Baldness or excessive hair loss is a condition that can affect patients as a result of genetics, hormonal changes, or as a normal sign of aging. While some people allow their baldness to remain untreated, others choose to try treatments claiming to restore hair growth or prevent further hair loss. Every year, new technologies that claim to help with baldness are developed.
So can baldness be cured by 2021? Not quite, because a miracle solution has yet to be discovered. There are many interesting solutions coming up such as hair cloning and gene editing but the best available treatments available so far are hair transplants, DHT blocking shampoos, and medication such as Minoxidil and Finasteride.
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In the US, there are around 80 million Americans who are affected by genetic hair loss — around 30 million women and 50 million men. Studies have found that hair loss negatively affects the self-esteem and confidence of both men and women.
While baldness may seem trivial compared to life-threatening illnesses, scientists are still trying to find a cure for hair thinning and shedding. Recent clinical trials have found some treatments which can potentially treat hair loss, such as:
Samumed is a US biopharmaceutical company working hard to cure baldness with their experimental drug SM04554. Instead of growing hair from scratch, the SM04554 focuses on stopping hair loss and regrowing existing hair follicles through the Wnt pathway of the scalp.
The Wnt pathway is a protein pathway that regulates hair growth by passing signals through surface cell receptors. When the SM04554 is applied to the Wnt pathway, it can keep hair follicles in their anagen (or active growth) phase. The medication can effectively stop hair fall, repair hair follicles, and even increase the number of active hair follicles.
Currently, Samumed has the SM04554 drug in a late-stage clinical trial. At phase three, they are currently monitoring the long-term effects of the medication on 625 male participants with androgenic alopecia, or male pattern baldness. Beginning in 2018, the scientists expect the third phase of the clinical trial to be finalized by January 2021.
The SM04554 topical solution is a big step forward in curing baldness but it may still take a few years for the medicine to be available to the public, even after getting FDA-approval.
As futuristic as it sounds, hair cloning is a potential solution for baldness. Once the technology is materialized, hair thinning and shedding will no longer be a problem because you can continually replace your hair follicles with clones after you have lost them.
Theoretically, the process for hair cloning will begin by applying local anesthetic to your scalp so the doctor can extract around 50 – 100 of your hair follicles. This part of the procedure will take no more than an hour and there will be no visible signs that it was done. Once the hair follicles are collected, they will be shipped to a laboratory.
At the laboratory, the hair follicles will be microdissected to isolate certain cells involved in the production of hair shafts. These cells will divide and multiply rapidly for around three weeks before they are shipped back to your provider and micro-injected into the balding areas of your scalp. The active cells will be like seeds that grow new, permanent hair where they are transplanted.
Hair cloning was a breakthrough expected for 2020 but so far, nothing has been confirmed and it seems as though a substantial amount of work still has to be done. There are also questions as to how the hairs will regrow when transplanted, in terms of direction, length, curl, color, shape, and coarseness. It’s likely that you would need other treatments to ensure your mane looks normal.
Stem cells are unique because they begin as undifferentiated cells with the potential to become any kind of cell in the future. Scientists have learned to use stem cells to regenerate entire organs and are now trying to unlock stem cell capacity for hair restoration.
The life cycle of each human hair begins with dermal papillae, special cells that regulate hair follicle development and growth. The dermal papilla cells create a new hair shaft and move upwards to get closer to the stem cells at the follicle’s tip. The stem cells receive signals from the dermal papillae to start the next growth phase once the previous hair shaft has been shed.
There are two problems connected to the concept of transplanting stem cells for hair regeneration. One is that the dermal papillae may disappear over time and interrupt the cell-to-cell partnership. Another flaw is that when the stem cells are applied to the scalp as cultures, they tend to spread out and let the follicular culture melt away. These two problems cause the transplanted cells to stop producing hair after a while.
Scientists believe that if they can preserve the cells together and maintain their teardrop shape, both stem cells and dermal papilla cells can continue to send signals to each other and grow into resistant hairs. One study theorizes that with 3D printing, scientists can create a mold to hold the cells in place until they become hairs.
With this technique, they can develop a microenvironment like the natural environment where hair follicles grow. While the research on perfecting this method is still ongoing, its potential is promising among the scientific community.
Gene editing is not going to be a solution in the immediate future but the idea behind it will allow generations to skip the hair loss gene altogether.
Male pattern baldness is caused by a genetic sensitivity to an offshoot of testosterone called dihydrotestosterone (DHT), a male sex hormone linked to the development of characteristics like body hair in men. High levels of DHT can shrink hair follicles, shorten hair cycles, prevent hairs from regrowing quickly, and cause hair to look thin and brittle.
In theory, you can treat hair loss permanently by changing your DNA so your body can be less sensitive to DHT. One of the most recent groundbreaking technologies developed is the CRISPR-Cas9 gene editing tool, which can allow you to switch off the genes that make men and women more likely to lose their hair.
South Korean biotechnology company Moogene developed a microbubble-nanoliposomal delivery system for androgenic alopecia therapy. They created a sequence of sgRNA or a ‘guide RNA’ to target the SRD5A2 gene, which is responsible for the creation of the 5AR enzyme that converts testosterone into DHT.
The gene editing particles of Cas9 and sgRNA are encapsulated into the nanoliposomes attached to microbubbles from a topical solution. Once the topical solution is applied to skin containing hair follicles, the scientists apply a specific ultrasound frequency to the skin that bursts the microbubbles and creates an entrance in the skin’s surface. Through this cavity, the nanoliposomes are transported past the epidermis and into the dermal papilla cells.
Once the Cas9 protein enters the dermal papillae, it acts as the scissors cutting through the native RNA and allows the crafted sgRNA sequence to stop the 5AR gene. A patient who undergoes this procedure would no longer be sensitive to DHT.
Although Moogene is still conducting the research program on this technology, they are optimistic about being able to perform human trials in approximately two years time.
|Expected Release Date|
|SM04554 Topical Solution||Results of the phase 3 trial are expected to be released in 2021|
|Hair Cloning||Research is still ongoing; industry experts predict release around 2027 – 2030|
|Stem Cell Therapy With 3D Printing||Studies were only begun in 2019 with research ongoing|
|CRISPR Gene Editing||Currently performing toxicity study for FDA; expects clinical trials to proceed to humans by 2023|
In the meantime, there are already a few treatments available on the market. These treatments have varying levels of efficacy as some products do not work for certain people. However, this is normal in medicine because each patient has a unique body affected by their habits, environment, or other factors. Some existing hair loss treatments include:
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One of the most popular ways to get a full head of hair is to have a hair transplant. Surgical hair restoration through the FUT or FUE methods are the best ways to restore hair growth in areas of the scalp that are completely bald. While both methods are effective, you will need to consult with a qualified physician on which is the better option depending on your budget and your scalp’s condition.
Hair transplants begin by removing healthy hair follicles from the back and sides of the scalp, as these areas are less sensitive to DHT and therefore unaffected by male pattern baldness. The healthy hair is surgically implanted into the bare areas and the procedure can take a long time, spread out over multiple days. You can also expect to have local anesthesia done as having sections of your skin removed and re-implanted will be painful.
The FUT and FUE methods vary slightly:
The end result of a hair transplant is the appearance of a full head of hair, without the use of concealer sprays or hair pieces. However, you may need to take medication like finasteride or minoxidil to maintain the hair after the transplant, depending on the severity of hair loss.
Certain FDA-approved medications can also work to help reduce the amount of DHT in the body and allow patients to treat hair loss effectively. The two most prominent medications are Finasteride and Minoxidil.
Finasteride is a hair loss medication designed to decrease the production of DHT in men as it inhibits the enzymes from converting testosterone into DHT. Studies on Finasteride have been conducted since the 1990s and research shows that most patients had no further hair loss after two years. In order to access Finasteride tablets, you will need a prescription from your healthcare provider.
If you’re not inclined to drink a tablet for hair loss, Minoxidil is a topical medication in liquid or foam form that opens up the blood vessels in the scalp for increased blood flow. The additional blood flow sends more nutrients to the hair, improving the scalp’s condition. In 2002 and 2014, scientists found that men who applied topical Minoxidil greatly improved hair growth in their frontal and vertex scalp.
The best way to promote hair growth and treat baldness without surgery is actually to combine these two medications together. When both Finasteride and Minoxidil were used, around 94% of men showed hair regrowth improvement with very minimal side effects.
Studies have found that excessive levels of DHT in the scalp can cause hair follicles to shrink and eventually die, causing hair to thin out. Certain DHT blocking shampoos can help reduce the DHT levels in the scalp and potentially minimize the severity of hair loss. DHT blocking shampoos commonly features ingredients like ketoconazole and saw palmetto:
Although these shampoos are far less effective than medications like finasteride and minoxidil, they can work as a treatment booster to prevent further hair loss.
|Treatment and Efficacy||Average Pricing||Pros||Cons|
|FUT or FUE Hair Transplants||Most effective on patients with complete baldness||$3000 – $15,000, depending on the location, your surgeon, and other factors||Treatment can be done with poor hair density;
Results and hair growth will be permanent
|Would require surgery and will take recovery time;
Considerably more expensive compared to other treatment options;
Side effects and unnatural-looking results may occur
|Minoxidil and Finasteride||Ideal for patients who want an effective, long-term treatment to combat hair loss and baldness||$26 for 60 grams of Minoxidil, but price may vary depending on your pharmacy;
$8 for 1 mg tablet of Finasteride, but prices may vary
|Highly effective and FDA-approved;
Easy-to-use, fairly affordable medications;
Very few likely side effects
|Long-term treatment needed to achieve desired results|
|DHT Blocking Shampoos||Best to use as a supplementary treatment||$10 – $50, depending on the brand and amount of product||Easy-to-use and effective when combined with medications||May not work for every patient;
Is not very effective on its own
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