Will Pavia and David Rose
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It has been a problem that has occupied our species throughout history. Ever since Man was divested of his body hair and became the naked ape, he has applied himself rigorously to the problem of holding on to what remains, against the merciless decimation wrought by androgenic alopecia – male pattern baldness.
In 1500BC Egyptians developed a therapy that required the toes of a dog, dates, the hoof of an ass and the blood from the neck of a gagbu bird.
A thousand years later Hippocrates, the Greek father of medicine, was applying his large brain to the thinning thatch that kept it warm. He prescribed himself a concoction of cumin, pigeon droppings, horseradish and beetroot or nettles, though with little success. He noticed that castration appeared to work, though it seemed a rather drastic procedure.
In 1995 researchers at Duke University, North Carolina, confirmed that castration was effective – indeed, it appeared the only permanant solution to male hair loss. This raised the question: which part of themselves would most men rather hold on to? The researchers concluded that “while castration may be a cure, it is not commercially viable”.
After Hippocrates, and Julius Caesar, to whom Cleopatra is supposed to have offered a ground-up compound of mice, horse teeth and deer marrow, a succession of old wives appear to have applied themselves to the problem. By the 17th century Peter Levens, author of The Pathway to Health, was proposing a variety of cures for bald Roundheads and thinning Cavaliers dreaming of a follicular restoration.
“Take the ashes of Culver-dung [chicken dung] in Lye [a solution of potassium salts made from ashes] and wash the head therewith,” he wrote. “Also Walnut leaves beaten with Beares suet, restoreth the haire that is plucked away. Also, the leaves and middle rinde of an Oak sodden in water, and the head washed therewith, is very good for this purpose.”
It was becoming increasingly clear that riches awaited the man or woman who propounded a commercially viable cure. The term “snake-oil salesman” comes from the name given to 19th-century American salesmen flogging dubious hair tonics. Queen Victoria did not fall victim to their particular quackery. Instead, confronted with a thinning crisis of her own, she drank draughts of wine fermented from the sap of silver birch trees.
In the 20th century a Japanese doctor by the name of Okuda happened upon a more plausible cure. In 1939 Dr Okuda extracted round sections of hair-bearing skin and implanted them into slightly smaller round holes, in scarred or burnt areas of the scalps of his patients.
Robert Leonard, a hair restoration surgeon from Rhode Island and a former president of the International Society of Hair Restoration Surgery, regards Okuda as the father of modern hair-transplant theory.
“Unfortunately because of World War II and the isolation of Japan, information of his discovery never left the island and was temporarily lost to history,” he said.
Norman Orentreich, of New York City, published a paper two decades later proving the theory of “donor dominance”. Hair taken from one area of the body and transplanted somewhere else would maintain its genetic integrity.
“He took round plugs of hair, 6mm in size, from the back of the head, and transplanted them to the bald scalp,” Dr Leonard said. “He took bald plugs from the front and transplanted them to the back. The characteristics of each did not adopt the characteristics of the scalp to where they were moved.”
This raised all sorts of possibilities, but there was still the problem that however these tufts were transplanted, a man only had so much hair he could rearrange. Then in the early 1980s, Colin Jahoda, now of Durham University, published a paper detailing how he had induced new rat whiskers to develop and grow from cultured cells.
Since then, the jackpot that researchers from all over the world have been chasing has been how to successfully develop new human hair, using cultured cells.
Apart from hair transplantation, there have been new advances in other therapies. Two proven drug treatments are now available. Min-oxidil, sold under the brand name Regaine, was originally developed as a blood pressure drug. Patients noticed that stronger hair growth was a significant side-effect. Used twice daily, it can slow hair loss in 60 per cent of patients.
Then came finasteride, sold as Propecia, a one milligram table that slowed hair loss in 83 per cent of men and even led to regrowth in 66 per cent of men.
A third treatment is low-level laser light therapy. Dr Leonard said that it allowed “stabilisation in 90 per cent of patients and regrowth in 50 per cent”.
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