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New drug promises hairier Xmas

By MARK SCHREIBER
Shukan Bunshun (Dec. 22)

http://www.japantimes.co.jp/cgi-bin/getarticle.pl5?fd20051225tc.htm

"All I want for Christmas is my two front teeth," go the lyrics to a popular seasonal song made famous by comedian Spike Jones and his City Slickers in 1948.
Four-year-olds whose incisors are missing during the Yuletide season soon get their wish; but for the millions of men who suffer from so-called AGA (male-pattern baldness), imploring Santa to restore their hair has been a pipe dream.

What Shukan Bunshun wants to know is, will a newly approved medication that can be taken orally really halt shedding? And perhaps even reverse the process?

The prescription drug, named Propecia, was developed by Merck & Co. of the U.S. It became available in Japan from December 14.

"According to data from the U.S., users' rate of balding over 24 months was reduced in some 66 percent of subjects, and those who maintained their hair reached 99 percent," says Yoshiharu Tsuboi, professor of dermatology at Tokyo Medical College.

The new drug achieves its "high batting average," as Shukan Bunshun puts it, by going to the root of the cause of baldness.

"Testosterone," explains Tsuboi, "is produced by the testes and transported to the scalp by the bloodstream. The enzyme called dihydrotestosterone (DHT) causes the hair follicles to shrink, which leads to baldness. There is no doubt about this."

The key to a remedy, then, was to suppress the generation of DHT.

"In other words," explains Tsuboi, "the idea is to suppress the function of the enzyme causing the change, preventing testosterone from changing to DHT. Finasteride -- the working ingredient in Propecia -- has this property."

Unlike Pfizer Inc's Rogaine, another baldness remedy available over the counter in Japan (but in a lower density formulation than the U.S. domestic variety), Shukan Bunshun points out that Propecia requires a doctor's prescription. But this is not likely to discourage men who are sold on the idea of the new product's efficacy. In addition to calling on dermatology clinics, some may chose to bypass the middleman and make purchases via the Internet.

One discouraging factor, however, may be the new drug's cost.

"Since it's not covered by health insurance, users can expect to pay about 30,000 yen a month, says a source at a Tokyo clinic. "After six months of use they can probably expect to see some results."

Some might see it as expensive and others as quite affordable. But at least, shrugs Shukan Bunshun, side-effects do not appear to be a major concern.

Research by professor Tsuboi suggests the preparations on the market from Japanese cosmetics and drug companies, including Lion, Kao and Dai-ichi Pharmaceuticals, may also achieve favorable results through a variety of other methods. But these all involve contact with the scalp; presently Propecia is the only recognized medication that can be taken orally.

"A lot of patients who come to us for consultations think their hair is thinning when the degree is actually quite normal for their age group," says Dr. Nagaoki Wakisaka, operator of a clinic in Osaka. "They shouldn't be overly concerned. The best thing they can do [for their hair] is eat a balanced diet, get sufficient sleep, and maintain a daily regimen of hair and scalp hygiene."

More than depending on a single wonder drug, Shukan Bunshun concludes, hanging on to one's hair requires comprehensive and never-ending efforts.


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