People have between 100,000 and 150,000 hairs on their head. The number of strands normally lost in a day varies but on average is 100. Young people regrow this hair quickly. However, by age 50, pattern hair loss affects about half of males and a quarter of females. There are no currently approved hair regrowth treatments for women in the United States.

Keeping healthy hair may not be critical for your survival or physical health, but it is part of making you feel good each time you look in the mirror and contributes to your sense of wellbeing. 

Unfortunately, over the counter medications to keep your hair are mostly ineffective. Some have risky side-effects. Of the options, Consumer Reports Health only considers topical minoxidil (Rogaine and generic) probably worth trying. When minoxidil is applied to the scalp, it stimulates hair follicles and pushes more hair into the growing phase. A 2017 review in the Journal of the American Academy of Dermatology found that men using the topical twice daily had an average increase of nearly 15 hairs per square centimeter with 5 percent minoxidil. Biotin-based treatments are ineffective unless you have a rare biotin deficiency. 

Prescription medications have risky side-effects. Finasteride has warnings about birth defects, libido and erectile issues. Spironolactone (Aldactone and generic) caused tumors in lab animals.

Monthly platelet-rich plasma (PRP) injections into the scalp are somewhat successful, but who wants to keep doing that regularly?

Low-level laser or light therapy combs, caps, and headband devices are said to stimulate follicles. Not much data is available on their efficacy.

Fortunately, there are many companies competing to launch promising new solutions which have few or no side-effects.  

Topical Creams:  

  1. Cassiopeia’s Breezula (™). Topical cream applied twice daily shows positive results for men with no side effects for stopping hair loss and stimulating hair growth per April 2019 Phase 2 trial results. Italian firm Cassiopeia plans 6-month Phase 3 trials in men in Q4, 2019. The company is also going to start proof-of-concept trials in women.
  2. Sanumed’s is a San Diego company with a topical cream to treat androgenic alopecia. They started a Phase 3 trial with 625 volunteers in November 2018 and expect to complete results in June 2020.  
  3. Follicum is a Swedish company providing a topical solution comparable in effectiveness to Minoxidil. Follicum’s advantage is it only needs to be applied once per day to achieve similar results. Follicum has conducted some Phase 2 trials.
  4. RiverTown combines three small molecule drugs including Minoxidil to provide a topical treatment which also reverses pigmentation loss. They launched in 2016 and as of 2018 were looking for funding for clinical trials. There is no news about clinical trials on their website. 

Stem Cell Regeneration / Scalp Injections:

  1. Organ Technologies plans to offer hair loss regenerative medicine in Japan in 2020 or 2021 at an initial price of ~$200K to $400K. The treatment is based on the epithelial and mesenchymal stem cell work of Dr. Takashi Tsuji at RIKEN. You can find out more on this crazy video or this one which explains the crazy video in plain English. 
  2. Shiseido sells Adenovital Scalp Essence containing adenosine, which is similar to minoxidil and popular in Asia. Shiseido’s Dr. Jiro Kishimoto is working on “Autologous cell-based therapy for hair loss using dermal sheath cup cells.”
  3. Follica is based in Boston and has licensed technology from UPenn to induce an “embryonic window” in adult skin via a proprietary form of micro-abrasion that initiates hair follicle neogenesis, the formation of new hair follicles from epithelial (skin) stem cells. This process of hair follicle neogenesis is enhanced through the application of a topical compound as part of the treatment regimen.Follica is initiating a Phase 3 study in 2H 2019
  4. Histogen is in Phase 1 testing for women and has a Phase 3 trial for men for their Hair Stimulating Complex (HSC) that is injected into the scalp. There is speculation that the Phase 3 trial has either been cancelled or will complete in 2H 2020. The company says HSC contains growth factors and related substances secreted by cells grown under simulated embryonic conditions in its “bioreactors.” For over ten years they’ve been trying to bring their solution to market. They are based in San Diego and funding from Allergan.
  5. UCLA Research from 2017 on using stem cells for hair regrowth via JAK-Stat activators and pyruvate blockers. No sign this received funding for advancement.
  6. Columbia University researchers are using 3D printing to create hair follicles and grow hair!

Drugs and Other Approaches

  1. Way316606 is an osteoporosis drug which also causes hair growth. Clinical trials are being considered.
  2. Italian entrepreneur Giampaolo Floris has created an interesting End Hair Loss video about natural hair loss causes and treatment. He raises an interesting point about why men lose the hair on the top of their head and not the sides and back. 

Keep Health will continue to monitor the progress of these interesting companies as they progress through clinical trials.  There is good discussion and commentary on the following websites:

At the end of each Keep Health article, we recommend rewarding yourself for taking time to focus on your health. Here’s your opportunity to get the long rainbow wig and holographic disco leggings you’ve always wanted for your next Halloween, birthday or New Year’s Eve party. If not for you, then perhaps as a gift for someone else. 

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