Source: Esquire, April 1997 v127 n4 p108(2). Title: New strategies to save your scalp.(male baldness) Author: Colin BeavanAbstract: Several popular, and effective new treatments to stop or slowbalding are analyzed, including Minoxidil, Propecia, and Tricomin. Tips onhairstyles for men with thinning hair are also provided. Full Text: COPYRIGHT 1997 Hearst Corporation. All rights reserved. Furtherreproduction prohibited. With at least forty treatments for baldness patented in 1996 and $200million budgeted for clinical trials in 1997, you'd think someone might havefigured out by now why men lose hair. But the lab guys know only one bigthing: Hairfollices shrinkdie. They'v proved thathi tragedy istriggered by the body's especially potent testosterone derivative, DHT. Butresearchers can still only theorize about why the perfectly normal presenceof DHT leaves some otherwise healthy men mourning their hair as it swirlsdown the drain. According to Houston researcher Dr. Peter Proctor DHT fouls up the "growhair" and "shed hair" mechanisms in follicle cells. The good guys, Proctor postulates, are nitric oxide (NO) molecules that are secreted from nearbyblood-vessel walls. They trip the cellular "grow hair" switch. The villainis superoxide--a highly reactive chemical produced by immune cells thataccumulates around hair follicles. Su peroxide throws the "shed" switch.Even healthy follicles release their hair about every four years, butbalding men shed more often. Their follicles, when DHT attaches to them, mayexcrete a protein that is not recognized by the body. The immune system then sends in the cavalry, triggering the release of more superoxide. "It's likewhen a transplanted organ is rejected," says Proctor. It's bad enough thatsuperoxide throws every shed switch in sight, but it seems to react withnitric oxide to form toxic chemica ls that irritate the follicles the way astrong bleach burns the skin.Under this onslaught, a balding man's follicles shrink and sicken until the growth cycle is reduced from four years to a pathetic four months. To add tothe outrage, their shrunken size makes for fine and uncolored hair, babyfluff that can never camouflage a shiny pate.According to Dr. Ken Washenik, director of dermatopharmacology at NYUMedical Center, such a process may not be reversible. "I am much moreoptimistic," he says, "that we can stop hair loss before it happens." Themoral is that hair-loss treatment should begin before bare skin appears. Mseeking to hold their hairline a re now turning to three main drugs.MINOXIDILThe now-ubiquitous minoxidil was first approved in 1979 as a blood-pressuremedication. Unfortunately for women, who preferred their faces hairless, itmade some people sprout hair everywhere. When topical applica tion showed localized hair growth, the drug was rolled back into the lab and rolled outten years later as Rogaine. Absorbed through the skin, minoxidil probablymimics NO, throwing the follicles' grow switches. In trials, it promotedmoderate regrowth on only 39 percen t of the men who used it for a year. Butbecause it remains the only FDA-approved hair-loss drug, it's the bazooka inthe balding man's battery. Practitioners like Washenik say it's the best betfor slowing the loss of existing hair.PROPECIA The next treatment to grind its way through the FDA-approval machinery,probably within the year, will be Merck's promising finasteride tablet,Propecia. Finasteride inhibits the enzyme that turns testosterone intoDHT--the first domino in the chain reaction that ends in follicle death. Ifirst appeared in the guise of Proscar, a drug that combats prostate enlargement, another problem caused by DHT. Merck's trial results haveraised high hopes for Propecia's effectiveness: More than half of thosetreated had "clinically significant increases in growth of new hair." Somebaldsters, wanting to get the jump on th e approval process, are alreadycadging prescriptions for Proscar from their physicians.TRICOMIN Developed at ProCyte in Kirkland, Washington, Tricomin is expected to comeout in the next year, too, not as a drug but as an additive in shampoos andconditioners. Early trials of a Tricomin topical solution resulted in 40percent denser hair growth in 80 p ercent of participants, but its approvalby the FDA could be years away. The copper-peptide compound may neutralizethe superoxide that makes follicles shed. Meanwhile, some balding menalready slather on another of ProCyte's copper-peptide compounds, Iamin, an over-the-counter gel originally developed to help heal wounds.As these new drugs head toward FDA approval, experience has already shownthat they often work best in combination, each combating a different facetof the balding process. While finasteride, for example, prevents further DHTdamage to follicles, minoxidil coaxes those already weakened into growinggood hair again. Thus, some practitioners prescribe minoxidil and Proscartogether. Other physicians tout proprietary mixtures. Proctor's laboratoryprodu ces Proxiphen, a prescription of compounds that mimic the NO growmessage, neutralize superoxide, and prevent DHT formation. In New York, Dr.Adam Lewenberg supplies a prescription hair-spray combining minoxidil withthe antiaging skin treatment Retin-A, whi ch seems to assist absorption. Heclaims that his combination grows new hair in go percent of patients.Before you pester your doctor for prescriptions, however, beware the risks of using drugs "off-label"-- for purposes other than those they wereapproved for. Proscar, for example, was developed for use in older men; itslong-term safety in younger men has not been established. So for now, youmight want to stick to Rogaine.Or you c ould join the likes of Michael Jordan and Patrick Stewart and becool with your heritage.RELATED ARTICLE: The Hair NetHair-challenged guys now chatter via the Internet about dosages, doctors,and treatments. At the Internet newsgroup alt.baldspot, members p ost ahundred or more messages a day, sometimes making cryptic arrangements toscore Proscar prescriptions for one another. But in its more high-mindedmoments, the group provides a forum where baldness researchers mix like gurus among the masses and hair-loss anxiety recedes like, well, a baldingman's hairline.RELATED ARTICLE: How to Let It Go Gently HE MAY HAVE ALL IN HOLLYWOOD, BUT IS MATTHEW McCONAUGHEY starting to loseit? "Did you see him in A Time to Kill?" asks Losi, who cats men's hair atPierre Michel ID New York. "Matthew is going to lose his hair so fast. . .the poor thing."Losi, who has trimmed the likes of Paul Newman, Harrison Ford, and LiamNeeson, as well as count less men for Esquire's fashion shoots, says it'seasy to spot the first signs of trouble up top: Your widow's peak starts to o, or your hair becomes a subtle shade lighter and thinner. Here are fourstrategies she deploys to help you cope with loss: THINK ABOUT PARTING WAYS. If you've always worn your hair straight back,consider parting it; or, if you part it already, try moving the part to theother side. "The way you've worn your hair is just not going to workanymore," Losi says. By changing the way your bar lies, you'll be ebb topush it slightly forward and make it look thicker.NO SHAGGING ALLOWED.When men hinkthey're losing ther, they panicand grow it long. "But that's the worst thing you can do," Losi says. Sherecommends a shorter cut, one that w on't weigh your hair down: "It'll lookfuller, no question."But be warned. "Women love long hair on men and always want their man's hair longer," she says. Consider a little talk before you take it off. Losirecalls that for one client an impromptu cut almost led to a divorce. "I'mnot kidding," she says.USE, BUT DON'T ABUSE. Gels and mousses work fine for thickening your hair,but be sure to dry your hair with a towel before applying them. "If youdon't," she cautions, "you'll get that Gekko look going. It's notattractive." DON'T BE AFRAID TO DYE. "We're not talking peroxide," she stresses. "We'retalking vegetable dyes." Using one that matches your hair color is aseamless way of adding body to hair; the dye bonds to each strand, givingyou a fuller look. Men are a little jitt ery at first she says, but "oncethey do it, they love it."