Despite several recent studies, the prognostic factors of the outcome for Alopecia Areata are not yet fully determined. In order to gain a fuller understanding of prognostic indicators, researchers at Tokyo Medical University conducted a study of 1030 patients with Alopecia Areata.

The study, which was published in Journal of American Academy of Dermatology, examined the participants retrospectively for three years and followed them up for 24 months or more using a questionnaire. The key areas of interest were age at onset, severity of hair loss and treatment modalities. The researchers were also keen to see whether there was a difference in prognosis between rapidly progressive alopecia areata (RPAA) and non- RPAA patients. In total there were 199 patients with RPAA and 831 patients with non-RPAA.

The findings indicated that the most typical age at onset was early 30s for males and in the 20s for females. Regardless of the type of alopecia areata, an early onset was associated with poorer prognosis than a late onset. Similarly, a previous history of alopecia areata was related to a poor prognosis but was not related to the type of alopecia areata. One factor that appeared to be associated with a good prognosis was regeneration of vellus hairs and the authors argued that the extent of hair loss was not related to a poor prognosis. This finding is particularly interesting as it is at odds with previous reports and implies that the hair loss that has previously been associated with poor prognosis may be relevant to alopecia areata patients in general but not RPAA patients. Perhaps the most encouraging finding was that treatment modality was not related to a poor prognosis.

The value of this study comes not only from its sample size, but also from the statistical analysis that they utilised, which is more robust than previous studies. However, the nature of the study is bound to have some problems. For instance, once the large sample has been divided into groups, it becomes clear that the comparison between them is challenging as the follow up period of patients differs from case to case. Similarly, the authors note that some patients changed treatment modality throughout the study, yet these were not excluded.

We reported back in March that scientists in the US had discovered a crucial role that Prostaglandin D2 has in inhibiting hair growth. A higher level of Prostaglandin D2 normally indicated a degree of thinness of the hair. Some animals with very high levels of this enzyme had no hair at all.

The same scientists are now talking to pharmaceutical companies about developing a medication to treat people with hair loss associated with high levels of Prostaglandin D2. According to news reports, such prostaglandin inhibitors already exist so a medication for hair loss may be just around the corner. We are not sure that it will be this simple. One of the most famous prostaglandin inhibitors is Aspirin. Have you hear of people taking Apsirin and suddenly growing hair? We thought not! We don’t what to dismiss the idea of drug therapy based on prostaglandin inhibition and we are sure that this avenue of research will prove fruitful, but any drug will have to be targeted at a particular receptor and this could take years of research. In the meantime, there is always Propecia or Regaine for men suffering from hair loss.

Has football made the sneaky hair transplant the ‘in thing’ to do? We’re sure that most men hope so anyway. Michael Gray, former Sunderland player, was filmed as he underwent the painful hair transplant. The piece was broadcast in an effort to get rid of any stigma or misconception that might be floating around regarding the procedure and the producers seem to think it will have done the job.

For those who would rather a brain transplant than to stay awake while undergoing the painful donor extraction and re-implantation of hair, Propecia is a simpler and much cheaper option than the current hair transplant procedure, which can cost up to £30,000. The key to getting the most out of Propecia is to start taking it as soon as hair loss begins since less hair will be lost initially. The treatment has also been seen to encourage hair growth in areas where hair had already fallen out.

Budgets permitting, there are now a few options for men who are losing their hair and for whom baldness is not an attractive option.

Scientists in the US have discovered an unusual amount of protein, prostaglandin D synthase, in bald men and this, they hypothesize, may be a contributory factor in male pattern baldness. Drugs that act on this protein are already under investigation and a report detailing recent study evidence is published in Science Translational Medicine.

Research has targeted particular genes that are activated when men start to lose their hair and it has been found that levels of this protein were highest in the areas of the scalp that were without hair.

In mouse studies, those with higher levels of the protein had no fur at all. Human hairs that had been transplanted also stopped growing when this protein was administered. Identifying this protein as a growth inhibitor could mean another successful hair loss treatment for men. Researchers will now look at how they can target this protein and its action to stop hair loss and maybe even use this knowledge to create a treatment that works to regrow hair that has fallen out. The existing treatment, Propecia (finasteride), has a very high success rate but does not always result in regrowth, although the overall success rate of Propecia is high at around 89%.

It will be interesting to see if this research throws up a potential treatment for hair loss in women as well as there is currently nothing on the market that has a good rate of success in this demographic.

There is a new calculator available on the internet that helps men gauge when they will lose their hair or if they will lose it. A hair loss expert at the Alpecin Research Institute in Germany came up with the novel idea and can even show men what they will look like bald if they decide to upload a photograph of themselves.

This new calculator will help men to act fast when it comes to the loss of their hair. The success of hair loss treatment is often down to how soon a man begins treatment. The sooner a man commences taking the once daily Propecia, for example, the better the results will be as this drug can stop the progression of male pattern baldness. In some cases the drug causes the regrowth of hair that has already fallen out. Starting early is crucial to maintaining a full head of hair.

Androgenic alopecia is genetic and it is the most common form of hair loss. It afflicts a large number of men but early intervention can help to maintain a full head of hair.