The other main hair-loss treatment that was recommended by all four dermatologists I interviewed is finasteride, often called by its brand name Propecia. This FDA-approved medication is only available with a prescription, but these days, it’s found as a generic and ordered online after a virtual consultation, through start-ups like Hims, Keeps, and Lemonaid.
However, this partnership ended in 2007 due to potential safety issues since SHH can potentially also cause basal cell carcinoma cancer. P&G was not willing to continue with the drug development work, since even a very minimal risk of developing cancer is not worth it for treating a cosmetic problem such as hair loss (at least in the eyes of government). Interesting comment from the at-the-time CEO of Curis:
A clinical researcher who has spent decades researching the fields of pattern hair loss, alopecia areata, endocrinology of the hair follicle and hair follicle morphogenesis, Hoffmann works in his private practice, as a teaching professor in the Department of Dermatology at the University of Marburg and as a researcher on histopathology on hair diseases. He has participated in dozens of clinical hair studies and is the inventor of TrichoScan®, a computerized technique to measure hair growth.

"Others are taking hair follicles out of human scalp and growing them with dermal papilla cells," Cotsarelis says. "If they grow in culture, you might be able to recombine them with skin cells and form new follicles. This would let you expand the number of follicles you get for a hair transplant. This may not be that far off -- five to 10 years, maybe. There's very good evidence you will be able to do that."


How about if you’d rather not get your head punctured? In Sweden, a company called Follicum is now doing Phase IIA clinical studies and planning to communicate results by the end of the year. The end product will be a cream or a lotion, one that could be applied as few as three times a week. In the first trial, Follicum claims, more than seventy-five per cent of patients experienced hair growth. This is the real dream, the one so artfully captured in the Hims ads: pop a pill, slap on some cream, and get Hair God locks.
That said, there are products that don’t have FDA approval or clearance, but may help prevent hair loss. For example, shampoos with ketoconazole, a chemical with anti-DHT properties, is widely used to treat fungal infections but has become popular among consumers as a hair loss treatment. It makes sense — research shows that ketoconazole actually has beneficial effects on hair growth (especially for those with seborrheic dermatitis).

Away from Silicon Valley, though, a clutch of companies are competing to provide the true cure. There are a few primary approaches. The San Diego company Histogen has been around since 2007, making it a veteran in this inchoate field. Histogen is working toward “an injectable for hair growth,” its founder, Dr. Gail Naughton, told me. What Histogen wants to inject in you are extracts from “neonatal cells grown under simulated embryonic conditions.” Histogen is convinced that these cells stimulate “growth factors” that signal hair formation. That’s option No. 1: first, a cell solution is whipped into a hair-growing frenzy, in a lab; then it’s punched into your head. “Some people would rather take a pill,” Naughton acknowledged. “But we have some nice benchmarks, with something like Botox. You’ll be able to have a physician come to a Tupperware party” and give the injections. The market, Naughton knows, will be huge. “It’s not just hair,” she said. “Anything in aesthetics has been booming worldwide. Anything to be more youthful-looking, anything to regenerate yourself. Anything to live longer.”


Ms. Imhof, who lives in Land O’Lakes, Fla., was skeptical. The company’s before and after photos seemed too good to be true. But she went for a consultation and made the cut. (Harklinikken’s products are not available to anyone with autoimmune illnesses like alopecia or baldness from scarring, or anyone who is unlikely to see at least a 30 percent increase in growth.)
I wonder whether hair loss would get as much attention if it were primarily suffered by women. But Kobren corrects me. “Actually, 40% of hair loss sufferers are women,” he says. “Except women are able to wear wigs and hair extensions and they can camouflage it in a way that men aren’t really allowed to.” He describes female pattern hair loss as a “silent epidemic of biblical proportions” that he puts down to the use of cosmetics and birth control (some women experience hair loss as a side effect to contraceptive pills).
Hair loss is not a hopeless condition. While there are certainly cases of permanent hair loss in men, there are still cases when it's only temporary and therefore can be treated, controlled and prevented. There are treatments and cures available, and many of these, especially those for temporary cases, can be as simple as lifestyle changes -- eating the right foods, learning to manage stress properly, and doing away with unhealthy, nasty habits that can aggravate the condition.
Re the post 10/17/18 I really liked your response to the request made by one of your readers to email companies asking for information. So I decided to do what you suggested and sent emails to Organ Technologies, Rivertown and Follicum (no particular reason) basically thanking them for their work and wishing them success with their products. Interestingly I received a very nice response from Organ Technologies which really surprised me. Correct me if I’m wrong but I think the sentiment is to be thankful and encouraging to what is being done appose to being negative that we have yet to get what we all want.
The method for applying hair loss shampoo is the same as regular shampoo, i.e., you apply it to wet hair, massage it into the scalp and rinse it. The difference with hair-loss shampoos, however, is that you should leave them in for a longer time before rinsing. Doing so ensures that their ingredients reach your hair’s roots and scalp, where they have the biggest impact.
It appears that the gene-editing company Sangamo Therapeutics has an interest in hair growth technology. Sangamo is an interesting company with technology applications in gene therapy, genome editing, cell therapy, and gene regulation. Gene therapy, especially, is at the cutting-edge of medical technology innovation. The company has multiple therapies at phase 1/2 of the clinical trial process for various diseases. 

But if thin hair is an issue that really bothers you, you might want to consider modifying your hair routine — and shampoos are a great place to start. “An ideal shampoo for thinning hair needs to not only improve the volume of your strands but also encourage growth and circulation of hair follicles,” advises New York City dermatologist Neil Sadick. But first things first: New York City dermatologist Francesca Fusco advises women to determine the cause of their thinning hair with a professional. She identified androgenetic alopecia and dandruff as two common reasons women lose hair without understanding why.


In 2013, RepliCel began working with the Tokyo-based Shiseido Company, Limited—a Japanese multinational skin care, hair care, cosmetics and fragrance producer—on a collaboration giving Shiseido an exclusive geographic license to use RepliCel’s RCH-01 hair regeneration technology in Japan, China, South Korea, Taiwan and the ASEAN countries representing a population of approximately 2.1 billion people. “Shiseido and RepliCel will collaborate on the continued improvement of the technology and will conduct human clinical trials in each of their territories with the goal of commercializing a safe and effective hair regenerative treatment to help those suffering from pattern baldness and thinning hair,” Buckler said.
"The majority of men lose their hair not through stress, or bad diet, or lack of sleep, but through the genetic trait of male pattern baldness which is hard to treat through shampoos or supplements alone. Women lose their hair for very different reasons, but the argument still stands that a lot of the hair loss products on the market are just offering false hope. That said, there are a few that really work."

Besides cost considerations, a hair transplant is generally prescribed as a last resort for permanent hair loss problems. It is also not allowed for people under the age of 25, those with a continuing problem of hair loss, as well as those with other health conditions like uncontrolled diabetes, serious heart problems and hypertension. Patients whose hair loss is caused by other factors, such as a skin or scalp disorder or who suffer from a psychological condition that causes them to pull at their hair are not recommended for this procedure. Since the procedure requires taking a sample from the back of the head, those who do not have enough follicles from this section that can be used for transplant are not also eligible.
Yet another company has made news this week for phase 2 trial progress. Concert Pharmaceuticals announced today that they have completed enrollment for their phase 2a trial using CTP-543 in alopecia areata. CTP-543 is an oral JAK inhibitor which acts on JAK 1 and 2, it’s also known as ruxolitinib. Concert’s version of ruxolitinib has been modified by the company’s proprietary deuterium chemistry technology which the company hopes will improve its effects on AA.
2. Pyrithione zinc shampoo. Traditional volumizing shampoos will give the hair you have a lift so it looks fuller (we like the sulfate-free L’Oréal Paris EverPure Volume Shampoo, $8). But some research suggests shampoos with the antidandruff ingredient zinc pyrithione can mitigate hair loss that’s caused by conditions like dandruff, says Mirmirani. Try Head & Shoulders Deep Moisture Shampoo ($6), and use a conditioner without silicones — they can make hair appear limper, especially if it's applied near the roots (we like Love Beauty and Planet Coconut Water & Mimosa Flower Conditioner, $9).
There’s also a women’s version (Women’s Rogaine Foam) — but a three-month supply costs $22 more online. The only difference between the two products are the instructions; women are instructed to apply once a day instead of twice. If you’re a woman who doesn’t feel like paying extra for marketing, the men’s product will suffice. A cheaper generic version is Kirkland Signature Minoxidil Foam, but with a longer history on the market and more customer testimonials, Rogaine is our first choice.
Minoxidil is a similar treatment to finasteride and is also available in the UK as a generic or as the well known brand-name “Regaine”. Minoxidil can be bought over the counter, unlike Propecia or finasteride, and comes in the form of a lotion, foam or cream that is rubbed into the scalp every day. Minoxidil is less effective than finasteride (only 60% of men who used Regaine Extra Strength reported regrowth after 48 weeks) but is still a viable option for men seeking treatment. It is also suitable for use by women, and can be used to treat alopecia areata. However, as with finasteride, any beneficial effects will cease once treatment has stopped.
To do the exercise, simply rub the fingernails of both hands - except the thumbs - against each other as hard as possible. Make sure not to let the surface of the nails rub against each other - just the tips. In acupressure therapy, it is believed that the hair follicles on the scalp are connected to the fingernails and by doing the exercise, it will stimulate blood circulation and nutrients into the follicles, therefore promoting hair growth.

Regarding the RCH news, is your source more reliable than Lee Buckler since he seems to know more about RCH than Lee buckler himself. Recently, Lee Buckler tweeted “We anticipate seeing data from the RCH-01 study in Japan sometime before year-end but the real answer is whenever the investigators/hospitals in charge of the trial (not us) decide to release the data once it ready”


But, there’s an even more important step to take – your participation and contribution. The topic of “a cure for hair loss” or “a hair growth treatment”, for many of us, is one of the most important issues in our lives. What are you doing to support its success? I realize that question may not have previously crossed the mind for many. It’s here now. For a personal example, I’m not a scientist who creates molecules in a lab, so I decided I would organize the hair growth treatment news and spread awareness. It’s been a gratifying practice for me. 
That said, hair loss isn't as bad or as hopeless as it sounds. It shouldn't be cause for added personal stress or social stigma, nor should it be something that should make us feel more self-conscious and less confident as individuals. With the advances in technology, you don't have to be saddled anymore with the uncomfortable choice of wearing an ill-fitting, unnatural-looking hairpiece. There is now a wide array of options available to treat and cure hair loss, whether temporary or permanent.
Treatment is based on patient preference. Topical minoxidil (2% or 5% solution) is approved for the treatment of androgenetic alopecia in men. Hair regrowth is more robust at the vertex than in the frontal area, and will take six to 12 months to improve.5 Treatment should continue indefinitely because hair loss reoccurs when treatment is discontinued. Minoxidil 2% solution is recommended for the treatment of androgenetic alopecia in women.6 Adverse effects include irritant and contact dermatitis.
However, this partnership ended in 2007 due to potential safety issues since SHH can potentially also cause basal cell carcinoma cancer. P&G was not willing to continue with the drug development work, since even a very minimal risk of developing cancer is not worth it for treating a cosmetic problem such as hair loss (at least in the eyes of government). Interesting comment from the at-the-time CEO of Curis:
Cloning has seen many false starts and wrong turns, Christiano told me. Now her team is building “an artificial skin with a dermis and an epidermis, with molds made to mimic the dimensions of hair density,” she explained. “When the artificial skin matures we pull out the pre-formed hairs and insert them into the skin.” Bernstein is convinced that, in the next ten years, cloned hair will happen. “And then the supply and demand problem is solved,” Bernstein said. “Without Bernanke!”
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A little something for you all to nibble on. I’ve recently discovered a stem cell therapeutic company who has an interest in putting out cosmetic hair growth products. The company, Stemedica, is working on treating a wide range of diseases through clinical stem cell therapies. I counted 6 clinical trials in progress on their pipeline page. Perhaps more interesting for this audience, the company is also developing skin and hair growth cosmetic products from their core stem cell technology. Stemedica has a specific subsidiary in place to roll out dermatology cosmetics called StemCutis. Their website mentions the use of stem cell-derived growth factors to to be used in the products. It’s not clear what stage of development the hair growth product is at, but it’s good to have it listed in Stemedica’s sights. 
Harklinikken does not advertise, but the 25-year-old multinational company is beginning an aggressive expansion into the $3.6 billion hair-loss market in the United States, meaning you’re likely to hear a lot more about it. A New York clinic opened in June inside the Core Club in Midtown (you don’t need to be a member to get an appointment); and in August, Harklinikken consultations became available at some 70 Women’s Care Florida obstetrics and gynecology clinics. (Roughly 75 percent of the company’s 50,000 active users are female.)
“The most common cause of hair loss in both men and women is androgenetic alopecia, which is genetic pattern hair loss,” explains Dr. Michael B. Wolfeld, a board-certified plastic surgeon and an assistant clinical professor of plastic surgery at the Icahn School of Medicine at Mount Sinai Hospital in New York. The root cause of this type of hair loss is dihydrotestosterone (DHT), a byproduct of testosterone that shrinks certain hair follicles until they eventually stop producing hair.
Trichorrhexis nodosa occurs when hairs break secondary to trauma or because of fragile hair (Figure 7). It affects the proximal hair shaft, although the distal shaft may also be involved.20 Causative traumas include excessive brushing, heat application, tight hairstyles, trichotillomania, and conditions that cause excessive scalp scratching. Chemical traumas include harsh hair treatments (e.g., excessive use of bleach, dye, shampoo, perms, or relaxers21) and excessive exposure to salt water. Examples of congenital or genetic conditions that may cause trichorrhexis nodosa include trichorrhexis invaginata (bamboo hair), intussusception of the hair shaft at the keratinization zone, Menkes disease, keratinization defects due to defective copper metabolism, and argininosuccinic aciduria.22 Rarely, trichorrhexis nodosa can be a manifestation of hypothyroidism.23
If you do decide to start treatment to save your hair, a good place to start is with minoxidil, more commonly known as Rogaine. Don’t expect this hair-loss treatment to create luscious locks; minoxidil is better at slowing down or preventing more loss rather than promoting hair growth. But, according to Dr. Amy McMichael, professor and chair of Wake Forest Baptist Medical Center’s Department of Dermatology, it is effective “if used as recommended, with evidence of improvement seen around six to nine months.” Simply massage the foam or solution into your scalp once or twice daily, and for best results, use a formula with 5 percent concentration.
Over the past year, the Hair Restoration Laboratories’ Professional Strength DHT Blocking Hair Loss Shampoo (and accompanying DHT Blocking Hair Loss Conditioner) has been a top seller on Amazon and many other sites. Combined, the daily use Shampoo and Conditioner has more DHT blockers than any shampoo/conditioner set presently available. Among the key DHT Blockers in this set are: Caffeine, Saw Palmetto, Black Cumin Seed Oil, Cayenne Fruit Extract, Rosemary Leaf Oil, Pumpkin Seed Oil, Green Tea Leaf Extract, Pea Extract and many more. By helping to block DHT, they should be a great asset in helping to halt the miniaturization of the hair follicles and regrow healthier and thicker hair.
And, for all of these collective efforts, Christiano reminded me, the only things that have really worked were discovered accidentally. Soon to join minoxidil and finasteride will be Xeljanz, or tofacitinib: originally developed for rheumatoid arthritis, it has remarkable effects on hair growth for patients with alopecia areata, an autoimmune disorder that causes patients to lose hair in big patches over their entire bodies.

While it’s not entirely clear why hair growth occurred after taking dupilumab, Senna hypothesizes that dupilumab may alter the immune system pathway that is overactive in eczema sufferers. "Right now, it's hard to know whether dupilumab could induce hair growth in other alopecia patients, but I suspect it may be helpful in patients with extensive active eczema and active alopecia areata," she explained. 

After the groundbreaking 1999 study on mice, some researchers were mildly optimistic that SHH activation could also have positive implications on human hair growth in balding men and women. A new company that was formed in 2000 called Curis partnered with Procter & Gamble in 2005 to try and develop a topical Hedgehog agonist product for scalp hair growth.
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