Fluridil
for hair loss
Overview
A NOVEL DERMO-COSMETIC AGENT FOR TOPICAL
APPLICATION IN ANDROGENIC HAIR LOSS, i.e. EFFLUVIUM AND ALOPECIA
Our lives depend on our hormones. Of those, the sex
hormones, estrogens in women and androgens in men, are of major
importance on influencing almost every aspect of our physiology and
social life.
The sex hormone levels physiologically change with
age. Thus, after levels of testosterone and its much more potent
derivative, dihydrotestosterone (DHT), peak in the twenties, a
continuous decline is observed throughout the remainder of life.
In women, estrogen levels peak in their twenties, and
then slowly decline until menopause, where the drop is sometimes
drastic. Women also produce some male sex hormones and inversely, men
produce estrogens, initially in very small quantities, but with years
the levels increase until around 60, women actually produce about as
much male sex hormone as men at that age.
As it happens, it is the male hormones which are
responsible for the most usual form of hair loss in both men and women.
The relationship between the sex hormones and the scalp
hair is not yet fully understood. Early in life, estrogens in women and
androgens in males make scalp hair grow.
Then, usually after 30, for reasons not
yet explained, in genetically predisposed males the
androgens start pushing the hair out of the follicles,
thus causing hair loss.
A similar phenomenon occurs in women who
have reached a stage in their life when they also
produce substantial levels of androgens. Hair loss,
which dermatologists call effluvium, ultimately results
in alopecia.
There are also other reasons for
alopecia which dermatologists diagnose and often can
treat, but by far the most prevalent is alopecia caused
by the male hormone and therefore called androgenic.
Testosterone by a small chemical modification normally
occurring in the body changes into an analog, the so-called
dihydroxytestosterone (DHT). As an androgen, this compound is much more
powerful.
One approach to the treatment of hair
loss, therefore, has been to inhibit this conversion by
a drug.
Such a drug has been developed and is
currently marketed as Propecia. The effectiveness of
Propecia has been reported as varying from 30-50% in
arresting hair loss, but clearly there is a disadvantage
of a chronic systemic administration and the uncertainty
of what changing basic physiological mechanisms may
cause.
Although there are no such indications
in the current clinical studies, no one is certain what
manipulation of the normal hormonal turnover in the body
will produce after extended use.
It has always been obvious to researchers that an agent
acting only on the skin and not penetrating into the body would be much
preferable for prevention of hair loss and/or restoration of hair
growth.
There have been countless attempts to
achieve this goal. One drug originally developed to
decrease blood pressure, minoxidil, was found to induce
upon longer use some hair growth, but only in the vertex
area.
The efficacy was reported as somewhere
around 30%; the effect was attributed to a number of
factors, most prominently an incidental increase of
blood flow in the scalp. Various vitamins, plant
extracts and other preparations were also developed, but
none really could overcome the essential effect of the
male hormones affecting the hair follicles.
It has been known for a long time that the male hormones
can act only after attaching themselves to a messenger, a small protein,
the so-called androgen receptor. The androgen receptors can be blocked
by certain drugs.
These were developed for therapeutic
purposes, among others, to keep in check the cancer of
the prostate, which squarely depends upon the androgen
hormones for its growth. These compounds are given
orally and are resorbed from the gut.
They act directly by blocking the
androgen receptor. It should be noted that such
inactivation is always temporary since the cells of our
body in their daily cycles continuously manufacture the
androgen receptor.
Further, there is the problem that
androgen receptors are distributed throughout our bodies
and are also copious in the brain, where their blockade
invariably induces loss of interest in matters of sex,
i.e., loss of libido.
When applied on the scalp these drugs
either had no effect or they were resorbed and passed
into the body eliciting systemic side effects. This is
why none of these drugs were developed into a safe dermo-cosmetic
product to combat hair loss.
In an effort to develop a more powerful inhibitor of the
androgen receptor, the biomedical laboratories Biophysica in California,
in collaboration with the research laboratories of a Czech biotech
pharma company, Interpharma Praha, developed a new class of substances
which proved to render the androgen receptor inactive in a novel way.
A large number of new molecules were
synthesized and tested. Some were not resorbed when
given orally or topically. The most promising molecule
was structurally modified so that minor amounts of water
would cause the molecule's decomposition, thus rendering
it pharmacologically inactive and incapable to act
inside the body.
To prove that this substance, now called
Fluridil, once resorbed into the skin would not enter
into the body, a number of experimental studies were
conducted using rats and rabbits, who are capable of
taking up substances through their skin 6 to 10 times
more than humans.
We applied large quantities of Fluridil,
far surpassing the highest conceivable dose in humans.
Using sophisticated equipment of high sensitivity no
trace of Fluridil or its fragments were ever found in
the blood.
Many studies were conducted to ascertain the systemic
and topical toxicity in animals and finally in human volunteers at the
specialized Experimental Dermatology Institute of the University of
California in San Francisco, under the leadership of Professor Howard
Maibach. The result of this study was remarkable in that no irritation
whatsoever was observed, thus confirming the data we previously gleened
from experimental animals.
By then, news had spread and several of our colleagues
of ours on their own started applying the compound to their scalp, soon
to report the unusual efficacy of the alcoholic solution of Fluridil.
We have thereafter optimized the
composition of the solution, conducted all required
safety tests and after having presented our findings to
the authorities, gained marketing approval in the Czech
Republic.
In a study with human volunteers, not even trace levels
of Fluridil were detected in the serum; therefore, it cannot be expected
to have systemic effects.
This was also confirmed by the clinical
study conducted presently at the Medical School
dermatology department (Chairman: J. Bucek, M.D.,
Palacky University, Olomouc, Czech Republic): in most
subjects, increase in anagens (growing hair) and
decrease in telogens (dying hair) after 3 months of
daily application of 2 ml Fluridil was substantial;
there were no changes in the hematological and hormonal
profiles and there were no adverse effects.
From what has been said above, it is obvious that the
mechanism of Fluridil as a dermo-cosmetic device is sufficiently clear
to judge Fluridil's prospective usefulness. Surely, when hair has been
missing from the scalp for a long time and the hair follicles were
obliterated by the ingrowth of connective tissue, there is very little
chance for growing new hair.
Here only transplants can
reasonably work.
Fluridil is therefore useful only
when the hair follicles are still active and their
androgen receptors are still intact.
So far, the most successful findings were reported by
volunteers who started using Fluridil at the time when the first loss of
hair was encountered. With men, this can start any time after 30 years
of age; with women very often the hair effluvium sometimes dramatically
and suddenly appears concurrently with menopause.
In these clients we find that the hair
loss ceases after a few weeks of once-a-day application.
Perhaps, unfortunately, but understandably based
on what had been said above, in order to keep the androgen receptor in
check it is necessary to continue applying Fluridil daily.
In a number of volunteers we found
that after some 3 to 4 months of use, new hair growth,
"peach fuzz" - the appearance of baby hair - was induced
in the scalp, unless it had been hairless for many
years.
With time and patience which the
hair growth cycle requires - and which may be as long as
one year - we often observe a gradual transformation of
the "baby hair" into hair of normal appearance.
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