Kenneth Glad
Hair-loss treatments have overpromised and underdelivered for decades. Now, a new generation of scientists is taking a very different approach, one that aims to wake up hair follicles rather than replace them. The results are early, but the shift has experts cautiously rethinking what a baldness cure might actually look like.
For years, hair-loss research cycled through big promises, but had modest results to show for it at best. Over the past five years, however, a quieter shift has taken place, with scientists focusing less on replacing hair and more on restarting follicles that have gone dormant. Skepticism remains. But the direction of travel has changed.
One of the most closely watched efforts comes from US biotech company Pelage, which is developing a topical drug known as PP405. The treatment targets stem cells already present in hair follicles that have slipped into a prolonged resting phase, BBC has reported.
Dr Christina Weng, Pelage’s chief medical officer, said initial safety testing in humans delivered “fantastic” results. Designed as a gel or cream for home use, the treatment avoids injections or surgery.
Roots of baldness
Pelage co-founder Dr William Lowry, a stem cell biologist at the University of California, Los Angeles, explained the basic mechanism: “They wake up at the start of a new hair cycle to produce very rapidly dividing cells that go on to make a new hair and then they return to quiescence a couple of days later.”
In balding follicles, that reset fails to occur.
Hair loss is not driven by a single malfunction. Ageing follicles, stress, hormones and inherited risk all play a part, with hundreds of genetic regions implicated.
A central factor is dihydrotestosterone, or DHT, a potent derivative of testosterone. By binding tightly to androgen receptors in hair follicles, DHT shortens growth cycles until hairs become progressively thinner.
Geneticist Dr Stefanie Heilmann-Heimbach of the University of Bonn has argued that directly blocking testosterone is a blunt and risky strategy, given the hormone’s many essential roles elsewhere in the body.
Regeneration drive
Those limits have steered researchers toward regenerative approaches that work around hormones rather than against them. Several small studies have explored stem cell–based treatments, including injections of stem cell-enriched fat, with temporary increases in hair growth.
The problem is scale. Harvesting, processing and reinjecting cells is expensive and complex, and results often fade. This has prompted many teams to focus instead on the molecular signals cells release, which may influence the hair growth cycle without the logistical burden.
Topical treatments dominate this stage of research for practical reasons. They are cheaper to test, easier to regulate and simpler for patients to use, making them attractive entry points even when the underlying biology remains uncertain.
Some of the most striking ideas are also the simplest. Researchers in Pakistan and the UK have shown that a naturally occurring sugar, 2-deoxy-D-ribose, restored hair growth in mice as effectively as minoxidil, with human testing still to come.
Past waves of baldness research often chased dramatic fixes and fell short. This one is different in tone: incremental, mechanism-driven and cautious. Whether that restraint finally pays off is the question now facing the field.
Sources: BBC, Pelage
