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Efficacy and Tolerability of Hairgain(R) in Individuals with Hair Loss: A Placebo-Controlled, Double-Blind Study



This randomized, placebo-controlled, double-blind study was designed to investigate the efficacy and tolerability of a new agent for the treatment of hair loss, based on a marine protein, minerals and vitamins. Sixty subjects with hair loss of different aetiologies participated in the 6-month blinded phase of the study. Objective assessments indicated that the treatment was effective and subjective assessments showed a statistically significant positive effect of treatment. Exposure to the active preparation for a further 6 months in an open phase indicated a further improvement in hair growth. Exposure of the patients previously treated with placebo to the active preparation for 12 months gave similar results. Tolerability was good and no side-effects were reported. The product investigated may provide an alternative to pharmacotherapy for the treatment of hair-loss problems in individuals with androgenic alopecia.
Hair loss can be a considerable psychological
and social problem for those affected.
Much effort and investment has been put
into attempts to develop efficient
pharmaceutical and other treatments for
hair loss. In most cases, however, the results
have been disappointing.
Hair loss may result from drug treatment
(cytostatics), pregnancy (telogen effluvium),
alopecia areata or different types of
dermatological diseases.
The most common form of hair loss is
androgenic alopecia or hereditary hair loss,
also called male hair loss. Most men will
have this form of hair loss, but the stage at
which the process starts varies considerably.
In 5% of the male population it starts before
the age of 20, normally bitemporally and
later over the vertex. Androgenic alopecia is
due to a genetically determined sensitivity
to androgens. The androgenic effect is
mediated through an increase in 5-α-
reductase activity and formation of
increased amounts of dihydrotestosterone
from testosterone locally in the hair follicles.
This process causes hair loss.
Three main treatment schedules are
available today: treatment with the drugs
minoxidil (topical) or finasteride (oral), or
hair transplantation. The two drugs have
been undergoing a number of controlled
clinical trials.
5 – 7
Minoxidil is registered in
The Journal of International Medical Research
2001; 29: 2 – 6
Efficacy and Tolerability of Hairgain
Individuals with Hair Loss: a Placebo-
controlled, Double-blind Study
PAREXEL Medstat AS, Lillestrøm, Norway
This randomized, placebo-controlled,
double-blind study was designed to
investigate the efficacy and tolerability of
a new agent for the treatment of hair loss,
based on a marine protein, minerals and
vitamins. Sixty subjects with hair loss of
different aetiologies participated in the
6-month blinded phase of the study.
Objective assessments indicated that the
treatment was effective and subjective
assessments showed a statistically
significant positive effect of treatment.
Exposure to the active preparation for a
further 6 months in an open phase
indicated a further improvement in hair
growth. Exposure of the patients
previously treated with placebo to the
active preparation for 12 months gave
similar results. Tolerability was good and
no side-effects were reported. The product
investigated may provide an alternative
to pharmacotherapy for the treatment of
hair-loss problems in individuals with
androgenic alopecia.
E Thom
Treatment of hair loss
Norway, while finasteride is registered in the
USA and a number of other countries for
the treatment of androgenic alopecia.
Finasteride is not yet on the market in
A number of questionable remedies have
‘over the years’ been available for the
treatment of hair loss.
is a new dietary supplement
developed in Norway containing a marine
protein extract and several different
vitamins and minerals. Based on favourable
effects on hair loss seen in open studies, it
was decided to carry out a placebo-controlled
double-blind trial in subjects with hair-loss
problems. To our knowledge this is the first
controlled study carried out with Hairgain
Subjects and methods
Sixty volunteers of both sexes, aged 18 years
or more, were recruited to the study through
an advertisement in a local newspaper. All
had had hair-loss problems for a period of at
least 1 year before entering the study, and
the majority of the participants had tried
different treatment approaches for their hair
loss. The majority of the volunteers had
androgenic alopecia (56), while four had
alopecia totalis. All participants gave written
informed consent before entering the study.
A regional ethics committee approved the
study, which was conducted according to the
principles of the Declaration of Helsinki,
good clinical practice and local regulations.
The study was designed as a randomized,
placebo-controlled, double-blind study with
two arms. The subjects were randomized to
treatment either with Hairgain
or placebo
by a simple block-randomization procedure
(blocks of six). The duration of the blinded
phase was 6 months. The subjects receiving
active treatment in the blinded phase were,
thereafter, followed for another 6 months
in an open study on active treatment.
Participants receiving placebo in the blinded
phase were followed for an additional
12 months on active treatment. All subjects
were thus exposed to the active treatment for
12 months.
and placebo capsules had the
same appearance and were packed in
similar plastic bottles in order to keep the
study blind. The dosage was two capsules per
day for subjects below 80 kg in body weight
and three capsules per day for those above
this weight, with one capsule to be taken in
the morning (together with food) and one or
two capsules to be taken in the evening. The
capsules were to be swallowed with 200 ml of
water on each occasion.
The Hairgain
treatment concept has
been developed by a Norwegian company
and contains minerals and vitamins in
addition to a marine protein extract from a
deep sea fish living along the Norwegian
coast line. Both the active and placebo
capsules were supplied by Med-Eq Ltd,
Tønsberg, Norway.
To ensure that hair-loss problems were
comparable in the two groups, a global
inspection of hair loss was performed at
baseline (day 0) and each volunteer’s hair
loss was graded according to internationally
accepted rating scales. The duration of hair
loss and previous treatment was recorded.
Participants came for a study visit every
second month during the blinded phase, and
every 6 months during the open part of the
Overview photographs were taken, in a
standardized format, at the beginning and
E Thom
Treatment of hair loss
end of treatment. The overview photographs
were assessed (blind) by a suitably qualified
person not involved in the study. A special
method for taking standardized close-up
photographs was used initially and at each
study visit (Capilli Care; UPB Ltd, Nice,
France). On each occasion the same four
pre-defined areas of the scalp were
photographed and the pictures were
enlarged (× 80), allowing us to follow the
development of hair growth in given areas
by hair counting.
The subjects were also asked at each visit
to score their satisfaction with the treatment
on a 10-cm Visual Analogue Scale (VAS)
ranging from 0, not at all satisfied, to 10,
very satisfied. Participants also reported any
positive reports from close family members
or their hairdresser on hair growth.
Tolerability was checked on each visit by
asking the question: ‘Have you felt any
adverse effects that could be linked to the
treatment you have received?’ Compliance
was checked at each visit by counting
returned capsules. A requirement that at
least 80% of the recommended dose should
have been taken was used.
SAS (version 6.0) software was used for all
statistical analyses. The two-tailed Wilcoxon
signed rank test was used to assess changes
compared with baseline. For significance
testing the 5% level was used.
At baseline, the two groups were comparable
with respect to gender, age, duration of hair
loss, body weight, previous treatment and
number of subjects with alopecia totalis
(Table 1). The degree of hair loss was also
comparable in the two groups.
The assessment of the overview
photographs (blind) involved sorting the
photographs into probable treatment
groups; this procedure resulted in a highly
significant positive correlation with the
actual treatment groups, with more than
85% of the subjects in the active group
correctly classified (P < 0.01). Hair counting
based on the close-up pictures showed a
significant average increase in hair growth
of 32.4% in the blinded phase in the active
group, while the increase was negligible and
insignificant in the placebo group (Table 2).
A further improvement in hair growth took
place in the period between 6 and 12 months,
resulting in an average improvement in hair
growth of 63.9% at the end of the study. A
similar effect was seen in the group exposed
to placebo for 6 months initially, whose hair
growth improved by 60.8% after 12 months
of active treatment, a highly significant
improvement (P < 0.001) similar to that in
the group who started on active treatment.
The VAS scores for satisfaction in the two
groups during the blinded phase differed
considerably in the two treatment groups
Sex (male/female) 28/2 27/3
Age (years) 37.8 (3.9)
38.6 (3.4)
Duration of hair loss (months) 18.6 (6.4)
20.4 (5.7)
Body weight (kg) 74.2 (11.1)
75.6 (10.6)
Previous treatment 15 (2.0)
13 (2.2)
No. of alopecia totalis cases 2 2
Means (± SD).
Baseline characteristics of volunteers with hair loss randomized to active treatment or placebo
E Thom
Treatment of hair loss
(Table 3). After 6 months the mean score of
the treated group was significantly higher
than that of the placebo group (P < 0.001).
There was a significant positive correlation
between the increase in hair growth as
measured by hair counting and the self-
evaluation by VAS score at the end of the
blinded phase (P < 0.001). The mean score of
the treated group after 12 months (open
phase) shows a further increase in
satisfaction. The results indicate that long-
term treatment (6 months or more) is
preferable in obtaining satisfactory results
with Hairgain
When the placebo group was switched to
active treatment, their VAS scores increased
from a mean (SD) of 0.9 (1.0) cm after
6 months of placebo to 6.2 (2.1) cm after
6 months of active treatment and 8.5 (2.4) cm
after 12 months of active treatment, progress
similar to that of the group who started with
the active treatment. The development in the
VAS score is highly significant (P < 0.001) after
6 months with a further improvement after
12 months’ exposure to the active treatment.
There was no response to either treatment
in the four patients with alopecia totalis. No
significant correlation was detected between
treatment result, age, gender or duration of
hair loss.
Several participants reported positive
responses from family and hairdressers
on their hair growth after having started
with Hairgain
. Several also reported a
pronounced improvement in nail and skin
quality after taking Hairgain
All the participants concluded the study
according to the protocol and none dropped
out due to side-effects of the study
medications. Tolerability was equally good
in the placebo and the active groups in the
double-blind phase. No serious side-effects
were reported in the open part of the study.
The results show that subjects reported
favourable effects of active treatment on hair
gain compared with placebo, and this effect
was also seen in the open longer term study.
Duration of treatment VAS score (cm)
(months) Hairgain
2 2.1 (1.9) 0.7 (1.3)
4 2.9 (2.1) 1.0 (1.5)
6 5.7 (2.6) 0.9 (1.0)
12 7.9 (2.5)
Values are means (± SD).
Participants’ evaluations of their satisfaction with treatment on a Visual Analogue Scale (VAS)
Treatment duration Hairgain
After 2 months 3.4 (3.1) 1.2 (3.6)
After 4 months 15.6 (3.2) 0.7 (3.1)
After 6 months* 32.4 (4.1) 0.9 (3.0)
*P < 0.001.
Values are means (± SD).
Average hair growth increase (%) based on hair counting in the two treatment groups during
the blinded phase
E Thom
Treatment of hair loss
The present results indicate that long-term
treatment is needed to obtain significant
results. There was a positive correlation
between the subjects’ self-evaluations of
treatment effect and the objective counting
of hairs in the photos. The results obtained in
the present study compare favourably with
the results obtained in studies with drugs. In
a study with finasteride in 1533 men, the
increase in the number of hairs was reported
to be 11% compared with a 2.5% decrease in
the placebo group.
All of the participants used the active
preparation for 12 months, and we do not
know what will happen when the treatment is
stopped. It may be necessary to continue with
maintenance treatment at a lower dose.
The mechanism of action of Hairgain
not known, and future studies should
concentrate on this aspect. The positive effect
seen in this study together with the
excellent tolerability suggest that Hairgain
may provide a valuable alternative treatment
for those with androgenic alopecia.
1 Gjersvik PJ: Mannlig skallethet. Tidsskr Nor
Lægeforen 2000; 10: 1120.
2 Fyrand O: Det gåtefulle språket. Om hudens
kommunikasjon. Oslo: Universitetsforlaget,1996.
3 Mørk C: Hårtap. Årsak, diagnostikk, klinikk og
behandling. Tidsskr Nor Lægeforen 1997; 117:
3103 – 3106.
4 Barth JH: Should men still go bald gracefully?
Lancet 2000; 355: 161 – 162.
5 Cash TF: The psychosocial consequences of
androgenetic alopecia: a review of the research
literature. Br J Dermatol 1999; 141: 398 – 405.
6 Olsen EA, Weiner MS, Amara IA, DeLong ER:
Five year follow-up of men with androgenetic
alopecia treated with topical minoxidil. J Am
Acad Dermatol 1990; 22: 643 – 646.
7 Kaufman KD, Olsen EA, Whiting D, Savin R,
DeVillez R, Bergfeld W, et al: Finasteride in the
treatment of men with androgenetic alopecia.
J Am Acad Dermatol 1998; 39: 578 – 589.
8 Leyden J, Dunlap F, Miller B, Winters P,
Lebwohl M, Hecker D, et al: Finasteride in the
treatment of men with frontal male pattern
hair loss. J Am Acad Dermatol 1999; 40:
930 – 937.
• Received for publication 7 November 2000 • Accepted 14 November 2000
©2001 Cambridge Medical Publications
Address for correspondence
Dr E Thom
Postbox 210 2001, Lillestrøm, Norway.
... This unique method is referred to as 'Proteoglycan Replacement Therapy (PRT)' in clinical literature. Numerous clinical trials and papers have confirmed and demonstrated the clinical efficacy and safety of PRT with Nourkrin ® in patients with diffuse hair loss [6][7][8][9]. ...
... In two independent randomised, placebo-controlled, clinical trials, 6 months of PRT with Nourkrin ® has significantly increased hair density by 32-36% in patients with pattern hair loss. Subjective assessments also indicated a high rate of treatment satisfaction in Nourkrin ® users [6,7]. A later trial reported considerable improvements in overall quality of life and all of its sub-scores after adding Nourkrin ® to the treatment regimen of women with hair loss [9]. ...
... Long-term administration of Nourkrin ® Woman in our study did not induce any side effects. This finding signifies the safety of Nourkrin ® in treating women with diffuse hair loss and confirms the former observational and interventional clinical reports [6][7][8][9]. ...
... Subsequent to this finding, good effort had been made in research centres in Denmark, Norway, and Sweden to formulate a specific enzymatic-extracted mixture of proteoglycans aimed to treat hair loss problems. e resulting product (Nourkrin ® with Marilex ® ,Pharma Medico Aps, Aarhus, Denmark) has been found to produce promising results in different clinical settings [99][100][101], reviewed by om and colleagues [102]. As yet, this line of research has admittedly had limited effects on global standard therapeutic guidelines for hair loss management; however, it appears to be the time for reconsideration. ...
... is positive improvement resulted in considerably higher treatment satisfaction among treated individuals [100]. ...
... Further exploration revealed that close to half of the proteoglycan absorption in the jejunum and the ileum is via clathrin-mediated endocytosis [116]. Furthermore, since bioactivity depends on sufficient bioavailability and bioaccessibility, positive outcomes produced by oral PRT with Nourkrin ® in clinical trials in a variety of health conditions [95,[99][100][101]117] may be taken as indirect evidence for oral bioavailability of specific proteoglycans. However, making reliable conclusions would require direct in vivo pharmacokinetic studies. ...
Full-text available
Follicular proteoglycans are key players with structural, functional, and regulatory roles in the growth and cycling behaviour of the hair follicles. The expression pattern of specific proteoglycans is strongly correlated with follicular phase transitions, which further affirms their functional involvement. Research shows that bioactive proteoglycans, e.g., versican and decorin, can actively trigger follicular phase shift by their anagen-inducing, anagen-maintaining, and immunoregulatory properties. This emerging insight has led to the recognition of “dysregulated proteoglycan metabolism” as a plausible causal or mediating pathology in hair growth disorders in both men and women. In support of this, declined expression of proteoglycans has been reported in cases of anagen shortening and follicular miniaturisation. To facilitate scientific communication, we propose designating this pathology “follicular hypoglycania (FHG),” which results from an impaired ability of follicular cells to replenish and maintain a minimum relative concentration of key proteoglycans during anagen. Lasting FHG may advance to structural decay, called proteoglycan follicular atrophy (PFA). This process is suggested to be an integral pathogenetic factor in pattern hair loss (PHL) and telogen effluvium (TE). To address FHG and PFA, a proteoglycan replacement therapy (PRT) program using oral administration of a marine-derived extract (Nourkrin® with Marilex®, produced by Pharma Medico Aps, Aarhus, Denmark) containing specific proteoglycans has been developed. In clinical studies, this treatment significantly reduced hair fall, promoted hair growth, and improved quality of life in patients with male- and female-pattern hair loss. Accordingly, PRT (using Nourkrin® with Marilex®) can be recommended as an add-on treatment or monotherapy in patients with PHL and TE.
... This degenerative pathological phenomenon, known as Proteoglycan Follicular Atrophy (PFA), is understood to be an important pathology in common types of diffuse hair loss. Mitigating PFA by PRT with a specific, proprietary combination of proteoglycans (Marilex ® ), marketed as Nourkrin ® , has shown efficacy in improving hair growth, hair density and reducing miniaturisation in several clinical trials [17][18][19]. However, the subjective impression of patients about these clinical improvements in different populations has not been sufficiently investigated. ...
... Objective measurements documented that six months of treatment with Nourkrin ® can decrease spontaneous hair loss, telogen/anagen ratio and improve hair growth rate in individuals with hair loss. A significant increase of up to 36% in hair density has also been reported in two separate placebo-controlled, clinical trials [18,19]. ...
... A significantly high satisfaction rate with Nourkrin ® monotherapy in this study was observed at both 3-and 6-month evaluations and points to a desirable efficacy and absence of substantive side effects. Similar levels of treatment satisfaction with Nourkrin ® have also been described in previous clinical trials on hair loss patients [18,19]. In comparison, the satisfaction rates with topical minoxidil plus a botanical remedy for four months have been reported to be lower (86%) among women [26] and men (28% after six months) with no meaningful changes after three months [28].The lower satisfaction rates with topical minoxidil may have been rooted from its delayed action or common side effects such as dizziness and facial/generalised hypertrichosis [29].On the contrary, the safety and tolerability of Nourkrin ® Woman have been confirmed by this study and several previously published clinical trials [17][18][19]. ...
Full-text available
... A specific cocktail of proteoglycans (Nourkrin), rich in lectican and decorin, was formulated. Clinical studies, conducted on patient with hair loss, have proven its efficacy on hair growth in monotherapy 242,243 or in add-on treatment 244 by increasing the hair count and reducing hair loss. Nourkrin is developed as oral treatment. ...
Full-text available
Heparan sulfate proteoglycans (HSPGs) are part of proteoglycan family. They are composed of heparan sulfate (HS)-type glycosaminoglycan (GAG) chains covalently linked to a core protein. By interacting with growth factors and/or receptors, they regulate numerous pathways including Wnt, hedgehog (Hh), bone morphogenic protein (BMP) and fibroblast growth factor (FGF) pathways. They act as inhibitor or activator of these pathways to modulate embryonic and adult stem cell fate during organ morphogenesis, regeneration and homeostasis. This review summarizes the knowledge on HSPG structure and classification and explores several signaling pathways regulated by HSPGs in stem cell fate. A specific focus on hair follicle stem cell fate and the possibility to target HSPGs in order to tackle hair loss are discussed in more dermatological and cosmeceutical perspectives.
... Per oral PRT using Nourkrin® with Marilex® has been in clinical use for the treatment of PHL for years with promising clinical results [33,34]. This method primarily works by preventing catagen in growing and inducing anagen in dormant hair follicles through the action of its bioactive proteoglycans as comprehensively reviewed by Wadstein, et al. [26]. ...
Importance Despite the widespread use of nutritional supplements and dietary interventions for treating hair loss, the safety and effectiveness of available products remain unclear. Objective To evaluate and compile the findings of all dietary and nutritional interventions for treatment of hair loss among individuals without a known baseline nutritional deficiency. Evidence Review The MEDLINE, Embase, and CINAHL databases were searched from inception through October 20, 2021, to identify articles written in English with original findings from investigations of dietary and nutritional interventions in individuals with alopecia or hair loss without a known baseline nutritional deficiency. Quality was assessed with Oxford Centre for Evidence Based Medicine criteria. Outcomes of interest were disease course, both objectively and subjectively measured. Data were evaluated from January 3 to 11, 2022. Findings The database searches yielded 6347 citations to which 11 articles from reference lists were added. Of this total, 30 articles were included: 17 randomized clinical trials (RCTs), 11 clinical studies (non-RCT), and 2 case series studies. No diet-based interventional studies met inclusion criteria. Studies of nutritional interventions with the highest-quality evidence showed the potential benefit of Viviscal, Nourkrin, Nutrafol, Lamdapil, Pantogar, capsaicin and isoflavone, omegas 3 and 6 with antioxidants, apple nutraceutical, total glucosides of paeony and compound glycyrrhizin tablets, zinc, tocotrienol, and pumpkin seed oil. Kimchi and cheonggukjang, vitamin D 3 , and Forti5 had low-quality evidence for disease course improvement. Adverse effects were rare and mild for all the therapies evaluated. Conclusions and Relevance The findings of this systematic review should be interpreted in the context of each study’s design; however, this work suggests a potential role for nutritional supplements in the treatment of hair loss. Physicians should engage in shared decision-making by covering the potential risks and benefits of these treatments with patients experiencing hair loss. Future research should focus on larger RCTs with active comparators.
Marine extract compounds are products that have appeared in the scientific literature since the early 1990s. Even though their ingredients are not fully disclosed and are allegedly based on patented, “secret” formulas, they share too many similarities. Some of these similarities are the similar design of the published studies, the unknown -but speculated- mechanism of action, and that almost all studies are published exclusively on the same pay-per-page journal. Another similarity these products share is having designated authors who publish studies that look solid to the inexperienced reader but actually suffer from severe limitations, conflicts of interest, and flaws. Most importantly, these products claimed to be impressively efficacious, with the authors typically reporting results two to threefold superior to FDA-approved compounds, 5% Minoxidil topical solution (MTS), and Finasteride 1 mg. Notably, claims of (quoting) “complete cure” of AGA, FPHL, alopecia Areata, even of alopecia Universalis are boldly reported in several of these articles.
Full-text available
Various studies addressing the increasing problem of hair loss, using natural products with few side effects, have been conducted. 5-bromo-3,4-dihydroxybenzaldehyde (BDB) exhibited anti-inflammatory effects in mouse models of atopic dermatitis and inhibited UVB-induced oxidative stress in keratinocytes. Here, we investigated its stimulating effect and the underlying mechanism of action on hair growth using rat vibrissa follicles and dermal papilla cells (DPCs), required for the regulation of hair cycle and length. BDB increased the length of hair fibers in rat vibrissa follicles and the proliferation of DPCs, along with causing changes in the levels of cell cycle-related proteins. We investigated whether BDB could trigger anagen-activating signaling pathways, such as the Wnt/β-catenin pathway and autophagy in DPCs. BDB induces activation of the Wnt/β-catenin pathway through the phosphorylation of GSG3β and β-catenin. BDB increased the levels of autophagic vacuoles and autophagy regulatory proteins Atg7, Atg5, Atg16L, and LC3B. We also investigated whether BDB inhibits the TGF-β pathway, which promotes transition to the catagen phase. BDB inhibited the phosphorylation of Smad2 induced by TGF-β1. Thus, BDB can promote hair growth by modulating anagen signaling by activating Wnt/β-catenin and autophagy pathways and inhibiting the TGF-β pathway in DPCs.
Hair loss has always been and remains an urgent challenge in the world today. Although this condition is not life-threatening, it still has a strong impact on the patients’ quality of life. Hairlines are affected by multiple factors including age, family history, smoking, nutrition, etc. Alopecia can take many forms, and the specialist’s objective is to determine the correct cause of the disorder of hair growth cycle by taking a medical history from a patient. The key role in the pathogenesis of androgenetic alopecia is assigned to changes in hormonal status. Telogen effluvium can be triggered by stress, medication, pregnancy, or other medical conditions. For instance, the high number of patients who have had COVID-19 are now faced with hair loss a few months after recovery. Despite the variety of underlining causes of hair loss, the principle of therapy is the same – the elimination of the trigger and the selection of drugs to normalize the natural hair growth cycle. In this case, the use of drugs containing proteoglycans that are specific proteins involved in the regulation of the hair growth cycle looks promising. Numerous studies demonstrate the efficacy of such proteoglycans as versican, decorin, and syndecan. They activate hair growth and help prolong the anagen phase. This effect of proteoglycans affords to speak about their good therapeutic and even prophylactic properties applied to the problem of hair loss.
Background: Androgenetic alopecia (male pattern hair loss) is caused by androgen-dependent miniaturization of scalp hair follicles, with scalp dihydrotestosterone (DHT) implicated as a contributing cause. Finasteride, an inhibitor of type II 5α-reductase, decreases serum and scalp DHT by inhibiting conversion of testosterone to DHT. Objective: Our purpose was to determine whether finasteride treatment leads to clinical improvement in men with male pattern hair loss. Methods: In two 1-year trials, 1553 men (18 to 41 years of age) with male pattern hair loss received oral finasteride 1 mg/d or placebo, and 1215 men continued in blinded extension studies for a second year. Efficacy was evaluated by scalp hair counts, patient and investigator assessments, and review of photographs by an expert panel. Results: Finasteride treatment improved scalp hair by all evaluation techniques at 1 and 2 years (P < .001 vs placebo, all comparisons). Clinically significant increases in hair count (baseline = 876 hairs), measured in a 1-inch diameter circular area (5.1 cm2 ) of balding vertex scalp, were observed with finasteride treatment (107 and 138 hairs vs placebo at 1 and 2 years, respectively; P < .001). Treatment with placebo resulted in progressive hair loss. Patients’ self-assessment demonstrated that finasteride treatment slowed hair loss, increased hair growth, and improved appearance of hair. These improvements were corroborated by investigator assessments and assessments of photographs. Adverse effects were minimal. Conclusion: In men with male pattern hair loss, finasteride 1 mg/d slowed the progression of hair loss and increased hair growth in clinical trials over 2 years. (J Am Acad Dermatol 1998;39:578-89.)
Thirty-one men with androgenetic alopecia completed 4 1/2 to 5 years of therapy with 2% and 3% topical minoxidil. Hair regrowth with topical minoxidil tended to peak at 1 year with a slow decline in regrowth over subsequent years. However, at 4 1/2 to 5 years, maintenance of nonvellus hairs beyond that seen at baseline was still evident. Topical minoxidil appears to be effective in helping to maintain nonvellus hair growth in men with androgenetic alopecia.
Loss of hair is a common complaint and may lead to psychosocial problems. Even the physiological and mildest forms of alopecia can cause considerable distress, and some degree of dysmorphophobia is experienced in a proportion of the patients. Hair loss may be a benign and transient process, or can be a serious and permanent problem. The majority of hair loss complaints seen in both males and females are caused by androgen-dependent or increased telogen hair shedding. Correct diagnosis is often reached by examining the clinical symptoms and presenting signs. A full explanation and open discussion of psychosocial problems and management of alopecia is advised. Starting to treat the complaint with hair stimulants should be restricted, and must be discussed critically with the patient. The approach should aim at a satisfied patient in the future. The author briefly discusses treatment options.
Finasteride, a specific inhibitor of type II 5alpha-reductase, decreases serum and scalp dihydrotestosterone and has been shown to be effective in men with vertex male pattern hair loss. This study evaluated the efficacy of finasteride 1 mg/day in men with frontal (anterior/mid) scalp hair thinning. This was a 1-year, double-blind, placebo-controlled study followed by a 1-year open extension. Efficacy was assessed by hair counts (1 cm2 circular area), patient and investigator assessments, and global photographic review. There was a significant increase in hair count in the frontal scalp of finasteride-treated patients (P < .001), as well as significant improvements in patient, investigator, and global photographic assessments. Efficacy was maintained or improved throughout the second year of the study. Finasteride was generally well tolerated. In men with hair loss in the anterior/mid area of the scalp, finasteride 1 mg/day slowed hair loss and increased hair growth.
Androgenetic alopecia is a common dermatological condition, with potentially adverse psychosocial sequelae. The present review critically examines scientific evidence concerning the effects of androgenetic hair loss on social processes and psychological functioning, as well as the psychosocial outcomes of medical treatments. Research confirms a negative but modest effect of visible hair loss on social perceptions. More importantly, androgenetic alopecia is typically experienced as a moderately stressful condition that diminishes body image satisfaction. Deleterious effects on self-esteem and certain facets of psychological adjustment are more apparent among women than men and among treatment-seeking patients. Various 'risk factors' vis-à-vis the psychological adversity of androgenetic alopecia are identified. Medical treatments, i.e. minoxidil and finasteride, appear to have some psychological efficacy. A conceptual model is delineated to explain the psychological effects of hair loss and its treatment. Directions for needed research are discussed. Strategies are presented for the clinical management of psychological issues among these patients.
Det gåtefulle språket. Om hudens kommunikasjon
  • O Fyrand
Fyrand O: Det gåtefulle språket. Om hudens kommunikasjon. Oslo: Universitetsforlaget,1996.
Årsak, diagnostikk, klinikk og behandling
  • C Mørk
  • Hårtap
Mørk C: Hårtap. Årsak, diagnostikk, klinikk og behandling. Tidsskr Nor Laegeforen 1997; 117: 3103 – 3106.