TOPICS > Health

Cure for Baldness?

December 23, 1997 at 12:00 AM EDT

PHIL PONCE: Now, could there be a cure for male baldness? The Food & Drug Administration has approved a new pill that shows some promise but has some drawbacks. The pharmaceutical company Merck will market the pill under the brand name Propecia by the middle of next month. Joining us now from Los Angeles is Dr. Ronald Savin, clinical professor of dermatology at the Yale University School of Medicine. Dr. Savin was one of a group of dermatologists worldwide who tested the pill in clinical trials. Welcome, Dr. Savin. First of all, just how well does this pill work?

DR. RONALD SAVIN, Yale School of Medicine: It works pretty well. You know, in an area where nothing else works, other than Rogaine to some extent, it produces a significant amount of re-growth, which is cosmetically pleasing.

PHIL PONCE: Now, for somebody who’s taken this for a couple of years and I understand that’s how long the trials have run, has anyone grown a full head of hair?

DR. RONALD SAVIN: Not a full head of hair in the sense that one had when a man was 13, but pretty good growth. About 1/3 of the patients after two years developed medium to dense re-growth, which is especially prominent over the back of the top of the scalp. We call it the vertex. It’s impressive re-growth. About 1/3 of patients re-grow a mild amount of hair, which is nevertheless cosmetically visible. And about 1/3 of the patients don’t re-grow any, but they don’t get any worse either. And that’s very nice as well.

PHIL PONCE: So as far as the total percentage impact, what are you talking about in terms of either a condition not getting any worse or actual improvement?

DR. RONALD SAVIN: About 2/3 of the patients improve. They get cosmetically pleasing new hair. And almost all of them stay stable at the worst.

PHIL PONCE: Dr. Savin, how long does a man have to take this drug before he knows whether or not it’s working?

DR. RONALD SAVIN: I think about six months. It takes about six months for it to sort of get it stride.

PHIL PONCE: And in simple terms, how does the drug work?

DR. RONALD SAVIN: It’s not so simple. It works by blocking the formation of DHT, Di Hydro Testosterone, which is a male hormone which controls the presence or lack of hair in older men, so by blocking DHT, it blocks the formation of baldness.

PHIL PONCE: And the side effects?

DR. RONALD SAVIN: Well, there’s sort of one significant side effect. Otherwise, it’s very safe. And that is in about one out of a hundred men it decreases sexual interest. That decrease tends to be transient over the course of a year. But for the one in a hundred it can be a problem. On the other hand, if you merely stop the pill, it goes away.

PHIL PONCE: When you say that it decreases–that it stops the end of a year–is that to say that after one has taken this medication for a year, that–the possible decrease in sexual interest just dissipates?

DR. RONALD SAVIN: Right. By that I mean after about one year the incidence of decreased sexual interest in the placebo group is the same as in the active group.

PHIL PONCE: And do scientists know why there’s this connection between this pill and a man’s libido?

DR. RONALD SAVIN: Well, this pill blocks a major form of male hormone. There are multiple male hormones, and so it blocks a major medicine. It blocks a hormone, which affects male sexual interest.

PHIL PONCE: And as far as the suitability of this pill for women, tell us about that.

DR. RONALD SAVIN: The pill is not suitable for women of child-bearing potential. If women of child-bearing potential become pregnant, it affects the gender determination of the male child and therefore is not appropriate, is really forbidden.

PHIL PONCE: And explain–

DR. RONALD SAVIN: For a female child there’s no problem.

PHIL PONCE: But expand on what you mean by that–the gender formation.

DR. RONALD SAVIN: The male child is born with ambiguous genitalia. The penis does not look normal. Now, this actually self-corrects by the age of 12, but it’s not something anyone wants to go through.

PHIL PONCE: Is there any danger to a woman who’s–who is having a child that’s been fathered by somebody who’s been taking this drug?

DR. RONALD SAVIN: No, I do not believe so. There is no specific language that the FDA has had the company put in the package insert. And so in my experience there has been no effect on children born to men who’ve been taking Proscar–I’m sorry–taking Propecia.

PHIL PONCE: This medication has been tested for a couple of years. Is two years long enough to know what the long-term impact might be, either beneficial or detrimental?

DR. RONALD SAVIN: Well, this medicine actually has been on the market for a number of years for the treatment of benign prosthetic hypertrophy, which is swelling of the prostate in older men. It’s been on the market under the name Proscar, which is five milligrams of the chemical pheaspheride, rather than one milligram, which is in Propecia. So there is a fair amount of experience but the experience is in older men, say an average age of 60 or 65.

PHIL PONCE: So what you’re saying is that a stronger dose of this drug has been out in the market for some time to treat something else and there’s been again–there are no negative side effects besides the ones you’ve already alluded to?

DR. RONALD SAVIN: Yes, that’s correct.

PHIL PONCE: The extent of independent testing that has been–that this drug has gone through–what can you tell us about that?

DR. RONALD SAVIN: Well, there have been a number of studies beginning with these two studies, which are small pilot studies, and face three studies, which are the major studies that prepare their background information for the FDA. Approximately 1500 men have been studied both in the U.S. studies and international studies, and there’s an awful lot of data. Some of these studies are still going on at five years, but the data that is available is the two-year data.

PHIL PONCE: Now, one can easily understand why any pharmaceutical company might be interested in putting a product out like this and making claims about it. How comfortable are you that these claims have been independently tested to follow up on what you’ve been saying?

DR. RONALD SAVIN: Well, I’ve seen the data. I’ve done the research. I’ve been privy to the combined photography experience of all the participants in the study, all 1500 patients, and the data really is impressive.

PHIL PONCE: Dr. Savin, excuse me for interrupting, in the time we have left, what do you say to people who look at the research, who look at this medicine and say, please, this is not the most pressing issue in the world, there are more important things to be spending money on?

DR. RONALD SAVIN: Well, I get that kind of statement more from some colleagues who are taking care of very serious illnesses. But the patients who come to me are very disturbed by their baldness. It’s upsetting their lives; it’s ruining for them some of their careers, their personal relationships, and baldness is a very disturbing medical defect to them.

PHIL PONCE: Dr. Savin, thank you very much for joining us.

DR. RONALD SAVIN: Thank you.