- Reaction score
- 43
I've already mentioned this first one at least a couple of times in the past when I've debated Stephen Foote, but he's never made any reply to it. He seems to have a tendency to get temporary amnesia whenever he sees something that doesn't fit well into his theory! :wink: This would be: "A Preliminary Study of the Effect of 11a-Hydroxyprogesterone on the Hair Growth in Men Suffering from Androgenetic Alopecia", A. H. Van Der Willigen et al, Acta Derm Venereol (Stockh) 1987; 67:82-85. What's unusual about this trial is not just that it's yet another successful test of a topical antiandrogen for male pattern baldness, it's that it's the only one I know of that tested the effects of the antiandrogen both in the area to which it was applied, AND in an area to which it was NOT applied (a control area). Every day before retiring to sleep, the test-subjects applied a 1% lotion of 11a-hydroxyprogesterone to the affected cranial area. Before the start of the study and again after 1 year, the hair roots were obtained in a standardized way from two fixed locations: the left temporal and the cranial scalp. Anagen/telogen percentages were determined at both sites.
After one year, the treated subjects showed an increased number of anagen hairs in the cranial (treated) area, but a further decrease in the number of anagen hairs in the temporal (untreated) area. The subjects who didn't get any treatment at all showed anagen decreases in both the cranial and the temporal areas.
The significance of this trial, of course, is that Stephen Foote has always argued that antiandrogens and 5a-reductase inhibitors work for male pattern baldness through an indirect systemic effect, rather than a direct effect on hair follicles. But the results here would seem to contradict that theory, because a beneficial effect was seen only in the top part of the scalp where the antiandrogen lotion was actually applied, and NOT in the nearby temporal area that didn't receive the drug. How do you explain THAT, Stephen?
The other thing I wanted to discuss is another of Stephen's odd claims, which is that even minoxidil doesn't have a "direct" growth-stimulating effect on hair follicles. He asserts that it, too, works by lowering the edema around hair follicles by supposedly shifting fluid away from them. But if that's the case, I'd like him to explain why topical minoxidil also works for alopecia areata, which has a tendency to occur in "patches" around the scalp, which generally move and shift their position on the scalp as time goes by. The disease is generally considered to be an autoimmune disorder, with the immune system attacking the hair follicles in those specific areas.
Here's another interesting study with a "twist" to it that's similar to the first one I mentioned above: "Double-blind, placebo-controlled evaluation of topical minoxidil in extensive alopecia areata", Vera H. Price, J Am Acad Dermatol 1987; 16:730-6. Here's the "twist", as described in the treatment protocol section (added emphasis in bold is my own): "Subjects were randomly assigned in a double-blind fashion to receive either the 3% minoxidil solution or placebo. The assigned solution was applied twice daily to affected areas on half of the scalp only, with overnight petrolatum occlusion. The other half of the scalp was left untreated throughout the 1-year study."
The treatment was generally successful, and here's what Price says in the Discussion section: "Subjects in the minoxidil group who regrew scalp hair had growth on both the treated and untreated sides, but hair growth always began earlier and was more abundant on the treated side. Hair growth on the untreated side of the scalp in the minoxidil group may have been either spontaneous regrowth or a response to the minoxidil in the nearby scalp areas. There is some speculation that topical minoxidil spreads across the skin surface or even within the skin, much like solvents through chromatograph paper. Alternatively, topical minoxidil may be transferred from the treated side to the untreated side by wigs, hats, or pillowcases. A systemic effect is unlikely in view of the low to very low minoxidil serum levels measured."
So I'd like to ask Stephen the obvious question: if topical minoxidil really only works to grow hair by supposedly shifting fluid away from hair follicles to some "central volume", just how small and confined a physical area do you think it's possible for it to do that in? After all, the left half of a human scalp isn't very far away at all from the right half; do you really think that it could make that much of a difference in "edema" in the top parts of a scalp that are only a couple of inches away from each other, not to mention the little problem of whether or not there even IS "edema" at all in a patient with alopecia areata?? Let's hear your thoughts on all that, Stephen! :wink:
After one year, the treated subjects showed an increased number of anagen hairs in the cranial (treated) area, but a further decrease in the number of anagen hairs in the temporal (untreated) area. The subjects who didn't get any treatment at all showed anagen decreases in both the cranial and the temporal areas.
The significance of this trial, of course, is that Stephen Foote has always argued that antiandrogens and 5a-reductase inhibitors work for male pattern baldness through an indirect systemic effect, rather than a direct effect on hair follicles. But the results here would seem to contradict that theory, because a beneficial effect was seen only in the top part of the scalp where the antiandrogen lotion was actually applied, and NOT in the nearby temporal area that didn't receive the drug. How do you explain THAT, Stephen?
The other thing I wanted to discuss is another of Stephen's odd claims, which is that even minoxidil doesn't have a "direct" growth-stimulating effect on hair follicles. He asserts that it, too, works by lowering the edema around hair follicles by supposedly shifting fluid away from them. But if that's the case, I'd like him to explain why topical minoxidil also works for alopecia areata, which has a tendency to occur in "patches" around the scalp, which generally move and shift their position on the scalp as time goes by. The disease is generally considered to be an autoimmune disorder, with the immune system attacking the hair follicles in those specific areas.
Here's another interesting study with a "twist" to it that's similar to the first one I mentioned above: "Double-blind, placebo-controlled evaluation of topical minoxidil in extensive alopecia areata", Vera H. Price, J Am Acad Dermatol 1987; 16:730-6. Here's the "twist", as described in the treatment protocol section (added emphasis in bold is my own): "Subjects were randomly assigned in a double-blind fashion to receive either the 3% minoxidil solution or placebo. The assigned solution was applied twice daily to affected areas on half of the scalp only, with overnight petrolatum occlusion. The other half of the scalp was left untreated throughout the 1-year study."
The treatment was generally successful, and here's what Price says in the Discussion section: "Subjects in the minoxidil group who regrew scalp hair had growth on both the treated and untreated sides, but hair growth always began earlier and was more abundant on the treated side. Hair growth on the untreated side of the scalp in the minoxidil group may have been either spontaneous regrowth or a response to the minoxidil in the nearby scalp areas. There is some speculation that topical minoxidil spreads across the skin surface or even within the skin, much like solvents through chromatograph paper. Alternatively, topical minoxidil may be transferred from the treated side to the untreated side by wigs, hats, or pillowcases. A systemic effect is unlikely in view of the low to very low minoxidil serum levels measured."
So I'd like to ask Stephen the obvious question: if topical minoxidil really only works to grow hair by supposedly shifting fluid away from hair follicles to some "central volume", just how small and confined a physical area do you think it's possible for it to do that in? After all, the left half of a human scalp isn't very far away at all from the right half; do you really think that it could make that much of a difference in "edema" in the top parts of a scalp that are only a couple of inches away from each other, not to mention the little problem of whether or not there even IS "edema" at all in a patient with alopecia areata?? Let's hear your thoughts on all that, Stephen! :wink:
