AAD: New Treatment Options for Baldness Soon Available

SAN FRANCISCO, March 1997

Great strides have been made over the last few years to help men and women who suffer from androgenetic alopecia or hereditary hair thinning. Within the next year there will be at least two additional treatments available. A stronger form of topical minoxidil for both men and women will be available in a 5% solution. The second medication will be finasteride 1 mg, taken as an oral tablet, which was developed to treat male pattern baldness.

Speaking at the American Academy of Dermatology's 55th Annual Meeting in San Francisco, Vera Price, MD, Professor of Dermatology, University of California, San Francisco and Keith Kaufman, MD, Director of Clinical Research for Merck Research Laboratories in New Jersey discussed these latest treatment options.

Dr. Price explained that hair thinning, which can be inherited from either the mother's or father's side of the family, or both, is very familiar in the male. The onset appears in the teens, twenties, or thirties for both men and women. "However, in young women," Dr. Price said, "the diagnosis is often missed and there is sometimes uncertainty how much hormonal evaluation in young women has to be done."

Androgenetic alopecia is due to the increased formation of dihydrotestosterone (DHT) in the affected hair follicles. DHT is the male hormone that interrupts the hair cycle and shortens the growth phase, thereby resulting in the gradual miniaturization of the hair follicle. Women's hair does not become as thin as that of men, and these women never become bald.

Dr. Price with her colleague Marty Sawaya, MD, have conducted studies, showing for the first time, that women with androgenetic alopecia have higher levels of 5 alpha-reductase enzyme (the enzyme required to convert the male hormone testosterone to DHT) in frontal hair follicles compared to occipital follicles. There are, however, marked quantitative differences in the two enzymes, 5 alpha-reductase and aromatase, and also in the androgen receptor in men and women, accounting for the milder expression of hereditary hair thinning in women.

The good news is that the increased concentration of minoxidil, from a 2% to a 5% topical solution, expected to be available within the year, will help both men and women.

For men, there is still another option for treating male pattern baldness -- finasteride 1 mg -- awaiting FDA approval. Dr. Kaufman reported, "Results from two large, multicenter trials, involving over 1,500 men, showed that the drug significantly increased hair growth in a majority of treated men ... we were able to measure changes in hair counts and quantify cosmetic significance to male patients."

Finasteride inhibits the action of the enzyme 5 alpha-reductase, thereby inhibiting the conversion of testosterone to DHT. Dr. Kaufman said, "Finasteride is a unique product because it inhibits a key underlying process responsible for hair loss. The research presented today confirms our initial theory about the etiology of hair loss and validates the treatment approach of inhibiting 5 alpha-reductase." The American Academy of Dermatology is the largest medical society representing physicians who specialize in treating skin, hair, and nail conditions.