Future of Treating Baldness

The best hair loss treatments available today such as topical minoxidil (Rogaine) and oral pills such as Propecia (finasteride) for men and Aldactone (spironolactone) for women can be used very effectively by hair loss patients in the early stages of baldness to keep their existing hair. However, their ability to reverse hair loss is relatively limited. Hair transplant surgery might be the best hair restoration option for those who have already lost a portion of their hair and need to restore their former appearance. Its restraints are given by the amount of available donor hair that can be transplanted. This number lies somewhere in the area of 15,000 hair follicles so that hair surgery is not suitable for patients who have lost large portion of their hair or for women affected by diffuse thinning. Therefore, scientists are constantly looking for new treatments and techniques for restoring lost hair, be it pills, topicals, new surgical methods or anything else.

NEOSH101 is topical application which has made it to the phase 2 of clinical testing. This substance should work as a hair growth stimulant so it does not interfere with DHT formation or its activity. Preliminary results showed that its once daily dose was as effective in promoting new hair growth as topical minoxidil used twice daily. NEOSH101 was being developed by Neosil which was yet in 2008 recruiting new test subjects for phase 2 clinical testing but it is the last news we have heard from them and the current status of this study is unknown. Later in 2008 Neosil was acquired by Peplin, a development stage specialty pharmaceutical company focused on advancing and commercializing innovative medical dermatology products, and the NEOSH101 project was most likely pushed to the backburner so that it is reasonable to consider it over for the time being.

RK-023 is a novel physiologically active fatty acid derivative thought to be similar to the aforementioned bimatoprost which happens to be in the Phase II. clinical testing to assess its application in the treatment of androgenetic alopecia and hypotrichosis of the eyelashes. It is being developed by the Japanese pharmaceutical venture R-Tech Ueno, specializing in developing ophthalmology and dermatology health care products.

Bimatoprost has been used for years in eye drops under the trademark Lumigan to treat glaucoma. It was later found to help extend eyelashes and it received an FDA approval recently to be used to grow longer and richer eyelashes. This new application is marketed under the trade name Latisse. An obvious assumption is that if it can promote the growth of eyelashes it could be equally effective in promoting new hair growth on the scalp. Preliminary studies show that it really is an effective hair growth stimulant but too expensive at the moment to be used on larger scalp areas. Bimatoprost appears to be currently the most promising drug being tested for topical use in treating baldness.

Hair Cloning, often also called hair regeneration, hair multiplication or follicular neogenesis, consists in extracting healthy hair follicles or just plucking hair from the back of the scalp and multiplying their germinative cells in vitro so that they could be later injected into the bald scalp where they would induce new hair growth. Apart from techniques for actual multiplication of germinative hair follicle cells there are several other difficulties that have to be overcome yet such as ensuring the original hair pigmentation of the new hair and telling the new hair to grow in the right direction. Bosley, the largest network of hair transplant clinics in the world, is the leader in the area of hair regeneration through its R&D arm Aderans Research Institute. This project is currently finishing the phase 2 of clinical testing.

Generation of new hair follicles in wounds of hair-free skin through abrasion of upper skin layers and administration of a compound that promotes a differentiation of an uncommitted epidermal cell into a hair follicle cell is yet another promising development in the area of hair loss research today. This research is based on incidental observation of open skin wounds in mice which started producing new hair follicles as they were healing. Follica is the world leader in this research area and it was recently awarded a patent for methods, kits and compositions for generating new hair follicles and growing hair. Similar to hair cloning, one of the tasks that must be solved yet is to tell the newly generated hair follicles what color the new hair should be and which direction it should grow.

It is really hard to estimate which of the projects could become available to the patient first and when. None of these developments are expected to come to the market earlier than in five years (realistically in seven years at the earliest) so the hair transplantation and the existing hair loss drugs will continue to be the best tools for treating baldness that the hair loss science can offer us for the time being.