7/26/18 Update: After positive early data, various trials of JAK inhibitors such as Ruxolitinib and Xeljanz are underway. Columbia researchers have had positive results with Xeljanz in 11 out of 12 subjects achieving some regrowth with no adverse side effects over 16 months of treatment. Investigators at Stanford and Yale are conducting three trials of oral and topical tofacitnib and Locks of Love Foundation is fuding another ruxolitinib study. At this time, there are about 15 publications looking at JAK inhibitors and their relationship to alopecia and its variants.
The Rogaine rep we spoke to explained that the different packaging (and therefore different prices) has to do with the FDA-approval process: “We discovered in clinical trials that the hair loss patterns between men and women are different,” she said by way of explanation. “Men typically have that bald spot on the crown of their head, where women generally have a general thinning throughout, but concentrated more on the top of the head. So for FDA approval, we had to come up with two different, gender-specific products, so the directions were more explanatory.”
Keranique is another line of products targeted towards women. They offer a complete system consisting of shampoos, conditioners, and topicals. Our testers found that it was one of the harshest shampoos and was not always color safe. Their topical foam contains Minoxidil which can irritate some scalps. Keranique hair products are safe to use and highly effective. They also have an anti-dandruff shampoo that has received amazing reviews.
That meant new products like Hims and Keeps were out.Hims and Keeps are relatively new companies that allow you to set up a subscription for hair loss treatments. Both offer finasteride (after an online consultation with a doctor) or 5 percent minoxidil. However, their minoxidil solutions contain propylene glycol, so we cut them from consideration.
Women’s magazine ‘New Beauty’ recently featured several prospective hair growth therapies in a print article. The feature contains several interesting and worthwhile anecdotes. Check the Articles main page to read about Dr. Cotsarelis’ new research on setipiprant for female alopecia, Histogen’s view on the number of injection sessions which may be necessary to get the most out of HSC, and more.
I have only used this twice, but in that short time of use, I believe my hair shedding has increased. In fact, immediately following the last use my hair seemed to be coming out more than I had seen prior to ordering the shampoo at all. Experiencing hair loss, thinning, or excessive shedding (especially for a woman) can be very distressing, and to purchase a product in hopes that it will help to curb or even reverse the issue only to find it exacerbates the problem is INCREDIBLY stressful. I was hopeful about this product, given the overall reviews, but I'm afraid to use this product even one more time, for fear of making my hair loss worse.
“We are extremely pleased with the continued development of the patent portfolio we exclusively licensed from Columbia. This new issuance continues to expand the breadth and depth of our JAK inhibitor intellectual property portfolio covering methods of use for certain JAK inhibitors for the treatment of hair loss disorders. The issuance of this patent is another step in the development of a robust patent portfolio relating to JAK inhibition and hair loss,”
Head over to the main Articles page to read an update from head researcher Junji Fukuda PhD of Yokohama National University. This is the research that spurred the “french fry hair cure” craze of recent news headlines. I asked Junji in a Q&A if he has received any interest from bigger companies to commercialize his technology. Find his answer and more insight to what lead him to hair follicle research in the full article.
The most common form of hair loss is androgenetic alopecia, or, in other words, male or female pattern baldness or hair loss. Androgenetic alopecia is genetic and affects an estimated 50 million men and 30 million women in the United States. Among white women in the U.S., an average of 19% are affected by female pattern hair loss, but that percentage increases with age. The prevalence is nearly doubled in Australia at 32% and much lower in Korea and China at < 6%. As of 2015, no studies had been done on the prevalence of female pattern hair loss in Brazil or Africa.
Anagen effluvium is usually reversible, with regrowth one to three months after cessation of the offending agent. Permanent alopecia is rare. A large meta-analysis of clinical trials concluded that scalp cooling was the only intervention that significantly reduced the risk of chemotherapy-induced anagen effluvium.27 However, scalp cooling should be discouraged because it may minimize delivery of chemotherapeutic drugs to the scalp, leading to cutaneous scalp metastases.27
Finasteride has limitations though, such as the requirement of daily treatment, a limit to how many damaged hair follicles it can revive, and that it may lose its effectiveness overtime for some people. This drug has shown to be better at preventing further hair loss than reversing it (regrowth). Just keep in mind that some side effects might make the hair loss seem more appealing.
Drugs normally used for rheumatoid arthritis and bone marrow cancer, they are now being studied for their uses as a hair growth medicine. These are a new class of medicines labeled as JAK inhibitors. In one study, 6 out of 9 patients dramatically went from bald to a full head of hair after taking Ruxolitinib for 5 months. In another study several subjects were able to regrow full heads of hair. Unfortunately, sustained use of such drugs will have severe side effects. Many of these concerns would be side stepped if a topical formula could be developed. Researchers at the Department of Dermatology and Genetics and Development at Columbia University Medical center are now studying other JAK inhibitors in placebo controlled studies.
A separate study, published in Skin Therapy Letter — a professional reference site for dermatologists — found that women also benefit from using the more potent 5 percent minoxidil treatment. “Patient-reported improvement in hair volume and coverage appears to be greater with 5 percent minoxidil foam,” reads the report. Plus, because the 5 percent treatment is stronger, women only have to apply it once a day to get the same results as they would with the 2 percent treatment applied twice daily.
"Firstly, even the very good ones won’t get to the root of the issue - pardon the pun - and prevent or treat male or female pattern baldness which is caused by genetics, nor deal with hormonal issues at the heart of female hair loss. But they can help make the hair you do have stronger and healthier. And they can be useful in putting a hair loss regime in place, along with medication like Minoxidil or Finasteride and/ or a hair transplant.
While trauma can come on suddenly and unexpectedly, you may be able to help manage ongoing stress in your life with exercise, like yoga, or mindfulness techniques, like meditation. Some researchers are even exploring these alternative healing modalities in relation to reversing hair loss. The idea is that yoga and meditation may help regulate blood sugar and enhance circulation, promoting regrowth.
Researchers from UCLA in the lab of Jing Huang have recently shown that certain molecules which activate the cellular process known as autophagy also drive hair follicles into the anagen (growth) phase. The researchers studied different metabolite molecules and other molecules which are FDA approved and on the market as drugs. The most recognizable drugs from the study were metformin and rapamycin, one is a diabetes medicine and the other an immunosuppressant. Dr. Huang says her lab is looking to study these drugs for human hair growth soon. In my opinion, results from that study are something to look out for. Full article on the Articles page.
Telogen effluvium is a nonscarring, noninflammatory alopecia of relatively sudden onset, with similar incidences between sexes and age groups. It occurs when large numbers of hairs enter the telogen phase and fall out three to five months after a physiologic or emotional stressor. The list of inciting factors is extensive and includes severe chronic illnesses, pregnancy, surgery, high fever, malnutrition, severe infections, and endocrine disorders. Causative medications include retinoids, anticoagulants, anticonvulsants, beta blockers, and antithyroid medications; discontinuation of oral contraceptive agents is another possible cause.17
Researchers from South Korea have identified a new peptide called PTD-DBM which exhibits wound healing and hair regeneration effects in preclinical studies. The research is being led by Professor Kang-Yell Choi of Yonsei University. Choi’s team identified the peptide PTD-DBM which targets a protein called CXXC5. The interaction of these two proteins leads to stimulation of the Wnt pathway, which then initiates hair follicle neogenesis. Choi hopes to develop this peptide further into a potential hair growth drug candidate. A research paper about these findings was put out by the team earlier this year. Source article about this development here.
Dr. Carlos Wesley, a hair restoration surgeon in Manhattan, said that women in his practice respond better to P.R.P. than men do, which may have something to do with the fact that women with genetic hair loss tend to have more inflammatory cells around the follicles. From 2013 to 2014, he said, he had an 83 percent increase in female patients, in part because of P.R.P.
Finasteride (brand name Propecia) is the closest to a hair loss cure pill that scientists have discovered to date. This is a DHT hair loss cure. DHT is made when 5 alpha reductase converts testosterone, and Propecia has been found to be an effective inhibitor of DHT by preventing this process from happening. It works internally, at the root of the cause. Therefore, DHT sensitive hair follicles in the front and top of the scalp don’t have to fight off nearly as much DHT.
Hair thinning occurs in a sex-specific pattern. Men typically present with bitemporal thinning, thinning of the frontal and vertex scalp, or complete hair loss with residual hair at the occiput and temporal fringes.5 Women typically present with diffuse hair thinning of the vertex with sparing of the frontal hairline. Some women experience thinning over the lateral scalp. Common conditions that mimic androgenetic alopecia include thyroid disease, iron deficiency anemia, and malnutrition.
The third and fourth stages are known as telogen and exogen, respectively. In telogen, the hair is supposed to be at "rest" until it finally detaches itself from the follicle and enters the exogen or shedding stage. Once the hair is detached from the follicle, the follicle remains inactive for about three months, after which a new cycle begins again.