Hair Loss

When it comes to combating hair loss, it is medicinal pills and topicals that spring to most peoples’ minds as the options holding the greatest promise. There also happen to be other available treatment options, such as surgical as well as non-surgical hair replacement, but to date only oral and topical medicinal treatments have been proven to reduce and reverse hair loss naturally. Hair transplantation, though providing the best cosmetic results, cannot slow or reverse hair loss. Natural and herbal hair loss treatments seek to mimic medicinal treatments in their mode of action but their effectiveness in treating hair loss has never been confirmed in any significant clinical study and many of them are associated with hair scams.

The two medicinal treatments that have been approved by the FDA (Food and Drug Administration) in the US for treating hair loss are topical minoxidil (trade name Rogaine/Regaine) and oral finasteride (Propecia). These two hair loss drugs have been also approved by national health supervisory authorities in many other countries. Topical minoxidil is suitable for both sexes, whereas finasteride can only be prescribed to male patients. Minoxidil is a vasodilator, originally used to treat high blood pressure, which was later found to stimulate new hair growth when applied topically to the scalp. Its exact mechanism of action is not known, though.

Finasteride (better known as Propecia) is an antiandrogen that was initially applied to treat benign prostatic hyperplasia (BPH), also known as prostate enlargement. It acts by inhibiting conversion of the male hormone testosterone to the follicle harming didydrotestosterone (DHT). The discovery of finasteride’s positive influence on hair growth led to finding the true cause of hereditary baldness, which are the harmful attacks of DHT on our hair follicles. Since making this discovery, a quest for other alternative DHT inhibitors has begun, especially amongst antiandrogen drugs and herbs that have, in the past, been used to treat urinary problems.

Dutasteride (trade name Avodart) is a drug similar to finasteride and has been studied extensively for treating hair loss. It is currently undergoing phase III clinical testing. It has been approved for treating BPH and is therefore available in pharmacies in many countries around the world. Although it has not yet been approved for treating hair loss by any national health supervisory authority, it is being prescribed by some clinics and doctors to male patients who no longer respond to finasteride. Dutasteride is believed to be a more powerful hair loss drug than finasteride but also with more severe side effects.

Flutamide (trade name Eulexin) is an extremely powerful antiandrogen used to treat prostate cancer. It works by binding to the androgen receptors and thus competing with DHT. Oral use of flutamide can cause serious side effects but it is believed that topical applications might have less adverse side effects and could be, in the future, used to combat hereditary hair loss. More research is needed to verify such claims.

Spironolactone (trade name Aldactone) is another antiandrogen that works by binding to androgen receptors, competing with DHT. It is used in women to treat acne, excess body hair and hair loss and although there are some generic topical applications designed for treatment of male pattern baldness containing spironolactone, it has never been approved to treat hair loss in men and should better be avoided.

Aminexil, was developed by L’Oreal to treat baldness in men and women and its molecule is very similar to that of minoxidil. Its mode of action is not exactly known and it is believed to be a less powerful weapon in the fight against hair loss than minoxidil.

NEOSH101 is one of the most promising novel hair loss drugs under development. It is in phase II clinical trials and is supposed to be a hair growth stimulant, distantly related in its actions to minoxidil. Although not expected to become an ultimate cure for baldness, it could improve the chances of many hair loss sufferers of regrowing some of their lost hair.

The above list of medicinal treatments for hair loss is not exhaustive. There are also other drugs though to help treat hereditary baldness, such as superoxide dismutase, fluridil, ketoconazole, alfatradiol, etc. but none of them has ever been proven in any serious clinical study to promote hair growth and further studies will be needed to evaluate their actual effects on hair loss. Therefore, for the time being, minoxidil and finasteride remain the main weapons in the fight against genetically-determined hair loss conditions in male patients.

Men have been seeking an ultimate cure for hair loss for thousands of years but until very recently with relatively little success as most available cures were either cosmetic cover-ups or unsophisticated vitamin/mineral pills and herbal lotions, with quite many of them just being scams. It was only with the advent of finasteride and minoxidil and improvements made in hair transplantation techniques in recent fifteen years that the new era began, enabling hair loss patients to halt the further progression of the balding process and replace the missing hair on top of their head using the hair left at the back of their scalp. However, to this day no ultimate cure for hereditary hair loss exists. There are presently several promising drugs and techniques under development but none of these new therapies is expected to hit the market before 2013.

NEOSH101 is being developed by the US company Neosil and it is currently undergoing phase IIb clinical testing. It has been shown to be a more potent and faster-acting hair growth stimulant than minoxidil and it only needs applying once daily. Though considerably improving the current hair loss treatment options, NEOSH101 is unlikely to become an ultimate cure for hereditary hair loss. The clinical trials seem to be advancing slower than most hair loss sufferers would like to see and, hence, do not hold your breath for it hitting the market anytime soon. NEOSH101 is mainly expected to replace minoxidil and other currently available hair growth stimulants.

Another promising area of development is genetics research, especially the telomerase research. Telomerase is an enzyme that puts natural caps on telomeres and thus protects them from shortening. Telomerase thereby maintains the genomic integrity. Shortened telomeres are associated with the premature aging processes. However, the uncontrolled activation of telomerase can cause cancer growth. Cancer research is the main focus of the telomerase study but scientists are also looking for other applications, such as anti-aging drugs and drugs against hereditary hair loss and premature grey hair. Although still under development, there are already some generic products available on the market that seek to emulate the mechanism of telomerase action but they have no scientific backing and should better be avoided. Telomerase research could really change the world of medicine but its commercial application might be a good decade away.

Hair multiplication, often called hair cloning, is the next hopeful treatment approach being developed. This technique involves extracting the healthy hair follicles from the back of the patient’s scalp, culturing and multiplying them and injecting the newly-grown hair cells into the bald scalp. Among several teams of scientists on three continents researching hair multiplication, the UK healthcare firm Intercytex appears to be the frontrunner. Intercytex reported results of the latest stage of the clinical phase II study of ICX-TRC (a suspension of a patient’s own dermal papilla cells) in March 2008 and they were positive. The next release is expected by the end of 2008. However, since the aforementioned data release no substantial progress has been reported and the company seems to be struggling, having serious difficulties to secure financing for its ongoing projects. This therapy might hit the market in 2013 at the earliest. The main benefit of hair multiplication would be solving the shortage of donor hair that is the main limiting factor in hair transplantation.

Generating hair follicles in wounds of hair-free skin is a completely new approach to growing new hair. It was discovered accidentally as wounded skin in mice started producing new hair. This technology is currently being developed by the US medical device company, Follica, which licensed this technology from the University of Pennsylvania. Though this technique may sound weird it is said to use only common instruments and drugs that have already been medically approved and thus it should not take too long for it to become commercially available.

This is the list of the main promising lines of research and development in the area of treating hereditary hair loss that are being currently developed but some others seem to be in the pipeline. It appears that becoming bald will one day be by choice rather than destiny.