Drugs for Curing Baldness

Baldness has stymied physicians since Cleopatra's day, when a potion of animal parts, fats and other ingredients was rubbed into Egyptian scalps to encourage hair to grow. Hair restoration is a $1.5 billion market that proves tempting for the unscrupulous. The Federal Trade Commission has investigated hundreds of false claims made by mountebanks hawking the latest scalp fertilizers, including special shampoos, tonics, and exotic herbal extracts.

Perhaps so many bogus products are on the market because the two FDA-approved offerings are pretty lame. The older of the two, minoxidil, has been around since 1988. It is available over the counter as Rogaine in both 2-percent and 5-percent "extra-strength" formulations. Rogaine is applied to the scalp twice a day and a month's supply costs about $25. Side effects, like itchy scalp, are minimal. Stories have circulated that minoxidil causes hair to grow in places where it is not wanted, but that rarely happens.

Unfortunately, minoxidil does not necessarily grow hair where it is. Propecia is taken one tablet a day and costs about $50 per month. Compared with Rogaine, its side effects are less common but more serious, including enlarged prostates and temporary sexual dysfunction in men. While finasteride appears to be somewhat better than minoxidil against a receding hairline, it is not effective at combatting "chrome dome." For this reason, some dermatologists recommend using both treatments for maximum impact. Even so, do not expect dramatic results.

With either drug it can take up to six months to see improvement and as long as two years for your hair to reach peak fullness. Furthermore, the benefits of each product only last as long as you keep using it, creating the Hobson's choice of financing a never-ending $25- to $75-per-month habit or watching your hair fall out again. If neither one works for you, sit tight. GlaxoSmithKline is working on getting its prostate drug dutasteride (brand name: Avodart) approved as a hair loss remedy. Dutasteride works like finasteride by blocking the DHT conversion that causes hair loss, but initial reports indicate it is much more potent. If the trials pan out, it could be approved as a treatment for baldness as early as 2003.

Also on the horizon is a process called angiogenesis-used to encourage blood vessel growth in cancer patients-that researchers at Massachusetts General Hospital have discovered also causes thick hair to grow in laboratory mice. In a potential boon for hairless mice everywhere, the process is now being tested on a mouse with pattern baldness and looks promising...