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However, many chemical agents are known that can induce hair growth, although many remain completely impractical.  Massive systemic doses of oestrogen for men, for example, will certainly induce hair growth, but the additional feminisation of the male concerned would be generally completely unacceptable, although this technique is used in male to female sex change operations.  The oestrogen supply swamps the testosterone present.

A more elegant approach involves the inhibition of di-hydroxytestosterone (DHT) production, the more potent form of testosterone, and a number of products have been developed to achieve this aim.  Finnasteride (Merck & Co) is a DHT inhibitor, taken orally and marketed as “Propecia”.  The clinical evidence suggests some re-growth for men (the product is contra-indicated for women), although after the initial two years, the reversal appears again, until after about five years the hair growth pattern has reverted back to its original position.  The product does assist in slowing the onset of Androgenic Alopecia but one must bear in mind the side effects, although only a small percentage (1 or 2%) are severe.

There are a number of naturally occurring DHT inhibitors, of which the herb Saw Palmetto (Serenoa Repens) is probably the best known.  Not surprisingly no comprehensive clinical trials have been undertaken but the anecdotal evidence remains strong.

The best known of the “growth” products is of course Minoxydil, applied topically in strengths of 2% to 5%.  Minoxydil certainly assists but is better in some cases than others, and all cases suffer from the drawback of hair fall when treatment ceases.  Minoxydil is a potent vasodilator; it increases the blood supply locally, although its precise mode of action is unknown. 

 A number of other products use a vasodilator technique and the idea of increasing the blood supply, and hence the nutrients carried in the blood, to the dermal papilla and the hair root seems eminently sensible.  However, the hair growth benefit from these products is not so clear cut.

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