Of all the numerous groundbreaking developments that have occurred in the hair loss cure research world during the past 3 years, Kythera Biopharmaceuticals and its Setipiprant prostaglandin D₂ (PGD₂) antagonist (inhibiting) product have easily been among the five most exciting developments to look forward to.  For a better understanding of the link between male pattern baldness (MPB) and PGD₂, this 2014 paper from the famous Dr. Luis Garza and Dr. Ashley Nieves is excellent reading as is this 2012 paper from Dr. Luis Garza, Dr. George Cotsarelis and others.  In the simplest of terms, prostaglandin D₂ levels are elevated in balding scalps, and inhibiting PGD₂ could prevent baldness from progressing.  In order to do this, you target the PGD₂-GPR44 pathway (since PGD₂ binds to the GPR44 receptor).

What excited me even more so than the research behind this subject matter is the following 2015 audio interview with Kythera founder and at-the-time CEO Keith Leonard.  When I first heard it, I felt like he really knew what he was talking about, was sincere and was very excited about the “elegant” science (via research from Dr. Cotsarelis and his team at the University of Pennsylvania) behind this product.   Unfortunately, it seems like Mr. Leonard is no longer with Kythera. Moreover, when I checked Kythera’s website today, the pages with a listing of board of directors and management were opening as blank placeholders.  I would not read too much into Mr. Leonard’s departure, as the release of Setipiprant is still at least several years away in a best case scenario. To learn more about Kythera and Setipiprant, read my post from 2015 in its entirety.

Private Clinic Made PGD₂ Inhibition Products to Treat Hair Loss

What made me think about this subject matter this week after several months of forgetting about it was an interesting new article published three days ago coming from India.  Apparently a local clinic named “Hairline International Hair and Skin Clinic” is now offering PGD₂ inhibitor therapy for hair loss.  The article is full of typos, bad science and ads.  Just like my take on the recent development from the Bahamas from a few weeks ago, my immediate reaction is that this Indian clinic’s product is likely to be totally ineffective and a sham. Nevertheless, this development is not surprising at all considering that so many hair loss forum members have been experimenting with similar homemade products for several years now (see links in next section).  So perhaps such a product is not too difficult to manufacture/compound?

Are we about to see more hair loss clinics offer proprietary products that inhibit PGD₂ or is this just a one-time thing that will spread to very few other places?  A decade ago, very few hair loss clinics offered lasers or platelet-rich plasma therapy to treat hair loss, but now both are commonplace worldwide.  Can PGD₂ inhibition therapy follow a similar path?  With PGD₂ therapy, I do wonder how much the patent held by Kythera negatively impacts the chances of other competing proprietary products from hair loss clinics becoming popular and legal, especially in the US?

Homemade (“ghetto”) PGD₂ Inhibition Products to Treat Hair Loss

There is a good chance that Setipiprant will significantly aid patients with androgenetic alopecia.  The only problem is that clinical trials for Setipiprant will not be completed for several years. So not surprisingly, many people on hair loss forums are creating their own versions of Setipiprant/PGD₂ inhibitors and testing them, or purchasing them from oftentimes sketchy vendors. The vast majority seem to have tested these “ghetto” products with no groundbreaking results to report.  However, as is always the case with such experiments, a majority of people are probably not even remotely correct in getting correct ingredients, dosages, vehicles and more.  In any case, I will leave you with some links to the said hair loss forum threads further below.

Also note that I plagiarized the “ghetto” term from “Swisstemples” who I have mentioned on this blog several times before.  He has what seems to be an excellent page on his site regarding “The Postaglandin Protocol.”  He also has a page on things to buy and use (where he uses the term “ghetto protocol” that includes some products to combat PGD₂.  I do not take any responsibility if you do what he suggests and get nasty side effects.  I would never try any of this myself unless I had a really good chemist friend.

Note that people use various essentially synonymous terms for the products that they are trying in some of the below links, including “PGD₂ receptor antagonist”, “PGD₂ blocker”, “PGD₂-GPR-44 receptor antagonist” and “CRTH2 receptor antagonist”.

— Update: Dr. Cotsarelis and Dr. Washenik are to present on this very subject matter on May 15th, 2016.

— An excellent poster from the 9th Congress for Hair Research last year  (thanks “Hellouser”) can be found here –> “CRTH2/DP2 Antagonists Reverse Hair Growth Inhibition Caused by PGD₂.” Main authors are Cotsarelis, Hsieh, Nace and Zheng.

— 51 page and growing HLT thread titled “dedicated Setipiprant log.”  Seem to be overall negative results, but I have only read 3-4 of those pages.

— BTT thread on homemade  PGD₂ inhibitors.

— HLT thread on whether anyone is still on PGD₂ blockers?

— HLH thread on OC000459, a CRTH2 antagonist.  Also see Oxagen.

— Ramatroban (a PGD₂ receptor antagonist) that many people seem to have purchased from iron-dragon.  I have no idea about safety and legality issues.

— Note that Kane from China was offering his version of Setipiprant in the past, but I do not know the current status.

— Seems of interest regarding CRTH2.

— PGD₂ Regimen — Cetirizine + Water.

— An interesting recent HLT thread on CRISPR type gene therapy to fix the three single nucleotide polymorphisms (SNPs)  — rs545659, rs634681, and rs7167 — that have been found to be responsible for this PGD₂ sensitivity.

— Resvertarol and PGD₂?  Not sure about this one.

— Quercetin and PGD₂  video.  Not sure about this one either, but many other hair loss forum posts on this subject.

There have been a number of important developments in the platelet-rich plasma world during the past several months, warranting a new post on the subject.

— In late March, the famous patient advocate Joe Tillman published a very interesting video on his first ever PRP treatment with Dr. Jerry Cooley.  Joe told me that he will give us an update on his results in the near future.  Here is his first highly instructive video (I love the centrifuge part):

— In the April issue of Dermatologic Surgery, a new favorable study from Spain on PRP treatment for hair loss was published.  It seems like no ACell was added into the mix.  I did not find the full study  via Google Scholar, but the abstract concludes that “PRP showed a positive effect on AGA and could be regarded as an adjuvant therapy for AGA.”  I still do not think that PRP will usually grow new hair (as has also been verified by some hair transplant surgeons), but it can often prevent baldness from progressing as rapidly, and it can without a doubt make existing hair thicker.  Why do I say this? Because at this point I have seen favorable studies from way too many countries to dismiss this oftentimes still controversial subject. Make sure to see a list of these studies in my 2014 post on how well PRP works, which I update whenever I see new studies.

— Dr. Jeffry Rapaport has a knack for frequently appearing in various respected US TV shows. The below video is from just a few days ago. Unlike many other US physicians who just go on TV for publicity, I feel like Dr. Rapaport comes across as much more sincere. Moreover, he only charges $500 per PRP treatment. Much more ethical than physicians who often charge over $2,000 for a treatment that is far from guaranteed to work.

— Renowned hair transplant surgeon Dr. John Cole regularly introduces his own esoteric and unique takes on various newer hair loss treatments.  PRP is no exception, as you can see in this past post of mine (see initial blue text in there).  Now, someone on the BTT forums has started a thread regarding Dr. Cole offering a new version of PRP to treat to treat hair loss, via “lysing the platelets to release growth factors.”

— Finally, although not related to hair loss, today it was confirmed that the currently injured NBA MVP Stephen Curry got PRP treatment on his right knee in order to try to speed up recovery. Kobe Bryant did the same thing in the past.  As more superstar athletes get PRP treatment, it can indirectly benefit hair loss sufferers via more research money flowing into this field.

In early April 2016, the renowned Dr. Takashi Tsuji from Japan was yet again involved in groundbreaking new hair (and skin) related research.  On April 3, I e-mailed him the following, hoping that he would grant my request for an interview:

Hello Dr. Tsuji,

I recently covered your two new partnerships (with Meiji Seika and with Adjuvant Cosmetics) as well as your paper regarding bioengineered skin.

Is there any way you would be willing to do an interview with me for my blog?

Admin

His almost immediate response:

Dear Admin,

Thank you so much for your interests to our study.

We collaborate with Adjuvant cosmetics to study on the development of a novel hair promoting agents by using our developed screening system. The collaboration with Meiji Seika pharma and other companies plan to develop a novel bioengineered skin in vitro with skin appendages including hair follicle and sebaceous gland. This bio-skin will contribute the developments to cosmetics, quasi drugs and anti-allergic agents.

Unfortunately, I would like to answer only by e-mail.

Thank you for your contact.

Sincerely,

Takashi

I was surprised that he replied (and mentioned both the companies that I mentioned in my e-mail), since he must have been extremely busy being bombarded with interview requests from around the world so soon after his latest groundbreaking paper was published. It also seemed like the ending of his above e-mail response implied that he would be willing to grant me an e-mail interview.  So I sent him a list of detailed questions. Unfortunately this time, no luck:-(  Dr. Tsuji sent me a generic reply that he was sending to all journalists (I do not blame him at all of course). Below is his reply and the pasted contents of his attachment for journalists.

His second response:

Dear Admin,

Thank you for your contact regarding our recent work.

I am grateful that you have great interests to our recent bioengineered skin study. Unfortunately, I enclosed FAQ, which was asked from many reporters in world-wide. I also enclosed the figure, which demonstrated successful transplantation of the bioengineered 3D integumentary system derived from GFP-expressed iPS cells. Green fluorescence indicates the bioengineered skin including iPS-derived hair shafts.

Regards,

Takashi

Here is the FAQ document from Dr. Takashi Tsuji.

Lots of interesting information in there and hopefully you can download it ok (should be in Word format).

The image below that he included is of “bioengineered skin with iPS-derived hair shafts”:

I was not planning to write a new post for several more days, but there have been two important developments that I thought were worth discussing separately from my upcoming “brief items of interest” once a month post.  I will update this post in more detail later today with my own thoughts if necessary (1:30 am here right now!), but for now, here are the main developments so as to let people comment about them here rather in my prior blog post on Dr. Tsuji.

•  First, Histogen has finally published a summary of its presentation at the recent Stem Cell Summit in Boston that I discussed in my last “brief items of interest post” from April. After reading blog reader “Sam”‘s comment in the last post that he got a response from Histogen, I also e-mailed them.  They sent me a pdf of their presentation that was made by CEO Dr. Gail Naughton: Histogen’s Presentation at the  5th Stem Cell Product Development and Commercialization Conference in Boston on April 27th, 2016.

• Second, if you recall, a month ago I wrote a post on Follica’s surprising return from being taken as almost dead by many people.  That post happened due to HLT forum member Xaser94’s great research, which he outlined in his now very popular thread.  Several days ago, forum member “Noisette” made an interesting post in that same thread (see page 8) with a link to a 271 page (!) propectus document from PureTech Health (majority owner of Follica) from June 2015.  There is a goldmine of information in there with some superb images.  The main Follica section starts on page 101.   Encouraging quote:  “Through the administration of Follica’s procedure by a trained clinician and use of its at home  ‘‘connected’’ device (meaning it is coupled with a digital service such as a companion smartphone application) the company seeks, in the near-term, to significantly improve the treatment expectations and satisfaction of hair loss patients by providing a more effective alternative to current FDA-approved drugs.“

I also want to give kudos to Mike, who e-mailed me some useful information on this development (this is the same Mike that I discussed in my Follica post from a month ago).  This time, I will just paste part of Mike’s e-mail:

“This section stands out – and there are many standouts – 

Follica’s patented platform employs a technique called targeted cutaneous perturbation (or TCP) to stimulate the growth of new follicles, followed by treatment with: (i) select, approved drugs indicated to be synergistic in maximising the quantity, quality and persistence of new hair, or in other cases (ii) new chemical entities that modulate pathways involved in the development of the hair follicle.

It’s the new chemical entities that interests me – could there be a treatment and then an upgrade treatment further down the line. A partnership with another company perhaps – maybe one that’s related to a certain Neal Walker?”

In seems like in the past month, most of my posts have been heavily influenced by commentators on this blog, e-mailers, hair loss forum posters and even one hair loss chat participant on this site!  The last mentioned is surprising, since most of the chat on this site often gets filled with garbage that I have to delete, or gets filled with childish but somewhat relevant messages pertaining to hair loss.  I am considering upgrading the chat via paying for a plugin that might require logins, but I am not sure yet.

Someone from Histogen e-mailed me yesterday after reading the reader comments to my last post.  I will not post this person’s name, exact job title or e-mail address here since some of this blog’s readers are nutjobs who will probably stalk the said person!  The e-mail contents, however, are important and pasted below:

Dear Admin,

Thank you for mentioning Histogen and HSC on your hair loss blog. We appreciate your consideration of our product.  I visited your blog today and noticed that there was some confusion about the trial photos included in Dr. Gail Naughton’s Stem Cell Summit presentation.  I was hoping to clear this up with you and that you could disseminate the information to your readers.

3 clinical studies of HSC have been completed: a Pilot study, Phase I/II study, and a Physician Sponsored study with Dr. Ziering.  As some of your readers pointed out, the photos from the Pilot study are from 2009.  However, the photos from Phase I/II and Dr. Ziering’s study are more recent.  In fact some of the photos from Dr. Ziering’s study were introduced for the first time at the 2016 Stem Cell Summit in Boston.  Histogen continues to be focused on developing this revolutionary new treatment and looks forward to beginning the next stages of clinical trials.

Best Regards.

It would be great if readers who post comments to this blog post maintain some civility in case this Histogen employee who e-mailed me comes back to read the comments.  Pertinent questions might get answered if we are lucky.

Hair loss news first:

There have been a huge amount of hair loss related news items of interest in the past month.  Several of them probably deserved their own blog posts.

— Since quite a few of the reader comments to my past few posts have mentioned Kerastem, I will start of with Christopher1’s thread on hairsite regarding his Kerastem treatment in Switzerland.  He had the treatment in early February of this year for $8,000.  Unlike his well covered failed experiment with topical JAK inhibitor tofactinib, this time he went to a professional clinic (more reliable in my opinion) to get the Kerastem treatment.  Per his latest post from three days ago (which has surprisingly still not received any replies), he has good news to share and I quote:  “After having brought you some bad news about my Jak inhibitor trial, I finally have some good news for you. It’s not great, but it’s very good.  My hair has stopped falling out. It stopped about three weeks ago, which was a bit over 2 months after my Kerastem treatment.”  Note that this is only one data point and there has been no regrowth and we do not know how long this cessation in hair loss will last.  The rest of his post indicates that this is the first time in 15 years that his hair has stopped falling out.  I find Chrisopher1 to be a highly reliable and sincere person, or else I would not mention him to start off a blog post.

— I did not realize that GSK was launching Dutasteride in Japan via the brand name Zagallo (to treat male pattern hair loss) and that this plan was delayed in late 2015.  I did, however, cover the favorable Japanese clinical trial results last year that are mentioned in that first link.  Now comes word that Catalent’s French plant has been cleared to restart production.  So there is a very high chance that Dutasteride will finally be approved to treat hair loss in 2016 (Edit: in fact it might have already been approved for hair loss treatment in Japan on September 28th 2015 per the details in the first link in this paragraph), one year later than I was hoping.  It would be the third ever drug to be approved to treat hair loss, almost 20 years after the second one (Finasteride/Propecia) was approved and almost 30 years after the first one (Minoxidil/Rogaine) was approved.  Make sure to read the Dutasteride testimonials post and related comments.  FYI — If you are worried about Finasteride (Propecia) side effects, do not even consider taking Dutasteride. The side effects from the latter are guaranteed to be worse for most people.

— Scientists at NYU Langone Medical Center in New York recently found the molecular pathways responsible for creating the color of skin and hair.  They found that a signaling pathway known as Edn/EdnrB interacts with other pathways (in particular, with the Wnt signaling pathway), which in turn causes the proliferation of melanocyte stem cells (McSCs) that are involved in the earliest stages of skin and hair pigmentation.  This suggests that targeting Edn/EdnrB signaling in McSCs can be a therapeutic approach to promote hair pigmentation retention.

— A new paper from China titled “Wnt/β-catenin signaling pathway activates melanocyte stem cells in vitro and in vivo.”  Research was done in mice.

— An update on research at Japan’s Yokohama University under the leadership of Dr. Junji Fukuda.  Translation required, and yes, it is in mice only for now.  Short interview with Dr. Fukuda in there that is partially lost in translation.  Thanks yet again to our wonderful Japanese blog reader and commentator “nosyu” who updates me regularly about developments in Japan that are not covered by the English media.  The Fukuda Lab lists hair regrowth as one of its key areas of research.

— Update on Thorn Medical’s further plans in the Bahamas.

— Topical methyl vanillate (a plant derived natural ingredient) increases hair count and hair mass index by inducing Wnt10b mRNA expression in the scalp.  According to the study, methyl vanillate has recently been shown to activate the Wnt/β-catenin signaling pathway, which has become a key target in the treatment of androgenic alopecia by numerous researchers in recent years.

— New drug BMD-2341 to target androgenic alopecia being developed by US-based BiologicsMD.  Although the company had a press release about this in July 2015, it was only brought to my attention via this recent summary by the Follicle Thought blog.  Yet again, we see a product that is targeting the beta-catenin pathway.

— I was not planning to cover this public relations type piece on Dr. James Harris, but I liked the ending: “And when Harris predicts the future of his profession, he sees stem cells and growth factors – not plucking and planting.”

— More good publicity for Samumed and its CEO Osman Kibar.

— I am always impressed by hair loss sufferers who go through impressive regimens and post regular updates.  The latest example is “westonci” on HLT who is supposedly going through the whole of SwissTemple’s prostaglandin protocol that I have mentioned on this blog several times before.

— For those in the United Kingdom, Dr. Steven Edgar is now prescribing topical Finasteride in the UK (his e-mail address is in that thread).

— An interesting new hair product from a company named “Reason to Believe” will soon be produced in North Carolina, based on the Alpha Keratin 60ku patent.  Hard to tell how good this product will be and how long it will last (I doubt it is permanent).

— Can protein shakes lead to hair loss?

— “Baldy Viking” has some videos on dermaroller and onion juice!  I just saw only part of one of those…seems interesting and not entirely crazy.  I have become more of a believer in natural treatments for hair loss having at least some minor benefit.

— An interesting story of an Irish woman’s battle with alopecia cicatricial related hair loss since age 21.

— Yet one more distraction for Dr. George Cotsarelis.

— In celebrity news, Rosie O’Donnell discusses her hair loss; it seems like golfer Jordan Speith may have had a hair transplant; and Charles Barkley has asked basketball superstar Lebron James to stop painting on his hair.  Search this blog for my past mentions of Lebron James if you are interested in this kind of news.

And now on to medical items of interest:

— CRISPR breakthrough is most clever yet, and increasingly relevant to humans.

— Scientist turn skin cells into heart cells and brain cells just using drugs.

— Regenerating brains of the dead.  A more interesting take from my favorite Daily Mail.

— Japan OK’s gene editing of eggs.  As long-time blog readers know, the Japanese have already fast tracked clinical trials for newer regenerative medicine and stem cell treatments, and earlier in this post I mentioned that Japan could be the first country to approve Dutasteride for hair loss treatment.  Everything is moving along fast over there and I am glad that we have both Shiseido and Dr. Takashi Tsuji based in that country.

— As expected, the first ever penis transplant in the US got widespread global news coverage yesterday.  I first heard about it via the radio in my car yesterday, then via a text message from a friend (wonder why?), and then again today via my yahoo homepage. Bill Gates must be horrified at global priorities.

— Now just imagine if this really happens in 2017?  I doubt it, but it would be absolutely ridiculous if that came to fruition before a hair loss cure.

— Alzheimer’s cure getting closer:

— Five-year update on face transplant recipient.

— MIT scientists and others create an artificial second skin:

— Histogen is also involved in skin care products via its growth factor technology in case people forgot.  Here is an update.

— Doubling lifespan of embryos in petri dishes.

— Maybe vitamin supplements are useful after all?

— Biohacking in Brooklyn.

— I am a bit skeptical about Liz Parrish and Bioviva, but since I have mentioned her a few times before, here is an update and some reddit comments on the subject.  I posted some of her videos on this blog before, and here is one more from January.

— Rapamycin and more to make your dogs live forever.

On this blog, while I have mentioned gene therapy and gene modification a few times in the past (especially when it comes to the now ubiquitous CRISPR/Cas9 genome editing method), I have hardly discussed its application towards a cure for hair loss.  The main reason has been due to my feeling that a genetic modification based cure for hair loss in adults is still a long way away (but perhaps not that far off when it comes to embryos).  This feeling is shared by virtually all hair loss forum members that have shared an opinion about this issue.  It also seems like more than a few genes could be involved in balding (e.g., see the excellent diagram in this recent research, which shows two of those genes — GRID1 and AR/EDA2R — and I suspect there will be more).  It should be noted that if certain national governments turn a blind eye towards experimental genetic therapy treatments, we could see faster results.

Moreover, one would have to be absolutely insane or exceedingly depressed by hair loss if one takes such a severe step such as gene therapy in tackling one’s hair loss problem.  I would not want to modify my genes to cure hair loss until it has been done safely on other adults for at least 10 years with no unforeseen side effects. Even then I might never go through with it, although of course this is all a moot point, since there will be a non-genetic cure for hair loss by the end of 2020 in my opinion:-)

Dr. Chunyu Han, NgAgo and Hair Loss

In any event, recently some important news came out of China regarding a genome-editing treatment for hair loss, and the work seems very reliable.  A 42-year old scientist by the name of Dr. Chunyu Han from Hebei University of Science and Technology made this discovery.  The most interesting thing is that this scientist discovered and is using a technique called Natronobacterium gregoryi Argonaute (NgAgo) that could end up being even better than CRISPR!  For more, read “whether NgAgo could challenge CRISPR.”  NgAgo is a DNA-guided genome editing technique, whereas the mainstream CRISPR technique involves RNA-guided genome editing.  Dr. Han’s original paper on this work was presented at MIT and has subsequently led to a great deal of excitement in the scientific community.

Interestingly, one of the co-inventors of the CRISPR technology is also a Chinese-born scientist by the name of Dr. Feng Zhang.  Also make sure to read my section on China and see the accompanying video under the medical items of interest portion of of this post from earlier this year.

Going back to the above article, the following quote from Dr. Han is very encouraging:

With this technique, middle-aged men with bald heads can probably regain their hair through genetic repair.

That is huge.  We all know how difficult it is to recover long-lost hair. Yet this respected scientist whose work is now being discussed in detail at universities such as MIT suggests that his solution will be very simple.  It should be noted that Dr. Han also states the following:

Although the science is currently futuristic.

Miscellaneous Notes

I cannot believe that an esteemed scientist such as Dr. Han is discussing how his new gene modification technique could cure hair loss.  It is close to impossible that the main scientists behind CRISPR or any other such breakthrough technologies in the western world would ever focus significant time on a cosmetic problem (in fact people would start to doubt there credibility if they shifted focus aways from diseases to cosmetic problems).

Even more surprising, Dr. Han is not losing his hair, so does not have a personal interest in the subject as is the case with someone such as Dr. Angela Christiano.  Of course I am not complaining about this.  It is very pleasing that a renowned scientist is focusing global media attention on hair loss.

It is also wonderful news that Dr. Han’s NgAgo discovery could reduce the significance of the patent controversy (and even worse, a potential patent monopoly) that the western world has become obsessed with when it comes to CRISPR.  Also see this 2014 article on the original controversy.

According to the original article about Dr. Han that I linked at the top of this post:

“To cut costs he and his team had to use discarded beverage bottles in the laboratory and struggled under a debt of more than 300,000 yuan ($45,870).“

When it come to the subject of JAK inhibitors and androgenic alopecia, commentator “nasa_rs” is always ahead of the curve and keeps adding tremendous value to this blog for which I am grateful. My taking time off my regular daytime work and writing this post is due to his comments from earlier today to my last blog post.

Just a few hours ago, it was announced that Aclaris Therpeutics had raised around $20 million from a private stock sale.  Main item of interest:

Net proceeds from this offering are expected to be used to fund research and development, including new JAK inhibitor programs for androgenetic alopecia (also known as male or female pattern baldness) and vitiligo, as well as ongoing business development.

— One more article on this development.

If you have not done so already, you should do a search on “JAK inhibitors” in this blog and read all the past posts on the subject.  The two biggest news stories of the year in 2014 both entailed different JAK inhibitors curing alopecia areata (which is a type of patchy scalp hair loss that affects <5 percent of people).  Ever since then, we have had some conflicting opinions from experts on whether JAK inhibitors will also cure androgenic alopecia, by far the most common (>95 percent) form of baldness.  The two leading researchers in this field, Dr. Brett King and Dr. Angela Christiano, have both been somewhat optimistic about this potential. Moreover, my recent post from March provides further reason for optimism.  It says a lot about my obsessiveness or whatever you want to call it that I got so much joy in bolding the text “androgenic alopecia” in that March post, and now again in this post.

In any event, I am still 50/50 about the potential for JAK inhibitors to cure androgenic alopecia.  However, raising $20 million in one go is no joke in the hair loss industry, especially since there is no evidence provided by Aclaris as yet that JAK inhibitors can really cure male pattern hair loss (I am even unsure if they can consistently cure/reverse vitiligo).

Several years ago, when Histogen raised $10 million (for a technology that they had already proven with many years of research behind it), it was touted to be a big deal.

This is a much bigger deal.

Further reading: Mr. Neal Walker, CEO of Aclaris Therapeutics.

Note: Voting buttons are at the bottom of this post below the photo.  Be careful before clicking.  Can’t change your choice.

This year, I plan to conduct some polls on this blog. I also plan to cover topics such as hair transplants and hairpieces more frequently. For many people, these options are almost as good as a hair loss cure and I have received a few requests for more posts on such subjects. As always, if you do not like a post, just comment on other ones instead.  Women should vote too in spite of the below male image.  I think far more women wear fake hair than do men.

Within the world of 3D printing, by far the most exciting developments to look forward to are those involving 3D printing of human body parts (more accurately known as 3D bioprinting).  Even after reading about this for a few years now and watching many videos on the subject, it still seems like science fiction to me. However, this is definitely not fiction, and the basic technology has already existed and been used in people for over a decade.  Dr. Anthony Atala (a pioneer in this field who I have mentioned a few times on this blog before) has two extremely popular TED Talk videos on this subject from 2010 and 2011  that you can view if you scroll to the bottom of this page.  Dr. Atala’s work was also well covered in this article from just a few months ago.

Much of the work entailing 3D printing of organs thus far involves a combination of printing cells plus biomaterials.  When it comes to 3D printing of hair follicles, all the work thus far seems to focus on the use of synthetic materials rather than actual cells, although I am not certain about this biology behind this. We are still not close to being able to implant such 3D printed hair into the scalp as far as I can tell.  Nevertheless, this subject is still fascinating.  Here is a video from last last year on this subject along with this article that I posted on this blog before.  In the past several months, two news items on 3D printed hair caught my eye.

MIT Media Group’s Cillia: 3D Printed Hair

The first of these was not widely covered, but since it involves researchers from MIT, I give it precedence.  These scientists are part of the MIT Tangible Media Group, led by Dr. Hiroshi Ishii, and their project is called Cillia.  Note that they do not discuss the human scalp whatsoever, and they are using bitmap technology to print this hair rather than any kind of actual cells.  For the scientists among you, Dr. Ishii and his team’s paper on this subject is probably extremely interesting.  I only glanced through it due to time constraints.

The futurism website has a much more detailed article on the subject, although I laughed when I read this quote:

“While there are a number of potential aesthetic purposes, customized paint brushes or strong adhesive surfaces might be at the top of people’s lists on what 3D printed hair could be used for.”

I would guess the exact opposite.  The aesthetic purposes will be far more important from a commercial perspective.  Or maybe I am just underestimating the market for paint brushes and adhesive surfaces?

Cesare Ragazzi

Italian company Cesare Ragazzi Laboratories has received tremendous publicity over the past several months, even thought its technology was already shown in a 2014 video on the company’s youtube channel:

Perhaps they have since improved upon their methodology even further?  In any case, here is a NY Daily News article from March where I first read about the company.  Their work was even covered on 3dprint.com earlier this year.  The company’s technology is essentially an attempt at making a much better wig/hairpiece/hair system/toupee than anything that is in existence today, with far less expensive and less frequent maintenance requirements, plus a better individualized fit (scalp mapping).  The technology is based on CNC systems that are being sold around the world by Cesare Ragazzi.

Did I just mention hair systems/hair pieces in a second consecutive post?  What is happening to this blog?!

On very rare occasions on this blog, I cover scientific/medical subjects that are either:

a) Entirely unrelated to a hair loss cure, or

b) Potentially related to a hair loss cure in the long run, but this is just happenstance and not the reason behind my original intention in covering the said subject.

This post falls under the second category.

Dr. George Church

I have discussed Dr. George Church a few times on this blog before. In my opinion, there is a good possibility that he will be known as one of the 10-20 greatest scientists the world has ever seen when all is said and done.  Interestingly enough, Dr. Church got an F on one of his graduate program college courses at Duke University in 1976, and it is funny that he has posted that letter of rejection from Duke on his current Harvard University website.  Talking about his site, it is well worth  going through this part of it in great detail.  Dr. Church was adopted as a child.  In his own words, he has had “early-onset health problems (insurance companies take note): heart attack, carcinoma, narcolepsy, dyslexia, pneumonia, motion sickness.”

Several days ago, a new interview (more like a speech) of Dr. Church was posted on youtube, and I was very impressed by the range of subjects that Dr. Church covers in this video.  The title of this video is “The Augmented Human Being.”  Hopefully, this augmentation will imply a full head of hair for all, even though that is  probably the last thing that Dr. Church is thinking of when he discusses things such as CRISPR and genetic therapy in the video.

It is quite amazing that the above video only had a little under 500 views when I embedded it in this post, despite being online for two days.  In sharp contrast, the one week old murdered gorilla video now has close to 11 million views.  Dr. Church will bring back that gorilla to life just like he will the extinct woolly mammoth.

Dr. Church is currently 61 years old, but from the looks of it, I doubt that he will retire any time soon despite his health problems.  He is a workaholic.

During the past few months Dr. Church has been all over the news almost every single day.  Some highlights:

• He is leading the way in starting work (and discussing the dangers with world leaders) that will one day result in synthetically creating the full human genome from scratch.
• He is working to cure aging.
• One of his companies named Veritas became the first one to offer whole human genome sequencing for under $1,000.
• He is one of leading figures behind research that may one day finally end human organ transplant shortages, courtesy of the pig.

Aldous Huxley increasingly looks like a genius.

On this blog, I have in the past discussed various dermatological associations and non-profits, including several important ones in the United States such as the American Academy of Dermatology (AAD) and Advancing Innovation in Dermatology (AID).  A third one called the Society for Investigative Dermatology (SID) recently had its 75th annual meeting on May 11th, 2016.

On SID’s youtube channel, you can find a number of the video presentations from this meeting, including a few that discuss hair in at least part of the presentation.  On SID’s website they have a summary list of presentations that includes quite a few involving hair, but none of those videos seem to be available as yet.  Hopefully they will make more of them publicly available soon assuming they videotaped all the presentations.

For now, the most relevant video when it comes to our cause is a presentation by Dr. Michael Rendl that I have embedded below.  On this blog, I have discussed Dr. Rendl’s work several times in the past, including in this post about his Rendl lab.  The below video is highly interesting, especially when it comes to the crucial dermal papilla cell and its induction of hair growth.  I did not realize how complicated this process is and how researchers still have so many uncertainties about the various signals, transcription factors, pathways and processes that lead to the dermal papilla inducing hair growth.

The parts on gene expression, RNA deep-sequencing and CRISPR-mediated genome editing are also very interesting, especially since CRISPR has been in the news so much in the past year (and it now seems inevitable that adult humans will be able to have their genes edited in the future).  A lot of the content is very technical and way above my head.

Kudos to Dr. Rendl for creating the hair-GEL (gene expression library) website for sharing this crucial information with everyone for free.

It is too bad that Dr. Rendl is totally bald and seems to be very comfortable with that look.  I would have preferred it if he had a combover or hairpiece that would suggest much more of a personal interest in this subject matter (as we have seen with Dr. Angela Christiano, who wears a wig fit for a queen).

Update: Listening to the webcast again (yes it is still available), Dr. Neal Walker clearly states that while systemic JAK inhibitors did not work for androgenetic alopecia, topical JAK inhibitors did work for androgenetic alopecia (and not just for alopecia areata)!  This is huge.  Thanks to commentator “Bob Ross’s Hair” for typing out the exact quote below for us:

“We will be developing a topical JAK inhibitor for androgenetic alopecia, and the data on that is quite interesting in that they found that the systemic JAK inhibitor does not work for that particular indication, but the topical does, mainly as a function of the target being more superficial in the skin and not really accessible from a systemic circulation.”

The important Jefferies 2016 Healthcare Conference is going on in New York City as I am writing this post.  It started five minutes ago (12pm EST — aka NYC — time).  The CEO of Aclaris Therapeutics, Dr. Neal Walker, is presenting.  You can view it live via registering here.  Or from here.

The best part is that 19 slides are already available to view at the top of the ongoing webcast, and Dr. Walker just mentioned that they are now more confident about JAK inhibiters and will be developing a topical version for androgenic alopecia!!  One more small leap for “nasa_rs”,  but will it finally translate into one giant leap for mankind?

Slide numbers 16 and 17 mention androgenic alopecia.  The key March 2016 acquisition of and partnership with Dr. Angela Christiano’s Vixen Pharmaceuticals (Columbia University IP) is what seems to have spurred the optimism behind developing and testing topical JAK inhibitors on androgenic alopecia patients.  Slide 16 also mentions that they are working on next generation JAK inhibitors called “covalently bound highly selective JAK3 inhibitors.”

Note that those slides and the audio webcast presentation are both supposed to soon be available on Aclaris’ website, but will only remain there for several weeks.

I was debating on writing this blog post, but the number of comments to the last post has become a bit insane and it is better to have some of the more intelligent discussions taking place in this post’s comments rather than continuing over there where it has become hard to find things.  For this post I will delete many of the one-line comments that entail repetitive whining, insults, sarcasm or totally unrelated material.  In the next post the garbage will be tolerated again.

My notes to the developments in the last post:

• I am now raising my estimate of Janus kinase inhibitors (JAK inhibitors) being at least a partial cure for androgenic alopecia (aka androgenetic alopecia aka AGA aka male pattern baldness aka MPB) versus not being a cure from 50/50 to 60/40.  I say “partial” cure because even for alopecia areata (AA) sufferers, JAK inhibitors do not seem to work for everyone.  So there is a good chance that we will see the same for AGA patients in the event that JAKs do work for AGA.  As I have said before, my gut instinct is that for those who have a lot of itching and dandruff associated with their balding, JAK inhibitors are more likely to work than for those who have hair loss without any of those symptoms.  Note that you should not really read too much into my own amateur estimates or untested theories, but I mention them here because so many commentators have asked me about my opinion, especially regarding the 50/50 estimate.

• In the comments to the last post as well as in the various hair loss forums, a small minority of people have been very pessimistic about this news.  Some have raised valid points of concern. However, some do not even seem to think that Aclaris will test JAK inhibitors on humans, even though the company clearly had two slides in their presentation saying that they will do so. Therefore, even in the most pessimistic scenario, the company will be testing these drugs on humans with AGA.  In my opinion, there is a very high chance that Dr Angela Christiano (and Dr. Brett King) have already tested them on patients with AGA. After all, both doctors tested these drugs on AA patients (and vitiligo patients in the case of Dr. King) in the past without letting us know in advance.  Heck Dr. King could even have tried it on himself for his own AGA.  As an aside, it bears repeating Dr. King’s comment in his interview: “It’s hopeful…it’s beyond hopeful.“

• Dr. Neal Walker talked about the two new areas in which they will be testing JAK inhibitors in humans: AGA and vitiligo.   To me, that almost sounds like he is implying that he is equally hopeful about the chances for each of those conditions in humans being successfully treated with JAK inhibitors. Perhaps I am reading too much there, but in any case, we already know that JAK inhibitors work for treating vitilgo in humans, courtesy of Dr. Brett King.

• Do not listen to Dr. George Cotsarelis when it comes to his skepticism about JAK inhibitors (see his comments in the CNN article linked in my post from 2014).  For one, he has been involved with numerous competing technologies, companies and patents over the past two decades.  Perhaps he has good scientific reason for his skepticism, but it is also human nature to favor your own work, especially when your work has entailed your whole career. If today someone suggested that a new car powering technology is far superior to electric, I would expect immediate reflexive skepticism from Elon Musk.

• One funny thing that I recently noticed is that even though Dr. Cotsarelis claimed that the immune system is not involved in MPB per his 2014 CNN article quotes, in Follica’s latest presentation (courtesy of the same Jefferies Conference via PureTech’s Daphne Zohar), they clearly classify androgenic alopecia as part of an “immune system” related problem.  This is strange, since Dr. Cotsarelis has been involved with Follica for many years.

• For that matter, do not base your decisions and optimism or pessimism on what people such as myself, commentator Matt, nasa_rs, and the many intelligent hair loss members out there state.  Most people have some bias, and every single person that you listen to on the internet has no idea what Dr. Christiano, Dr. King, and now Alcaris Therapeutics’ scientists are up to in their labs.  It is amazing how many times I keep getting asked whether I still think a cure will be here by 2020, whether I think JAKs will work, whether I think their are conspiracies in the hair loss world etc…I will only know for sure once I have access to insect-sized and insect-lookalike drones that I can use to spy on the various labs that are working on a cure for hair loss!  Till then, my posts and comments will only give you my guesstimates and nothing more.

• Despite my great optimism, I still see some negatives, including the fact that JAK inhibitor treatment will remain expensive (even if prices go down significantly as I expect), and clinical trials will take a few years.  However, regarding the latter,  there is a remote possibility that the companies can find ways to speed up the trial process due to the fact that JAK inhibitors already treat so many medical conditions as well as alopecia areata.  At the moment, it does not seem like JAK inhibitors are causing cancer in anyone, and they have probably been used in many people for at least 10 years. Ruxolitinib was first approved for human use in 2011, and Tofacitinib was approved in 2012.  Both were probably tested on humans for at least around five years prior to approval. There are many other JAK inhibitor “-tinibs” out there that may be approved soon.

Longtime JAK Superfan “nasa_rs” and his Blast from the Past

About one week ago, nasa_rs asked me to find an important link to a relatively old study that he had posted in one of his past comments on this blog.  I found the link (it was in my Elon Musk post and I even replied to it at the time) and was excited to read the contents of the study, which was published back in 1994.  Not sure why I never mentioned that great find before.  In any case here it is.  The key quote:

The hair growth stimulating effect of CsA is observed not only in normal but also in pathological conditions of hair growth, i.e. in patients with alopecia areata and also in some patients with male-pattern alopecia.

Clear evidence that immune system suppressants help hair. However, I am not sure how closely cyclosporin A and FK506 are linked to JAK inhibitors.  Also, later on in the abstract they mention that topical application of FK506 induces hair growth in mice, but oral ingestion does not.  A similar situation as with JAK inhibitors so more good news. However, in the abstract they do suggest that this means that the hair growth effects of FK506 may not be related to immune suppression, since oral ingestion does not help hair growth. Topical application might be impacting some other mechanism that is not well elucidated as yet per the study authors.

FYI — This was supposed to be my big blog post last week, but I first postponed it because I had delayed discussing the Dr. Rendl presentation for too long and needed to do that, and then of course I had to postpone it again due to the excellent new development discussed in the last post.  Matt and nasa_rs had some discussion about the above study in the comments to the last post, but perhaps they can do that in this post now.

“Matt” (aka “matt”)

When I first started this blog, I was hoping there would be at least a few very intelligent (at least when it comes to biology and chemistry) people who post accurate highly technical comments on here every so often so as to overcome my own shortcoming as well as laziness in reading up in that area.  I think user “Matt” is now the go to guy for that purpose, and we are all grateful to have him on board as can be inferred from the numerous appreciative comments that he has received in the comments to the last post.  I find it funny that so many people who are appreciative of him (including myself) probably do not even understand half of what he writes.  However, my intuition tells me that what he is writing is accurate and grounded in legitimate science.  I would encourage people to go through all his comments in the last post (you can search via ctrl-f to find his name on each page of comments).  Matt, you can repeat (i.e. paste) some of your most useful comments to the last post within this post’s comments if you want since most people will not want to search through those 500 comments.  One of these days, I hope I will have time to go through your most important comments in extreme detail.  FYI — “Matt” also goes by “matt”, and there was another commentator who briefly used the same name before my asking him to change it.

One of the interesting things that Matt wrote caught my eye:

“It sure looks like jak/stat signaling has a ton to do with all of hair biology (really, all of biology in general) not just AA.”

This is clear, just based on the number of conditions that the -inib drugs are already approved to treat or pending approval to treat. Moreover, there are many studies out there that suggest totally unexpected benefits of JAK inhibitors and the JAK-STAT signaling pathway (e.g., white-to-brown fat cell conversion).

Hair loss news first:

Very busy past month in the hair loss world.

— Allergan starts phase 2A clinical trials for Setipiprant this month.  Study completion date is set as September 2017.  They are going to be recruiting all over the US for volunteers.

— I am disappointed that in my last blog post, despite over 350 comments, there was essentially zero discussion of the two most salient points that I made:

1. Commentator “nasa_rs”‘ blast from the past and its relevancy if any to JAK inhibitors (i.e., topical>system plus works for both AA and AGA).
2. Androgenetic Alopecia (AGA) being classified as an immune system problem in Daphne Zohar’s presentation slide on Follica (enlargeable slide is here under “Tracksterdam’s post — see vertical text on left side). Yet, the same company’s co-founder Dr. Cotsarelis claimed to CNN in 2014 that AGA was not an immune system problem so JAK inhibitors were unlikely to work.  What gives? The exact words in the CNN article: “Cotsarelis was adamant about it because male pattern baldness isn’t related to the immune system.“

— An interesting new interview with Dr. Takashi Tsuji.  Not too much on hair, but nevertheless worth a read.  Key part:

Interview question: “Speaking of hair loss, it was recently reported that you are working with a private company to development a treatment for using regenerative medicine to regrow hair. Will this be available soon?”

Dr. Tsuji’s answer: “I think it will. We have developed technology to grow hair follicles using stem cells, as hair follicles are one of the few organs where we always have stem cells ready. We hope to be able to start clinical trials in the next few years so that the treatment can move into the clinic.”

Having a mathematics background, I am biased and was pleased to read two quotes from Dr Tsuji: “Biological phenomena are governed by mathematics” and “I think that probably all of biology can be explained by math.”

— I hate to give Donald Trump’s hair any more coverage than has already been given by the media for years, but this new 10 page (!!) or so article is pretty spectacular in its depth and research effort. The best ever analysis of Trump’s hair.  I learnt a new hair loss industry term: “microcylinder intervention.”  The 25th floor in Trump Tower is apparently where all the hair action has been taking place for years.

— A new privately-held company named  RiverTown Therapeutics claims to have a proprietary topical product called RT1640 that regrows hair and also darkens gray and white hair.  They claim to have tested the product in seven humans so far.  Way too few to garner any confidence, and the company does not even seem to have a website as yet.  If the company’s CEO David Weinstein ever changes his Linkedin photo and suddenly has dark hair, I will follow the company more closely:-)  The three agents that comprise RT1640 are supposedly very safe and together they promote “the reanimation of hair follicles through the recruitment and differentiation of follicular stem cells, including melanocyte stem cells.”  Thanks to Xaser94 for continuing to find these hidden gems.

— Also thanks to Xaser94 for finding out about yet another new company named Gemstone Biotherapeutics.

— New study from the UK on β-catenin signalling and hair follicle regeneration during wound healing.  Thanks to commentator Paul Pheonix for the find.

— New study from China titled “Self-assembling peptide hydrogel scaffolds support stem cell-based hair follicle regeneration.”  Bit above my level of understanding, but thankfully we now have around 3-5 commentators who seem to understand this stuff well and are in the biology field in some capacity or other.

— I have covered Dr. Kevin McElwee on this blog before.  It seems like his lab at The University of British Columbia in Canada (plus others) might be doing some hair loss related research for a new company named Avagenesis.

— Increasing rumors that Prince William is finally considering getting a hair transplant.

— A real life Rapunzel.

— Bulgarian soccer/football player Dimitar Berbatov gets a great hair transplant.

— Ending on a sad note.  A really tragic hair transplant related death. Be very careful when you go abroad for cheap hair transplants, and run away immediately if they offer you a 50 percent discount.

And now on to medical items of interest:

— An artificial heart for 555 days in a backpack prior to finally getting a heart transplant!  And the guy played basketball with it. More here.

— Wearable artificial kidneys could change painful dialysis treatment forever.

— A story that some stroke patients were walking again after stem cell therapy at Stanford caused a lot of excitement recently, but some scientists remain skeptical.

— After all the hoopla surrounding the crazy Italian Dr. Sergio Canavero and his full body transplant (inaccurately called a head transplant) ambition, we now have similar goals from China.

— More improvements in bionic hands.  And even more.   Mr. Hugh Herr will be pleased.

— Baby-making in the lab instead of via sex and eugenics.  No longer far fetched.

— BBC Panaroma — Gene Editing  (my favorite part starts around 22:30 and my favorite quote is right after 28:20):

— Gene editing will change entire species forever.

— HIV genes cut out of animals via CRISPR.

The 17th annual meeting of the European Hair Research Society (EHRS) just started in Tbilisi, Georgia today and runs through June 26th.  The final scientific program/schedule is here.  Also see first day and second/third day documents.

When I first saw the thread about this conference on HLT (seems to have become more important than the one I mention in red below), I was not too excited.  These guys are focusing on alopecia areata almost as much as they are on androgenetic alopecia, even though over 95 percent of us balding people suffer from the latter! Moreover, the World Congress for Hair Research annual meetings have far more extensive lists of speakers and presenters compared to this one.

However, it turns out that there are still some presentations that could potentially be very useful when it comes to our main interest in a hair loss cure based on hair regeneration, hair multiplication or hair cloning (or even new studies on things such as fat injections, PRP and laser). I am in a rush today or else I would try to pick out presentations that I find the most interesting as I have sometimes done in the past for such events.  On HLT, a person named “Solomon” who lives in Georgia is planning to attend this conference and post audio and/or video of some of the most interesting presentations. He has created a thread where you can ask him questions.  I hope he asks Dr. Christiano or her team of presenters about JAK inhibitors, AGA and Aclaris.

A significant portion of these conferences is always devoted to hair transplants.  I used to discuss those a bit more during the first two years of writing this blog, but reduced that significantly in the past year.  This will probably change soon.

As if the great news from Aclaris earlier this month wasn’t enough, out of the blue we get three new positive developments from totally separate entities in the past week.

Shiseido

Yesterday, this blog’s unpaid but respected Japanese correspondent “nosyu” provided us with a link to a big news story that Shiseido was commencing clinical trials in Japan in partnership with Tokyo Medical University and Toho University.  You can translate via Google Translate or via right clicking on your browser and selecting the “Translate to English” option.  Update: Better summary from today’s Japan News. Seems like the trial will entail 60 men and women and go on for up to 3 years. Thanks for the link to commentator “SS”.  Another new article estimates the cost of treatment to be around $900.

Shiseido’s technology is probably identical to what the original inventor Replicel is/was doing in terms of autologous cell culturing and transplantation using the permanent hair at the back of a balding person’s scalp.  Perhaps Shiseido might have its own improvements to the Replicel process, but that is hard to tell at the moment.  It seems like one set of injections will give lifelong results!

Note that Dr. Ryoji Tsuboi of Tokyo Medical University (who will lead the clinical research work there), is also co-president of next year’s 10th World Congress for Hair Research. So Shiseido is hiring very reputable people. This development is especially good news since Replicel’s stock price and previously strong social media responsiveness have both tanked in recent months (perhaps this newly published video with Replicel CEO Lee Buckler was not filmed too long ago and Replicel is still continuing work in the hair department). Thankfully, Shiseido (the world’s fifth largest cosmetics company) is not letting us down.  Also see my post from 2014 on Japan’s new laws fast-tracking stem cell treatments.

Histogen

To my utmost surprise, Histogen’s CEO Dr. Gail Naughton responded to some questions from HLT forum member “Tomtom21”. Over the years, I have become disenchanted with this company (despite my regular coverage of it on this blog) since it seems to have been in the news for at least ten years. Numerous presentations, successful funding rounds and much media attention have still not led anywhere insofar as treatment being made available anytime soon to the general public. Nevertheless, it is refreshing to see the CEO responding to people in person.  I always found Ms. Naughton to be fairly genuine and sincere and hope that her company does end up like this.

Getting back to the subject matter of this news item, Dr. Naughton states that Histogen’s HSC treatment will be made available in Mexico first in 2018 (!) and they will soon be conducting a large-scale 330-person clinical trial in Mexico with a local partner.  They are also close to getting a partner in China for what I assume will be human trials in that country.  The company is also planning for Phase I trials in women and Phase II trials in men in the US soon.  Dr. Naughton said that higher doses are more effective per Dr. Craig Ziering’s findings. Finally, the company will most likely get more funding from an Asian partner, and will also prepare for an initial public offering (IPO) thereafter.

Dr. Giovanni Brotzu

While all these new-age companies with their sizable funding rounds look into cellular biology, 81-year old Dr. Giovanni Brotzu is old school and prefers a topical product.  I never wanted to cover this man’s work in the first place, but here I am mentioning him for a second time this year!  Last week Dr. Brotzu gave a detailed interview to an Italian hair loss forum team.  The big news is that there is an ongoing trial for 60 androgenetic alopecia patients.  Virtually everything he says sounds reasonable to me, although I have done very little research on the accuracy of some of the more esoteric things that he mentions that I do not understand.  HLT forum members for the most part seem to agree with my gut feelings too. He does make some excuses about the lack of photos.

Someone more motivated than myself can check out the Italian forum threads on this man and see if people over there are also optimistic.  I like the fact that Dr. Brotzu openly and honestly states that his product will not help regain long-lost hair.  Most likely, the best case scenario is that you will only regain what you lost in the past five years.  Still a great potential solution for many younger people.  Dr. Brotzu has a few patents to his name (the details for some of which include information on hair growth related applications).

Unlucky on the Scalp, Lucky (?) on the Back (and Chest)

In the early years of this century (i.e., 2000-2003 or so), I started noticing that the vast majority of people that I saw in the gym or at the pool who had very hairy backs also tended to be heavily balding. If I had to put a figure to it, I would guess that 75 percent of men with very hairy backs tend to be balding severely.  In contrast, for those without back hair, the balding rate is much lower. In fact for young and middle-aged adults without any back hair whatsoever as well as little to no chest hair, the balding rate is probably less than 30 percent.  I doubt that I am off by much in both my above percentage guesses.

Besides at the gym and in the pool, I also noticed this trend among my own immediate family members and in-laws.  My father has zero back hair and very little chest hair, but he had an absolutely stellar head of hair into his 60s. Even in his early 70s, he still has better hair than I have in my 30s and of course I have a lot more body hair then him.  My brother-in-law is bald and has a hairy back.  Same case with several of my current best friends.

When I first started noticing this phenomenon, I was a big tennis (and sports in general) fan, and the two superstars of the game at the time, Andre Agassi and Pete Sampras, were both very hirsute in their bodies, but not so much on their scalps.  Agassi used to wax his chest and back hair regularly.  Since retiring, balding Sampras has been rumored to have had one or several hair transplants, and I would guess that his scalp would look more like his father’s if not for the transplant(s).

A common sight at American sporting events (source):

East Asian People — Lucky on the Scalp, Unlucky (?) on the Back (and Chest)

Native Americans/American Indians (related to East Asians) have almost zero body hair, and not surprisingly, I have rarely seen balding native Americans.  The one native American that I did see with major hair loss turned out to be half caucasian.  Chinese, Japanese and Korean people (all part of the East Asian family) rarely have chest or back hair, and tend to have much less balding in comparison to other races.

It should be noted that even among Asians, there are some exceptions to the stereotype:

Finasteride Works Better for People with Excessive Body Hair

Around a year ago, I discovered a very interesting 2014 study from Japan that found that people with more body hair (i.e., men who were “pileous” in areas other than the scalp) tended to respond better to finasteride treatment for androgenetic alopecia.  I found this to be a fascinating discovery.  Its all the more interesting because very few Japanese people are likely to be very “pileous”.  I wish someone would do the same study on very hairy caucasian men (I am including Armenians, Greeks, Persians, Turks, Afghans, East Indians, Middle Easterners etc… all as part of the caucasian race here).

Countless People on Finasteride or Dutasteride Have Seen a Subsequent Reduction in Body Hair

Over the years, I have read countless testimonials on various hair loss forums of people who were taking 5α-reductase inhibitors finasteride or dutasteride (to treat their scalp hair loss) seeing a significant reduction in body hair. People taking anti-androgens such as spironolactone and cyproterone acetate also report similar side effects.

However, to me, the surprising thing is that there are probably far more people who see no or negligible reduction in body hair than are those who see a reduction in body hair while on finasteride or dutasteride.  I would have guessed that drastically reducing DHT levels is bound to reduce body hair in most people, especially in those who have a ton of it to start off?  Yet, less than half of those hirsute people seem to be see a reduction in body hair when on those drugs.

In any case, below are  a few recent examples of people who noticed a reduction in body hair while on finasteride or dutasteride:

• In an excellent recent thread worth bookmarking, HLT forum member “dnpuntold” stated: “body hair looks a lot thinner and less which is nice since I’m a freaking gorilla.”
• On this very blog, in the comments to my post on the cost of generic finasteride, “paddy” stated: “I have been taking Propecia (non generic) for 18 yrs, I agree with the “hold the line” comment above. It pretty much stopped by hair loss when I started it. Have experienced no negative side effects that I know of but a nice bonus is that much of my other body hair (back, butt, arms, chest, etc) has thinned dramatically as if it reapportioned that hair back to my head. Was a welcomed “side effect”.
• Also on this very blog, in the comments to my post on dutasteride success and failure stories, six (!) people thus far have mentioned body hair reduction after taking Avodart.

Do Men with Excess Body Hair and Balding Scalps Have Higher Testosterone and DHT Levels?

One of the biggest myths ever purported in the hair loss world is that balding men are more virile and have higher levels of testosterone.  This is not true.  I also do not think that balding men have significantly higher levels of dihydrotesterone (DHT) in comparison to non-balding men, although I have not read any data on that subject.  What is true is that balding men’s scalp hair follicles are more sensitive to the damaging effects of DHT.

For me, the more interesting thing is that it seems like balding men’s body hair is also more sensitive to the effects of DHT — but in the opposite direction.  DHT seems to make a high proportion of balding men grow copious amounts of body hair (a condition called hypertrichosis).

Some Skeptics

To my big surprise, two hair transplant surgeons that I have talked to about this phenomenon have told me that they are not sure of such a correlation regarding men with hairy backs and chests being more likely to bald then men without hair backs and chest. I am 100 percent convinced of such a correlation. In recent years, I have also read many hair loss forum members suggest the same thing. However, since there are always exceptions to the rule (e.g., most balding Asians with little body hair), this correlation theory does not get as much attention as it should.  There is always some person who will ruin a thread on this subject by writing “I have no body hair and am still balding.  So I do not buy this theory!”

Exception: Khalid Sheikh Mohammed has more scalp hair then would be expected based on his plentiful body hair:

Body Hair Transplants (BHT)

In the headings for the first two sections of this post, I implied that people with hairy backs are lucky, but added a question mark (?) there. My reasoning for this ambiguity was that while most people with robust back hair would probably consider themselves unlucky, a somewhat recent trend in the hair transplant world has resulted in many people being grateful to have more body hair.  This trend involves moving body hair to balding regions of the scalp and is termed as body hair transplants (BHT).  I have discussed this a few times over the years, and will probably have more posts on the subject in the near future.

For now, its worth noting that only certain types of body hair are usually worth transplanting (beard, chest and back seem to be the most utilized, in that exact order), and body hair will never be as good as scalp hair that is moved from the permanent donor region at the back of the head.  Nevertheless, there are now 100s of video documented cases online of people who have been happy with body hair transplants.  For many people with very limited scalp donor hair (i.e., those with very extensive balding patterns), robust thick back hair and chest hair might now be considered to be a good/lucky thing!  Dr. Ray Wood’s first BHT patient video is worth watching.

Hairy Balding Women

While this post has been focused on men (since I doubt there are many women in the world who have their backs covered with thick lengthy hair), it should be noted that a high proportion of balding women also complain of excess body hair (usually in areas other than the back).  Many of these women suffer from a condition called polycystic ovary syndrome (PCOS) in which they have high levels of male hormones.  Here is a good resource for such women.

And Last and Definitely the Least: Ernie Primeau

In the history of the online hair loss world, there has never been anyone more insane and crazier than a certain Mr. Ernie Primeau.  I briefly discussed him in a post here.  Ernie holds the all-time record of number of forum and hair loss group posts….a record that will never be surpassed by another human.  Even into his old age, the man is still present online and continues to promote his theory that removing all of ones body hair via plucking will regrow scalp hair!! Of course I do not believe it.  However, perhaps it might very well have been Mr. Primeau who got me thinking about the inverse correlation between body hair and scalp hair over a decade ago, even though I believe it was probably my fellow gym and pool members and my family members.  In any event, I hope to never mention him again on this blog after today.

After I wrote a post on the cost of generic finasteride last year, I received several requests to write one on the cost of generic dutasteride.  However, the reason for my not being able to do that right away was because the patent for Avodart (which is the original brand name dutasteride that is made by GlaxoSmithKline) only ran out late last year and it took a few more months before generics became readily available.

Note that dutasteride has only been approved to treat hair loss in South Korea and Japan as of the time of writing this post.  In the US and EU, it is approved to treat enlarged prostates, but not yet for hair loss.  I am optimistic that this situation will change in the next year, but no guarantees.  As I have mentioned many times on this blog before, dutasteride (see positive and negative testimonials) is likely to give substantially superior results in comparison to finasteride when it comes to treating hair loss, but at the same time likely to cause more frequent side effects.  Do your research carefully before deciding to proceed with such a strong drug and always discuss taking it with your doctor before proceeding.  In rare cases, it seems like the side effects from both finasteride and dutasteride can be permanent.

Note that various online sites now offer coupons for drug purchases if you are buying them with cash and not paying via insurance. Perhaps the most popular one is GoodRx, which has coupons for numerous drugs, including for dutasteride. For those not in the US, feel free to provide your country’s prices and discount options in the comments to this post.

Note: Prices and brands at the same pharmacy chains may vary by US state. Also keep in mind that many stores may price match or have internal savings plans.

Country of manufacture entries in the below table could be off and I have not tried to go through product brochure attachments on company websites for now to try to find out.  Teva Pharmaceuticals is headquartered in Israel, but a pharmacist told me their generic dutasteride was made in the US.  The Breckenridge Pharmaceuticals website says it is based in the US, but a Costco employee told me that the packaging on their generic dutasteride says its made in New Zealand. Amneal Pharmaceuticals website says that 95 percent of its products are made in the US and 5 percent are made in India. GSK is headquartered in the UK, but it seems like the company’s Avodart is made in the US.  Please let me know country of manufacture if you purchase any of the below and come to find out any errors on my part.

Update: RIKEN added a brief summary of this development on its site and included the below photo on its home page:

Update: Commentator “sets” e-mailed Kyocera and got a response:

“Hello. My name is Hina Morioka from the Corporate Communications Division at Kyocera Corporation. Thank you very much for your question about our research with RIKEN and Organ Technologies.

Regarding timeline, we aim to put the technologies into practical use and make medical treatment available in 2020 in Japan (medical treatment at one’s own expense).”

I was planning on publishing an entirely different post today, but things continue moving along rapidly in the hair loss research world and you regularly encounter sudden usually pleasant surprises.  In the last post, commentator “Lewa” just brought to my attention that major Japanese electronics manufacturer Kyocera was entering the hair regeneration market via a collaboration with the government-affiliated RIKEN Institute in Japan (where the renowned Dr. Takashi Tsuji leads the hair related research department) and Organ Technologies in Japan (a company in which Dr. Tsuji is one of the directors).  In that article, I read that they plan to commence clinical trials BY 2020, but that they also planned to start their business IN 2020.  They will develop prototype equipment by March 2018.  Very ambitious and rapid progression targets, but if it can be done anywhere, it would be in Japan where the government is very supportive of expediting research.  With the addition of Kyocera into the mix, Dr. Tsuji now has access to funding that all other hair researchers around the world can only dream of.  The only other hair loss cure research related company with this kind of funding access is also based in Japan in the name of Shiseido.

At first I was only intending to mention the above development in my once a month “brief items of interest” post.  However, then I discovered an even better version of the above article on Kyocera’s website. This second article is far less ambiguous when it comes to the dates and therefore this development deserves its own post now.  Key quotes from the above second article:

“The companies aim to put the technologies into practical use in 2020.”

“Kyocera, RIKEN and Organ Technologies plan to establish cell culture and transplant technologies and develop devices for transplantation, aiming to put the technologies into practical use for the treatment of human alopecia in 2020 in Japan.”

Update: Forbes magazine now has a story on this news too.

Update: A brief Japan Times summary.

The division of labor between the partner companies will be as follows:

Kyocera = Development of cell processing devices via the utilization of its microfabrication and manufacturing technologies.

RIKEN and Organ Technologies = “Development of stem cell culture/amplification technologies, development of cell manipulation technologies, establishment of production processes, implementation of preclinical studies, etc.”

The technology (“regenerated follicular primordium” via a combination of epithelial stem cells and mesenchymal stem cells) being developed is outlined in the bottom part of the below image taken from Kyocera’s press release.  Top image shows a modern day FUT (strip) hair transplant procedure with limited donor hair supply limitations.