Yesterday marked the “estimated study completion date” for setipiprant’s phase 2a trial in androgenetic alopecia in males. The participants of the trial received 1000 mg of setipiprant by oral tablets twice a day over a 6 month period. I expect the results to be presented sometime in 2nd half 2018. Here’s to hoping for positive results from this trial and expediency in beginning a phase 2b or phase 3 trial for setipiprant. Clinical trial page here.
RepliCel is a regenerative medicine company focused on developing autologous cell therapies (or therapies that involve one individual as both donor and recipient) that address conditions linked to a deficit of healthy cells required for normal healing and function. Located in Vancouver, British Columbia, the company has developed first-of-their-kind cell therapies that will, they hope, treat conditions that now affect 1 in 3 Americans: pattern baldness, aging and sun-damaged skin, and chronic tendon degeneration.

A clinician diagnoses female pattern hair loss by taking a medical history and examining the scalp. She or he will observe the pattern of hair loss, check for signs of inflammation or infection, and possibly order blood tests to investigate other possible causes of hair loss, including hyperthyroidism, hypothyroidism, and iron deficiency. Unless there are signs of excess androgen activity (such as menstrual irregularities, acne, and unwanted hair growth), a hormonal evaluation is usually unnecessary.
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.
But in November, after 10 years of research, Rogaine introduced a new 5 percent minoxidil formulation for women. It’s a mousse (instead of a liquid) that needs to be applied only once a day instead of twice, which means that it can be more easily incorporated into a woman’s evening skin-care routine. Teal replaces the blue and silver palette of the men’s Rogaine, and the packaging bears a lotus flower. (Also last year, Pantene introduced its Hair Regrowth Treatment for Women, which is 2 percent minoxidil.)
A popular skin care drug—which is intended to target eczema—was just found to have an unusual side effect: hair growth. According to an article on Newsweek, the FDA-approved drug dupilumab was given to a 13-year-old alopecia sufferer to treat her eczema. The patient, who hadn’t grown hair on her scalp since she was two, suddenly grew a significant amount of hair on her head after continual use of the drug, a study in the journal JAMA Dermatology reports.

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.
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.
Anagen is the growth phase. This lasts for about 3 - 5 years, where you can observe your hair growing half an inch every month. Full-length hair from this phase is about 18 - 30 inches long. Studies show that this phase may also be affected by other factors. Asian hair, for example, has been found to have a longer anagen phase. Weather is also a factor; hair growth can be faster in summer than in winter.
As the name suggests, androgenetic alopecia involves the action of the hormones called androgens, which are essential for normal male sexual development and have other important functions in both sexes, including sex drive and regulation of hair growth. The condition may be inherited and involve several different genes. It can also result from an underlying endocrine condition, such as overproduction of androgen or an androgen-secreting tumor on the ovary, pituitary, or adrenal gland. In either case, the alopecia is likely related to increased androgen activity. But unlike androgenetic alopecia in men, in women the precise role of androgens is harder to determine. On the chance that an androgen-secreting tumor is involved, it's important to measure androgen levels in women with clear female pattern hair loss.
There are pharmaceutical solutions, too. Finasteride (often referred to by its brand name, Propecia) and Minoxidil (aka Regaine/Rogaine) are both available via online prescription in the UK. They stop hair falling out as opposed to making it grow back again, though some report more lustrous locks after three months or so. Donald Trump is the world’s most famous Propecia user. “Never go bald,” he once counselled. “The worst thing a man can do is go bald.” He’s not wrong. The anti-bald dating prejudice that David lamented extends to politics. Only five US presidents have ever been bald. As laughable as Trump’s follicular arrangements are, chances are that if nature had taken its course, a bald Trump wouldn’t have got to the White House. Careful what you wish for.
In Michael Wolff’s “Fire and Fury,” Kuntzman’s theory is bolstered. Wolff writes that Ivanka Trump “often described the mechanics behind it to friends: an absolutely clean pate—a contained island after scalp-reduction ­surgery—surrounded by a furry circle of hair around the sides and front, from which all ends are drawn up to meet in the center and then swept back and secured by a stiffening spray.”
The cause of female-pattern hair loss is unknown, but doctors said there is a strong genetic component. The risk can come from male or female relatives. Though it looks as if the hair is falling out, that's not really what's happening. Cotsarelis said hair follicles are becoming smaller and producing hairs that may be so small that you can't see them.  Women tend to retain more normal, thick hairs than balding men do.
Studies have indicated that one of the ways to slow hair loss is by maintaining a healthy scalp environment. Regular shampooing aids in the prevention of genetic hair loss by removing excess sebum containing elevated levels of DHT. Unfortunately, there is no silver bullet hair loss shampoo on the market that will regrow a full head of hair in a couple weeks.
For those of you who only check the Updates page, there was a new Brotzu Check-In article published yesterday. Giovanni Brotzu will be presenting data pertaining to his lotion’s use in androgenetic alopecia at an Italian hair research Congress this Saturday, April 14th. We hope to see photo results from the presentation. Check back to the Brotzu article next week for updates.
David made this claim back in 2000. But fast-forward a few years and his enhanced compensation strategy begins to look a little quaint. Androgenetic alopecia, or male pattern baldness, afflicts about half of all men aged 50 and they can’t all reinvent the sitcom. And significant advances in the £3bn hair regrowth industry mean that they have other, seemingly easier, options. The man who is “ideally bald” (to use Vladimir Nabokov’s description of his comic hero, Pnin) may soon become a rare sight.
The history and physical examination are often sufficient to determine a specific etiology for hair loss. It is convenient to divide the various causes into focal (patchy) and diffuse etiologies, and proceed accordingly. Patchy hair loss is often due to alopecia areata, tinea capitis, and trichotillomania. Diffuse hair loss is commonly due to telogen or anagen effluvium. Androgenetic alopecia may be diffuse or in a specific pattern, and may progress to complete baldness.
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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.
It looks like Organ Technologies’ recent announcement of its hair cloning progress has attracted some investment capital. Earlier this week, Organ Technologies issued a press release announcing that they have issued new shares to three new investors in exchange for approximately 590 million yen. That’s a lot of yen. In US dollars this converts to roughly $5.3 million, still a good haul. The press release mentions: 
The best hair loss shampoos are gentle enough so that you can use them multiple times a week. Nizoral, however, is most effective when used only a few times a week (and should be left on the hair for three to five minutes before rinsing). But you can also alternate Nizoral with another type of hair loss shampoo – such as the Lipogaine products or Alpecin’s Caffeine shampoo – for an effective one-two hair loss fighting punch. Use Nizoral twice a week while using your other hair loss shampoo on the other days.
In-office laser light treatments or at-home handheld devices, such as the HairMax LaserComb, supposedly grow new hair by stimulating blood flow to the area (think: an amped-up version of a scalp-stimulating shampoo). Just don’t expect the device to make your noggin go from looking like George Costanza’s to Jerry Seinfeld’s. “These lasers won’t grow any new hair. If anything, they may just help you hang on to some of the hair that you already have a bit longer,” says Dr. Joyce.
During this procedure, surgeons remove a narrow strip of scalp and divide it into hundreds of tiny grafts, each containing just a few hairs. Each graft is planted in a slit in the scalp created by a blade or needle in the area of missing hair. Hair grows naturally this way, in small clusters of one to four follicles, called follicular units. As a result, the graft looks better than the larger "plugs" associated with hair transplants of yesteryear.
If you’re looking for an au naturel option, look no further. This shampoo has been an Amazon best seller since 2012. It smells great, lathers well, and has no harsh chemicals mixed in. Pura d’or has elimated all the bad stuff from this shampoo—no Parabens or SLS. It does have a ton of good stuff too! Practically every clinically proven natural ingredient that aids against hair loss is packed into this shampoo. Nettles extract, he shou wu (fo-ti), argan oil, B vitamins, biotin, and saw palmetto.

Kerastem, a company developing an autologous fat-derived stem cell therapy for hair growth, has reported positive data from their phase 2 trial. The results have come from a 6 month clinical trial involving 70 patients. In this study, the patients received a one-time injection of fat-derived stem cells, and purified fat, into their scalp. Kerastem reports an average increase of 29 hairs per cm2 from the treatment, or an increase of 17% from baseline. The press release does mention that the treatment “successfully stimulates hair growth in people with early stage hair loss”, so that is something to take into consideration when evaluating the results. For more info visit Kerastem’s website. 
Baldness is not caused by excess testosterone as is commonly thought; nor is it inherited from your maternal grandfather. It’s caused by sensitivity to testosterone: an enzyme converts testosterone into a substance called dihydrotestosterone – which then causes the follicle to shrink and fall out. Male pattern baldness is inherited, but from both or either side of your genetic line. Why men go bald, we’re not sure – though there is a hypothesis that baldness was once a genetic advantage. People tend to associate baldness with virility and wisdom. The bald hunter-gatherer would have been a natural choice for a chieftain back when life expectancies were shorter and bald heads rarer. In our age of appearances not so much. Of 17 male members of Cabinet, two are bald (Chris Grayling and Sajid Javid). Studies correlate baldness with depression; the term “psycho-trichological” is used to describe the feelings of disfigurement, social avoidance and anxiety disorders that often arrive with premature baldness.
“This industry can be ruthless—full of liars,” Farrell told me. “Just imagine how emotional people can be about their hair. If it didn’t work, some bruiser could throw me right out the window!” He laughed. “I’d rather sell hamburgers than make people ugly. But they’re always just so beautiful. I’ve done it almost forty-seven thousand times.” (Forty-six thousand and seventy-four, he later clarified, in more than thirty years.) He was originally a hairdresser; he learned the ways of wigs from a stylist on the set of a Ronald McDonald shoot. Now he’s an unabashed proselytizer. It’s all in the details, he said. “Clockwise growth patterns. Counterclockwise retention. Gravity splits according to your growth patterns and gravitational force. Irregularly shaped hairlines. The density, the texture, the colors, the highlights, the grays, the curls, the curl clash. I mean, this is rocket science! We have proprietary techniques!”
For the first twenty years of my life, I took having hair for granted. One day, in college, I woke up and looked in the mirror, and was convinced that my hair was falling out. Not receding—dropping, that minute. Later that day, I told a roommate. He took a beat, and then asked, not without kindness, “Were you on PCP?” That semester, in a creative-writing workshop, I was moved enough to write a long, confused story about a teen-ager with male-pattern baldness who suffers a meltdown and robs the hot-dog counter where he works. By my late twenties, hair loss was something that I thought about all the time. I understood, largely, that my obsession was a specific expression of a more general anxiety. I’ve never been to therapy. There are many things that have led me to consider it. But one of the most distinct, definable, and pressing has been my obsession with hair loss.
Please help. My hair has always been my pride and joy. I figured since it is pretty damn healthy, it could deal with some bleach damage. And I figured the master stylist who did all the color-corrections would know how much would be too much. I was wrong, and now I want to burst into tears every time I look at my hair or touch it. I just don’t know what to do. my hair has also NEVER been shorter than this and it breaks and falls out. What should i do to regrow hair? 

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The Holy Grail remains a drug that will promote regrowth, but this might not be so far away. Earlier this year, Manchester University announced that an osteoporosis drug had been found to have “dramatic results” promoting hair growth when applied to tissue samples in pre-clinical trials. The resultant frenzy left the PhD student responsible, Dr Nathan Hawkshaw, a little dazed. “Every other week, something comes out about hair loss and it doesn’t generate as much media coverage as what I experienced,” he grumbles. He’s in this for the science – there aren’t many fields where you get to mess around with real human tissue – but such is the distress caused by hair loss and such is the potential customer base that interest is always high.
Why? Unwanted hair growth (sideburns, for example) is a reported side effect of minoxidil. The belief is that a higher concentration of minoxidil would result in more unwanted hair, which is why women are instructed to use it less often. However, the study in Skin Therapy Letter reports that unwanted hair was more common in 2 percent minoxidil solutions than 5 percent, and women are instructed to use Rogaine’s 2 percent solution twice daily — so what gives?
Patients with hair loss will often consult their family physician first. Hair loss is not life threatening, but it is distressing and significantly affects the patient's quality of life. The pattern of hair loss may be obvious, such as the bald patches that occur in alopecia areata, or more subtle, such as the diffuse hair loss that occurs in telogen effluvium. As with most conditions, the physician should begin the evaluation with a detailed history and physical examination. It is helpful to determine whether the hair loss is nonscarring (also called noncicatricial), which is reversible, or scarring (also called cicatricial), which is permanent. Scarring alopecia is rare and has various etiologies, including autoimmune diseases such as discoid lupus erythematosus. If the follicular orifices are absent, the alopecia is probably scarring; these patients should be referred to a dermatologist. This article will discuss approaches to nonscarring causes of alopecia.
The combination of silent suffering, public shame and poorly understood science makes hair loss sufferers easy prey – type “hair loss” into Google and you’ll see what I mean. Kobren tells me that he had to remove the personal messaging function on the Bald Truth message board, as users were being bombarded by scams. Meanwhile, the higher visibility of celebrity transplants means that baldness is at risk of being seen as a sign of poor self-care. Many treat surgery lightly – and enter into punitive financing deals. One of Kobren’s recent guests was The Only Way is Essex star Maria Fowler, who complained that surgery at the controversial KSL Hair in Glasgow left her with an unnatural hairline. “She ended up having a hair transplant because her fiancé was having one. She had always thought her hairline was too high. She went in like she was having her nails painted – and it destroyed her life.”

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.

Though, it is important to point out that a lot of these companies are developing procedures that involve implanting hair, which means there is a chance they will be expensive — as we mentioned before, traditional hair transplants are costly. But a few companies and products such as Follicum’s FOL-S-005 and Fidia Pharma’s Brotzu Lotion are being designed as topical treatments.

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