The Bald Truth
Americans turn to weaves, rugs, plugs, and drugs to alleviate hair loss, creating a $1.5 billion industry
People with pattern baldness have genes that at a certain point trigger the creation of an enzyme called 5-alpha reductase. When it comes in contact with the testosterone that is typically present in a hair follicle, the enzyme creates an offshoot called dihydrotestosterone (DHT), which causes the follicle to dry up. Each time a new hair sprouts from a root where DHT is present, it grows a little shorter and thinner. In time, the follicle becomes dormant and new hairs stop growing altogether. Where this process occurs on a human scalp is determined by the genes.
Baldness can take a heavy psychological toll. A study last year by David Przybyla of Denison University found that both women and men--those with hair and those without--view bald men as "less physically attractive, less socially skilled, and less socially successful than their counterparts." (One small consolation: The same study found that bald men are assumed to be more intelligent.) Another recent poll revealed that 1 in 4 balding men would happily sacrifice five years of life for a full head of hair.
The search for weapons against baldness began long before Delilah sheared Samson's locks. Nearly 3,500 years ago, Egyptians created a concoction to cure baldness that consisted of fat from lions, crocodiles, geese, and hippopotamuses combined with, among other things, hedgehog prickles, oil, honey, and red ochre. Around 400 B.C., Hippocrates, the father of modern medicine, tried to regrow his own hair by applying sheep urine to his barren scalp. Perhaps because it was assumed any experiment by Hippocrates could do no harm, a similar technique, involving dog urine, was tried in the 18th century.
Only within the last quarter century have modern scientific methods offered even the slightest hope of offsetting the cause of hair loss. This first step came with the heavily publicized drug Rogaine, which became available by prescription in 1988. Sold over the counter as minoxidil since last year, the topical treatment costs about $30 a month and is the only solution that the Food and Drug Administration has judged capable of regrowing hair. The hitch is that it doesn't work for everybody.
Minoxidil was initially developed as an oral medicine to reduce high blood pressure. But in the course of performing a clinical trial in 1971 for Upjohn, researchers noticed that some patients were growing hair on their shoulders, legs, temples, and elsewhere. Several members of the lab team then began rubbing a powder form of minoxidil on their arms each day. Initially, the skin simply became irritated, but after several months they noticed an increase in hair growth. In December 1971, Upjohn filed for a patent for minoxidil as a potential hair-regrowth medication. Seventeen years later, the company received permission from the FDA to sell Rogaine as a prescription drug. Minoxidil also proved effective--and, under the name Loniten, is still available--as a drug for high blood pressure.
Rogaine (which Upjohn originally wanted to call "Regaine," a brand name vetoed by the FDA) is no panacea. The company's own clinical studies find that it produces "meaningful" results in about only one quarter of the men--and 20 percent of the women--who apply it to their scalps twice a day. That's compared with the 11 percent of men and 7 percent of women who had similar results taking only a placebo in the same trial. (Placebo groups in other clinical studies have experienced similar, or even greater, levels of success, leading researchers to conclude that psychology plays an important role in hair growth.) The FDA is now considering whether to approve a stronger, nonprescription version of Rogaine, which the company says can stimulate as much as 46 percent more hair growth in men than today's product.
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