Hirsutism and unwanted hair growth

Hair removal, also known as epilation or depilation, is the deliberate removal of body hair and it is carried out for both medical, as in the case of hirsutism, and non-medical reasons.

For the medical condition of hirsutism there is not a single drug on the market approved by the Foods and Drugs Administration (FDA) to treat it. The only product which is approved is Vaniqa®, a skin cream that can be used to slow the growth of unwanted facial hair in women. It does not remove hair permanently. Most treatments today consist of combination treatments and many include laser therapy or the contraceptive pill.

The more physical methods of treatment include:

  • Shaving
  • Chemical hair removal, waxing, and bleaching
  • Electrolysis
  • Laser hair removal

Although not directly comparable with Follicum’s compounds, there are several systemic medications available for the treatment of hirsutism today. These fall in to two groups, Hormonal treatments, which must be stopped if a woman would like to become pregnant and anti-androgens, which may cause birth defects. Most of these medications must be taken for at least six months before any improvement is detectable and they are not equally effective in all women.

As Follicum’s drug candidate is based on an endogenous peptide, no serious adverse effects are foreseen.

Hair loss

There are basically only two treatments that have been clinically proven to successfully treat hair loss, to varying degrees, in men. Currently there is only one FDA-approved treatment for female pattern hair loss. Other treatments have not been approved by the FDA for the treatment of hair loss, but have been approved for other applications and are often used “off-label” to treat hair loss.

Finasteride (Proscar and Propecia)

This was originally developed by Merck as a drug to treat enlarged prostate glands (Proscar).

Finasteride is not approved for use in women, due to the risk of birth defects occurring in a fetus. It is classified in the FDA pregnancy category X.

The effect of finasteride on sexual function is controversial. There are case reports of persistent diminished libido or erectile dysfunction, even after treatment with the drug has stopped, and the FDA has updated the label to inform healthcare professionals of these reports.

Minoxidil (Rogaine®)

This was first used in tablet form as a medicine to treat high blood pressure. It was noticed that patients being treated with minoxidil developed excessive hair growth (hypertrichosis) as a side effect. Further research showed that applying a solution of minoxidil directly to the scalp could also stimulate hair growth.

Minoxidil was the first drug approved by the FDA for the treatment of male pattern baldness. While minoxidil has been clinically proven to slow the progression of hair loss and regrow some hair, most informed experts see it as a relatively marginally effective drug in the fight against hair loss.

Minoxidil is generally well tolerated when applied topically. However, it is clear from some hair loss web sites that some people, desperate to increase their hair growth, are taking minoxidil orally. Common side effects of oral treatment with minoxidil include; burning or irritation of the eye, itching, redness or irritation at the treated area, as well as unwanted hair growth elsewhere on the body. Exacerbation of hair loss/alopecia has also been reported. Some more serious side effects include: severe allergic reactions (e.g. rash, hives, itching, difficulty breathing, tightness in the chest), chest pain, dizziness, fainting, tachycardia (rapid heartbeat). Manufacturers note that minoxidil-induced hair loss is a common side effect and describe the process as “shedding”.