Baldness treatments
Encyclopedia
Baldness treatment is a US $1 billion per year industry. In males past their early 20s, the incidence of balding is roughly equivalent to chronological age. Thus, by age 50, roughly half of men experience male pattern baldness (MPB). Beginning in the 1980s, drug therapy has increasingly become a realistic management option for baldness
in both men and women. For example, increased understanding of the role of dihydrotestosterone
(DHT) in male and female pattern baldness has led to targeted intervention to prevent this hormone from acting on scalp androgen receptors.
Like many other medical conditions, baldness can be treated, but not cured. Moreover, experts warn that many treatments marketed as hair loss cures are ineffective aside from the placebo effect
.
levels. Other variables include androgen receptor density and distribution in the scalp. Vigorous aerobic exercise
daily, as opposed to short workout periods designed to raise androgen levels and build muscle or more sporadic exercise, and a diet which is adequate, yet more moderate in fat and total calorie intake, have been shown to reduce baseline insulin levels as well as baseline total and free testosterone.
Lower insulin levels and reduced stress both result in raised levels of sex hormone-binding globulin (SHBG). SHBG binds to testosterone. Only free testosterone improves muscle growth and insulin sensitivity, but free testosterone can also be converted to the ineffective (regarding insulin sensitivity) DHT. The levels of free androgens and not of total androgens are relevant to the levels of DHT in the scalp and the progression of male pattern baldness.
Androgenic alopecia occasionally correlates with metabolic syndrome
. This may be because typically bald men have low testosterone levels (hypogonadism
) which can easily trigger also diabetes mellitus
and erectile dysfunction
. Medically increasing androgen levels improves this condition, demonstrating that androgens do not cause metabolic syndrome. Instead, high insulin levels (and possibly chronic inflammation) seem the likely link in the demonstrated correlation between baldness and metabolic syndrome. This reinforces the notion that behaviors which help to keep insulin levels low and reduce chronic inflammation might also help to preserve hair.
(Rogaine) and finasteride
(Propecia).
Finasteride is recommended as first-line treatment for male pattern baldness. They may also be used simultaneously when hair loss is progressive or further regrowth is desired after 12 months.
(Rogaine) is a vasodilator originally used as an oral drug (Loniten) to treat high blood pressure
. However, minoxidil was discovered to have the side effect of hair growth and reversing baldness. Consequently, in the 1980s, Upjohn Corporation received FDA approval to market a topical solution that contained 2% minoxidil to be used to treat baldness and hair loss as Rogaine, marketed as Regaine outside the USA.
Objective evidence shows that minoxidil is effective for treatment of male-pattern hair loss in both the frontal areas and the vertex area of the scalp. At the conclusion of a 48 week study, improvements were seen in the vertex area regions of 51% of men using 5% minoxidil, 42% using 2% minoxidil, and 13% of placebo users. Among these men, moderate to great increases in hair growth were seen in the frontal scalp regions of 19% of men using 5% minoxidil, 10% using 2% minoxidil, and 3% of placebo users.
The mechanism of action for minoxidil
is not known. Its action as a vasodialator may involve opening vascular smooth muscle potassium channels or "K-channels", perhaps through mimicking the most important natural vasodialator, nitric oxide
, whose structure minoxidil incorporates
. This agent can also cause follicles in the telogen phase to shed, usually soon to be replaced by new, thicker hairs. As the hair-growth-stimulating effect is temporary and does not seem to change the follicle in any other way, minoxidil needs to be applied regularly (once or twice daily) for hair gained to be maintained.
(marketed by Merck
under the trade names Propecia and Proscar) is a 5 alpha-reductase inhibitor
of the type II isoenzyme.
It was originally FDA approved for treatment of benign prostatic hyperplasia
(BPH) and works by binding to 5-alpha-reductase, the enzyme responsible for the conversion of free testosterone to DHT.
Merck sought to find the smallest effective quantity of finasteride and test its long-term effects on 1,553 men between ages 18 and 41 with mildly to moderately thinning hair. Based on their research, 1 mg/day was selected, and after two years of daily treatment, over 83% of the 1,553 men experiencing male hair loss had actually maintained or increased their hair count from baseline. Visual assessments concluded that over 80% had improved appearances.
In 1997, finasteride was approved by the US FDA for the treatment of male pattern baldness. A 5-year study revealed that 9 of 10 men taking finasteride (1 mg/day) experienced visible results (42% of men taking Propecia experienced no further hair loss while 48% experienced no further hair loss and hair regrowth). In clinical studies, finasteride, like minoxidil
, was shown to work on both the crown
area and the hairline area, but is most successful in the crown area.
is a dual 5-a reductase inhibitor
that inhibits conversion
of testosterone
to dihydrotestosterone
(DHT).
Dutasteride inhibits both isoforms of 5-alpha reductase, type I and type II, whereas finasteride only inhibits type II.
Dutasteride (trade name Avodart by GlaxoSmithKline
) is FDA approved for treatment of benign prostatic hyperplasia
(BPH).
Phase I and II clinical trials for dutasteride as a hair loss drug were undertaken, but called off in late 2002, with reasons for terminatation unknown.
The phase II results indicated that dutasteride at both 0.5 mg and 2.5 mg/day generated a superior hair count to finasteride 5 mg at 12 and 24 weeks.
Phase II study results at 24 weeks:
In December 2006, GlaxoSmithKline launched a new phase III, six month study in Korea
to test the safety, tolerability and effectiveness of a once-daily dose of dutasteride (0.5 mg) for the treatment of MPB in the vertex region of the scalp (types IIIV, IV and V on the Hamilton-Norwood scale
). The study was completed in January 2009. Future intentions by GlaxoSmithKline to continue or abandon plans for FDA approval of dutasteride in treatment of male pattern baldness (MPB) remain unknown.
, to move hair-producing follicles to balding areas of the hair restoration
patient's scalp. These follicular units are surgically implanted in the scalp in very close proximity to one another and in large numbers. The grafts are obtained in one or both of the two primary methods of surgical extraction, Follicular Unit Transplantation
(FUT) or Follicular Unit Extraction
(FUE). In FUT, a strip of skin containing many follicular units is extracted from the patient and then dissected under a stereoscopic dissecting microscope. Once dissected into individual follicular unit grafts, the surgeon implants the grafts into small incisions, called recipient sites, in the recipient area of the patient's scalp. According to the new approach the roots of the hair are extracted from the "donor", and then literally cut into tiny strips, for transplantation. Bald patches on the scalp are isolated and given the donor strip, which is two to three millimeters thick only.
When the transaction is completed, the patient should wear a head bandage for the next two days. This will allow the scalp to treat not weakened, and increase the chances of success.
has been identified as a stimulator of human hair growth in vitro, and reduced testosterone
-induced follicle growth suppression. It has been demonstrated that the addition of caffeine to a shampoo-formulation is effective in administering caffeine to the hair follicles in the scalp. Further research must be done to evaluate the efficacy and adequate dosage of caffeine in the treatment of androgenetic alopecia
.
A spray made with coffee beans is claimed by the UK pharmacy chain Boots to prevent age-related hair loss in women.
announced they have found the genetic basis of two distinct forms of inherited hair loss, opening a broad path to treatments for baldness. They found that a gene, P2RY5
, causes a rare, inherited form of hair loss called hypotrichosis simplex. It is the first receptor
in humans known to play a role in hair growth. The fact that any receptor plays a specific role in hair growth was previously unknown to scientists and with this new knowledge a focus on finding more of these.
In May 2009, researchers in Japan
identified a gene
, SOX21
, that appears to determine cyclical hair loss in mice. The researchers also believe it may be responsible for hair loss, or alopecia, in people.
Through 2006, a drug development company spent $1,000,000 on a hair growth program focused on the potential development of a topical hedgehog
agonist
for hair growth disorders such as male pattern baldness and female hair loss. The hair loss research program was shut down in May 2007 because the process did not meet the proper safety standards.
s TEMPO
and TEMPOL also enhance hair regrowth following radiation. For example, there is currently a National Cancer Institute-sponsored clinical trial for TEMPOL in radiation alopecia
In 2008, Intercytex
, a company in Manchester (UK), announced positive results of a Phase II trial for a form of cloning
hair follicles from the back of the neck, multiplying them and then reimplanting the cells into the scalp. The initial testing resulted in at least two thirds of male patients regrowing hair. As of 2009, the company estimates this treatment will take "a number of years to complete" Phase III trials before it can go to market. However, after failing to achieve subsequent success in their trials, the company announced discontinuation of its hair multiplication project in January 2010 with intention to sell off its assets and research. On March 25, 2010 Aderans Research Institute Inc. (ARI) announced it acquired key technology assets from Regenerative Medicine Assets Limited (formerly Intercytex Group plc). ARI is currently conducting Phase II clinical trials in cities throughout the U.S.
In December 2010, scientists at the Berlin Technical University in Germany
revealed they had grown the world's first artificial hair follicles from stem cells. Research leader Dr Roland Lauster said within five years millions of hair-loss sufferers could grow new hair from their own stem cells and have it implanted into their bald spots. He also announced that preparations for clinical trials were "already in motion".
which can regenerate hair follicles by reawakening genes
which were once active only in the embryo
stage of human development. Skin apparently can be brought back to this embryonic state when a wound is healing. Hair growth was discovered in the skin wounds of mice when Wnt proteins were introduced to the site. Development of a human treatment is expected to take several years.
in men with androgenic alopecia.
Baldness
Baldness implies partial or complete lack of hair and can be understood as part of the wider topic of "hair thinning". The degree and pattern of baldness can vary greatly, but its most common cause is male and female pattern baldness, also known as androgenic alopecia, alopecia androgenetica or...
in both men and women. For example, increased understanding of the role of dihydrotestosterone
Dihydrotestosterone
Dihydrotestosterone is an androgen or male sex hormone. The enzyme 5α-reductase synthesises DHT in the prostate, testes, hair follicles, and adrenal glands...
(DHT) in male and female pattern baldness has led to targeted intervention to prevent this hormone from acting on scalp androgen receptors.
Like many other medical conditions, baldness can be treated, but not cured. Moreover, experts warn that many treatments marketed as hair loss cures are ineffective aside from the placebo effect
Placebo effect
Placebo effect may refer to:* Placebo effect, the tendency of any medication or treatment, even an inert or ineffective one, to exhibit results simply because the recipient believes that it will work...
.
Lifestyle modification
Several genetic factors determine susceptibility to male pattern baldness (MPB). These factors include androgen receptor polymorphisms and scalp 5-alpha-reductase5-alpha reductase
5α-reductases, also known as 3-oxo-5α-steroid 4-dehydrogenases, are enzymes involved in steroid metabolism. They participate in 3 metabolic pathways: bile acid biosynthesis, androgen and estrogen metabolism, and prostate cancer....
levels. Other variables include androgen receptor density and distribution in the scalp. Vigorous aerobic exercise
Aerobic exercise
Aerobic exercise is physical exercise of relatively low intensity that depends primarily on the aerobic energy-generating process. Aerobic literally means "living in air", and refers to the use of oxygen to adequately meet energy demands during exercise via aerobic metabolism...
daily, as opposed to short workout periods designed to raise androgen levels and build muscle or more sporadic exercise, and a diet which is adequate, yet more moderate in fat and total calorie intake, have been shown to reduce baseline insulin levels as well as baseline total and free testosterone.
Lower insulin levels and reduced stress both result in raised levels of sex hormone-binding globulin (SHBG). SHBG binds to testosterone. Only free testosterone improves muscle growth and insulin sensitivity, but free testosterone can also be converted to the ineffective (regarding insulin sensitivity) DHT. The levels of free androgens and not of total androgens are relevant to the levels of DHT in the scalp and the progression of male pattern baldness.
Androgenic alopecia occasionally correlates with metabolic syndrome
Metabolic syndrome
Metabolic syndrome is a combination of medical disorders that, when occurring together, increase the risk of developing cardiovascular disease and diabetes. It affects one in five people in the United States and prevalence increases with age...
. This may be because typically bald men have low testosterone levels (hypogonadism
Hypogonadism
Hypogonadism is a medical term for decreased functional activity of the gonads. Low testosterone is caused by a decline or deficiency in gonadal production of testosterone in males...
) which can easily trigger also diabetes mellitus
Diabetes mellitus
Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced...
and erectile dysfunction
Erectile dysfunction
Erectile dysfunction is sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual performance....
. Medically increasing androgen levels improves this condition, demonstrating that androgens do not cause metabolic syndrome. Instead, high insulin levels (and possibly chronic inflammation) seem the likely link in the demonstrated correlation between baldness and metabolic syndrome. This reinforces the notion that behaviors which help to keep insulin levels low and reduce chronic inflammation might also help to preserve hair.
Medications
The U.S. Food and Drug Administration (FDA) has approved only two medications for the treatment of male pattern baldness; these are minoxidilMinoxidil
Minoxidil is an antihypertensive vasodilator medication which also slows or stops hair loss and promotes hair regrowth. Now off-patent, it is available over-the-counter for the treatment of androgenic alopecia. Minoxidil must be used indefinitely for continued support of existing hair follicles and...
(Rogaine) and finasteride
Finasteride
Finasteride is a synthetic antiandrogen that inhibits type II 5-alpha reductase, the enzyme that converts testosterone to dihydrotestosterone...
(Propecia).
Finasteride is recommended as first-line treatment for male pattern baldness. They may also be used simultaneously when hair loss is progressive or further regrowth is desired after 12 months.
Minoxidil
MinoxidilMinoxidil
Minoxidil is an antihypertensive vasodilator medication which also slows or stops hair loss and promotes hair regrowth. Now off-patent, it is available over-the-counter for the treatment of androgenic alopecia. Minoxidil must be used indefinitely for continued support of existing hair follicles and...
(Rogaine) is a vasodilator originally used as an oral drug (Loniten) to treat high blood pressure
Hypertension
Hypertension or high blood pressure is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. What that means is that the heart is having to work harder than it should to pump the blood around the body. Blood pressure involves two measurements, systolic and...
. However, minoxidil was discovered to have the side effect of hair growth and reversing baldness. Consequently, in the 1980s, Upjohn Corporation received FDA approval to market a topical solution that contained 2% minoxidil to be used to treat baldness and hair loss as Rogaine, marketed as Regaine outside the USA.
Objective evidence shows that minoxidil is effective for treatment of male-pattern hair loss in both the frontal areas and the vertex area of the scalp. At the conclusion of a 48 week study, improvements were seen in the vertex area regions of 51% of men using 5% minoxidil, 42% using 2% minoxidil, and 13% of placebo users. Among these men, moderate to great increases in hair growth were seen in the frontal scalp regions of 19% of men using 5% minoxidil, 10% using 2% minoxidil, and 3% of placebo users.
The mechanism of action for minoxidil
Minoxidil
Minoxidil is an antihypertensive vasodilator medication which also slows or stops hair loss and promotes hair regrowth. Now off-patent, it is available over-the-counter for the treatment of androgenic alopecia. Minoxidil must be used indefinitely for continued support of existing hair follicles and...
is not known. Its action as a vasodialator may involve opening vascular smooth muscle potassium channels or "K-channels", perhaps through mimicking the most important natural vasodialator, nitric oxide
Nitric oxide
Nitric oxide, also known as nitrogen monoxide, is a diatomic molecule with chemical formula NO. It is a free radical and is an important intermediate in the chemical industry...
, whose structure minoxidil incorporates
. This agent can also cause follicles in the telogen phase to shed, usually soon to be replaced by new, thicker hairs. As the hair-growth-stimulating effect is temporary and does not seem to change the follicle in any other way, minoxidil needs to be applied regularly (once or twice daily) for hair gained to be maintained.
Finasteride
FinasterideFinasteride
Finasteride is a synthetic antiandrogen that inhibits type II 5-alpha reductase, the enzyme that converts testosterone to dihydrotestosterone...
(marketed by Merck
Merck & Co.
Merck & Co., Inc. , also known as Merck Sharp & Dohme or MSD outside the United States and Canada, is one of the largest pharmaceutical companies in the world. The Merck headquarters is located in Whitehouse Station, New Jersey, an unincorporated area in Readington Township...
under the trade names Propecia and Proscar) is a 5 alpha-reductase inhibitor
Enzyme inhibitor
An enzyme inhibitor is a molecule that binds to enzymes and decreases their activity. Since blocking an enzyme's activity can kill a pathogen or correct a metabolic imbalance, many drugs are enzyme inhibitors. They are also used as herbicides and pesticides...
of the type II isoenzyme.
It was originally FDA approved for treatment of benign prostatic hyperplasia
Benign prostatic hyperplasia
Benign prostatic hyperplasia also known as benign prostatic hypertrophy , benign enlargement of the prostate , and adenofibromyomatous hyperplasia, refers to the increase in size of the prostate....
(BPH) and works by binding to 5-alpha-reductase, the enzyme responsible for the conversion of free testosterone to DHT.
Merck sought to find the smallest effective quantity of finasteride and test its long-term effects on 1,553 men between ages 18 and 41 with mildly to moderately thinning hair. Based on their research, 1 mg/day was selected, and after two years of daily treatment, over 83% of the 1,553 men experiencing male hair loss had actually maintained or increased their hair count from baseline. Visual assessments concluded that over 80% had improved appearances.
In 1997, finasteride was approved by the US FDA for the treatment of male pattern baldness. A 5-year study revealed that 9 of 10 men taking finasteride (1 mg/day) experienced visible results (42% of men taking Propecia experienced no further hair loss while 48% experienced no further hair loss and hair regrowth). In clinical studies, finasteride, like minoxidil
Minoxidil
Minoxidil is an antihypertensive vasodilator medication which also slows or stops hair loss and promotes hair regrowth. Now off-patent, it is available over-the-counter for the treatment of androgenic alopecia. Minoxidil must be used indefinitely for continued support of existing hair follicles and...
, was shown to work on both the crown
Crown (anatomy)
A crown is the top of the head.The following birds and other animals are said to have a crown on their head:* Cranes** Grey-crowned Crane** Red-crowned Crane** Black-crowned Crane* Crowned eagle* Gray-crowned Rosy Finch* Yellow-crowned Gonolek...
area and the hairline area, but is most successful in the crown area.
Dutasteride
DutasterideDutasteride
Dutasteride is a dual 5-a reductase inhibitor that inhibits conversion of testosterone to dihydrotestosterone ....
is a dual 5-a reductase inhibitor
5-alpha-reductase inhibitor
5α-Reductase inhibitors are a group of drugs with antiandrogenic activity, used in the treatment of benign prostatic hyperplasia and androgenic alopecia...
that inhibits conversion
Enzyme inhibitor
An enzyme inhibitor is a molecule that binds to enzymes and decreases their activity. Since blocking an enzyme's activity can kill a pathogen or correct a metabolic imbalance, many drugs are enzyme inhibitors. They are also used as herbicides and pesticides...
of testosterone
Testosterone
Testosterone is a steroid hormone from the androgen group and is found in mammals, reptiles, birds, and other vertebrates. In mammals, testosterone is primarily secreted in the testes of males and the ovaries of females, although small amounts are also secreted by the adrenal glands...
to dihydrotestosterone
Dihydrotestosterone
Dihydrotestosterone is an androgen or male sex hormone. The enzyme 5α-reductase synthesises DHT in the prostate, testes, hair follicles, and adrenal glands...
(DHT).
Dutasteride inhibits both isoforms of 5-alpha reductase, type I and type II, whereas finasteride only inhibits type II.
Dutasteride (trade name Avodart by GlaxoSmithKline
GlaxoSmithKline
GlaxoSmithKline plc is a global pharmaceutical, biologics, vaccines and consumer healthcare company headquartered in London, United Kingdom...
) is FDA approved for treatment of benign prostatic hyperplasia
Benign prostatic hyperplasia
Benign prostatic hyperplasia also known as benign prostatic hypertrophy , benign enlargement of the prostate , and adenofibromyomatous hyperplasia, refers to the increase in size of the prostate....
(BPH).
Phase I and II clinical trials for dutasteride as a hair loss drug were undertaken, but called off in late 2002, with reasons for terminatation unknown.
The phase II results indicated that dutasteride at both 0.5 mg and 2.5 mg/day generated a superior hair count to finasteride 5 mg at 12 and 24 weeks.
Phase II study results at 24 weeks:
- Placebo: - 32.3 hairs
- Finasteride 5 mg: + 75.6 hairs
- Dutasteride 0.1 mg: + 78.5 hairs
- Dutasteride 0.5 mg: + 94.6 hairs
- Dutasteride 2.5 mg: + 109.6 hairs
In December 2006, GlaxoSmithKline launched a new phase III, six month study in Korea
Korea
Korea ) is an East Asian geographic region that is currently divided into two separate sovereign states — North Korea and South Korea. Located on the Korean Peninsula, Korea is bordered by the People's Republic of China to the northwest, Russia to the northeast, and is separated from Japan to the...
to test the safety, tolerability and effectiveness of a once-daily dose of dutasteride (0.5 mg) for the treatment of MPB in the vertex region of the scalp (types IIIV, IV and V on the Hamilton-Norwood scale
Hamilton-Norwood scale
The progression of male pattern baldness is generally classified on the Hamilton-Norwood scale, which ranges from stages I to VII.This measurement scale was first introduced by Dr. James Hamilton in the 1950s and later revised and updated by Dr. O'Tar Norwood in the 1970s....
). The study was completed in January 2009. Future intentions by GlaxoSmithKline to continue or abandon plans for FDA approval of dutasteride in treatment of male pattern baldness (MPB) remain unknown.
Hair transplantation
A medical hair transplant involves using small grafts of naturally-occurring units of one to four hairs, called follicular unitsHair follicle
A hair follicle is a skin organ that produces hair. Hair production occurs in phases, including a growth phase , and cessation phase , and a rest phase . Stem cells are principally responsible for the production of hair....
, to move hair-producing follicles to balding areas of the hair restoration
Hair restoration
Hair restoration includes the medical and surgical treatment of various forms of hair loss. The most common cause of hair loss is androgenetic alopecia , also known as male pattern baldness or female pattern baldness.-Medical hair restoration:...
patient's scalp. These follicular units are surgically implanted in the scalp in very close proximity to one another and in large numbers. The grafts are obtained in one or both of the two primary methods of surgical extraction, Follicular Unit Transplantation
Follicular unit transplantation
Follicular Unit Transplantation is a hair restoration technique where a patient's hair is transplanted in naturally occurring groups of 1 to 4 hairs, called follicular units. Follicular units also contain sebaceous glands, nerves, a small muscle, and occasional fine vellus hairs...
(FUT) or Follicular Unit Extraction
Follicular Unit Extraction
Follicular unit extraction , also known as follicular transfer , is one of two primary methods of obtaining follicular units, naturally occurring groups of one to four hairs, for hair transplantation. The other method is called strip harvesting...
(FUE). In FUT, a strip of skin containing many follicular units is extracted from the patient and then dissected under a stereoscopic dissecting microscope. Once dissected into individual follicular unit grafts, the surgeon implants the grafts into small incisions, called recipient sites, in the recipient area of the patient's scalp. According to the new approach the roots of the hair are extracted from the "donor", and then literally cut into tiny strips, for transplantation. Bald patches on the scalp are isolated and given the donor strip, which is two to three millimeters thick only.
When the transaction is completed, the patient should wear a head bandage for the next two days. This will allow the scalp to treat not weakened, and increase the chances of success.
Laser therapy
Some devices claim to use low-level laser therapy (LLLT) to stimulate hair growth through "photo-biostimulation" of the hair follicles.Caffeine
CaffeineCaffeine
Caffeine is a bitter, white crystalline xanthine alkaloid that acts as a stimulant drug. Caffeine is found in varying quantities in the seeds, leaves, and fruit of some plants, where it acts as a natural pesticide that paralyzes and kills certain insects feeding on the plants...
has been identified as a stimulator of human hair growth in vitro, and reduced testosterone
Testosterone
Testosterone is a steroid hormone from the androgen group and is found in mammals, reptiles, birds, and other vertebrates. In mammals, testosterone is primarily secreted in the testes of males and the ovaries of females, although small amounts are also secreted by the adrenal glands...
-induced follicle growth suppression. It has been demonstrated that the addition of caffeine to a shampoo-formulation is effective in administering caffeine to the hair follicles in the scalp. Further research must be done to evaluate the efficacy and adequate dosage of caffeine in the treatment of androgenetic alopecia
Androgenetic alopecia
Androgenic alopecia is the most common cause of hair loss and thinning in humans. Variants appear in both men and women. Androgenic alopecia also occurs in chimpanzees, and orangutans. In humans, this condition is also commonly known as male pattern baldness...
.
A spray made with coffee beans is claimed by the UK pharmacy chain Boots to prevent age-related hair loss in women.
Genetics
In February 2008 researchers at the University of BonnUniversity of Bonn
The University of Bonn is a public research university located in Bonn, Germany. Founded in its present form in 1818, as the linear successor of earlier academic institutions, the University of Bonn is today one of the leading universities in Germany. The University of Bonn offers a large number...
announced they have found the genetic basis of two distinct forms of inherited hair loss, opening a broad path to treatments for baldness. They found that a gene, P2RY5
P2RY5
Lysophosphatidic acid receptor 6 also known as LPA6 and P2RY5 is a protein that in humans is encoded by the LPAR6 gene. LPA6 is a G protein-coupled receptor that binds the lipid signaling molecule lysophosphatidic acid ....
, causes a rare, inherited form of hair loss called hypotrichosis simplex. It is the first receptor
Receptor (biochemistry)
In biochemistry, a receptor is a molecule found on the surface of a cell, which receives specific chemical signals from neighbouring cells or the wider environment within an organism...
in humans known to play a role in hair growth. The fact that any receptor plays a specific role in hair growth was previously unknown to scientists and with this new knowledge a focus on finding more of these.
In May 2009, researchers in Japan
Japan
Japan is an island nation in East Asia. Located in the Pacific Ocean, it lies to the east of the Sea of Japan, China, North Korea, South Korea and Russia, stretching from the Sea of Okhotsk in the north to the East China Sea and Taiwan in the south...
identified a gene
Gene
A gene is a molecular unit of heredity of a living organism. It is a name given to some stretches of DNA and RNA that code for a type of protein or for an RNA chain that has a function in the organism. Living beings depend on genes, as they specify all proteins and functional RNA chains...
, SOX21
SOX21
Transcription factor SOX-21 is a protein that in humans is encoded by the SOX21 gene. It is a member of the Sox gene family of transcription factors.- Function :...
, that appears to determine cyclical hair loss in mice. The researchers also believe it may be responsible for hair loss, or alopecia, in people.
Through 2006, a drug development company spent $1,000,000 on a hair growth program focused on the potential development of a topical hedgehog
Hedgehog signaling pathway
In a growing embryo, cells develop differently in the head or tail end of the embryo, the left or right, and other positions. They also form segments which develop into different body parts. The hedgehog signaling pathway gives cells information that they need to make the embryo develop properly....
agonist
Agonist
An agonist is a chemical that binds to a receptor of a cell and triggers a response by that cell. Agonists often mimic the action of a naturally occurring substance...
for hair growth disorders such as male pattern baldness and female hair loss. The hair loss research program was shut down in May 2007 because the process did not meet the proper safety standards.
Spin labels
Originally patented for treatment of pattern hair loss, in animal models, the nitroxide spin labelSpin label
A spin label is an organic molecule which possesses an unpaired electron, usually on a nitrogen atom, and the ability to bind to another molecule. Spin labels are normally used as tools for probing proteins or biological membrane-local dynamics using EPR spectroscopy. The site-directed spin...
s TEMPO
TEMPO
oxyl, or oxidanyl or TEMPO is a chemical compound with the formula 32NO . This heterocycle is a red-orange, sublimable solid. As a stable radical, it has applications throughout chemistry and biochemistry. TEMPO was discovered by Lebedev and Kazarnowskii in 1960...
and TEMPOL also enhance hair regrowth following radiation. For example, there is currently a National Cancer Institute-sponsored clinical trial for TEMPOL in radiation alopecia
Hair multiplication
Stem cells and dermal papilla cells have been discovered in hair follicles. Research on these follicular cells may lead to successes in treating baldness through hair multiplication (HM), also known as hair cloning. HM is being developed by ARI (Aderans Research Institute, a Japanese owned company in the USA).In 2008, Intercytex
Intercytex
Intercytex LTD is a biopharmaceutical company based in Alderley Edge, UK.-History:Intercytex was originally founded in 2000 and listed on the Alternative Investment Market in February 2006. As a result of the recession and disappointing trial results with another product, Intercytex plc delisted...
, a company in Manchester (UK), announced positive results of a Phase II trial for a form of cloning
Cloning
Cloning in biology is the process of producing similar populations of genetically identical individuals that occurs in nature when organisms such as bacteria, insects or plants reproduce asexually. Cloning in biotechnology refers to processes used to create copies of DNA fragments , cells , or...
hair follicles from the back of the neck, multiplying them and then reimplanting the cells into the scalp. The initial testing resulted in at least two thirds of male patients regrowing hair. As of 2009, the company estimates this treatment will take "a number of years to complete" Phase III trials before it can go to market. However, after failing to achieve subsequent success in their trials, the company announced discontinuation of its hair multiplication project in January 2010 with intention to sell off its assets and research. On March 25, 2010 Aderans Research Institute Inc. (ARI) announced it acquired key technology assets from Regenerative Medicine Assets Limited (formerly Intercytex Group plc). ARI is currently conducting Phase II clinical trials in cities throughout the U.S.
In December 2010, scientists at the Berlin Technical University in Germany
Germany
Germany , officially the Federal Republic of Germany , is a federal parliamentary republic in Europe. The country consists of 16 states while the capital and largest city is Berlin. Germany covers an area of 357,021 km2 and has a largely temperate seasonal climate...
revealed they had grown the world's first artificial hair follicles from stem cells. Research leader Dr Roland Lauster said within five years millions of hair-loss sufferers could grow new hair from their own stem cells and have it implanted into their bald spots. He also announced that preparations for clinical trials were "already in motion".
WNT protein introduction
In May 2007, U.S. company Follica Inc, announced they had licensed technology from the University of PennsylvaniaUniversity of Pennsylvania
The University of Pennsylvania is a private, Ivy League university located in Philadelphia, Pennsylvania, United States. Penn is the fourth-oldest institution of higher education in the United States,Penn is the fourth-oldest using the founding dates claimed by each institution...
which can regenerate hair follicles by reawakening genes
Gênes
Gênes is the name of a département of the First French Empire in present Italy, named after the city of Genoa. It was formed in 1805, when Napoleon Bonaparte occupied the Republic of Genoa. Its capital was Genoa, and it was divided in the arrondissements of Genoa, Bobbio, Novi Ligure, Tortona and...
which were once active only in the embryo
Embryo
An embryo is a multicellular diploid eukaryote in its earliest stage of development, from the time of first cell division until birth, hatching, or germination...
stage of human development. Skin apparently can be brought back to this embryonic state when a wound is healing. Hair growth was discovered in the skin wounds of mice when Wnt proteins were introduced to the site. Development of a human treatment is expected to take several years.
Ketoconazole shampoo
Some preliminary research suggests that ketoconazole shampoo may be beneficial in men suffering from androgenic alopecia. Support for this comes primarily from a single study in 1998 that compared ketoconazole to the proven hair loss drug minoxidilMinoxidil
Minoxidil is an antihypertensive vasodilator medication which also slows or stops hair loss and promotes hair regrowth. Now off-patent, it is available over-the-counter for the treatment of androgenic alopecia. Minoxidil must be used indefinitely for continued support of existing hair follicles and...
in men with androgenic alopecia.
External links
- "Medical Treatments for Balding in Men," April 1999, American Family Physician (medical journal)
- Health Alternatives: zinc, silica, methylsulphonylmethane (MSM) and cod-liver oil, to slow down the process.
- The Trichological Society
- International Society of Hair Restoration Surgery
- How Hair Replacement Works