Little tan pill can grow hair on your head Baldness drug OK'd, but it's for men only


WASHINGTON -- For as long as there has been baldness, it seems, there have been efforts to cure it: oils and creams, toupees and transplants, not to mention what hair stylists gingerly term "the comb-over."

But as much as some men may have wanted one, there has never been a baldness pill -- until now.

The Food and Drug Administration announced yesterday that it had given Merck & Co., the maker of crucial treatments for heart disease, osteoporosis and AIDS, permission to sell a tiny tan octagonal tablet that, experiments show, either promoted the growth of hair or at least stopped hair loss in 83 percent of men who took it.

There are, however, some drawbacks: The pill, which will be marketed as a prescription medicine under the brand name Propecia, can cause birth defects, so it is not approved for women. It is useful only for the genetic condition known as male pattern baldness. It must be taken once a day, every day, for the rest of a bald man's life. And it carries a slight risk of impotence, lasting only as long as the pill is taken.

"This is not a panacea," said Dr. E. William Frank, a dermatologist at Beth Israel Deaconess Medical Center in Boston who has been following the progress of the drug during testing. "It's not going to grow hair on the pate of every man who takes it. But the clinical studies which have been done so far are promising."

Critics, however, say the idea of a prescription drug for baldness is frivolous, and complain that no long-term studies have been conducted on the drug.

"It is a cosmetic issue," said Dr. Sidney Wolfe, director of Public Citizen's Health Research Group, an advocacy organization in Washington. "What is the risk that we are trading off for a cosmetic benefit?"

And John T. Capps III, founder of Bald-Headed Men of America, a support group for bald men, said no right-thinking bald man would even consider a pill. "We believe that skin is in," he said.

Officials at the FDA, however, said they had become convinced that for some men, hair loss is nothing to laugh about.

An estimated 33 million American men have male pattern baldness, characterized by a receding hair line and hair loss at the vertex, or crown, of the scalp. One survey found that more than 90 percent of men who were growing bald worried about the future of their hair.

"One man's frivolity," said Dr. Michael Weintraub, the director of the FDA office that evaluated Propecia, "is another man's serious problem."

Merck conducted three clinical trials of Propecia, involving 1,879 men, 1,215 of whom were followed for as long as two years.

None of the men in the studies grew back a full head of hair. But when scientists counted the number of hairs in a one-inch circle on the scalps of the subjects, they found that 83 percent of the men had kept their hair or grown more.

The active ingredient in Propecia is one milligram of finasteride, which can cause birth defects. Because the drug can be absorbed through the skin, Merck encases its tablets in a coating, and warns that women should not touch the actual powder.

There is only one other FDA-approved medicine for baldness: minoxidil, an ointment sold over the counter as Rogaine by Pharmacia & Upjohn Inc. Because there have been been no studies testing Rogaine against Propecia, there is no accurate way to compare the two.

Capps, the founder of the bald men's group, suggested another treatment for hair loss: "We try to let people know that it's more important what's in their head than what's on top of it."

About Propecia

What it does: Promotes hair growth or stops hair loss.

Effectiveness: Studies show the drug worked on 83 percent of men tested.

Side effects: Slight risk of impotence for men. The drug is not approved for women because it can cause birth defects.

Cost: About $45 per month.

Pub Date: 12/23/97

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