In search of a head of hair

Tue, Aug 28, 2012, 01:00

Finding a cure for baldness has kept generations busy, but has the search come to an end? US academics and dermatologists seem to think so

EARLY LAST week reports emerged from US academic circles that a cure for baldness had been discovered and could be on our pharmacy shelves within two years. If the story stands up – and that is by no means certain – the cure will have been a long time coming. More than 4,000 years in fact.

Almost since we crawled out of the primordial soup, looked down and realised those opposable thumbs might be quite handy, the males of our species have worried about losing their hair.

It’s not hard to see why. It doesn’t matter what culture you’re talking about or when, baldness has always had a really bad press.

Samson with hair was strong and manly while Samson without was a pathetic weakling who couldn’t push over a pram never mind the pillars of a massive temple. The holy man Elisha took such a dim view of his own hair loss that he ordered wild bears to slaughter 40 children who called him “baldy”.

Ezekel wasn’t such a touchy prophet but was still pretty hard on the sleek headed when warning that sinners would have to “put on sackcloth, and horror will overwhelm them. Shame will cover all [their] faces, and all their heads will be bald”.

Julius Caesar came, saw, conquered and then went and spoiled it all be creating the comb-over. Rather than opting for the side-to-side style that is the, um, fashion, of our time, the greatest of the Romans opted to comb from the back of his head to the front. He also wore a laurel wreath to cover his bald patch – a bit like the way the Edge wears a hat today just in case we see that (shock, horror) he may have lost some hair.

Male pattern baldness has been blamed on many things – too much testosterone, too many hats, too little virility, too much stress, too much thinking, slow circulation, diet and sin. The sin link comes from Ezekel.

The causes are one thing, the “cures” are quite a different kettle of rancid fish, rubbed on to your head.

Yes, rancid fish is just one of the treatments which has been peddled to the desperate over the many years since the hunt for hair repair began. Romans smeared chicken poop on their scalps while the Egyptians went for the fat of lions, geese, crocodiles and snakes. The inventor of western medicine, Hippocrates, swore quite the oath when he realised his diligent applicant of chicken urine to his bald spot had inexplicably failed to re-grow his hair.

By the middle ages, European men had moved on from chickens and were rubbing cow spit onto their heads with mixed results to no avail.

Meanwhile, their China cousins were mixing the testicles of farm animals with ground herbs and rubbing the paste into themselves. While in India men tried headstands. As the age of enlightenment dawned in Europe, the cures increased. Electric shocks, vibrators, suction devices, caustic agents, wilful blistering and lights were all tried with absolutely no success at all.

But today, after all the broken promises, the failures and the heartbreak, the answer is tantalisingly close.

First, for the science bit – concentrate. There are roughly 100,000 follicles on the human head and each produces hair for between two and six years. Testosterone and its stronger derivative dihydrotestosterone (DHT) play a crucial role in the development of the male foetus and are essential elements leading towards male maturity.

But they have a dark side. Certain hair follicles in the scalp are genetically programmed to be vulnerable to DHT and when attacked they wither like a plastic straw held over a candle.

They produce thinner, shorter hair and their growing phase becomes shorter as hairs fall out that can not be replaced fast enough.

About 40 per cent of men can expect to lose some of their hair before they hit 35. Most of these men would do almost anything to reverse the process which is why the baldness industry is worth well in excess of a billion US dollars each year and more money is spent on finding a “cure” for something which is not actually an illness than is spent on finding a cure for TB, malaria and sleeping sickness. Combined.

Last week, a team of US dermatologists moved things on by discovering that an enzyme, called prostaglandin D2 (PGD2), instructs follicles to stop producing hair.

They hope to reduce the levels of PGD2 on the male scalp and stop hair loss dead. George Cotsarelis, the head of dermatology at Pennsylvania University, says he is now talking to several drugs firms about creating the anti-baldness product and he says a lotion could be on the market within two years.

It seems a tad optimistic as taking any drug from the drawing board to the pharmacy tends to take quite a bit longer than that.

Cotsarelis is not the only general fighting in the war on hair loss. Earlier this year, researchers working at the forefront of stem cell technology in Switzerland and Scotland may also have accidentally come up with a cure.

They were looking at stem cells from the thymus, a small organ which helps run the body’s immune system, to see how the cells would perform if transplanted into growing skin.

The researchers were looking at ways they could help burns victims regrow skin.

Unexpectedly, they managed to change one cell type into a different one and ended up with skin cells that had working hair follicles – the holy grail of the bald cure merchants.

The scientists transplanted these cells into the skin of lab rats and found that the cells forgot they were from the thymus and began performing just like healthy skin cells. Eureka. Possibly.

It is not, however, likely these treatments will be available in the months or even years ahead and for the most common hair loss treatments that actually work (a little bit) are Minoxidil and Finasteride. The former is a lotion you rub on to the scalp while the latter is a prescription-only tablet.

Finasteride inhibits DHT and is said to have an 80 per cent success rate at preventing hair loss. Minoxidil was originally developed as a drug to reduce blood pressure but in trials brought about hair regrowth in some patients. It was modified and developed as a spray for the scalp and released onto the market in the late 1980s.

It stops hair loss in 80 per cent of cases, according to the company, and leads to new hair growth in one in four users, although much of the regrowth is said to be downy and light in colour and about as attractive as having mouse hair stitched to the scalp.

Laser therapy is popular and apparently works by stimulating blood supply to the follicles and scalp although medical experts are deeply sceptical about such treatments. They are less so about hair transplant surgery, which has come a long way since hair was first stitched into Japanese men’s scalps in the 1930s.

During a transplant, hair-bearing skin from the side of the head is removed and dissected to produce grafts which are then sewn onto the balding area.

While it is effective, it is not a cure. And it is very expensive and you could expect to have little change out of €10,000 after the procedure. Alternatively, you could cut your losses, shave your head and deal with the self-esteem issues another way.

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