Study Suggests Drug May Reverse Balding in Men

Men whose hair is going down the drain got the first clinical evidence of a new potential remedy Monday, in a report that a male-hormone-blocking drug seems to reverse the type of baldness that starts at the top of a man’s head.

If the results of a small trial at UCLA are replicated in other studies, the drug Cyoctol would represent the best hope since the drug Rogaine--approved in 1988--for turning a man’s sparse meadow into a thicket.

Cyoctol is to be tested by Bristol-Myers Squibb Co. to treat acne and baldness, and a derivative is being investigated as an anti-wrinkling drug. The drug would not be available to the public until these tests are completed, perhaps a matter of years.

At a presentation to the American Academy of Dermatology in San Francisco, Dr. Richard A. Strick described a small study in which balding men who used a solution of Cyoctol had 12% more hair on a test patch of scalp than they had a year earlier. Men who had not been treated lost 9% of their hair in a patch the same size.

Moreover, unlike steroidal preparations, Cyoctol appears to have no side effects. Animal studies have shown Cyoctol to have no systemic effects at many hundreds of times the 0.5% concentration used in the study, Strick said. Human studies have shown concentrations of 15% do not cause skin irritation, he said.

The only drug approved for use in the United States against male pattern baldness is minoxidil, or Rogaine, a non-steroid that is used at a 2% concentration. Strick suggest that perhaps using a combination Cyoctol and Rogaine could produce results even more dramatic than in his study.

However, the Cyoctol study is small and preliminary, cautioned Dr. Dowling B. Stough, a dermatologist at the University of Arkansas. Because baldness remedies frequently don’t live up to their early promise, the results also need to be carefully scrutinized before physicians can accept them, he said.

The gains in Strick’s study were experienced by 10 of 12 men who applied the solution twice daily. Of another 11 men in a placebo group, seven continued to lose hair and four had some hair regrowth. Nine other men applied a weaker solution of Cyoctol, with insignificant hair growth, Strick said.

Cyoctol is a synthetic compound developed by a small Los Angeles firm, Chantal Pharmaceutical Corp. It blocks the sites on the walls of scalp cells at which the male hormone testosterone attaches to cause male pattern baldness.

When attachment occurs, the hair follicle shrinks and eventually stops growing hair. This type of baldness runs in families and affects about 30% of American men.

One reason Cyoctol is considered an exciting drug is that, although it is an anti-androgen, or anti-male hormone, it does not act as a steroid interfering with hormonal balance. Steroidal anti-androgens can reverse baldness, but have also been shown to give men certain feminine body characteristics, such as cessation of beard growth and enhanced breast development.

Strick’s results seem at least comparable to the hair-growth gains men make with Rogaine, Stough said. Previous studies found that Rogaine resulted in moderate to dense hair growth in 39% of men who used it for a year.

Strick shied away from directly comparing Cyoctol’s results to those with Rogaine. The studies are not directly comparable both because they analyzed different sections of the balding spot and also because they counted hairs in test sections differently. In Rogaine studies, the hairs were counted by hand; the Cyoctol used a new computerized method.

Although Cyoctol may indeed prove to be as good as this initial study suggests, Strick said, just as important will be its other potential uses.

The testosterone receptor against which Cyoctol acts also is known to be important in causing acne, he said. It was for this initial use that Bristol-Myers Squibb acquired licensing rights to Cyoctol in September.

In addition, because facial hair growth requires that the hair follicle be stimulated by testosterone, Cyoctol might eventually give women an alternative to waxing and bleaching for excess facial hair, Strick said.

The U.S. Food and Drug Administration also recently approved a Cyoctol analog as an investigational new drug against skin wrinkling.