Drug trial to end bad hair days for bald women

Dec 2008

For men coping with baldness, the solution can be as simple as shaving their head. But for women the effects can be devastating.

Losing their hair often means a loss of femininity and sense of self-esteem. With rates of anxiety and depression high among sufferers, some even resort to tattooing their heads to hide thinning patches on their scalps.

But a world-first trial at a Melbourne hospital is offering hope to the estimated 700,000 Australian women affected by severe hair loss.

Doctors at St Vincent's aim to prove that a drug used to reduce excessive facial and body hair can stop hair loss on the scalp of women, as well as stimulate partial hair growth in up to a third of sufferers.

They hope that this evidence will encourage doctors — many of whom tell women there is no treatment for hair loss — to prescribe the tablets more widely.

Eventually the plan is to develop the drug in an implant form, which would allow women to receive treatment for up to three years at a time without the need for a daily tablet. A patch like those used by smokers trying to kick the habit would also be trialled.

Rod Sinclair, professor of dermatology at St Vincent's, said up to 55 per cent of Australian women will suffer hair loss during their lifetime. While the condition often develops after menopause, Professor Sinclair said up to 10 per cent of teenage girls and 20 per cent of women in their 30s were affected. There is no known cure and treatment options are limited.

"Often these women come to us in tears. A lot of the time they are so distressed they end up on antidepressants. It can make them feel very guilty for being so upset about something that is purely cosmetic, but it affects their whole sense of femininity and they feel as if everybody is staring at them," Professor Sinclair said.

"Hundreds of millions of dollars have been invested in finding new treatments for male baldness, but with women it is still very much a taboo subject."

Around 80 women suffering hair loss are being recruited to trial the drug Spironolactone. While there is some evidence the drug is effective in arresting the progress of female baldness, the trial will be the first in the world to provide medical proof of its efficacy. Half of the women will take a placebo; the rest will take the drug.

Sebastiana Biondo, a clinical psychologist and hair loss expert from the Skin and Cancer Foundation, said she had seen an increase in the number of women affected by baldness in recent years. She said it should not be viewed as a cosmetic problem.

"It's hard to get funding for research and treatment because it's not seen as a health issue, but it affects their quality of life and psychological wellbeing in a really profound way," Ms Biondo said.

"Women invest a lot of their self-esteem in their hair and their appearance, so this can be a debilitating condition. I see women who are very distressed and become quite obsessed and paranoid about it."

The cause of female hair loss is still unknown but it is thought genetics and stress may play a role. Normally, three hairs grow out of one pore. While men lose all the hair from the pore, women tend to lose two, usually leaving them with a thin covering of hair rather than complete baldness.

Ms Biondo said some women used camouflage makeup or tattoos to hide bald or thinning patches on the scalp. "They do it out of desperation. They'll try anything. Some spend thousands at hair loss clinics or with herbal medications they find on the internet. They're very vulnerable."

Some forms of alopecia — a severe form of hair loss — can cause complete baldness including loss of eyebrows and eyelashes. "Often people ask these women if they've got cancer or if they've had chemotherapy, which can be very upsetting. It seems to be socially acceptable for men to be bald but for women it's completely different," she said.

From 'big hair' to barely there: a survivor's story

MOST teenage girls can overcome a bad hair day with a blow-dryer and some product, but for a few it's not that simple. And at an age when appearance is everything, it can be devastating.

Loukia Gauntlett was 17 when she first realised her hair was falling out. The process was so gradual it took an observant classmate to point it out.

"I walked into a classroom one day and one of my friends said, 'I can see through your hair.' I must have been sitting in front of a window and the light was shining in a particular way. I went Hair Loss and we realised that a lot of my hair had started to disappear. It had become very thin across the top and around the back," Ms Gauntlett said.

Coming to terms with female pattern baldness as a teen was distressing. Little was known about the condition and Ms Gauntlett felt alone and conspicuous.

"Growing up, I was the one in the family with big hair, it was down below my bum for most of my childhood, so to lose it was pretty horrible. When I went to see doctors there was a lot of talk of options for men like hair transplants and lotions that they rub into their hair, but not much targeted at women. I felt like a bit of a freak. I'd go to hairdressers and they wouldn't really know what to do with my hair. For a 17-year-old, that's pretty devastating."

Now 29, Ms Gauntlett, of North Melbourne, has learnt to disguise her condition by keeping her hair short and putting highlights through it to cover up the lightness of her scalp. While her mother was convinced the hair loss was caused by her turning vegetarian for a year in her teens, Ms Gauntlett believes it may be genetic as an aunt and grandmother both suffer from the condition.

The thinning does not seem to have progressed since her teens, but in a bid to regrow new hair she is taking part in the trial at St Vincent's and began taking medication in October. She has already noticed some new hairs sprouting.

"If it works that will be great, but if not at least I'll have been part of an attempt at a solution. I've come to realise that I have friends who have beautiful hair and they're not happy with it, so I'll just live with it. It's just hair, we don't need it to survive."