Hope for hair loss sufferers
September 15, 2001 | 12:00am
Male pattern hair loss (MPHL), or androgenetic alopecia, is a perennial cause of concern and frustration for a large segment of the male population. It has been estimated that nearly fifty percent of all men will experience hair loss during their lifetime.
But there is hope, as advances in the science of hair loss have spurred the development of a class of drugs that targets an enzyme that plays a major role in the baldness process.
Male pattern hair loss is a hereditary condition where the follicle produce vellus-like (short, fine, soft) rather than terminal (large, pigmented) hairs. This process is known as miniaturization. MPHL is by far the most common form of hair loss.
The process of miniaturization is a function of androgen metabolism in patients who are genetically predisposed to hair loss. In 1974, a seminal study was published in Science describing a group of pseudohermaphrodites in the Dominican Republic. It was found that these individuals had reduced levels of dihydrotestosterone (DHT) and, among other characteristics, did not develop hair loss. It is now known that DHT is a factor in the development of MPHL and is believed to cause premature baldness. Men who develop hair loss may be genetically inclined to have increased sensitivity of hair follicles to DHT.
The search for a "cure" for hair loss is driven by strong consumer demand. The reason is simple: hair loss can be distressing. For many, it is a reminder of lost youth that can generate fear, pain and emotional vulnerability.
Younger men with hair loss are often seen by others as unattractive and older than they actually are. Hair loss can be associated with depression, low self-esteem, introversion and feelings of unattractiveness. This effect is more pronounced in men who experienced hair loss at a younger age.
Recently, however, the scientific understanding of hair loss has made important advances, heralding the potential development of new therapies. The landmark Science report on the pseudohermaphrodites who did not suffer hair loss noted that their reduction in DHT was due to an unusual genetic defect – the lack of a particular enzyme, 5 -reductase. Conversion of testosterone to DHT in certain cells depends on the presence of 5 -reductase. These findings suggest that selective inhibition of the enzyme could interrupt the process of hair loss.
Finasteride, a specific inhibitor of type II 5 -reductase, has been on the market for some years for the treatment of benign prostatic hyperplasia. In men with male pattern hair loss, a new dose of finasteride has been found to have an effect in preventing hair loss and in stimulating hair growth in some men.
Several clinical trials have been undertaken in men with MPHL. Phase III clinical trials using finasteride at the dose appropriate for MPHL have demonstrated improvement in hair growth compared with placebo or sugar pill. In two placebo-controlled trials involving men with mild-to-moderate vertex (crown of the head) hair loss, 86 percent of men treated with finasteride for MPHL maintained or showed an increase in the amount of their hair based on hair counts during the course of the studies. Only 14 percent of men treated with finasteride had further hair loss after 12 months of treatment, compared with 58 percent of placebo patients.
In these same two trials, an expert panel of dermatologists assessed standardized patient photographs, and found that 48 percent of men treated with finasteride had increased hair growth versus 7 percent on placebo. Based on validated self-administered questionnaires, the study patients themselves also reported noticeable improvement resulting from treatment with finasteride. Overall improvement compared with placebo was seen as early as three months.
Phase III trials with finasteride suggest that finasteride may offer important treatment advantages, including ease of use (oral versus topical), and demonstrated efficacy. Not only effective and convenient, this new oral medication for male hair loss provides men with an alternative to prevent and treat baldness. Consult your dermatologist and find out more about Propecia (finasteride 1mg.).
Dr. Jay Nuñez is a dermatologist at the Skin and Surgery Specialists, Lower Ground, Globe Telecom Plaza.
But there is hope, as advances in the science of hair loss have spurred the development of a class of drugs that targets an enzyme that plays a major role in the baldness process.
Male pattern hair loss is a hereditary condition where the follicle produce vellus-like (short, fine, soft) rather than terminal (large, pigmented) hairs. This process is known as miniaturization. MPHL is by far the most common form of hair loss.
The process of miniaturization is a function of androgen metabolism in patients who are genetically predisposed to hair loss. In 1974, a seminal study was published in Science describing a group of pseudohermaphrodites in the Dominican Republic. It was found that these individuals had reduced levels of dihydrotestosterone (DHT) and, among other characteristics, did not develop hair loss. It is now known that DHT is a factor in the development of MPHL and is believed to cause premature baldness. Men who develop hair loss may be genetically inclined to have increased sensitivity of hair follicles to DHT.
The search for a "cure" for hair loss is driven by strong consumer demand. The reason is simple: hair loss can be distressing. For many, it is a reminder of lost youth that can generate fear, pain and emotional vulnerability.
Younger men with hair loss are often seen by others as unattractive and older than they actually are. Hair loss can be associated with depression, low self-esteem, introversion and feelings of unattractiveness. This effect is more pronounced in men who experienced hair loss at a younger age.
Recently, however, the scientific understanding of hair loss has made important advances, heralding the potential development of new therapies. The landmark Science report on the pseudohermaphrodites who did not suffer hair loss noted that their reduction in DHT was due to an unusual genetic defect – the lack of a particular enzyme, 5 -reductase. Conversion of testosterone to DHT in certain cells depends on the presence of 5 -reductase. These findings suggest that selective inhibition of the enzyme could interrupt the process of hair loss.
Finasteride, a specific inhibitor of type II 5 -reductase, has been on the market for some years for the treatment of benign prostatic hyperplasia. In men with male pattern hair loss, a new dose of finasteride has been found to have an effect in preventing hair loss and in stimulating hair growth in some men.
Several clinical trials have been undertaken in men with MPHL. Phase III clinical trials using finasteride at the dose appropriate for MPHL have demonstrated improvement in hair growth compared with placebo or sugar pill. In two placebo-controlled trials involving men with mild-to-moderate vertex (crown of the head) hair loss, 86 percent of men treated with finasteride for MPHL maintained or showed an increase in the amount of their hair based on hair counts during the course of the studies. Only 14 percent of men treated with finasteride had further hair loss after 12 months of treatment, compared with 58 percent of placebo patients.
In these same two trials, an expert panel of dermatologists assessed standardized patient photographs, and found that 48 percent of men treated with finasteride had increased hair growth versus 7 percent on placebo. Based on validated self-administered questionnaires, the study patients themselves also reported noticeable improvement resulting from treatment with finasteride. Overall improvement compared with placebo was seen as early as three months.
Phase III trials with finasteride suggest that finasteride may offer important treatment advantages, including ease of use (oral versus topical), and demonstrated efficacy. Not only effective and convenient, this new oral medication for male hair loss provides men with an alternative to prevent and treat baldness. Consult your dermatologist and find out more about Propecia (finasteride 1mg.).
Dr. Jay Nuñez is a dermatologist at the Skin and Surgery Specialists, Lower Ground, Globe Telecom Plaza.
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