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More than
half of men are affected by male pattern baldness by age 50, and
baldness treatments are estimated to be a US $1 billion per year
industry. Since the 1980s, drug therapy has increasingly become
a realistic management option for baldness for men and women.
Increased understanding of the role of dihydrotestosterone (DHT)
in male and female pattern baldness has led to targeted intervention
to prevent this hormone from acting on receptors in the scalp.
Coupled with chance discoveries and the ever-present lure of a
breakthrough involving stem cells and hair multiplication, scientifically
proven baldness treatments continue to be an area of research
that receives a large amount of funding.
It is easier to prevent the apparent 'aging' and falling out of
healthy hairs than to regrow hair in follicles that are already
dormant. There are products that have good success rates with
regrowth, including the scientifically proven finasteride (marketed
in the U.S. as Propecia) and minoxidil (marketed in the U.S. as
Rogaine, and outside the U.S. as Regaine). Without preventive
treatment, in three double-blind, placebo-controlled, randomized
studies, 72% of the balding men on placebo had lost hair compared
to baseline by 24 months. This is compared to 17% of participants
on Propecia.
The prospective
treatment of hair multiplication/hair cloning, which extracts
self-replenishing follicle stem cells, multiplies them many times
over in the lab, and microinjects them into the scalp, has been
shown to work in mice, and is currently under development, expected
by some scientists to be available to the public in 2009-2015.
Subsequent versions of the treatment are expected by some scientists
to be able to cause these follicle stem cells to simply signal
the surrounding hair follicles to rejuvenate.
The below
treatments are some of the most prominent. Generic brands, often
with identical chemical structure or the same active ingredients,
may be equally effective and are cheaper.
Interestingly,
placebo treatments in studies often have reasonable success rates,
though not as high as the products being tested, and even similar
side-effects as the products. For example, in finasteride (Propecia)
studies, the percent of patients with any drug-related sexual
adverse experience was 3.8% compared with 2.0% in the placebo
group.
While treating
hair loss most successfully is a multi-faceted, ongoing experiment
for the individual, there are three principles, sometimes called
"The Three P's" that are considered important to help
produce success and avoid the somewhat common mistakes that can
sabotage treatments. The Three P's are: proven treatments first,
take pictures, and be patient. The average hair loss treatment
takes a minimum of 6 months to begin working, and sometimes up
to 24 months to truly see optimal results. Treating hair loss
takes time because of hair cycles. The process of hair loss is
the process of "miniaturization," which takes many years.
Hairs grow in, cycle into dormancy, and then grow in again several
months later. Each time they re-emerge, they do so thinner, shorter,
and less pigmented. In time, they become so small that they are
no longer noticeable. This can take many years. New hairs only
grow in a 2 or 3 year cycle, which is why it can take a year or
more to be able to detect the success of a treatment.
This difficulty
can be increased because it is speculated that many (scientifically
proven) treatments often cause initial periods of shedding, as
some resting hair follicles are ejected and a new cycle of growth
begins, hopefully with a thicker follicle. Discontinuing all treatment
will cause a period of shedding, likely to one's non-treatment
baseline, but probably not worse.
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