Hair loss is a devastating condition and one that is largely still misunderstood. As such, there are many new drugs springing up that may offer a viable treatment option, even if the exact mechanism is unknown.
One such drug is latanoprost, which is currently used in the treatment of glaucoma and ocular hypertension (1).
In this post, the past and current research on the topic of latanoprost for hair growth will be discussed.
The process for drug approval will also be introduced, which may help to indicate when, if ever, latanoprost will be available on the market for the treatment of Androgenetic Alopecia (AGA).
What is Latanoprost?
Latanoprost, also known under the brand name of Xalatan, is a prescription medication used in the treatment of glaucoma (1). It can also be used in other conditions that increase pressure within the eye, such as ocular hypertension.
How Does It Work?
Prostaglandins have been shown to lower intraocular pressure, which is critical in the treatment of glaucoma (4).
They do this by increasing the permeability of the sclera, the white part of the eye connected to the cornea, to allow aqueous outflow (5). This reduces fluid buildup, and therefore lowers pressure.
But prostaglandins have other roles in the body, including reducing inflammation, pain modulation, and reducing allergies (4). And prostaglandins have even been implicated in both hair loss and hair growth (6, 7).
Is Latanoprost a Viable Hair Loss Treatment?
While it’s currently only approved for use in glaucoma patients, researchers have found that latanoprost has an interesting side effect – hypertrichosis (8). That is, it promotes hair growth, sometimes excessively.
But does this mean it’s a viable treatment for balding and, if so, what are its odds of treating AGA successfully?
To answer these questions, numerous studies have been conducted over the years. These include initial trials of the drug’s hair-growth-promoting effects on macaque monkeys and, more recently, even human studies (9, 10).
The first study was small – consisting of just eight monkeys – but it shed light on latanoprost and its use in treating hair loss (9).
The monkeys were split into two groups, of which one received a daily topical application of 50 microg/ml of latanoprost for five months and the other received a placebo.
Two monkeys from each group were then given 500 microg/ml latanoprost daily for an additional three months. The results were tracked via monthly photographs and photo-trichographic analysis.
At the end of the study, the results were clear.
Fifty microg/ml latanoprost daily induced minimal hair growth, but the 500 microg/ml dose induced moderate to marked regrowth. According to researchers, there was a “5-10% conversion of vellus hairs to intermediary or terminal hairs.”
But how does this translate to treatment of AGA in humans?
In 2012, researchers recruited 16 men with mild AGA (Hamilton II-III) (10). For a total of 24 weeks, each of the men were given two treatments in different minizones of the scalp:
- Latanoprost 0.1%
The topicals were applied daily and measurements including growth, density, diameter, pigmentation, and anagen/telogen ratio were tracked.
At the end of the 24-week study, the results showed that the latanoprost-treated zones saw increased hair density when compared to baseline and the placebo-treated zones
As researchers concluded, these results indicate that “Latanoprost could be useful in stimulating hair follicle activity and treating hair loss.”
NOTE: This study was performed on men with mild AGA, and the results may not be similar for more advanced stages of the condition. As such, further studies need be done.
When Will Latanoprost Be Available?
While latanoprost is current available by prescription for the treatment of glaucoma and similar conditions, it’s not yet FDA-approved for use in treating AGA (11). Will it ever be?
This question is nearly impossible to answer, as drugs must undergo various stages of rigorous testing before FDA approval. This process can take years and, many times, drugs fail to successfully complete the process for one reason or another.
Here’s just a brief run through of the process, and the various trial phases that the drug must go through to be approved (12):
- Phase I – These trials focus on the safety of a drug, and they usually only consist of a small number of healthy individuals (less than 100). This usually only takes a few months.
- Phase II – These trials will test the efficacy of a drug, and they often contain a larger number of subjects than the Phase I study. These are commonly carried out on affected individuals (i.e. those affected with the condition that the drug is believed to treat), and they can take anywhere from a few months to a few years.
- Phase III – With a larger range of participants, usually several hundred to several thousand, Phase III trials can take several years to complete. These look to further understand the drug’s efficacy, but also determine what possible side effects may occur.
- After Phase III trials, the pharmaceutical company is likely to seek approval from the FDA. If approved, the drug will enter the market.
- Phase IV – The final phase of trials occurs after a drug has entered the market. This phase tests longer-term efficacy of the drug while also comparing it to similar drugs that are currently available. The results of this phase of trials will determine whether dosage changes should be made or whether the drug should be removed from the market altogether.
As you can see, the FDA approval process is long and it requires many steps prior to the pharmaceutical company even applying for approval. This means that if manufacturers do want to see latanoprost approved for use in hair loss, it will be several years before that happens.
However, this assumes that the pharmaceutical company is interested in FDA approval, as well as whether the drug will pass the first few clinical trials.
Is There a Natural Alternative?
There’s no doubt that current research on latanoprost in treating hair loss is promising. But is there a natural alternative which can provide the same, if not better, results with minimal side effects?
The exact cause of AGA is still unknown, though researchers believe that multiple factors play a part (13). In particular, they are:
- Sensitivity to Dihydrotestosterone (DHT)
It makes sense, then, that many treatments (such as finasteride and dutasteride), natural and synthetic, aim to reduce DHT levels or at least make it possible for the follicles to thrive in a DHT-sensitive environment (such as minoxidil) (14, 15).
However, it’s also possible to reduce DHT levels and improve your scalp’s overall health without drugs.
Use Natural DHT Blockers
The most direct way to treat AGA is to target DHT, which can be done with various topical and oral DHT blockers. These include pumpkin seed oil, reishi, and saw palmetto just to name a few.
By blocking DHT or at least minimizing its production, you can effectively reduce inflammation that is commonly seen in the follicles of AGA patients (16).
Be aware that completely blocking DHT can have adverse effects, including loss of sexual function and depression (17, 18). This is why topical blockers are recommended, as they have less systemic effects.
Increase Blood Flow
Blood flow is intricately linked with hair loss, as the inflammation that’s so common in AGA sufferers tends to cut off circulation to the follicle and ‘strangle’ the hair bulb (19).
In turn, this can lead to progressive hair loss as the follicles are unable to obtain oxygen and nutrients and even irreversible baldness.
The answer, then, is to increase blood flow to the scalp.
You can do so with various topical treatments, such as peppermint essential oil. However, there are mechanical methods, including scalp massage and microneedling, which have been proven to effectively improve blood flow (20, 21).
Improve Oxygen Levels
As mentioned, the poor circulation that occurs as a result of follicle miniaturization can lead to lack of oxygen delivery to the follicles. But oxygen plays a more important role in hair growth than was once known.
Oxygen is needed for many biological processes, and the conversion of testosterone and 5AR to DHT is no different (22).
This means that low oxygen levels can actually increase the levels of DHT being produced, as there’s not enough oxygen available for the other common conversion.
To increase oxygen levels, you first have to focus on blood flow. After all, Red Blood Cells (RBCs) deliver oxygen throughout the body (25). However, you can also work on improving your oxygen levels with meditation, yoga, and even exercise (26, 27).
There are many drugs on the market – including Rogaine, Propecia, and dutasteride – which claim to treat the underlying cause of androgenetic alopecia, and even reverse its effects (28). However, new drugs are being developed and discovered every day that can offer hope to sufferers of balding.
Is latanoprost one such drug? While initial trials seem promising, there is still much research that needs to be done.
And even if latanoprost is later approved for use in treating AGA, it’s not the only option available. Instead, natural options can be a much better way to treat, and even reverse, hair loss.