Hair Loss Diagnosis

Restoring the hair lost due to hereditary factors is the dream of many men and women suffering from hair loss. Until not too long ago, the only effective and authentic-looking options for reversing hair loss were non-surgical cover-ups. It was only with the arrival of follicular unit transplantation and the discovery of the true cause of baldness - the harmful effects of dihydrotestosterone (DHT) on our hair follicles - that the hair-loss sufferer’s chances of reversing their condition naturally have greatly improved.

The three best weapons in the fight against hair loss available today are the two FDA-approved medicinal drugs – finasteride (Propecia) and minoxidil (Rogaine/Regaine) and hair surgery, the follicular unit transplantation and, especially, the follicular unit extraction technique. However, no ultimate cure exists yet as each of the three aforementioned hair restoration methods has its limitations. Minoxidil and finasteride work well only in the vertex area of the scalp, and finasteride cannot be used by women. Hair transplantation is suitable only for people who have sufficient hair density in the donor area, and many women, who typically suffer from diffuse thinning, do not make good candidates for hair transplant surgery.

Therefore, scientists around the world are relentlessly searching for new approaches to treating baldness. There are presently several promising drugs and new techniques under development listed below but progress seems to have slowed down recently due to the global financial crisis, as some R&D projects are finding it increasingly difficult to raise financing to further their research.

The most progress has been achieved on dutasteride. Dutasteride is an antiandrogen drug, in its chemical structure and mode of action it is similar to finasteride. It is used to treat benign prostatic hyperplasia (prostate enlargement) and since it is a dual 5-alpha reductase inhibitor, it should be a more potent DHT blocker than finasteride. Therefore, it is believed to be more effective in treating hair loss, especially in the frontal area of the scalp. Dutasteride completed Phase III clinical testing this year and the study results are expected to be published soon.

NEOSH101 was originally developed by the US medical research company Neosil and was until recently undergoing phase IIb clinical testing. At the end of 2008, Neosil was acquired by Peplin, Inc., a development stage specialty pharmaceuticals firm and since then no information on the further progress of the clinical trials has been released. In previous clinical trials, NEOSH101 was shown to be a more powerful and faster-acting, hair growth stimulant than minoxidil and it only needs applying once daily. Though significantly improving the current hair-loss treatment options, NEOSH101 is not going to become the ultimate cure for baldness. The clinical trials seem to be advancing slower than most hair-loss sufferers would like and, hence, do not hold your breath waiting for it to hit the market anytime soon.

Another promising development area is the telomerase research. Telomerase is an enzyme that is able to put natural caps on telomeres and thus protect them from shortening. Telomerase thereby maintains the genomic integrity. Shortened telomeres are associated with causing premature aging processes. However, the uncontrolled activation of telomerase can trigger cancer. Cancer research is the main focus of the telomerase studies but scientists are also looking for other applications, such as anti-aging drugs and drugs against baldness and grey hair. Telomerase research could really change the world of medicine but its commercial application might be a good 15 years away.

Hair multiplication, often called hair cloning or hair regeneration, is the next hopeful treatment option being explored. This technique involves extracting 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. The UK healthcare firm Intercytex appears to be the frontrunner in hair multiplication research. Intercytex has already completed phase II clinical study of ICX-TRC (a suspension of a patient’s own dermal papilla cells). The main benefit of hair multiplication would be solving the shortage of donor hair, which is the main limiting factor in hair transplantation. However, Intercytex is currently facing financial difficulties and after failing to find an investor, it will have to continue operating on its own. Aderans, the main competitor of Intercytex, has also recently launched a Phase II clinical study on cell-based hair regeneration for men and women.

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

This list of the undergoing projects in the area of hair-loss research includes the most promising lines of development but it is not exhaustive. However, none of the new therapies, with the exception of dutasteride’s application for treating hair loss in men, is expected to hit the market before 2013 and the immediate future of hair restoration lies in improving the surgical techniques, increasing the yields of the follicular unit extraction method and making it more affordable to a larger portion of the population.

At the moment, there are only two medicinal treatments that have been approved by the FDA (Food and Drug Administration) in the US for treating hair loss - topical minoxidil (trade name Rogaine) and oral finasteride (Propecia). 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 hair growth when applied topically to the scalp. Finasteride is an antiandrogen that was first used 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 dihydrotestosterone (DHT). The discovery of finasteride’s positive effects on hair growth led to finding the true cause of hereditary baldness, which is the harmful attacks of DHT on our hair follicles. Since making this discovery, a quest for other alternative DHT blockers has begun, especially amongst antiandrogen drugs and herbs that have, in the past, been used to treat urinary problems.

Dutasteride (trade name Avodart) is an antiandrogen medication similar to finasteride in its chemical structure and mode of action and has been studied extensively for treating hair loss. It has recently completed phase III clinical testing for efficacy and safety in the treatment of male pattern baldness and the study results are pending. Like finasteride it is also used for treating BPH. Dutasteride is believed by many to be a more potent hair loss drug than finasteride but also with more severe side effects.

Flutamide (brand name Eulexin) is a very strong antiandrogen used to treat prostate cancer. It works by binding to the androgen receptors where it competes 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 treat 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, hair loss and excess body hair and although there are some generic topical applications for the treatment of male pattern baldness which contain spironolactone, it has never been approved to treat hair loss in men and should be avoided. For women, spironolactone can be considered as a reasonable alternative to the men’s best hair-loss pill, finasteride, which cannot be used in women.

As has been mentioned earlier, following the discovery of harmful DHT attacks on hair follicles being the true cause of hereditary baldness, herbalists started looking for possible natural alternatives to finasteride among plants that have been traditionally used to treat urinary problems and, more specifically, enlarged prostates.

Saw palmetto has been used for several decades to treat prostate enlargement and it is one of the few plants used in natural remedies that have been subjected to some sort of scientific research in regards to their potential for treating BPH. Its supporters believe that it works by inhibiting the conversion of testosterone into prostate and follicle-harming DHT but no study has yet confirmed this assumption. No clinical research has ever been conducted on saw palmetto’s effects on hair loss. Despite that, saw palmetto is widely used by thousands of hair loss sufferers around the world as a safe natural alternative to finasteride.

Extract from the bark of the evergreen tree pygeum africanum is another popular herbal ingredient found in natural hair-loss treatments and many herbalists believe it is more potent in treating hair loss than saw palmetto. Its rise to fame also comes from the general assumption that this plant, thought to be beneficial for treating prostate enlargement, must be also effective in treating hair loss. Pygeum africanum has been less well studied than saw palmetto and it has never been used in any clinical hair-loss study.

The third most popular herbal ingredient used in natural hair-loss cures is nettle root extract. This herbal drug is derived from the root of the stinging nettle, a popular healing plant found in temperate and subtropical zones of the northern hemisphere. Its use in natural hair-loss remedies also stems from the fact that it is supposed to help shrink enlarged prostates and is thus thought to inhibit the conversion of testosterone to DHT. Like the two aforementioned herbal extracts, nettle has never been subjected to any clinical hair-loss study.

This list of hair-loss drugs and herbal extracts that are believed to mimic the actions of finasteride/Propecia, the only approved pill for hair loss, is not exhaustive. There are many other ingredients, mostly of natural origin, that claim the ability to block DHT and thus reverse hair loss. However, no clinical proof exists that any herb contained in the natural remedies promotes new hair growth. Whether you decide to try a commercial herbal remedy or just one or two herbs on their own, keep in mind that, besides there being no guarantee of their effectiveness, no daily dosage has been established and side effects might occur, despite the general belief that herbal hair-loss remedies are safe and free of them. Furthermore, it is not advised to try any of the aforementioned medicinal substitutes to finasteride without first consulting your doctor. On the same note it is not advisable to buy finasteride online without having a prior approval from your doctor.