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General Questions
What are the symptoms of hair loss?
Losing a few dozen hairs is part of the human body’s daily hair growth cycle. Suddenly finding larger quantities in brush or sink may be indicative of an abnormal condition while possible symptoms over time may be a receding hairline or thinning patches.
Pattern baldness may typically be experienced earlier by men than women although both may be affected at some point in their lives. In both, the hair growth cycle may slowly change and eventually cease altogether in certain areas of the scalp.
Stress due to any cause, hormonal changes, otherwise unrelated illness, or the side effects of drugs may result in hair loss from all areas of the scalp. Hair loss in patches may be indicative of a tinea (fungal) infection which may also cause broken hairs and scaling of the scalp.
Alopecia areata’s main indicator is the loss of round or oval-shaped patches, usually appearing quite suddenly. In rare cases, hair loss may develop over the entire scalp or body; this may happen only one time or at irregular intervals.
What medicines may be used to combat inherited hair loss?
Available treatments include:
- Minoxidil (Rogaine) which may be purchased over the counter is applied to the scalp twice a day and may be used by both men and women.
- Finasteride (Propecia) is available only by prescription. It is taken internally once a day. It’s effectiveness has not been proven in women and is not FDA approved for women. Finasteride can cause birth defects and should never be ingested or handled by women who are pregnant or may become pregnant.
How effective are these remedies in treating inherited hair loss?
Efficacy of either finasteride or minoxidil depends on patient’s age and the location of their hair loss. They do not work for everyone. Regrowing a full head of hair should not be expected.
Both must be used daily. 6 months of treatment may be required before results are obtained.
These remedies may slow thinning and increase coverage by growing new hair. They may also thicken the shafts of existing hair. If treatment is stopped, any gains may be gradually lost. Within a year of ceasing treatment, patients my return to the same condition as before treatment.
Minoxidil appears to be most effective for people less than 30 years old who have been experiencing loss for under than 5 years. In men, a 5% solution appears to be more effective than the 2%, but costs are higher and side effects may be greater.
Finasteride is recognized as a useful treatment for male inherited hair loss, however coverage may not be complete.
What are the side effects of Minoxidil and Finasteride?
Side effects of minoxidil include skin irritation, dandruff, and an itchy scalp. In women, minoxidil may cause facial hair growth, especially on the forehead and cheeks. If you have heart problems, ask your doctor before you use this medicine.
What are the disadvantages of using these medicines?
The disadvantages of using these medicines for hair loss include the following:
The medicines may not work. You should not expect to regrow a full head of hair. It may take from a few months to a year before you see results. You must take the medicine every day. If you stop, any regrown hair will fall out, and you will end up with the same amount of hair you had when you started treatment. The medicines are costly and usually aren’t covered by insurance.
What are the risks of not using these medicines?
There are no risks to your health if you decide not to use medicine for hair loss. But some people may be bothered by hair loss that they feel has affected their appearance.
If you don’t use medicine, your hair loss will probably continue. But medicine doesn’t always work, and hair loss may continue despite treatment with medicine.
What is DHT?
Dihydrotestosterone (DHT) is an androgen generated from the male hormone testosterone. Male pattern baldness, or androgenetic alopecia is thought to be connected with DHT which is estimated to be up to ten times more potent than testosterone itself. Another androgen DHEA, especially in women, may also be significant in pattern loss.
Is stress a factor in hair loss?
It is believed that stress can play a role in diffuse hair loss called telogen effluvium. Stress-induced hair loss usually regrows within a year of eliminating the cause. In the absence of any prolonged emotional or physical trauma that has affected overall health, stress is not likely the cause. Crash dieting, medical conditions, certain medications, pregnancy, and other major life changes can also initiate telogen effluvium shedding. However, if you are male and you are seeing thinning hair or hair loss in a pattern, you are most likely experiencing male pattern baldness.
Thinning hair in women can be more difficult to diagnose. The diffuse hair loss due to stress can look similar to female pattern hair loss. However, stress induced hair loss tends to be a more all over thinning while female pattern hair loss is usually more apparent on the top of the scalp with the side and back much less affected. Stress induced hair loss often reverses itself with time and a reduction in stress levels.
Can hair loss be avoided?
There is no way to avoid hair loss caused by androgens, as it is primarily hereditary; caused by genes. If one or both of your parents have genes that cause hair loss, you will inherit some of those genes and so it is most likely that you will lose your hair as well. It is possible that the environment also contributes to the development of pattern hair loss, but genes are certainly the dominant factor. Medical treatments that are offered by doctors can help reduce pattern hair loss. Recently, some genetic tests have been developed that can be used to predict whether a person will develop hair loss and also whether they might respond to certain drug treatments.
What is the best treatment for pattern hair loss?
There are many different products on the market including finasteride which reduces the conversion of testosterone to dihydrotestosterone (DHT). There are also hair follicle growth stimulants such as minoxidil and therapeutic antimicrobial shampoos containing ketoconazole. Women also have several anti-androgen drug options that cannot be used in men such as spironolactone. Some regimes show some effect but have to be used for life and may be associated with side-effects.
The only permanent cure currently available is hair transplant surgery which requires a large patch of hair to be surgically removed from the back of your scalp and replanted in bald areas. The problem with transplant surgery is that it is a major surgery and it only works if you have enough hair to take from one area to move to another. With RepliCel’s treatment a very small punch biopsy is taken and new hair cells are replicated eliminating the need for a large hair donor site to be moved to the bald area.
Clinical Trials:
Can I volunteer to be in your Phase II trial?
Once we obtain approval from the appropriate regulatory body(ies) and ethics board(s) the clinical site(s) that will be conducting our upcoming Phase II trial will be ‘activated’ and will be able to recruit subjects. An announcement of site activation will be made on our website. For logistical reasons, recruitment will only be open to volunteers living in the same country(ies) in which the trial is being conducted. Our Phase II RCH-01 dose-ranging trial will be located in Germany.
When will your Phase II trial commence?
We anticipate initiation of our Phase II dose-ranging trial in late-2013.
Do you have a rough estimate of how long it will take for the treatment to be available to the public?
RepliCel is following a clear regulatory clinical pathway. Upon completing the first-in-man Phase I clinical trial, which is designed to test safety as well as efficacy, the company will initiate a Phase II dosing trial followed by a Phase III approval trial. The timeline to a commercial product depends on the execution of these trials and regulatory approvals. Nevertheless, if the technology proves safe and effective, RepliCel anticipates that a commercial product may be available in 2015 in non-Western jurisdictions.
How much will the treatment cost?
The cost of the treatment has not yet been established. However, we expect that it will be more than competitive on a price/performance basis with micro-transplant in developed nations.