Why We May Be The Last Men To Go Bald

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Balding is the hoverboard of medical research. If someone had told me in 1989 that, morethan 20 years later, my Birdhouse deck wouldn't float, I'd have told the butthead to getlost. But here we are in 2012. Hoverboardless. Dinosaurs.Worse: Men have beenlosing their hair for thousands of years, and the best science has done is smoke andmirrors, ointment and wigs. Perhaps it's what we deserve for all our vanity, preening andgrooming while the promises of liberal democracy smolder. Maybe we should shave our headsand rebuild America. But the truth is even the most stoic guys struggle with hair losswhen it sets in, and it'll happen to about 50% of us by middle age. Only a much smallerpercentage -- as low as 7% -- will ever seek medical treatment.Understandingwhy this is boils down to the fact that there hasn't been a single groundbreakingtreatment that permanently stopped or turned back the clock on hair loss. In fact, therehas never been a clinical treatment specifically developed for hair loss that worked.The options from recent history: wearing a wig; using a topical solution or foamwith minoxidil, like Rogaine (developed initially to treat high blood pressure); takingfinasteride, which is in Propecia and Proscar (first used to treat an enlarged prostate);or getting hair transplants. Each of these works in a piecemeal way, but they're allproblematic. Wigs are a bit silly. Rogaine and Propecia have mixed results and must beused every day, for life. Transplants are limited by the amount of donor hair from thecrown and back of the neck. None of them will bring back the flowing locks of your teenageyears.Some scientists and doctors think that could change in the next 10years. Is it for real this time?The best defense is a good offense

In recent years the theme of the balding conversation has changed from“maintenance” and “prevention” to actual regrowth. The reason? Abetter understanding of hair biology, including new knowledge of how cells communicatewith the hair follicle. A study led by George Cotsarelis, M.D., chair of the Department ofDermatology at the University of Pennsylvania School of Medicine, that was published lastyear in the Journal of Clinical Investigation found that a bald scalp andone with hair both have the same number of stem cells, but in the bald scalp, the stemscells are sort of chilling out, just sitting there instead of going to work repairing andreplenishing hair follicles and fibers. “However, the fact that there are normalnumbers of stem cells in a bald scalp gives us hope for reactivating those stemcells,” Cotsarelis said in a news release issued by Penn Medicine. Get the stemcells working again and the hair comes back.New Biotech: Follica, Histogen, Replicel

Cotsarelis declined to be interviewed for this story, but he's been hard at work asco-founder and member of the scientific advisory board of Follica, a privately heldbiotech company that has an exclusive license from Penn Medicine to develop technologybased on the JCI study and another from 2007, which showed that mice with skin woundsregrew hair at the injured site in a process that mimicked embryonic development. Thismeans that activated stem cells can grow new hair follicles. Little else is known ofFollica's forthcoming balding treatment, except that it will likely include a drugcompound and some sort of wounding of the skin akin to what went down with the mice.Follica isn't the only biotech company trying to find a cure forhair loss and stake a claim in the multibillion dollar market for treatment, one thatcould conceivably balloon if a better treatment existed. San Diego-based Histogen, aprivately held company headed by Gail Naughton, Ph.D., an expert in tissue engineering,also views Dr. Cotsarelis' work (along with studies at Rockefeller University by ElaineFuchs and University of Southern California by Cheng-Ming Chuong) as the foundation ofcurrent biotech progress in hairrestoration.“Our approach is to take cells that are normally foundin the scalp and grow them under embryonic conditions of very low oxygen and suspensionculture to trick the cells into thinking they're back in the embryonic environment,”Naughton said.“Within a couple of days they start acting likemultipotent stems cells and secreting the growth factors that are necessary to stimulatestem cells in the body, including stem cells of the human hair follicle. We've basicallylearned how to manufacture a complex physiological group of growth factors that arenormally responsible for stimulating stem cells to create new hairs. We simply mimicnature by figuring out how to make what the body makes to grow a new hair.”Those growth factors, chemical signals produced by cells that induce more cell growthand maturation or differentiation, are what go into Histogen's Hair Stimulating Complex(HSC), an injectible liquid formula currently in clinical trials in Manila, Philippines.Naughton believes she and her team have identified the four growth factorsthat are most important for the cycling of a hair follicle and for stimulating growth:Follistatin, Noggin (seriously), Vascular endothelial growth factor (VEGF), andKeratinocyte growth factor (KGF). So far, according to Histogen, patients have hadstatistically significant hair growth (including increases in hair count, hair thicknessand hair density) at 12 weeks and at one year. Histogen aims to have a product on themarket in Asia in 2015 and in the U.S. a year later. The actual procedure involves a one-or two-time set of injections in the scalp with a very fine 32-gauge needle, taking onlyseveral minutes rather than the hours required for a hair transplant. Continue Reading

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