Blog title: Hair loss treatments - a closer look

If you’re one of the thousands of Australians who’ve been treated for hair loss and been underwhelmed by the results, spare a thought for the millions who’ve come before you – and grown nothing but irate.

For anyone who’s prematurely bald or has a receding hairline, hair loss can be a distressing experience. If you don’t want to take daily medication or have a hair transplant the best option usually involves embracing the march of time and genetics – or adopting a fashionable buzz cut.

However, we can all take comfort from the fact that we didn’t live 3,500 years ago – when the latest must-have cure for baldness involved rubbing fat from hippos and ibexes into your scalp. From Julius Caesar’s famous comb-over, to a salve made from burned bees, the annals of history are littered with spurious remedies that are as odd as they are smelly.

Snake oils and bogus balms

The Ebers Papyrus, written in Egypt around 1550 BC, contains the oldest known prescription for baldness: a mixture of iron-oxide, lead, onions, honey, alabaster and fat from various animals, including snakes, crocodiles, ibexes, hippos and lions. 

This literal snake-oil cure had to be swallowed after reciting an invocation to the Sun God: ‘Oh shining one, who hoverest above!’ – presumably a reference to the god Ra, rather than one’s own shiny pate.

Fast forward to ancient Greece in 420 BC, where Hippocrates, the father of modern medicine, treated his own pate with a mixture of cumin, pigeon droppings, horseradish and nettles. 

Although this did not succeed, the Greek physician did discover a remedy far worse than even this rancid mix.

The unkindest cut of all

In his medical journals, Hippocrates noted that the Persian Army eunuchs guarding the king’s harem did not experience hair loss if they were castrated before the age of 25. ‘Eunuchs are not affected by gout, nor do they become bald,’ he observed.

Some 2,400 years later, in March 1995, researchers at Duke University in North Carolina confirmed the great physician’s hypothesis – although, they bleakly noted, ‘while castration may be a cure (for baldness), it is not commercially acceptable.’

Compost for the head 

Excreta of various sorts have featured heavily in history’s baldness cures – presumably inspired by the same fertilising properties sought by gardeners. 

A physician in ancient Rome prescribed burning the genitals of a donkey and mixing the ash with one’s own urine to form a paste. 

While Aristotle reputedly applied goat’s urine to his scalp, King Henry VIII was said to favour dog and horse urine, while some Native American tribes preferred a poultice of chicken or cow manure.

19th century quackery

In the 1850s, the expanding British Empire reached out to its colonies for the latest baldness cure: cold India tea. This was to be vigorously rubbed into the scalp with fresh lemon juice. It may well have been a big improvement on body odour, but it did nothing for hair growth.

In America, the 19th century was a time of shameless quackery, with self-styled ‘hair professors’ marketing tonics containing irritants such as capsicum and cantharides (Spanish fly), which were said to increase circulation to the scalp. 

Other hare-brained treatments contained bear oil, beef marrow, butter, and even sulphur and mercury.

Industrial marvels

The early 20th century saw the creation of several dubious mechanical devices, including: 

  • the heat-emitting Thermocap (under which hopeful users would sit for 15 minutes a day) 
  • a glowing glass comb called the Super Marvel 
  • the magically named Xervac – a vacuum-like machine that claimed to use suction to spur hair growth.

At the other end of the spectrum, the growing naturopathy and ayurveda movements were embracing a growing list of herbal and plant-based remedies for hair loss. Many of these are still popular today, including castor and almond oil, coconut milk, fenugreek seeds, liquorice roots, lemon seeds, rosemary, beetroot, onion juice (there it is again!), aloe vera and amla (Indian gooseberry). 

Some alternative practitioners also recommend iron-rich diets, head massages – or even headstands to get the blood flowing to the scalp.

The birth of transplants

One of the greatest breakthroughs of the early 20th century almost remained hidden. In 1939, Japanese dermatologist Dr Shoji Okuda successfully pioneered a procedure for grafting hair from the back of the scalp onto patients’ bald patches. 

World War II ensured that Okuda’s invention remained entirely hidden from the world until the 1950s – when hair transplants were popularised by a New York doctor, Norman Orentreich.

Today, hair transplants have evolved into a highly sophisticated art, with ‘follicular unit micrografting’ enabling microscopic transfers of one to three hair follicles – creating a much more natural look than the spiky clumps of earlier efforts. 

Together with promising research into ‘cloning’ hair from cultured stem cells, prospects for future sufferers are increasingly hirsute.

Clinical validation, at last

It wasn’t until 1988 that the first drug to be clinically proven to replenish hair was approved by the US Food and Drug Administration. 

Today, minoxidil is a household name in Australia, available as a lotion or foam over the counter in most pharmacies. Originally used as a tablet to treat high blood pressure, studies have shown the drug can promote hair regrowth in about 40 per cent of men after six months. Minoxidil can be used as a topical lotion applied to the scalp, or in tablet form, to grow hair.

The most popular prescription drug for male hair loss in Australia – and worldwide – is Finasteride, which restricts the conversion of testosterone to dihydrotestosterone (DHT), the male hormone that shrinks hair follicles. Available in Australia since 1998, one tablet a day has been shown to arrest further hair loss and stimulate partial regrowth in up to two-thirds of men.

Despite the widespread efficacy of these drugs, questions linger about their long-term use and potential side effects – fed by a number of populist health and consumer websites, but that's a future blog story.  

 

A group of red apples

BHC Team

BHC Team

Just like you, we live all things health. We're lucky enough it's also part of our work. Join us each week as we share ideas and new ways to enjoy even better health.