Bald today, hair tomorrow
CMAJ 1997;157:867
© Canadian Medical Association
It may seem like the stuff of advertisements in your TV listings: a drug that really does help balding men grow back some of their hair. But this time the claims are backed by scientific evidence. A double-blind multicentre placebo-controlled trial sponsored by the manufacturer shows that finasteride halts the progression of male-pattern hair loss and often leads to hair growth. Results were presented during a meeting of the American Academy of Dermatology Aug. 1 but have not been published.
Finasteride is widely used to treat benign prostatic hyperplasia. However, according to Dr. David Gratton, associate professor of dermatology at McGill University and one of the study investigators, taking finasteride also results in visible improvement in hair growth.
"We looked at men 18 to 40 years of age who were actively losing hair. At the vertex you could see through to the scalp. After a year of taking finasteride, you couldn't. So it filled in the 'bald spot.' " On the front of the scalp, where the usual "M"-shaped receding hairline occurs, the hair did not fill in as well, Gratton says.
The study was designed to be as objective as possible. Participants' scalps were photographed periodically with a camera that provides a close view, and hairs within a 2.5 cm circle were photographed and meticulously counted. Manufacturer Merck Frosst says that after 1 year 86% of men taking finasteride maintained or increased the number of hairs in the scalp area being observed, whereas 58% of patients taking a placebo lost hair. Furthermore, 48% of the men taking finasteride had increased hair growth, compared with only 7% of men receiving the placebo. Three Canadian centres are involved, with 20 patients enrolled at each site.
Finasteride is not currently approved for treating hair loss, although Merck Frosst is pursuing approval. Gratton says the drug "is probably going to be used in 2 ways: in men who are losing their hair at a young age and want to delay hair loss, and in men with hair transplants who want to grow hair to fill in the space between the transplants. Hair loss is not a disease, but hair is a very important sociologic aspect of people's lives."
He says finasteride appears to have no effect on a normal prostate. However, he believes that it may be useful to conduct prostate-specific antigen testing periodically in men taking finasteride for hair loss until more is known. -- C.J. Brown
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