Hair loss treatment

Alopecia areata is well known as an unpredictable hair disease affecting about 2% of the world’s population and it happens to be the second most common type of hair loss after male and female pattern baldness. It is often called patch baldness or spot baldness due to its patchy, balding pattern. In severe cases, it can affect the whole scalp (alopecia totalis) or the whole body (alopecia universalis). It is not yet known what causes alopecia areata. It is thought to be an autoimmune condition triggered by a person’s autoimmune system, which decides to attack its own hair follicles. Sometimes the hair grows back a few years later and stays and sometimes it falls out again. Although there is no ultimate cure for alopecia areata, some treatments have been proven to improve this condition. The most popular treatment option, which does not require a doctor’s prescription, is topical minoxidil, such as Rogaine. It can be used alone or in combination with other medicinal treatments that will be discussed later.

The most common amongst prescription treatments used for alopecia areata are corticosteroid shots, injected straight into the bald spot, and steroid gels and creams. Corticosteroid injections are said to be a more effective but also the more painful option of the two. The aim of this approach is to suppress the autoimmune reaction but it has been proven to work only on small bald spots. Another common treatment for small bald patches, which is also thought to affect the autoimmune reaction, is the application of topical anthralin. Anthralin is a tar-like substance used to treat psoriasis.

Topical immunotherapy is the most common form of treatment for extensive alopecia areata. It relies on an immunosuppressant such as cyclosporine that is applied to the skin to cause a skin reaction similar to mild eczema, which in some cases leads to hair re-growth. This method is also the most radical form of treatment, causing an array of negative side effects.

Another treatment applied for extensive alopecia areata is PUVA, which stands for "psoralen plus ultraviolet A radiation", consisting of a topical or oral application of psoralen, followed by ultraviolet radiation. This method is better tolerated than topical immunotherapy but it is also less effective.

A recently conducted research study with sulfasalazine also spells some promise for patients with severe cases of alopecia areata. Sulfasalazine is an anti-inflammatory medication first used to treat rheumatoid arthritis and is hoped to be soon used to treat alopecia areata.

This is the list of the most commonly prescribed medicinal treatments for alopecia areata. There obviously is an array of other alternative therapies that are claimed to improve this condition and do not require a doctor’s visit. Consumers should be aware that none of such products has ever been clinically shown to be effective in treating alopecia areata and such claims are possible only because these products are not regulated pharmaceuticals but non-regulated cosmetics.

A hair system can be any type of supplemental hair in the form of a full wig, hairpiece, toupee, hair extension or a weave, which replaces your own missing hair. Hair systems are for many hair loss sufferers the only existing option to replace the lost hair and to regain the former appearance of a full head of hair. The quality and the price of hair systems depend on a variety of factors, such as the type of hair used, the production process used to weave the wig, the foundation of the hair system and how it is attached to the scalp.

The origin of hair is the first thing most prospective buyers will ask about. Both artificial and natural hair can be used. The natural hair can be of human or animal origin. Some hair systems blend human hair with animal hair to save on cost. The human hair can be of Asian origin (the least expensive option), Indian origin or European origin (the most expensive option). Asian and Indian hair must be usually bleached, which makes it brittle and less durable. Considering the harvesting methods, virgin hair is the most expensive and hair gained from hairbrushes and combs the least expensive option. Human hair requires more care than artificial hair but it looks more authentic, lasts longer and is more comfortable to wear. Its downside is its higher cost and the fact that it can lose its colour when exposed to direct sun for long hours or break, as normal human hair does.

As far as the manufacturing process is concerned, hair systems can be hand-tied or machine-tied. Hand-tied wigs can be also custom made, which happens to be the most expensive alternative. The foundation of a hair system can be either a polymer or a mesh. The polymer foundation is a more affordable but also a less comfortable option. A mesh structure breathes better than polymer structures and is therefore more comfortable to wear but, besides being more expensive, it is also a less durable alternative and more difficult to maintain. Mesh is suitable for creating authentic-looking hairlines, so many wigs combine both technologies, mesh for the hairline and the polymer structure for the inside of the wig.

The technique of fixing a wig to your scalp and blending it with your existing hair is an extremely important factor. There are semi-permanently attached hair systems that are either glued to your scalp or woven into your remaining hair and these can only be removed in a hair salon once every five or six weeks for cleaning and maintenance. These systems cling tightly to your scalp but can be unhealthy and uncomfortable to wear after a couple of weeks of use. The temporarily-attached hair systems use double-sided sticky tape or clips to fix the hairpiece to your scalp and existing hair. They can be removed and cleaned any time you like but can also be easily and unexpectedly removed, leading to embarrassing situations.

The final determining factor when deciding on buying a suitable hair system is the price. Any hair system happens to be temporary in nature, it will not last for ever like hair transplants do. Nevertheless, it can be quite expensive. Hair transplants can cost as much as ten thousand dollars or more. Although you can get a wig for a few hundred dollars, the more authentic looking pieces cost a few thousand dollars and require regular maintenance costing a couple of hundred dollars a month. Besides that, you have to buy at least two identical pieces, one to wear while the other is being maintained by your hair salon. Though not cheap, hair systems are often the only option to replace the lost hair for many alopecia areata patients, as well as a large percentage of female hair loss sufferers. 

The two main methods of non-surgical hair replacement today involve the use of hair systems and hair loss concealers. Various types of hair systems such as full wigs, hairpieces, hair extensions, toupees and weaves can look extremely authentic and have been used for ages to cover bald spots and typically with good rates of success. Their main weaknesses are high maintenance costs and, in some situations, the discomfort of wearing them. Hair loss concealers and hair thickeners on the other hand have been around for a shorter period of time and have often been looked down upon for being incapable of withstanding adverse external conditions and for appearing unnatural. This does not seem to be true any longer as many of them have greatly improved recently, both in terms of their authentic appearance and their resistance.

There are three types of hair loss concealers: those that simply paint your scalp to match your hair colour, then there are hair thickeners that thicken your hair by coating and penetrating the hair and trapping moisture and volume-building proteins inside the hair shaft and, lastly, there are bald spot concealers that apply microfibers that cling to your hair like branches to the trunk of a tree, increasing the hair density. Some products combine two of the aforementioned approaches and paint your scalp and thicken your hair at the same time. All of these products come in various forms, such as a powder, cream or a spray. Hair loss concealers do not contain any ingredients that would combat hair loss but some of them allow you to continue with a topical hair loss treatment such as minoxidil.

Microfiber-based hair loss concealers can be typically applied in as little as 30 seconds versus a minimum of five minutes needed for hair thickeners. However, microfibers are less water-resistant and it is quite difficult to apply them precisely and, therefore, they are not too good for creating an authentic-looking frontal hairline. Their greatest advantage is that they are unrecognisable in your hair, even with a very close inspection. Hair thickeners, mainly those that also colour your scalp, are extremely water-resistant and excellent for frontal hairlines but they take longer to apply. They cover your scalp with a layer of colouring substance, which makes it difficult to effectively apply any topical hair loss treatment. Their greatest weakness in comparison to microfibers is that in direct sunlight it can become visible to the sharp eye that the scalp has been painted.

The common complaint about all products used for concealing hair loss is the limited choice of available shades. Some hair loss sufferers use a combination of two products simultaneously to overcome the weaknesses of individual products and to achieve the most authentic shade and appearance. Most often a combination of a hair thickener and a micro fibrous concealer is used. The results of such combinations are typically very satisfactory. If you want to try any such combinations, make sure that you apply the scalp-painting, hair loss thickener first and then use the microfibers to hide the remaining imperfections. There are many different products in all three categories of hair loss concealers and you may want to test several of them in order to identify those that best match you hair colour and style of application.

The current medical options for reversing hair loss in people suffering from hereditary forms of hair loss are limited to relatively few products which are most effective in the early stages of baldness. Once you have lost a substantial portion of hair due to hereditary factors or an accident, such as a burn, the only remaining option is to replace the missing hair. Your options can be either of a temporary nature, such as the use of hair pieces and hair loss concealers, or a permanent surgical solution. Hair transplantation happens to be the most effective way of surgical hair replacement and the only permanent solution that offers satisfactory results.

Hair transplantation consists in transplanting your own hair follicles from the back of your scalp to the frontal, balding area. The main limiting factor of hair transplantation is the shortage of donor hair and, therefore, many patients do not make a good candidate. The suitable hair transplant candidate should have a high hair density in the back of the scalp, his hair should be wavy and thick, his scalp flexible and the contrast between the colour of his hair and scalp should not be too great, and he must be in good physical condition. Women usually suffer from a diffuse form of hair loss and thus do not make very good hair transplant candidates. Hair transplantation also cannot be performed on patients suffering from unpredictable forms of hair loss such as alopecia areata.

Given the shortage of donor hair, the hair transplant surgeon must be able to utilise the little hair he can use to create the optical illusion of a full head of hair. This represents the biggest risk in hair transplantation, as it can happen that the patient does not like the final result. Although you can usually arrange for another hair transplant session, some damage can be irreparable. Other risks and side effects occurring during and after hair transplant surgery include excessive bleeding and scarring, the lengthy healing of wounds, the transaction and eventual death of many implanted hair follicles, post transplant shock hair loss, which, though temporary, can affect your newly-implanted hair as well the hair in the donor area, scalp tension and numbness and the further progression of hair loss after surgery, which can lead to unnatural patterns of baldness. In one recent study, which analysed the experiences of 425 hair transplant patients who had undergone 533 hair transplant procedures in total, it was determined that about 5% of the patients experienced complications either during or after surgery.

Hair transplants can cost around ten thousand dollars, depending on the technique used, the location and reputation of the clinic, the extent of hair loss and the number of hair transplant sessions needed to achieve the eventual effect. However, sometimes it is impossible to estimate the final cost, which represents another risk you take when deciding on hair transplantation. Given the pain, time and cost involved, it pays to educate oneself prior to signing up for hair transplant surgery. The hair transplant industry is a fast-growing business and the quality and affordability of hair surgeries are improving, so do not let anybody push you into hasty uninformed decisions.

Having unrealistic expectations is the first and foremost mistake. This will always lead to frustrations, no matter how good or bad the treatment was. No matter what the marketers of any hair loss product say, do not believe that you can recover all of your lost hair. Most treatments only enable you to slow down the balding process or, in better instances, to keep the existing hair. The best possible result you can expect from any treatment is to regrow the hair you have lost in the previous three years. But this is only possible if you start treating your condition at an early stage. This brings us to the second most common mistake many hair loss sufferers make - denying their hair loss and beginning to treat their condition only after they have already developed a bald patch. The later you start treating the baldness, the less chances you have of regrowing lost hair. In order to regrow hair you must have fine miniaturised hair left in your bald area. This baby hair is often called peach fuzz. Once your hair follicles have died and there is no hair left, no miracle can rejuvenate them.

Many hair loss sufferers, as they start working on their research, get scared reading about the potential negative side effects of proven medicinal treatments and opt for allegedly safer alternative treatments. Marketers of natural, hair loss remedies tend to exaggerate the harmful side effects of Propecia (finasteride) and Rogaine (minoxidil) in order to lure you into buying their product. The chances that you will lose your sex drive from finasteride or grow additional facial hair because of minoxidil are statistically under 1%. You should first try the proven medicinal treatments and only if you have experienced negative side effects or no positive improvement try some alternative therapy. Starting with unproven products right away deprives you of the opportunity to test some of the best remedies available out there. If you start treating your condition with an alternative remedy, the likelihood you pick the one that works well for you is close to zero. Thus, you are almost certainly wasting time while the hair loss continues to advance. And do not believe that all natural, hair loss treatments are safe. That is not true either.

Another frequent mistake is to use multiple treatments simultaneously. If you feel like trying different things, do not try them all at the same time. Any treatment requires a minimum of four months to kick in and you should give it at least six months to deliver results. Please note that overdosing will not speed up or improve results.

And lastly, do not overreact to sudden increase in shedding. Shedding is common to almost any hair loss treatment. If you start a new treatment such as Rogaine, you will first have to shed the old hair. Rogaine works by stimulating hair follicles, resulting in increasing the thickness of your miniaturised hair. But this will not happen overnight. First, the old thin fibber must be shed and then the hair follicles rearrange themselves in order to start producing thicker hair. Therefore, the first sign that the treatment is working is accelerated hair loss.

The first hair transplantations were performed in Japan in the 1930s. In the early days of hair transplant surgery relatively large pieces of skin of four millimetres in diameter, the so called punch grafts, were transplanted from the back of the scalp to the frontal receding area. Hair transplantation techniques have evolved tremendously since then and today’s hair transplantation can give you a genuinely natural look. This is due to the miniaturisation of hair transplants, which now contain only one hair follicle (holding between one and four hairs) and are less than one millimetre in diameter. These tiny, single follicle grafts are then implanted into the needle-made incisions in the balding area. Today’s technology enables dense packing of hair follicles, which gives you a truly natural-looking frontal hairline. Gone are the days of ‘pluggy’ grafts that made you look like a toothbrush.

The two leading technologies that are used today are called Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE). The main difference between them is in harvesting hair follicles. The FUT is the older method, using strip harvesting, when a linear strip of skin of up to 20 centimetres long and 1.5 centimetres wide is removed from the back of the scalp and the opening is then sewn closed. This strip is then placed under special dissecting microscopes and dissected into small grafts, containing just one follicular unit each. Such follicular grafts are then implanted into the receding area. The advantage of this method is its high yield, measured as a percentage of the follicles that are successfully transplanted into the balding area. This yield is around 98%. The weakest point is that it leaves the patient with a linear scar at the back of the head. The FUT is less expensive than the FUE and is used when a large area needs to be filled with transplanted hair in one single session.

The FUE method uses a micro-extraction technology to harvest individual follicles that can be directly implanted into the small needle-poke holes in the balding area. The FUE method is the latest technology, introduced only a few years ago. Its greatest benefit is the fact that it leaves the patient with only minuscule scars at the back of the head, which are hardly visible, and the healing time is significantly shorter than with the FUT, due to the small size of the wounds. However, this technique cannot be used to cover large areas in one session and it is more expensive than the FUT. Additionally, its yield is much lower, due to the transaction of many follicles, and since the supply of donor hair is limited, it cannot be used in patients whose hair loss has progressed above NW4 level.

Currently explored surgical hair restoration technologies, such as hair cloning and the generation of new hairs in wounds, should in the future help solve the constraints of the limited amount of donor hair. It seems that hair transplants will in the long future only be used for frontal hairlines and, therefore, the follicular harvesting should manage to provide a sufficient number of hair implants. However, none of the aforementioned potential future techniques is expected to become commercially available before 2013. Hence, the immediate future probably lies in improving the harvesting methods of the FUE in order to improve its yields and make it financially more affordable to customer. The FUT with its strip harvesting, which started a revolution in the hair transplant industry less than two decades ago, may become history in the not too distant future.

When it comes to combating hereditary hair loss, it is medicinal pills and topicals that spring to most peoples’ minds as the options holding the greatest promise. There also happen to be other available treatment options, such as surgical as well as non-surgical hair replacement, but to date only oral and topical medicinal treatments have been proven to reduce and reverse hair loss naturally. Hair transplantation, though providing the best cosmetic results, cannot slow or reverse hair loss. Natural and herbal hair loss treatments seek to mimic medicinal treatments in their mode of action but their effectiveness in treating hair loss has never been confirmed in any significant clinical study and many of them are associated with hair scams.

The two medicinal treatments that have been approved by the FDA (Food and Drug Administration) in the US for treating hereditary hair loss are topical minoxidil (trade name Rogaine/Regaine) and oral finasteride (Propecia). These two hair loss drugs have been also approved by national health supervisory authorities in many other countries. Topical minoxidil is suitable for both sexes, whereas finasteride can only be prescribed to male patients. Minoxidil is a vasodilator, originally used to treat high blood pressure, which was later found to stimulate new hair growth when applied topically to the scalp. Its exact mechanism of action is not known, though.

Finasteride is an antiandrogen that was initially applied to treat benign prostatic hyperplasia (BPH), also known as prostate enlargement. It works by inhibiting conversion of the male hormone testosterone to the follicle harming didydrotestosterone (DHT). The discovery of finasteride’s positive influence on hair growth led to finding the true cause of hereditary baldness, which are the harmful attacks of DHT on our hair follicles. Since making this discovery, a quest for other alternative DHT inhibitors has begun, especially amongst antiandrogen drugs and herbs that have, in the past, been used to treat urinary problems.

Dutasteride (trade name Avodart) is a medicine similar to finasteride and has been studied extensively for treating hair loss. It is currently undergoing phase III clinical testing. It has been approved for treating BPH and is therefore available in pharmacies in many countries around the world. Although it has not yet been approved for treating hair loss by any national health supervisory authority, it is being prescribed by some clinics and doctors to male patients who no longer respond to finasteride. Dutasteride is believed to be a more powerful hair loss drug than finasteride but also with more severe side effects.

Flutamide (trade name Eulexin) is an extremely powerful antiandrogen used to treat prostate cancer. It acts by binding to the androgen receptors and thus competing with DHT. Oral use of flutamide can cause serious side effects but it is believed that topical applications might have less adverse side effects and could be, in the future, used to combat hereditary hair loss. More research is needed to verify such claims.

Spironolactone (trade name Aldactone) is another antiandrogen that works by binding to androgen receptors, competing with DHT. It is used in women to treat acne, excess body hair and hair loss and although there are some generic topical applications designed for treatment of male pattern baldness containing spironolactone, it has never been approved to treat hereditary hair loss in men and should better be avoided.

Aminexil, was developed by L’Oreal to treat baldness in men and women and its molecule is very similar to minoxidil. Its mode of action is not exactly known and it is believed to be a less powerful weapon in the fight against hair loss than minoxidil.

NEOSH101 is one of the most promising novel hair loss drugs under development. It is in phase II clinical trials and is supposed to be a hair growth stimulant, distantly related in its mode of action to minoxidil. Although not expected to become an ultimate cure for baldness, it could improve the chances of many hair loss sufferers of regrowing some of their lost hair.

The above list of medicinal treatments for hair loss is not exhaustive. There also happen to be other drugs though to help treat hereditary baldness, such as superoxide dismutase, fluridil, ketoconazole, alfatradiol, etc. but none of them has ever been proven in any serious clinical study to promote hair growth and further studies will be needed to evaluate their actual effects on hair loss. Therefore, for the time being, minoxidil and finasteride remain the main weapons in the fight against genetically-determined hair loss conditions in male patients.

Adhering to certain principals is necessary if you want your hair loss therapy to be successful. The first thing you should do before you start looking for a suitable hair loss treatment is to determine whether you are a hair loss sufferer at all and what type of hair loss you are suffering from. For male patients who have already lost a substantial portion of their hair on the top and front of their head, it is easy to self-diagnose. But if you are suffering from diffuse hair loss or your hair loss began only recently, you need to go and see a dermatologist. It would be senseless to treat a condition that does not exist. It is very common for hair loss patients to skip the doctor’s consultation while many others simply deny their condition. This very often leads to hair loss progressing too far for it to be treated successfully. In order to regrow hair you must have fine miniaturised hair left in your balding areas. Once your hair follicles have died and there is no baby hair left, no miracle can rejuvenate them.

After you have determined which type of hair loss you are suffering from, the journey can begin. Whether you want to adhere to you doctor’s advice or be experimental, you need to have realistic expectations. False hopes necessarily lead to frustration, no matter how effective the treatment was. Do not believe that there is a hair loss remedy that can regrow all of your lost hair. You will be lucky to find a treatment to arrest your balding process and if you manage to regrow a few hairs, take it as a bonus. Keep in mind that the ‘before and after’ pictures on promotional websites are skilfully forged. The best possible achievement one can expect from any treatment is to regrow the hair you have lost in the previous two to maximum three years.

Many hair loss patients fail to follow professional recommendation of using proven treatments and instead opt for allegedly safer alternative remedies, as they get scared off by the potential negative side-effects of medicinal drugs. This is a common trick used by the shrewd marketers of hair loss scams - to spread stories exaggerating the harmful side-effects of medicinal drugs. They lure you into buying their own product, which is most likely a waste of your money, time and effort. Starting with unproven remedies deprives you of the opportunity to test some of the best hair loss treatments available today.

The key to any successful treatment is, besides picking the right remedy, adherence to the prescribed daily regimen. Many people, in their impatience and effort to improve results, fail to follow their doctor’s instructions and start experimenting with multiple treatments simultaneously. This often leads to them abandoning certain treatments before they have got any chance of producing results. Any hair loss treatment requires a minimum of four months to kick in and you should allow it at least six months to deliver noticeable results. Overdosing will not speed up or improve results.

And finally, do not overreact to shedding. Shedding is a common occurrence in any effective hair restoration therapy. If you start a new treatment, such as Rogaine, you will first have to shed the old hair. Rogaine stimulates hair follicles, resulting in an increase in the thickness of your miniaturized hair. But this will not happen overnight. First, the old thin miniaturized hair must be shed, and then the hair follicles rearrange themselves in order to start producing thicker hair. Typically, the first sign that the treatment is working is accelerated hair loss.

Given the currently available treatment options it appears that the premature graying process cannot be reversed. There is no scientific evidence that any existing medicine, herb, dietary supplement or natural substance can prevent or reverse graying hair. Several cosmetics and pharmaceuticals firms are working on the discovery of the ultimate cure for gray hair but no satisfactory solution is commercially available yet.

Premature gray hair is often associated with excessive stress, sudden trauma, bad diet, vitamin B deficiency, thyroid problems and smoking. The fact is, however, that the number one cause for premature graying hair is genetics. The pigment that determines the color of our hair is produced by special cells at the root of our hair called melanocytes. It is the lifespan of these cells that determines the onset of the graying process. Once melanocytes die, the hair turns white.

There is no fundamental difference between a premature and a normal, age-related greying process. It is by virtue of nature that some people will experience their first white hair in their teens and turn completely white in their early thirties, while others will keep their original hair colour for many decades. If more than 50% of a person’s hair is white by the age of 40, it is considered premature.

There are several commercial products out there that claim to be able to rejuvenate the dead pigment-producing cells and reverse grey hair. Such claims, however, are utterly unsubstantiated. The sad truth is that at this point in time no proven remedy exists that can reverse the greying process. Most of the anti-grey hair products either use Fo-Ti, referring to the centuries old legend of Mr He, who recovered his original hair colour, youthful appearance and vitality thanks to this traditional Chinese medicinal herb, also known as He Shou Wu or use vitamins B (mostly PABA and folic acid) as their main active ingredients, since some forms of premature greying are said to be caused by vitamin B deficiency. However, such products are ineffective for the majority of grey hair sufferers.

Thus, the only option for treating premature gray hair that seems to deliver guaranteed results is to cover grey hair. Women use various types of permanent, semi-permanent and demi-permanent hair dyes but men usually prefer a subtle and less noticeable change in their hair color that does not cover all their gray. Such products are usually called progressive hair colorants. It is obvious that none of these products can make the dead cells produce pigmented hair and thus they must be used continuously to cover the gray of fresh hair. Although there are some natural hair dyes that claim to effectively cover your gray hair, the products that really work well all use certain chemical substances. When deciding about hair dyes or progressive hair colorants, you should always consider the potential health risks, as most of them contain chemicals that can cause poisoning if used inappropriately or can lead to severe allergic reactions. You should always use a patch test before applying any such product and follow the application guidelines in order to minimise exposure to aggressive chemical substances.

Men have been seeking an ultimate cure for hereditary hair loss for thousands of years but until very recently all available cures were either simple cosmetic cover-ups or unsophisticated supplement pills and herbal lotions, with many of them just being scams. It was only with the advent of finasteride and minoxidil and improvements made in hair transplantation in recent years that the new era began, enabling hair loss sufferers to halt the further progression of the balding process and replace the missing hair on top of their head using the hair left at the back of their scalp. However, to this day no ultimate cure for hereditary hair loss exists. There are presently several promising drugs and surgical techniques under development but none of these new therapies is expected to hit the market before 2011.

NEOSH101 is being developed by the US company Neosil and it is currently undergoing phase IIb clinical trials. NEOSH101 has been proven to be a more powerful and faster-acting, hair growth stimulant than minoxidil and it only needs applying once daily. Though significantly improving the current hair loss treatment options, NEOSH101 is not going to become an ultimate cure for hereditary hair loss. The clinical testing seems to be advancing slower than most hair loss sufferers would like and, hence, do not hold your breath for it hitting the market anytime soon. NEOSH101 is mainly expected to replace minoxidil and other currently available hair growth stimulants.

Another promising field of development is the telomerase research. Telomerase is an enzyme that is able to put natural caps on telomeres and thus protect them from shortening. Telomerase thereby helps maintain the genomic integrity. Shortened telomeres are associated with the premature aging processes. However, the uncontrolled activation of telomerase can cause cancer growth. Cancer research is the main focus of the telomerase study but scientists are also looking for other applications, such as anti-aging drugs and drugs against hereditary hair loss and gray hair. Although still under development, there are already some products commercially available that seek to emulate the mechanism of telomerase action but they have no scientific backing and should be avoided. Telomerase research could really change the world of medicine but its commercial application might be a good decade away.

Hair multiplication, often called hair cloning, is the next hopeful treatment approach being developed. This technique involves extracting the hair follicles from the back of the patient’s scalp, culturing and multiplying them and injecting the newly-grown, hair cells into the bald scalp. Among several teams of scientists on three continents researching hair multiplication, the UK healthcare company Intercytex appears to be the frontrunner. Intercytex reported results of the latest stage of the clinical phase II study of ICX-TRC (a suspension of a patient’s own dermal papilla cells) in March 2008 and they were quite positive. The next release is expected in Q4 2008. This therapy might hit the market in 2011 at the earliest. The main benefit of hair multiplication would be solving the shortage of donor hair that is the main limiting factor in hair transplantation.

Generating hair follicles in wounds of hair-free skin is a completely new approach to regrowing lost hair. It was discovered accidentally as wounded skin in mice started producing new hair. This technology is currently being developed by the US medical device company, Follica, which licensed this technology from the University of Pennsylvania. Though this approach may sound weird it only uses common instruments and drugs that have already been medically approved and thus it might not take too long for it to become available.

This is the list of only a few promising treatment options for hereditary hair loss that are being currently developed but many others are in the pipeline. It seems that becoming bald may soon be by choice rather than destiny.