Treating Baldness is "Not Like Growing Grass"

Treating Baldness is "Not Like Growing Grass"

By Rose Eveleth

Date: June 8, 2012
Source: scientificamerican.com

Progress may seem slow, but new treatments for hair loss are underway

Plain Grass lawn

More than 40 percent of men in the U.S. will show signs of male-pattern baldness sometime between the ages of 18 and 49. But studies looking at the genomes of this group of men have failed to turn up a genetic cause, which makes a true cure seem an unlikely prospect. 

Treatments for male-pattern baldness, also known as androgenic alopecia, may be forthcoming, however. Recent work is homing in on three types, including one that was reported in March in the journal Science. In the new paper, George Cotsarelis of the University of Pennsylvania and his team found that a compound known as prostaglandin D2 (PD2) was elevated in the blood of men with male-pattern baldness. When they blocked PD2 receptors in mice, they ensured that the hair did not stop growing. Those blockers could be applied topically, Cotsarelis says.

He is also working on growing new hair. Researchers have noticed that if you wound a mouse, the animal generates new hair follicles as part of the healing process. The new follicles come from skin cells that turn into hair follicles through what is called the Wnt-mediated signaling pathway. It is the same pathway that helps you generate new hairs naturally as they fall out. Cotsarelis is working with a company to replicate that process.

A third approach, called follicular neogenesis, would allow doctors to remove, multiply and then reimplant the stem cells found inside a person’s hair follicles. So far, though, when researchers remove the stem cells and culture them, the cells appear to “forget” they were ever hair cells. Researchers are now attempting to figure out how to restore their “memory.”

As scientists continue to search for treatments to androgenic alopecia, they recommend patience. “People think of it like growing grass or something, but it’s nothing like that,” Cotsarelis says. “It’s like trying to treat cancer; it’s a complicated process.”

This article was published in print as "It's Not "Like Growing Grass"."

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'Hedgehog' may cure baldness

'Hedgehog' may cure baldness

by PAT HAGAN, Daily Mail
Source: dailymail.co.uk



Sonic the Hedgehog

A gene that 'switches on' hair growth when it's injected into the skin could one day offer hope to thousands of bald men. Scientists have discovered that the gene - which goes by the unlikely name of Sonic Hedgehog - can stir dormant hair follicles back to life.

The first tests on humans are being planned after laboratory studies on mice showed they grew thick tufts of new hair within two weeks of the treatment. If this success is repeated in human trials, a cure for baldness could be developed within the next few years.

The breakthrough treatment is potentially far more effective than the Propecia regrowth pills about to be launched in Britain.

Doctors who discovered the genetic therapy believe it will work best on sick patients who, for example, may have lost their hair through chemotherapy. But they are also confident it could trigger new hair growth in men who have 'pattern baldness' - where their hair has receded for no obvious reason.

Up to half of men over 40 and a significant number of women - may be affected by hair loss, and although new drugs are coming on the market, they have had mixed results and are not suitable for everybody.

The genetic breakthrough by scientists at the Institute of Genetic Medicine at Cornell University, New York, came after they decided to apply technology already being used to repair diseased hearts to the problem of hair loss. This involves identifying genes known to play an important part in the development of the body and deploying them to kick-start growth in organs that are giving up.

In the case of hair, scientists pinpointed the Sonic Hedgehog gene as the ideal candidate for the job. So-called because the researcher who first identified it thought its shape resembled the computer-game character, the gene plays a key role in the embryonic development of the brain, heart, lungs, skeleton, skin and hair.

It was injected into the mice to see if it could speed up the natural process of producing hair. To measure if hair around the site of the injection was growing, the black-haired mice were dyed blonde. After seven days, hair follicles around the patch being treated had sprung back into action and were showing signs of thickening. After just 14 days, shafts of black hair 1/2 cm long had emerged on the backs of the mice.

Everybody has this gene. And, as it seems to be involved in hair growth, we thought that if we turned up expression of the gene for a few days we could wake up sleeping hair follicles and make them grow,' says Dr Ronald Crystal, who led the research team.

'There are 100,000 hair follicles in your head when you are born and you don't get any more - that's it. 'But if you look at someone who has lost their hair through chemotherapy, they still have those follicles. It's the same for a man who is bald. He has hair follicles too, but they are sleeping.

'We don't have the slightest idea if this would work in bald men - humans are not just big mice. But we are hopeful.' Dr Crystal and his team are considering trying out the therapy on humans, and several leading drug companies have already expressed an interest in the technique.

But one of the biggest problems they face is that over-expression of the Sonic Hedgehog gene is directly linked to a type of skin cancer called basal cell carcinoma. This is the most common form of skin cancer in the UK with at least 30,000 new cases every year. During laboratory tests, none of the mice developed the condition. 'The mice are six months old now and so far as we can tell they look normal,' says Dr Crystal. 'There are no adverse effects and what we are essentially doing is accelerating the normal process.

There are 100,000 genes so you have to choose your gene carefully but it's not rocket science. 'It's the same technique we are using to grow new blood vessels in people with severe cardiovascular disease, though we use different genes.'

John Mason, president of the UK Institute of Trichologists experts in hair loss - said it was too early to judge whether the treatment could be the answer to baldness. 'I am rather negative about this. I doubt if there is anything in it, and if there is, then it's a long way away,' he said.

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Norwood-Hamilton Scale of Male Pattern Baldness

Norwood-Hamilton Scale of Male Pattern Baldness

Original title: Male hair loss & pattern baldness in men - Inherited condition
Source: ishrs.org
Date: August 26, 2012

It is estimated that 35 million men in the United States are affected by male pattern baldness or androgenetic alopecia. "Andro" refers to the androgens (testosterone, dihydrotestosterone) necessary to produce male-pattern hair loss (MPHL). "Genetic" refers to the inherited gene necessary for MPHL to occur. In men who develop male pattern baldness the hair loss may begin any time after puberty when blood levels of androgens rise. The first change is usually recession in the temporal areas, which is seen in 96 percent of mature Caucasian males, including those men not destined to progress to further hair loss.

Hamilton and later Norwood have classified the patterns of male pattern baldness (see illustration below). Although the density of hair in a given pattern of loss tends to diminish with age, there is no way to predict what pattern of hair loss a young man with early male pattern baldness will eventually assume. In general, those who begin losing hair in the second decade are those in whom the hair loss will be the most severe. In some men, initial male-pattern hair loss may be delayed until the late third to fourth decade. It is generally recognized that men in their 20’s have a 20 percent incidence of male pattern baldness, in their 30’s a 30 percent incidence of male pattern baldness, in their 40’s a 40 percent incidence of male pattern baldness, etc. Using these numbers one can see that a male in his 90’s has a 90 percent chance of having some degree of male pattern baldness.

Hamilton first noted that androgens (testosterone, dihydrotestosterone) are necessary for the development of male pattern baldness. The amount of androgens present does not need to be greater than normal for male pattern baldness to occur. If androgens are present in normal amounts and the gene for hair loss is present, male pattern hair loss will occur. Axillary (under arm) and pubic hair are dependent on testosterone for growth. Beard growth and male pattern hair loss are dependent on dihydrotestosterone (DHT). Testosterone is converted to DHT by the enzyme, 5¤ -reductase. Finasteride (Propecia®) acts by blocking this enzyme and decreasing the amount of DHT. Receptors exist on cells that bind androgens. These receptors have the greatest affinity for DHT followed by testosterone, estrogen, and progesterone. After binding to the receptor, DHT goes into the cell and interacts with the nucleus of the cell altering the production of protein by the DNA in the nucleus of the cell. Ultimately growth of the hair follicle ceases.

The hair growth cycle is affected in that the percentage of hairs in the growth phase (anagen) and the duration of the growth phase diminish resulting in shorter hairs. More hairs are in the resting state (telogen) and these hairs are much more subject to loss with the daily trauma of combing and washing. The hair shafts in male pattern baldness become progressively miniaturized, (see hair follicle miniaturization illustration) smaller in diameter and length, with time. In men with male pattern baldness all the hairs in an affected area may eventually (but not necessarily) become involved in the process and may with time cover the region with fine (vellus) hair. Pigment (color) production is also terminated with miniaturization so the fine hair becomes lighter in color. The lighter color, miniaturized hairs cause the area to first appear thin. Involved areas in men can completely lose all follicles over time. Male pattern baldness is an inherited condition and the gene can be inherited from either the mother or father’s side. There is a common myth that inheritance is only from the mother’s side. This is not true.

In summary, male pattern hair loss (Androgenetic Alopecia) is an inherited condition manifested when androgens are present in normal amounts. The gene can be inherited from the mother or father’s side. The onset, rate, and severity of hair loss are unpredictable. The severity increases with age and if the condition is present it will be progressive and relentless.

Hair loss in men is likely to occur primarily between late teen-age years and age 40-50, in a generally recognizable "male-pattern" baldness known as androgenetic alopecia. Men with male-pattern hair loss may have an expectation of hair loss if they have male relatives who lost hair in a recognizably male pattern.



Norwood-Hamilton Scale of Male Pattern Baldness (Source: haircubed.com)

 

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There's hope for balding Prince Harry and William and the other 7.4million men

There's hope for balding Prince Harry and William and the other 7.4million men

FOR Prince William, it started in his mid-20s and now, at 28, Prince Harry is showing the first signs of following suit. He is, according to the experts, losing his hair.

By: Julie Carpenter

Published: Tue, May 28, 2013
Source: express.co.uk

Prince William, pictured, and now Prince Harry have both shown evidence of baldness

Pictures of the royal crown taken during his recent trip to the United States have been examined by trichologists and the conclusion is that Harry – who loves to rib his brother about his thinning thatch – is also developing signs of male pattern baldness. Jonny Harris, hair loss expert at the Belgravia Centre, London, believes Harry won’t lose his ginger locks quite as quickly as his brother but: “He may have very thin hair by the time he is 50.”

William and Harry are hardly alone in having male pattern baldness, the most common cause of hair loss in men. The condition affects about half of all men over 50 while one man in four starts losing his hair by the time he is 20 and two-thirds by the age of 65. For some, the effects can be psychologically devastating.

Research is continually being done into the condition but it is known to be caused when enzymes in the body convert testosterone into dihydrotestosterone (DHT). DHT has an adverse affect on hair follicles on the head while often encouraging the growth of body hair. The condition is hereditary but is often more complicated than the old idea that it passes from the maternal grandfather.

So what are the treatments out there?

THE VAMPIRE CURE
This is still in its infancy but research published this month showed that scientists in Italy and Israel could regrow hair on volunteers’ bald patches by injecting them with a solution derived from their own blood. The volunteers’ blood had been processed and a “platelet-rich plasma” extracted. When injected back into the relevant area, the plasma is believed to have stimulated new stem cells below the skin which can aid the regrowth of hair.

The research was carried out on people suffering from alopecia areta, which affects about two per cent of the population, but Dr Fabio Rinaldi believes their method could also lead to regrowth of hair on men who are suffering male pattern baldness. “We believe it is the best treatment available, apart from surgery,” he says. Watch this space.

"...scientists in Italy and Israel could regrow hair on volunteers’ bald patches by injecting them with a solution derived from their own blood"

THE NEW SALON TREATMENT
This month’s other “breakthrough cure” is a cream from L’Oreal called Kerastase Densifique which costs £285 for a three-month treatment and is just starting to be offered by hair salons.

L’Oreal’s scientists have discovered that many of those suffering from hair loss have skin tissue in the scalp that has an oxygen deficiency. They have developed a product that targets this condition by attempting to increase the oxygen levels in the scalp, helping follicles to produce thicker hair and reawakening dormant ones.

How effective is it? One study showed that the cream – used once a day for three months – gave people a four per cent increase in the number of hairs they had, representing an average of 1,700 new ones.

Actor James Nesbitt after his hair transplant

TRANSPLANT
This treatment, recently used by actor James Nesbitt and footballer Wayne Rooney, is considered the most effective way to combat baldness and the only real chance to regain a head of growing hair.

Transplants have also come on in leaps and bounds since the early hairbrush-style plugs that were around when Sir Elton John is rumoured to have undergone such a procedure.

Now, says Lesley Reynolds from the Harley Street Skin Clinic, “new technologies in hair transplant sur- gery mean it is virtually impossible to tell when someone has had the procedure it’s so natural”.

A follicular transplant uses the patient’s own hair, which is replanted on the scalp and continues to grow there. During the 10-hour procedure, the surgeon takes hair follicles from the back of the head, where most men still have some hair growth, and inserts them in the area of baldness, creating a new hairline. The follicles are either taken one by one or in strips.

“Once repositioned, the hair rests for up to 16 weeks and then starts its natural growth cycle,” says Lesley. “Around nine months later there will be a great improvement in the density of hair.”

Costs range from approximately £1,000 to upwards of £10,000 and while the results can be amazing (Nesbitt said it “changed my life”) sometimes several transplants are required. It will also not work on men who have insufficient hair left at the back of their head. Artificial hair cannot be transplanted as the body will reject it like a splinter.

LICENSED DRUGS
Two types of drug are used to help counteract thinning hair. The first, finasteride (sold as Propecia), is an oral tablet available on private prescription and costs around £60 a month. It works by blocking the enzyme that converts testosterone into DHT and is thought to be effective in around 68 per cent of men. It stops further loss and in some cases helps the growth of new hair. However, up to two per cent of men have reported side-effects including decreased libido.

The other drug is minoxidil (sold as Regaine). Originally a treatment for high blood pressure until it was noticed that those using the product began sprouting excess hair, it is now available over the counter as a foam or lotion.

Believed to work by encouraging blood flow to the scalp, it is best used on men who are just starting to lose hair. “It has a good success rate,” explains Lesley, “but it can take up to a year for any changes to take place.” Both drugs only work for as long as they are used.

Wayne Rooney also had a hair transplant last year

MESOTHERAPY
Lesley Reynolds says: “We are seeing great success for treating thinning hair with a new treatment called Biomimetic Mesotherapy.”

Involving a cocktail of vitamins and minerals injected directly into the scalp, the idea is to stimulate the natural regeneration process.

It works best when there is still hair to work with. Up to seven treatments are usually needed for hair loss, given once a week and costing around £350 per session.

LASER LIGHT TREATMENT
Treatments such as the HairMax Laser Comb (costing between £300 and £400) are believed to utilise the stimulating effects of light therapy to activate growth by encouraging the blood flow to the scalp.

The HairMax website is full of testimonials but the science behind laser light is limited.

SHAMPOOS, CONDITIONERS AND CAMOUFLAGERS
None of these will promote hair growth or reverse the process of going bald. However, many high street brands and salons have “volume” ranges of shampoos and conditioners that plump up the hair and at least make it look thicker.

Products that conceal hair loss include spray-on fibre treatments (such as Nanogen) which add artificial hairs to your thinning locks until washed out.

And if all else fails…

TOUPEES
Yes, hair pieces have a bad reputation and they can go flying off in the wind, but in recent years the quality has improved and they may be the only option for men who have gone completely bald and are self-conscious. The best ones are made of a good microfibre or real hair and are generally attached with double-sided tape.

So-called “hair systems” are also now available where your own hair is cut short and a netting cover (such as a wig) is glued on top. They usually cost upwards of £1,000 each.

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