hypothesized that fungal infection is the underlying risk factor for both baldness and CHD. Several interventions, which have proved beneficial in CHD like statins and drug coated stents, also have antifungal effects, lending further credence to the present hypothesis.

Fungal elements have been detected atherosclerotic plaques (27% of those examined). Fungal DNA has also been found in plaques.

Male pattern baldness is also strongly linked to insulin resistance and metabolic syndrome. The Japanese have both a lower prevalence of diabetes and obesity, and male pattern baldness in Japan develops a decade later and less frequently than in the West.

Hemochromatosis, or hereditary iron overload, causes hair loss in the majority of cases, though apparently mostly body hair.


Admittedly that’s a lot of information. Here’s where we are:

  1. Fungal infections of the skin cause dandruff and seborrheic dermatitis. Fungi, like all microorganisms, require iron to grow.
  2. Blood donation as well as iron chelators lower iron in the skin, depriving fungi (Malassezia, in this case) of a required nutrient. They then die off. Dandruff and dermatitis cured.
  3. Male pattern baldness may very well be caused by fungal infection, together with other factors, such as androgens and genetic susceptibility.
  4. The common link between male pattern baldness and coronary heart disease might be fungal infection, in turn caused by too much free iron.
  5. Bladness is associated with insulin resistance, and this in turn associates with coronary heart disease.

Conclusion: What to do

  • If you have male pattern baldness, anti-fungal shampoo may fight it. Blood donation or iron chelators might also.
  • If you have male pattern baldness, you’re at higher risk of heart disease. If the fungal/iron connection holds true, getting your ferritin (iron) lower could lower your risk. In fact, even if the fungal connection isn’t solid, lowering your ferritin still lowers your risk.
  • Male pattern baldness is strongly linked to metabolic syndrome, which if not taken care of, often ends in diabetes. Taking care of yourself with a low-carbohydrate diet and exercise treats metabolic syndrome. It might make your hair grow back too.

Male pattern baldness is usually discussed in terms of cosmetics only, and is thought to be caused by androgens in the skin. But it could be caused by fungi that feed on iron, and a sign that something deeper and unhealthy is going on.

PS: Read my book, Dumping Iron.

PPS: You can support this site by purchasing through my Supplements Buying Guide for Men.

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  1. MG says:

    Mr. Mangan,
    This article is amazing. Thanky you for intellectual curiosity.
    You said “After his first blood donation, it started clearing up, and after his third donation, it completely disappeared.” Iwould like to know how long did it take him to complete the three donations? and the second question is the following: do you know the ferritin values if this person before/after donation?

    • P. D. Mangan says:

      Thanks, MG, intellectual curiosity is what I’m all about. I don’t know his ferritin levels, and as for blood donation, all I could say is I assume there was at least 2 months between donations, which is what blood banks allow.

  2. Salicylate and other ingredients in some shampoos are weak lipophilic iron chelators. The strongest agent is EDTA or DTPA for water soluble iron, possiby not in oily scales. Lipid bound iron may require a lipophilic iron chelator and possibly also a thiol for releasing the bound ferric iron as the more soluble ferrous iron.

  3. Ted says:

    PD- look into sulforaphane for hair regrowth.

    Sulforaphane lowers DHT (converts dht to smth else), in mice it accelerated hair regrowth. The full paper on scihub has before/after pictures vs control. Also sulforaphane is antifungal

    • ted says:

      most hairloss drugs try to reduce conversion of T into DHT as far as I know, so sulforaphane is interesting in that it has a different approach – convert existing DHT into something else.

  4. James says:

    I’ve had seborrheic dermatitis my entire adult life. I’ve donated blood five times in the past year and haven’t noticed any improvement yet, although I suspect that I started with very high iron levels, so I may need to donate more before my iron reach ideal levels and the benefits kick in.

    So far, the only reliable way I’ve found to treat seborrheic dermatitis is going ultra-low-carb. Typically I eat a single sweet potato per day, and I barely have any symptoms. If I eat a lot more carbs, even relatively healthy ones, I get an ugly, disfiguring facial rash.

    Many of the things you recommended in your post about acne are also useful for mitigating s.d. For example, sunlight is very beneficial–my face breaks out whenever I visit my family in the Midwest over winter. I think the sun’s benefit comes from uv rays because vitamin d supplements do nothing for me.

    • Caleb says:

      I’d agree that UVs in sunlight most likely have a beneficial effect in killing skin pathogens, this doesn’t mean that we can rule out a beneficial role of viatmin D _on the skin_. Oral vitamin D is not like getting it from the sun, because the Vitamin D made by the skin is absorbed slowly over a 48 hour period and could be doing a lot of good for the skin microbiome, helping kill bad skin pathogens and promoting beneficial bacteria that crowd them out (our modern excessive showering washing off this D before it’s fully absorbed is another reason so many people are D deficient). I’ve started experimenting today with mixing in D drops into a lotion for my own dermatitis. We’ll see how it goes.

      I’ve noticed as well that fructose will cause my scalp inflammation to flare up painfully if I overindulge.

      Thanks a ton for this info Mangan. Picked up some 1% Ketoconazole shampoo yesterday and am trying it out.

  5. Chris says:

    Great article thanks. When you say blood donation will make you look younger, did you notice this personally, and is this change immediate or gradual over a number of blood giving cycles? Thanks

    • P. D. Mangan says:

      I’m personally ineligible to donate. I base the statement on ferritin levels in pre- vs post-menopausal women, which I discussed in the linked article, and on what a couple of people have told me.

  6. bigmyc says:

    It sounds more and more like fungus is more of an insidiously pervasive entity than convention has related. In this day and age of “super bug” concerns do to the rampant and wanton use of anti-biotics, I wonder why fungal maladies aren’t so publicized. I have recently learned of a super fungal strain that was life threatening in a few reported cases but by and large, you don’t hear about it as much. Perhaps that’s due to the creeping nature of how the pathogen proliferates as opposed to the relative rapid expansion of bacteria colonies.

    • P. D. Mangan says:

      There are serious fungal diseases, though many of them occur in the tropics, and others in people with lower immunity. In California, there’s coccidioidomycosis, which cases valley fever. But your point stands that “ordinary” fungi may be more implicated in disease than we know.

      • bigmyc says:

        Ah, thanx for the follow up. I was thinking particularly, candida albicans, as it is endemic to a normal microbiome but is quite opportunistic, especially in the case of dysbiosis.

        Also, I remember you mentioning in a post a while back that you were under some sort of new protocol (which has probably become a regular thing for you) that resulted in your hair getting darker…what was that?

        • P. D. Mangan says:

          Well, I’ve let my hair grow out a bit, and it’s a bit darker. The only thing different that I could attribute that to is dumping iron. If it reduces oxidative stress in hair follicles, that could do it. But I still have lots of grey.

  7. Nate says:

    I’m the reader who noticed my sebhorreic dermatitis clear up after the third blood donation.

    MG: I donated blood in May, August, and November of this year. The local blood bank tries to get it’s regular donors to donate three times a year-so I decided to make that my goal. I’ll probably donate again in February. Unfortunately, I didn’t check a ferritin before starting.

    I should note that my sebhorreic dermatitis was fairly mild-I don’t think most people even noticed it on me. It did have a long duration, and it was something that I was mildly self conscious about. I noticed it improve markedly after the first donation, a little more after the second, and after the third, all gone!!

    Of course, this is just anecdotal. It may be just chance.

    I did a literature search after it resolved, and I couldn’t find anyone else who had noticed or reported this.

  8. fwh says:

    I’ve regularly heard the saying that baldness comes from your mother’s father. Maybe there is something to that.


    1. If baldness is iron related

    2. and the iron is coming from your food and the kitchen implements/technology that flake off into your food supply ( e.g. a preference for cast-iron skillets)

    3. and your mother is the primary decider of the basic menu of the house and the chooser of kitchen implements / technology

    4. and your mother developed these preferences by growing up in her mother’s house surrounded by these foods and tools

    5. and your mother’s mother was the primary effect of iron intake on your mother’s father over the course of his life

    then, your mother’s father is indeed a reasonable rule of thumb for your own baldness.

    • fwh says:

      doggone it. I just read my chain of logic and it has a weakness. Your mother’s father would only eat your mother’s mother’s food after he was married, but you eat it until you move out. Anyways, a mother and daughter could significantly create an iron load in your system either in the first 18 years of your life or at the beginning of a marriage.

  9. Some guy says:

    If fungus were the cause, wouldn’t it affect men and women; grown-ups and children; and, the top and sides of the head at equal rates?

    • P. D. Mangan says:

      Obviously other factors are involved, such as androgens. But equally with androgens, one could say why it doesn’t affect the sides of the head, and why it doesn’t affect all men.

      Also, some of the reports I’ve read indicate that it’s not presence of Malassezia that causes dandruff, etc, but increased numbers. If that’s the case, then Malassezia could be considered normal flora.

      • MG says:

        Interesting point, the one about affecting the sides of the head.

      • Some guy says:

        After reading some studies about rosemary essential oil being as effective as minoxidil for hair regrowth (and without the warnings about not letting my wife and kids touch it). I’ve been doing a self-experiment of applying a few drops of a homemade hair tonic consisting mainly of rosemary and lavender essential oils suspended in a carrier of sesame oil to my scalp and beard.

        At the start of the experiment, in mid-Summer, the top of my head was a cue-ball with a few stray short hairs here and there. During the first week or so after I started, it was like an unnoticed whitish, salt-like crust came up off of the top of my scalp. Then, I noticed hair growth. At first, they were short, blonde baby hairs, but now I have extensive patches of brown hair on the top that need regular trimming.

        My hair seems to be coming back in the reverse order that I originally “lost” it. It isn’t fully back yet though. But the progress has been surprising. I continue to use my normal shampoos and conditioners, or whatever partially-used mini bottles my wife asks me to help finish. Sometimes I wear hats, sometimes I don’t. Sometimes I brush it, sometimes I don’t.

        I haven’t used any other hair growth products or treatments during this time and haven’t tried anything else for 5+ years. I had basically resigned myself to look like my father.

        Now, what is the rosemary changing on the top of my head, I don’t know. But by using it, my hair looks healthier. Also, my beard looks fuller.

        Rosemary vs. minoxidil:

        Rosemary turns out to also be anti-fungal:

        Apparently, the hair on the top of the head becomes more sensitive to DHT as people age. I wonder if genetics + scalp fungus has anything to do with that increase?:

        • P. D. Mangan says:

          Thanks for all that, Some guy – great info. I may make a post from that.

        • joel says:

          @Some Guy, how many drops of EOs you mix in how much oil? How many times you apply to your scalp? DO you wash it out after some time or you just let it on your scalp?
          Thank you

        • Dusan says:

          How many drops of rosemary essential oil you mix in how much oil? How many times you apply to your scalp?

  10. Ted says:

    There is research showing hair becomes more sensitive to DHT under hypoxia. Maybe there is poor vascularization at the top of hear, or maybe it’s that top of head is furthest from heart so bloodflow is weaker. Here are some links

  11. John says:

    I was the first person in my class at school to get acne and had it for over 20 years. I tried many treatments but nothing worked (except antiseptic creams – which is not a long-term solution). I cured it by eating 2 slices of fresh pineapple each day. It only took about 3 days to almost completely clear up. Whenever I stopped the acne came back. However, after a few years I was able to stop and it didn’t come back. The side-effect is that pineapple is quite harsh on tooth enamel. Wait at least 1/2 before brushing. I have read that pineapple contains an anti-inflammatory called Bromelain, which also breaks down proteins. I think it has great potential for use in other types of conditions.

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