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Topical Hair Loss Medication

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An article in the New York Times discusses research surrounding a potential new hair loss treatment. The NY Times’ article “Old Transplant Drug May Have A Fringe Benefit” states that an immunosuppressant used to prevent organ rejection in those having liver, kidney or heart transplants also stimulated hair growth.

First prescribed in the 1980’s it is now used for the treatment of many diseases including rheumatoid arthritis and psoriasis. Nathan Hawkshaw, at the University of Manchester found that cyclosporine A stops the production of a protein that inhibits the growth of some tissues, one of them being hair follicles.

Old Transplant Drug May Have A Fringe Benefit

What was important to the first patients who took cyclosporine A was that it made their bone-marrow transplants work; few reported the increased luster of their hair. Now scientists think the drug may hold the key to an effective treatment for baldness.

Patients began using cyclosporine A in the Eighties and it is now prescribed for dozens of conditions, including rheumatoid arthritis. Like all immunosuppressants it has serious side-effects, so hirsutism (increased body hair) was never considered a big downside. And neither was it seriously considered an upside.

Increasing your vulnerability to infection to reverse hair loss is not a risk many would take. But a team at the University of Manchester think they have found a way to mimic the hair promoting effects without the serious consequences.

Nathan Hawkshaw, then a PhD student, found that the drug decreased production of the protein SFRPI, which acts as a brake on the growth of some tissues, among them hair follicles. He and his colleagues then learned that another compound already existed that was designed to target SFRPI – and not do much else.

In a paper in Plos Biology they wrote that the compound enhanced follicle growth better than cyclosporine A, and Dr. Hawkshaw believes that this could work as a topical hair treatment. However, since the test follicles were healthy, it is not known whether actual balding could be reversed.

If the compound turns out to be safe and effective, it will still take several years to make it onto the market.

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Q: What is more important against baldness, decreasing DHT in serum with oral finasteride or decreasing DHT in the scalp with topical finasteride? — A.G. ~ Brooklyn, N.Y.

A: Decreasing serum DHT with oral finasteride is more effective in combating hair loss, as the decreased blood levels also lowers the DHT in follicles and seem to do it better than finasteride applied topically.

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Q: Have you any experience with Azelaic Acid as a hair loss treatment — is this something you would recommend using with Rogaine (minoxidil) 2% or 5% solutions? — S.V., Short Hills, N.J.

A: Azeleic acid has no direct benefit in promoting hair growth. Azelaic acid (like retinoic acid) increases the absorption of minoxidil, but also the side effects, so I would especially not recommend it in your case.

Read more about Rogaine (minoxidil)

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Journal of the American Academy of DermatologyA double-blind scientific study published in the May 2012 issue of the Journal of the American Academy of Dermatology has found that latanoprost, a drug that mimics naturally-derived compound molecules called prostaglandins, significantly increases hair density on the scalp after 24 weeks of treatment in young men with mild hair loss.

Latanoprost, like the eyelash restoration drug bimatoprost (better-known by its brand name Latisse), has been used to treat glaucoma. And like bimatoprost, latanoprost has been used to treat eyelash alopecia. The scientists who conducted the study sought to determine if latanoprost could stimulate hair growth when applied topically on the scalp.

While the sample size of the study was small (only 16 subjects), the researchers found that 50% of the subjects had statistically significant differences in hair density associated with increased hair pigmentation and thickness. Overall, at 24 weeks into the study, hair density had increased 22% in the entire study population. Another interesting finding is that the proportion of hairs in the anagen phase versus the telogen phase — referred to as the anagen/telogen ratio — remained stable. The authors of the study describe the significance of this finding:

“The stabile anagen/telogen ratio might indicate that latanoprost does not modify the length of anagen and telogen phases of individual hair follicles. However, as the absolute number of both anagen and telogen hair increased, it seems latanoprost recruits new hairs into the growth phase.”

In conclusion, the authors suggest that the study shows the possibilities of using prostaglandin analogues, like latanoprost, to treat androgenetic alopecia, or common hair loss on the scalp. More research is needed on latanoprost, or other prostaglandin analogues, to determine the ideal dosage and duration of treatment for hair loss.

Latisse, the brand owned by American pharmaceutical company Allergan, is currently being studied as a topical hair loss medication. The study will conclude in September 2012.

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Journal of Drugs in DermatologyThe January 2012 issue of the Journal of Drugs in Dermatology contains an article, written by Drs. Schweiger and Bernstein, which is the first case study of eyebrow growth from the topical use of bimatoprost.

Latisse (bimatoprost) is a topical medication that is FDA-approved for eyelash growth. Some physicians have used the medication for “off-label” use, such as use with eyelashes and scalp hair. However, until recently, there had not been any published medical literature describing the off-label use.

In the case report, a 47-year-old Caucasian woman visited Bernstein Medical for an evaluation of hair loss in one of her eyebrows, also known as eyebrow hypotrichosis. The hair loss was gradual, but had become cosmetically significant, and so she became interested in treating her thinning left eyebrow.

At her evaluation, the doctor discussed treatment options with the patient, including Follicular Unit Transplantation (FUT) and medical treatment with bimatoprost. She decided on medical treatment, and so started a four month treatment regime.

At a follow-up visit four months later, the patient reported significant thickening of her left lateral eyebrow. […] Physical examination revealed increased left eyebrow density, hair length, darker color, slight skin pigmentation, and eyelash treatment.

The conclusion of the article states:

We report one of the first cases of topical bimatoprost for successful treatment of eyebrow hypotrichosis. Studies are needed to confirm the efficacy and safety of topical bimatoprost to treat eyebrow hypotrichosis.

Also noted is that if the efficacy and safety of the medication are confirmed through additional testing, it would be a viable non-surgical option for eyebrow restoration.

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Dr. Scweiger on GMA - Eyelash Enhancement

From hair extensions to eyelash enhancement, our resident expert on hair loss in women is on the case. Dr. Eric Schweiger was featured in a segment on Good Morning America where he discussed the enhancement of eyelashes, which he called, “a universal sign of beauty.”

According to Dr. Schweiger, eyelash enhancement is growing in popularity. One way to enhance your lashes is through topical hair loss medication called Latisse. Here is what Dr. Schweiger said on the topic:

“Latisse is a medicine you apply to the eyelash skin, and it actually increases the growth phase of the eyelashes,” Schweiger said, referring to the prescription treatment that is the first and only FDA-approved eyelash growth product. “You get longer, fuller eyelashes.”

In recent years, Latisse has attracted media attention for its eyelash growing properties. Testing has begun for use as an eyebrow enhancer and begun testing for hair loss on the scalp.

Read more about Latisse, which is the brand name for the product. The active ingredient in the medication is called bimatoprost.

The GMA segment goes on to discuss eyelash enhancement using eyelash extensions. Watch the segment below, or visit the article on ABC News:

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Q: I use Nizoral for my dandruff. Does it work for hair loss too? — M.D., Danbury, CT

A: The active ingredient in Nizoral is Ketoconazole. This medication, originally developed to treat fungus infections, has slight anti-androgen action. It is supposed to work in hair loss by inhibiting the action of DHT on hair follicles. Although, in theory, it should be useful for androgenetic hair loss, there have not been conclusive scientific studies to show that it works to treat balding when used as a topical application for balding.

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