4 min readHAIR LOSS: CONFIDENCE-killing, difficult to treat, ubiquitous. In fact, the most common form of shedding—male androgenic alopecia (also known as male pattern hair loss)—is estimated to affect between 30 percent to 50 percent of men by age 50, according to research.
Of course, there are plenty of proven treatments—there have been for years—but none are fail-proof. Results can take time and, in some patients, may not come at all. Even when they do work, commonly prescribed medications such as minoxidil and finasteride come with potential risks and side effects. "One of the main problems with finasteride, for example, is that it inhibits testosterone in the actual hair follicle, which means some men find they get erectile dysfunction from it," says David Goldberg, MD, clinical professor of dermatology at the Icahn School of Medicine at Mount Sinai.
That's why scientists are hard at work developing new therapies that solve for some of these issues and, in some cases, may work even better than what's currently on the market. That was the big news out of the annual meeting of the American Academy of Dermatology, which took place this past weekend in Denver and featured two such advancements. The first is a new-to-market regenerative molecule that has been shown to reactivate dormant hair follicles; the second is a time-released oral minoxidil that may work faster than the medications currently available to patients.
We talked to dermatologists and the scientists behind both brands to find out how these investigative drugs work, when they may become available to patients, and why they may be the future of hair loss treatment.
A Drug That Targets “Dead” Hair Follicles
Hair loss medications available today work by energizing already-active hair follicles, but in a presentation entitled Emerging Treatments for Hair Loss Targeting Dormant Follicles, scientists at Pelage Pharmaceuticals shared details of their novel PP405 molecule, which targets dormant follicles—an industry first. "What's interesting about the time-lapse photos in our data is that they show hair growing where there was never hair before—or where there may have been hair ten years ago," explains Pelage CEO Daniel Gil, PhD.
Previously, Pelage presented the results of a phase 2a clinical trial of 78 men and women with androgenic alopecia who applied a solution containing PP405 or a control to their scalps once daily for four weeks. The medication was well tolerated with no systemic absorption into the bloodstream—an important safety indicator. What's more, during a week-eight assessment, 31% of subjects using the PP405 solution showed a greater than 20% increase in overall hair density compared to 0 percent of placebo users.
Reengineering a Classic
As you read this, minoxidil (which can be used topically or taken in pill form) remains the gold standard solution for hair loss. Originally prescribed as a blood pressure medication, researchers still aren't exactly sure how it works, though it's currently FDA-approved to treat androgenetic alopecia and commonly used off-label to treat hair disorders such as alopecia areata and scarring alopecia.
Effective, yes—but not without its drawbacks. In addition to rare negative cardiac events, it also tends to take a long time to work, with initial results showing up at around the six-month mark. More substantial changes don’t appear until around twelve months or more, says Reid Waldman, MD, a board-certified dermatologist and chief executive officer and board member of Veradermics. This bug is ultimately part of the design: "The way in which oral minoxidil performs in the body is exactly how you would expect it to as a blood pressure medication—it spikes quickly in blood plasma and, within four hours, the majority of it is gone," says Dr. Waldman. "Hair follicles, on the other hand, need consistent and durable exposure over time to experience an improvement."
Veradermics believes it has the solution: VDPHL01, an extended-release oral minoxidil that allows for sustained absorption. According to three posters that Veradermics presented at the recent AAD meeting, VDPHL01, currently in phase 3 trials, demonstrated superior efficacy and faster onset than current oral minoxidil medications. One of the posters, Comparative Efficacy of an Investigational Oral Minoxidil Extended-Release Tablet (VDPHL01) Versus Existing Minoxidil Formulations in Androgenetic Alopecia: A Blinded Retrospective IGA Analysis, demonstrated visible improvement at two months versus six months for topical or oral minoxidil. "It's clearly safe and it works better than the current oral minoxidil," says Dr. Goldberg, whose practice, Schweiger Dermatology, has been involved in conducting these trials.
Things Are About to Get Interesting
Despite the fact that neither treatment is currently available—it may be a year or more before they are—the technology has dermatologists excited. "Oral minoxidil is part of my practice every single day and while it's generally well-tolerated for the vast majority of patients, I still see someone every few months who has to stop because of chest tightness, palpitations, or headaches," says Robert Finney, MD, a board-certified dermatologist who specializes in hair loss and founder of Soho Skin & Hair Restoration. "The hope with Veradermics’ formulation is that by keeping blood concentrations lower and more stable—avoiding those early peaks—some of those patients may be able to tolerate it where they couldn’t before. That alone would be clinically meaningful."
Dr. Finney is also cautiously optimistic about PP405. "What makes this particularly interesting clinically is that the drug is topical, and it was specifically engineered to penetrate the scalp deeply while being essentially unstable in blood, so the risk for systemic side effects will hopefully be minimized," he says. "The Phase 1 data also showed something promising beyond safety: biopsy evidence of follicles reactivating after just seven days of treatment."
While you wait for these next-gen therapeutics to hit the market, here are some tried-and-true at-home treatments you can try:
4 Effective At-Home Hair Loss Treatments
This solution contains 5% minoxidil, the only FDA-approved topical ingredient to deal with hair loss. A great first-line treatment.
Research shoes that laser light can reverse hair loss. Run this comb through your hair three times a week for eleven minutes to get results.
Just two tiny capsules a day can net you longer, stronger, thicker hair in just three months, courtesy of a patented peptide blend.
Dandruff shampoo helps to quell inflammation and scalp yeast at bay—and may help improve hair loss too.
Brian Underwood is beauty director at Women’s Health, where he oversees content strategy for the brand across all platforms, including digital, print, and social. Underwood previously served as beauty and wellness director at Oprah Daily and O, The Oprah Magazine. During his tenure leading beauty content for the Oprah brand at Hearst, stories Underwood commissioned were awarded the Skin Cancer Foundation Media Award and a Fragrance Award for Editorial Excellence (his second). He was the launch Beauty Director of Dr. Oz THE GOOD LIFE, and has held additional editorial positions at Fitness, Organic Style, Good Housekeeping, Life & Style Weekly, and Woman’s Day and has written for Self, Shape, Seventeen, Redbook, Cosmopolitan, and many more. Underwood previously served on the Skin Cancer Foundation’s gala committee and as partnerships director of the Trans Beauty Clinic, a New York-based charitable organization that provided beauty services and workshops to the city’s trans community.
