HEALTH
WHEN SOMEONE IS TRYING to point me out in a room, I’m “the bald guy over there”. But even then, I don’t stand out, since an estimated 70 per cent of Australian men will be affected by something called androgenetic alopecia, more commonly known as male-pattern baldness. Losing your hair in your twenties and thirties might seem like the end of the world at the time, but I’m here to tell you it isn’t. Forget the fear that beautiful women won’t date a man whose hairline has turned and fled. A few years ago, a study from the University of Pennsylvania’s Wharton School found that guys with shaved heads were perceived as being more dominant than those with full heads of hair. Check out John Malkovich or Vin Diesel for proof. And we shouldn’t have to tell you that many women find power sexy. Still, most bald blokes, given a choice, would prefer to have more hair to comb rather than more hair in the comb. We’ve been promised for more than a decade that a cure for thinning hair is just around the corner, and frankly our patience is now thinning too. Sometimes, despite the huge and lucrative potential market for an affordable and effective hair-loss remedy, it seems as if nobody worthwhile is even trying to find one. A troll through some hair-loss forums led me to a few interesting underground “remedies”, including scalp tattooing (camouflage that bald spot!), caffeinelaced shampoos (make those follicles so jittery they have to produce something!) and herbal concoctions containing capsaicin, the compound that makes chillies hot (flush out your scalp with fresh, oxygenating blood!). According to a National Enquirer story – and who am I to doubt such an august publication? – Leonardo DiCaprio regularly smears his noggin with all kinds of stuff, including lemon juice, horseradish and spices. Evidently, it’s so smelly that some of the models he chats up have complained. Before you make the titanic mistake of spending lots of your hard-earned money on any of these solutions, understand that none of them will restore your onceflowing mane or fill in your bald spot in a way that preserves your respectability. But legitimate treatments are coming – really, says Dr Angela Christiano, a Columbia University professor who specialises in researching hair loss and its potential remedies. In fact, sometime in the next decade I may be able to choose from several good options to regrow my mane and once again enjoy the distinction of being identified at parties as “the guy with the great head of hair over there”. Here’s what’s on the horizon.
JAK Inhibitors The Wait 3-5 years Healthy hair grows in cycles. A follicle produces a hair, the hair stays around for a while, then the hair falls out. When that happens, the follicle goes dormant before sprouting anew. The number of cycles should be unlimited, but in balding men, the new hair grows back finer each time, until it’s like peach fuzz. The hair isn’t gone; it’s just imperceptible. In October last year, Christiano successfully used a class of drugs called JAK inhibitors to stimulate follicles back into robust growth cycles in mice and human cells. Whether it’ll work on real men remains to be seen. Since the drugs already have US Food and Drug Administration approval for other uses, they’ve cleared major safety hurdles and could be in clinical trials in the US for hair loss soon.
Stem Cells The Wait Five years For some time, researchers have been betting big on the potential for stem cells to grow human hair. But when hair-follicle stem cells are grown in the lab, they lose their capacity to induce new follicles when placed back into the scalp. These hair-follicle stem cells don’t seem powerful enough to do the trick on their own. One solution, says Christiano, is to find ways to restore their inductive properties, by growing them in special conditions in the lab and coaxing them back into a potent state. Scientists at the US-based Sanford Burnham Prebys Medical Discovery Institute recently discovered they could grow new follicles by using a type of human skin cell derived from pluripotent stem cells. So far, only mice have been enjoying the fruits of these findings. Human trials are due to begin in the near future.
Hair-Follicle Engineering The Wait 5-8 years Right now, the best way to restore a receding hairline is via hair transplant surgery (see “A Tale of Two Transplants”, p106). The days of rows of obvious hair plugs are long gone, sometimes replaced by robot-assisted microsurgery devices that can create a remarkably natural look. But these procedures aren’t cheap and, rather than creating new hair, transplants merely move existing follicles from the back and sides of the head to the front of the scalp. If you’ve been balding for a while, your remaining hair may be
too sparse to provide enough donor sites. But what if you could take just 100 follicles and clone them into 100,000 – the number most men are born with on the scalp? In 2012, a Japanese group reported preliminary success cloning follicles. According to Christiano, the field of regenerative medicine is rapidly advancing, so you might have the opportunity to become a successful farmer soon.
Fibroblast Growth Factor The Wait About eight years Conventional wisdom says we’re born with all the hair follicles we’ll ever have, and some of us are simply destined to have clogged shower drains in our future. But in a study published in Nature Medicine, Dr George Cotsarelis, a University of Pennsylvania dermatologist, reported on a possible way to grow new follicles by wounding the scalp and treating it with a substance called Fgf9. The process produced hairier mice by creating new follicular stem cells in an area of the epidermis called the bulge. The problem is that humans don’t have much Fgf9. The solution, says Cotsarelis, is a combo treatment that involves “microwounding” the scalp and then applying a drug with synthetic Fgf9. Cotsarelis is involved with a startup company, Follica, that’s exploring the feasibility of doing the same thing with men.
Quorum Sensing The Wait At least 10 years What if the cure for baldness involved yanking out your few remaining hairs? Counterintuitive, yes, but science backs this theory. Last year, researchers at the University of Southern California discovered that removing about 200 individual hairs induced the regrowth of about 1200 dormant hairs – again, only in mice. Still, there’s hope. The science behind this has to do with a process called “quorum sensing”, where a group of stem cells responds to an injury afflicting its colleagues. The resulting inflammation signals the surviving stem cells to wake the hell up, get busy, and grow more hair. For this procedure to sprout significant coverage in humans, researchers say they need to figure out how to deploy stem cells to foster controlled regrowth. So be patient. Someday soon we may finally have a legitimate reason to go pluck ourselves.
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TWO HAIR REPLACEMENT RIP-OFFS TO STEER CLEAR OF NIOXIN If wishful thinking is a commodity, consider Nioxin its primary purveyor. The company that makes this line of topical treatments claims it can rid your scalp of follicleclogging sebum and surface residue. While this may be true, it’s irrelevant for balding men. “Every shampoo does that,” says dermatologist Dr Papri Sarkar. “Sebum is simply an oil produced by your sebaceous glands. Getting rid of it does nothing to help reduce male-pattern hair loss.” So why do some men insist they’ve seen results? It’s probably because they’re initially washing their hair more often, which leads to fewer hairs clogging the drain. “If you wash your hair every three days, you might lose 300 hairs per wash,” says Sarkar. “But when you do it daily, you’ll lose only 100 hairs.” Plus, clean hair has more body than greasy hair, so it looks thicker. HAIR-LOSS SUPPLEMENTS The hair you see is dead tissue; feeding it won’t bring it back to life. Don’t bother googling “supplements for hair loss”. All you’ll get are bogus claims and “reviews” from shills working for companies that sell overpriced rubbish. The US FDA is clear: “Based on evidence currently available, all labelling claims for over-the-counter hair grower and hair-lossprevention drug products for external use are either false, misleading or unsupported by scientific data.”
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