The Evolution of Hair Loss Treatments

How have treatments for baldness evolved over the years?

I am now in my early thirties, and like most men my age, I have suffered from male pattern baldness since I was in my mid twenties.  Luckily, with the help of some potent treatments, I have managed to slow down the pattern of hair fall, but I am still hoping there will be a cure one day in the not so distant future. 

Unfortunately for hair loss sufferers, there is no cure for baldness, and there doesn't seem to be anything in the pipeline in the near future.  So, what is the next best thing?  And without a cure, how has the hair loss treatment market developed and evolved over the years?  

So, in order to help you find a decent solution for your balding issues, I'll go through the step-by-step developments of the hair loss treatment industry, and how it has evolved to become what it is today... 

The discovery of Minoxidil

Minoxidil was developed in the late 1950s by the Upjohn Company to treat ulcers. In trials using dogs, the compound did not cure ulcers, but proved to be a powerful vasodilator. Upjohn synthesized over 200 variations of the compound, including the one it developed in 1963 and named minoxidil. These studies resulted in FDA approving minoxidil (with the trade name 'Loniten') in the form of oral tablets to treat high blood pressure in 1979.
 
Upjohn conducted two further studies, the second study showing unexpected side-effects of hair growth. The possibility of using minoxidil for treating hair loss was then considered. The effect of minoxidil on hair loss prevention was so clear that in the 1980s physicians were prescribing Loniten off-label to their balding patients.

In August, 1988, the FDA finally approved the drug for treating baldness in men under the trade name 'Rogaine'. 39% of the men studied had moderate to dense hair growth on the crown of the head.  In 1991, Upjohn made the product available for women. 

In 1998, a 5% formulation of minoxidil was approved for non-prescription sale by the FDA. This is still the only topical product that is FDA-approved for androgenic hair loss.  Although many men and women have experienced great results from using minoxidil as a treatment, it should be noted that the risk of side-effects is quite high, and common side-effects can include headaches, weight gain, acne, vomiting, and dizziness. 

Although it isn't for everyone, minoxidil is still regarded as the most revolutionary topical hair loss treatment. 

A pill to stop male pattern baldness 

Finasteride (labelled as Propecia) is a prescription-only oral pill that treats male pattern baldness. 

After studies from the 1940s and 1950s analysing the development of male pattern baldness, it was 1974 that saw birth defects as a potential clue to solving the problem of male hair loss. A research group on specific individuals found that genetic mutation at birth was causing deficiency of the 5α-reductase enzyme and male hormone dihydrotestosterone (DHT), which was found to have been the etiology behind abnormalities in male sexual development. Upon maturation, these individuals were observed to have smaller prostates which were underdeveloped, and were also observed to lack incidence of male pattern baldness.

It was found that decreased levels of DHT led to the development of smaller prostates. Dr. Vagelos then sought to create a drug which could mimic the condition found in these individuals to treat men who were suffering from benign prostatic hyperplasia.

Finasteride was developed under the code name MK-906. In 1992, finasteride (5 mg) was approved by the U.S. Food and Drug Administration (FDA) for treatment of BPH, which Merck marketed under the brand name Proscar. In 1997, Merck was successful in obtaining FDA approval for a second indication of finasteride (1 mg) for treatment of MPB, which was marketed under the brand name Propecia.

Propecia became one of the most popular treatments from 2000-2010, but has since seen a wane in popularity, due to the common side-effects associated with the pill.  These harsh side-effects can include a low libido, erectile dysfunction, severe skin rash, and even mental health problems. Most men, including myself, are now seeking safer alternatives. 

The potassium channel theory of hair loss

In 2009 Thomas Whitfield founded the company Oxford Biolabs. In 2011 its first product TRX2, a dietary supplement, became publicly available.  In January 2014 the UK Advertising Standards Authority upheld a complaint against TRX2 and Oxford Biolabs, citing that advertisements that the company had run for TRX2 were misleading and in breach of EU advertising codes. The company agreed and changed their advertising in line with the code of conduct.
 
TRX2® hoped to revolutionise the industry with their theory of potassium channels. Potassium ion channels have been implicated in a vast array of diseases ranging from hepatitis C to diabetes. These small pore-forming protein structures control the transport of potassium ions across the hair follicle’s cell membrane and are essential for retaining the follicle’s full biological activity and function. The recent discovery that potassium ion channels exist within the dermal papilla cells of human hair follicles provided a novel therapeutic target for researchers. 

Scientists have demonstrated that as people experience hair loss the function of potassium channels within hair follicles diminishes. The effect is impaired membrane potential and interrupted ion transportation across the hair follicle's cellular membranes – resulting in shrinking follicles and thinning hair.

According to Oxford Biolabs, by restoring the functionality of potassium ion channels that have broken down over time, the proprietary TRX2® formula helps to maintain normal, healthy hair on a molecular level. Whether it works or not (in my case it didn't work, after using it for the most part of a year), based on its theory, this certainly is first supplement of its kind on the market.

Saw Palmetto

Serenoa repens, commonly known as saw palmetto, is the sole species currently classified in the genus Serenoa. It is a small palm, growing to a maximum height around 7–10 ft. It is endemic to the subtropical South-eastern United States, most commonly along the south Atlantic and Gulf Coastal plains and sand hills. It grows in clumps or dense thickets in sandy coastal areas, and as undergrowth in pine woods or hardwood hammocks. 

Saw Palmetto extract has been researched into treatment for people with prostate cancer. However, according to the American Cancer Society, "available scientific studies do not support claims that saw palmetto can prevent or treat prostate cancer in humans". 

Although very promising so far, more tests are needed to confirm exactly how effective saw palmetto is for blocking DHT. An extract of saw palmetto berries may block 5-alpha-reductase, an enzyme that converts testosterone to DHT. DHT is the molecule responsible for hair loss and also is involved in the enlargement of the prostate.

One study showed saw palmetto’s ability to treat an enlarged prostate. Researchers hope it can play a key role in slowing down and even preventing hair loss entirely. In fact, the components of saw palmetto that block the enzyme work in a similar way as synthetic ingredients in prescription medication for hair loss.

Research is still limited on saw palmetto’s efficacy in treating hair loss, but the vast majority of multi-vitamin hair supplements contain this potent extract.  A viable treatment for hair loss can be formed when saw palmetto is mixed with other potent ingredients, such as Biotin, Zinc, Vitamin C, and Folic Acid.

There are some good multi-vitamin supplements on the market that contain saw palmetto, such as Viviscal and Nutrafol.  I used saw palmetto on its own for some time and noticed some promising results, but once I started using the multi-vitamin supplement, HR23+, my hair loss practically halted.  So, these types of products can work effectively.

Not only does this supplement work, but it also means I can avoid the harsher treatments like Propecia, thus helping me avoid all those nasty side-effects.