Missy Gough (847) 240-1734 [email protected]
Karen Klickmann (847) 240-1735 [email protected]
EMBARGOED UNTIL JULY 29, 1999
HAIR DISORDERS IMPACT MENTAL HEALTH; NEW THERAPEUTIC STRATEGIES IN TREATING HAIR LOSS HOLD PROMISE
NEW YORK (July 29, 1999) - Unexpected hair loss at any age can have detrimental effects on a person's emotional well being. From feeling self conscious in social situations to suffering from major depression, adults and adolescents afflicted with hair loss commonly experience some type of psychological disorder as a result of their condition. However, dermatologists are hopeful that the recent increase in hair biology research could hold the key for future treatments of hair loss.
Speaking today at Academy '99, the American Academy of Dermatology's summer scientific meeting in New York, dermatologists Elizabeth Reeve, M.D., Regions Hospital, St. Paul, Minn., and Marty Sawaya, M.D., Ph.D., University of Miami School of Medicine, discussed the psychological impact of hair loss and emerging strategies to treat this common hair disorder.
Androgenetic alopecia, commonly referred to as female- or male-patterned baldness, has been linked to personality disorders in patients afflicted with this form of hair loss. One study of 116 patients with androgenetic alopecia found that 76.3 percent of the participants had at least one DSM-III-R (the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition) diagnosed personality disorder. Personality disorders are clustered into three types - suspicious/obsessive, impulsive, and dramatic/emotional. In contrast, only 10 percent of the general public has a personality disorder.
A similar study on patients with androgenetic alopecia found that compared to men, women reported a more negative body image and decreased adaptive functioning to hair loss. In fact, twice as many women rated themselves as "very" or "extremely" upset about their hair loss. "It's not surprising given society's demands on a woman's appearance that women would be more adversely affected by hair loss from a psychological standpoint than men," said Dr. Reeve.
Alopecia areata is another form of hair loss characterized by hair falling out in smooth, round patches on the scalp. In some cases, alopecia areata can cause the complete loss of scalp and body hair. The condition is most common in people under 30.
Stress - triggered by a significant life event such as the death of a loved one or the loss of a job - has long been thought to be linked to alopecia areata. "Sometimes patients who experience hair loss months after a life event will assume the stress causes their hair loss," explained Dr. Reeve. "The relationship between stress and hair loss is unclear. Cumulative stressors may be more significant than single stressors, and positive events may have just as much impact as negative events."
Studies also have shown a link between psychiatric diagnoses and alopecia areata. "With alopecia areata, it isn't uncommon to see patients who have suffered from either major depression or generalized anxiety disorder at some point during their lives," said Dr. Reeve. "On the other hand, research has shown that patients who suffer from hair loss may be more predisposed to depression or anxiety than the general population."
TREATMENT
While hair loss can wreak havoc on a person's self esteem, there are promising new medical therapies under development that could provide effective treatment for the disorder. Currently, there are two drugs approved by the U.S. Food and Drug Administration (FDA) for the treatment of hair loss - finasteride and minoxidil. These are the only two products on the market that have undergone vigorous clinical trials and are proven to grow scalp hair.
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New medications in FDA clinical trial testing include other 5a-reductase inhibitor agents for men and 5% minoxidil for women. "We hope that by early next year 5% minoxidil will gain approval so that we can offer more treatment options for women who suffer from hair loss," said Dr. Sawaya.
Research in gene therapy, antisense technology and cell cloning are still the biological approaches to conquering hair loss, but are more technical strategies. "The challenge in gene therapy is twofold. First, you must find the set of genes; and second, you have to strategize a way to treat the genetic problem," explained Dr. Sawaya.
It is now thought that male pattern hair loss involves more than one gene. "It's possible that in 10 years or so, gene therapy could be an effective treatment for various forms of hair loss."
While research in antisense technology and cell cloning continues, the application of these findings remains uncertain. "With antisense technology, you are essentially blocking the function of genes," said Dr. Sawaya, "but the problem is there is too much variability with this method, which makes it harder to treat."
Despite the increased interest in cloning, it is important to realize that cloning animal hair follicles is much easier than cloning human hair follicles - which are more technical and, for now, not a viable option. Caution should always be given when studies describe successful outcomes based on animal hair follicles, as this may not always correlate to human hair follicles.
Medical devices are other options listed as "alternatives to medical therapies," which involve the use of electrical fields or energy wavelengths to stimulate the hair follicles to grow. There are several products on the market that make claims to grow hair. "From the limited studies done, they are not as beneficial as the two FDA approved medical products and are considerably more costly," explained Dr. Sawaya.
Other treatments that are not approved by the FDA to treat hair loss but are still currently used by physicians include off label prescription products, such as Spironolactone, Flutamide, Ketoconazole, Cimetidine, Progesterone, Retinoids, and oral contraceptives for women; and a multitude of over-the-counter herbals/nutritionals, such as horsetail and black bryony, Iamin, Polysorbate 80, Foligen, Nioxin, and Kevis, among others.
"We're finding that consumers are spending a lot of money in trying these different hair loss treatments without much success. With any unapproved treatment, there are no controlled studies to back the product's claims so the results are inconclusive. Consumers really need to be cautious because often these products can be harsh and cause side effects or possible drug interactions," explained Dr. Sawaya.
Before starting any treatment regimen for hair loss, Dr. Sawaya recommends first seeing a dermatologist who can diagnose the type of hair loss a person has and prescribe the best medical therapy available. Whether patients try medical or over-the-counter products, consulting a dermatologist to guide them is essential - especially since there are so many hair loss products available on the internet, radio, television, and newspapers with various claims, making it confusing for the patient. Dermatologists can inform patients how the product should be used with proper dosage, duration, as well as cost, in order to give them a set of realistic expectations in treating their hair loss.
The American Academy of Dermatology, founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership over 12,000 dermatologists worldwide, the Academy is committed to: advancing the science and art of medicine and surgery related to the skin; advocating high standards in clinical practice, education, and research in dermatology; supporting and enhancing patient care; and promoting a lifetime of healthier skin, hair, and nails. For more information, contact the AAD at 1-888-462-DERM or www.aad.org.
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