When will hair loss be cured? It’s a question of significant interest to many men and women experiencing thinning hair and baldness. At least on the face of it, though, not much progress has been made in the last few decades. But does the future hold more promise? Let’s take a look at what’s on the horizon.
The current options
As of 2017, there are just two FDA approved hair loss treatments:
- Finasteride (Propecia)
Minoxidil (orginially sold exclusively under the brand name Rogaine) is a topical liquid that is applied to the scalp twice daily. It was first approved as a hair loss treatment in 1988.
Whilst minoxidil can be effective at regrowing lost hair (and even growing beards on those without facial hair), it is by no means a miracle cure. The 2% version was found to cause “moderate to dense hair growth on the crown of the head” in 39% of men. And whilst there are now stronger formulas, minoxidil does not work for everyone.
1mg finasteride – sold under the brand name Propecia – was approved as a prescription hair loss treatment in 1997. However, a 5mg version, Proscar, has been available since 1992 for the treatment of benign prostatic hyperplasia.
The current medical consensus of male pattern hair loss is that it is caused when the hormone dihydrotestosterone (DHT) binds to hair follicles. Propecia dramatically reduces levels of the DHT hormone, which has the effect of slowing and even stopping hair loss.
However, Propecia is a controversial drug. DHT is a vital hormone for men and is responsible for many things besides hair loss, such as sexual function.
It is for this reason that Propecia has developed such a bad reputation in recent years. Many users report experiencing erectile dysfunction, abnormal ejaculation, and even gynecomastia from taking finasteride. Merck, the company that makes Propecia, argues that these side effects are rare.
It’s pretty disappointing to think that it has been 20 years since the last hair loss treatment was approved by the FDA.
If you look online, you can find news reports, forum posts, and interviews that claim a hair loss cure is only five to ten years away.
The problem? Many of these claims were made more than 10 years ago!
So why has progress been so slow? Perhaps the reason is that scientists have been looking in the wrong places. For example, there is strong evidence to suggest that DHT is not, in fact, the primary cause of hair loss as has always been assumed.
And in 2012, a groundbreaking study suggested an alternative mechanism altogether: prostaglandin D2 (PGD2).
The research found that PGD2 levels are around 3x higher in bald scalps compared to hairy scalps. Not only that, mice without receptors for PGD2 do not experience hair loss.
Since these findings, the race has been on to produce a hair loss cure based on this theory. But there are also various other approaches in development that also show promise.
Setipiprant is a drug that looks to tackle hair loss by preventing the effects of PGD2 on hair follicles.
Currently owned by biopharmaceutical company Kythera, it’s the first hair loss treatment to really utilise the findings of the 2012 study described above.
So far, it’s early stages. In August 2016, Kythera began dosage testing trials (phase 2A). If successful, it still needs to pass phase 2B and phase 3.
But it looks promising so far. The link between PGD2 and hair loss is undeniable. Not only that, Setipiprant could be used to treat various different types of hair loss – not just androgenetic alopecia.
What’s more, when Kythera acquired the rights to Setipiprant, it also acquired the rights to 45 other PGD2 inhibitors. So even if Setipiprant isn’t the one, there are many other avenues of potential!
Earliest date available: 2023
Pharmaceutical company Cassiopeia recently completed phase 2 testing for a hair loss treatment known as CB0301.
CB0301 – commercially known as Breezula – is a topical cream with supposed anti-androgenic properties. But instead of reducing entire DHT levels, it only affects the hormone receptor in the area it is applied:
If it works, CB0301 would be preferable to oral DHT inhibitors such as finasteride and dutasteride. By reducing the effects of DHT in the scalp only, such a treatment would be far less likely to cause the negative side effects of these drugs described earlier.
The initial results of the phase 2 trial found CB0301 to be slightly more effective than minoxidil. Whilst this is positive, it’s certainly not reason to suspect it is a full blown cure – at least not yet.
But it’s early days. The next stage of the trials are dose ranging studies. It may well be that a different dose produces far superior results. Cassiopeia will release these dose ranging results in 2018.
If successful, we can expect to see Breezula on the markets by 2022 at the earliest (it still has to pass Phase 3). However, a version formulated for acne may be available as soon as 2019.
Earliest date available: 2022 (2019 for acne)
Last year, California biotech company Samumed released promising phase 2 results for its SM04554 hair loss treatment.
SM04554 tackles hair loss via a unique mechanism of action. It selectively activates and deactivates wnt pathways.
Wnt pathways are complicated, and their functions not fully understood. But it is wnt pathways that are proposed as the mechanism through which microneedling causes hair loss.
So, has this avenue yielded success? Here’s an extract from Samumed’s press release:
Both concentrations of SM04554 – 0.15% and 0.25% – were more effective than the placebo. Somewhat surprisingly, the 0.15% concentration proved far more effective than the stronger 0.25% concentration.
90 days application of the 0.15% concentration resulted in a 10% increase in hair count and a 13% increase in hair density. Better still, hair continued to improve even after the 90 days was up.
And the good news continues:
“There were no serious adverse events (SAE) observed in the treatment groups, and the incidence of adverse events (AE) was similar between treatment and control groups.”
While a 10% increase in hair count may not sound like a miracle cure, this was achieved in just 90 days. Who knows, maybe after a year subjects might have seen even better results.
In light of these results, it would be promising to see Samumed take SM04554 to stage 3 trials.
Earliest date available: 2022
Hair cloning involves taking hair follicle cells from hairy areas, multiplying them in a lab, and injecting them into balding areas.
If successful, it would mean an unlimited supply of hair. The trouble is, it is so far proving very difficult to do!
Two companies – Aderans and Intercytex – have already abandoned their hair cloning research. But a third, Replicel, shows more promise.
Even so, it’s likely to be a long time before the process is perfected. And even then, it’s likely to be extremely expensive – at least initiallly.
Hair cloning touches on a areas of research that are still in their infancy. Stem cells, organ cloning, and so on look to revolutionise many areas of medicine. But they’re not fully understood yet and we’re far from able to harness the full potential of these therapies.
Earliest date available: 2027
So, when will hair loss be cured?
It’s impossible to say for certain.
I hesitate to say within 5-10 years as this timescale has been bandied about far too often. However, it does seem the most accurate answer as of 2017.
And it also depends what you mean by cure.
Going from Norwood 7, say, to a perfect Norwood 1 is a more difficult task than maintaining an existing head of hair. If this is what you mean by cure then the 10 year timescale looks to be the more accurate answer.
But you never know with medical discoveries. The hair-growing effects of both minoxidil and finasteride were discovered by accident. Who knows – maybe there’s a drug that has already been approved which has the unintended side effect of hair regrowth?
And that’s to say nothing of natural hair loss treatments. With no financial incentive to take unpatentable natural treatments through expensive clinical trials, they’ll never be FDA approved for hair loss. Nevertheless, there are plenty of people who swear by them.
It is certainly possible to maintain your existing hair using the treatments currently available – and this doesn’t necessarily mean a lifetime of Propecia.
There are even many individuals who’ve successfully regrown lost hair. Often, this takes a lot of effort – more effort than many deem worthwhile – but it is possible.