Retane Is Effective In Reducing Male & Female Hair Loss

Hanita Ina, MD
Metiska Farma Research Laboratory, Jakarta, Indonesia (2002)

ABSTRACT
This preliminary study focuses on the effect of a commercial proprietary topical application called “Retane”, in the reduction of hair loss and the promotion of new hair growth in men and women. Twenty-two subjects (15 men and 7 women), with varying levels of hair loss, were enrolled in this four-week study.

This study concludes that Retane is effective in reducing hair loss in both men and women: 86% of the male and female participants reported a noticeable decrease in hair loss after four weeks of treatment. For the majority of men under 40 years of age, this reduction is observed after only one week of treatment. For men over the age of 40 years – a group of particular interest as alopecia in Asian men often manifests itself after middle age – the reduction of hair loss is not significantly observed by the majority until the end of the second week. Nevertheless, 88% and 83% of men under and over the age of 40 years, respectively, reported this positive benefit of Retane.

This study also suggests that Retane may be beneficial in stimulating new hair growth: after four weeks of treatment 57% of men and 71% of women reported noticeable new hair growth. This effect, however, seems to be more pronounced in men and women under the age of 40 years, who are expected to have normal hair growth cycles. After four weeks of treatment, only 33% of men over the age of 40 years reported new hair growth. This may represent a delay, similar to that observed in the reduction of hair loss in men over the age of 40 years. Nevertheless, as most the subjects of this study have not been diagnosed with alopecia, this result suggests that a subsequent study should be performed to determine quantitatively the effect of Retane in stimulating hair regeneration in alopecia patients.

INTRODUCTION
Androgenetic alopecia or pattern baldness is a common condition affecting approximately 50% to 80% of Caucasian men and is the most widespread form of baldness. Alopecia is an inherited condition, most likely dominantly inherited with variable penetrance, which progressively appears as men age (Ellis et al., 1998; Harris, 1946; Kuster and Happle, 1984; Smith and Wells, 1964). Typically, 30% of Caucasian men in their thirties have alopecia. This number increases to 40% for men in their forties, and so on, up to 80% of men in their eighties and older. This progressive rate of appearance of alopecia is also found in other ethnicities, although in total, baldness may appear at a lower rate than in Caucasian men. For example, it is estimated that only a total of 30% to 40% of Asian men are affected by androgenetic alopecia.

Although not often appreciated, alopecia is also present in a significant portion of women. It is estimated that 20% to 40% of women have this condition, although not with the same severity as men (Birch et al. 2002; Ludwig, 1977; Snyder and Yingling, 1935). In women, hair loss typically begins in their twenties to forties, and does not continue to progress with increasing age.

It has been suggested that androgenetic alopecia is linked to the activity or concentration of enzymes, such as the 5-alpha-reductase which makes a potent form of testosterone called dihydrotestosterone or DHT, in the scalp and hair follicles, or to the sensitivity of hair follicle receptors to DHT (Takashima and Montagna, 1971, Sawaya, 1991; Sawaya and Price, 1997). Indeed, medications for androgenetic alopecia concentrating on blocking the activity of 5-alpha-reductase have been developed, with varying degrees of success and sometimes with the presence of serious side effects (Khandpur et al 2002).

As it has proven difficult to regenerate hair in alopecia patients, attention has also been focused on stopping the hair loss in the first place. In this preliminary study, we investigate the effectiveness of a proprietary topical application consisting of Vitamin B5 or ethyl panthenol, Ginseng Panax extract, Vitamin E, Aloe Vera, protodioscin, inositol, biotin, and folic acid, in preventing hair loss and promoting new growth of hair in men and women. This topical application is commercially available under the trade name “Retane®” from PT Teguhsindo Lestaritama, Indonesia, and Nutrica, Inc., United States of America.

MATERIALS AND METHODS
Twenty two volunteer subjects, composed of 15 males and 7 females, were enrolled in the study. The subjects range in age between 21 and 71 years, with the mean age of 39.1 ± 15.5 years for the male subjects and 31.5 ± 6.9 years for the female subjects. Although most of the subjects have not exhibited alopecia, all reported hair loss or shedding, with varying degrees of severity, as shown below:

Hair loss severity is defined as light if the subject estimates that daily hair loss is less than 40 strands per day; medium if it is between 40 and 100 strands per day; and severe if it is more than 100 strands per day (Van Neste, 2002).

The subjects were given the topical solution Retane® for a total study period of 4 weeks with daily application of at least 10 ml (0.34 fl oz) to the scalp and hair root after hair washing. The application is followed by gentle rubbing or massage for 3 minutes, and is left to dry naturally without blow drying or toweling. The subjects were given a weekly questionnaire to determine qualitatively the status of their hair loss and new hair growth, as well as the presence of side effects.

All subjects were in apparent good health, and none have been enrolled in any studies or treatment for hair loss.

RESULTS AND DISCUSSION
The overall result of this preliminary study suggests that even a short term treatment with Retane is effective in significantly reducing hair loss and may stimulate new hair growth in a portion of the subjects.

Prevention of Hair Loss
A significant portion of the male and female subjects reported noticeable and significant reduction in hair loss even after only a short treatment period (Graph 1)

Graph 1. Subjects reporting noticeable reduction in hair loss.

After the first week of treatment, over 64% of the male and 57% of the female participants noted a perceptible reduction in shedding or hair loss. For the male subjects, this number increased steadily to 79% after the second week, and reached a maximum of 86% of men after the third and fourth week of treatment. For the female subjects, the percentage of women reporting a noticeable reduction in hair loss increased after the third week to 71% and reached a maximum of 86% after the fourth week.

After four weeks of treatment, a small minority of the subjects (21% of men and 29% of women) reported that near complete elimination of hair loss. Two male participants reported that prior to the Retane treatment their hair loss had been severe (i.e. clumps of hair on pillow after sleeping, in the drain after showering, and significant amounts of hair stuck in combs after gentle combing). After four weeks of treatment, these men reported that their excessive hair loss had been virtually eliminated. Similarly, two female subjects reported that their moderate hair loss was nearly completely eliminated after only four weeks of treatment.

Upon closer inspection, it is apparent that older men (i.e. forty years of age or older) showed a delayed reaction to Retane. This group is of particular interest, as alopecia in Asian men often starts to manifest after reaching middle age. It is estimated that approximately 20% of Asian men have androgenetic alopecia in their forties, as compared to 40% of Caucasian men.

Graph 2. Male subjects reporting noticeable reduction in hair loss.

As shown in the graph above, most of the men under the age of 40 years reported an immediate positive effect from the Retane treatment. At the end of the first week, approximately 88% of these men reported a noticeable reduction in hair loss.

In comparison, men over the age of 40 years reported a delayed positive effect of Retane, although a similar proportion as the younger men reported noticeable reduction in hair loss after four full weeks of treatment. Here, only 33% reported reduction in hair loss after the first week of treatment. This number increased steadily to 67% after the second week and reached a maximum of 83% after the third and fourth week.

This result is significant as it shows that Retane is effective in reducing hair loss in a segment of the male population that is most likely to exhibit early symptoms of alopecia. Furthermore, as 50% of men over 40 years of age reported severe hair loss and are at the onset of baldness, this result suggests that Retane may be an effective treatment for stopping alopecia.

Even though there is a significant portion of women who are afflicted by pattern baldness, alopecia in women is often underappreciated. It is estimated that between 20% to 40% of Caucasian women have alopecia, although to a lesser degree of severity as compared to men. In Asian women, it is estimated that between 10% to 20% are affected by thinning hair. Nevertheless, the emotional aspects of losing one’s hair are generally higher and more serious for a woman as compared to a man.

In this study, it is shown that a majority of women under the age of 40 reported a noticeable reduction in hair loss after the Retane treatment.

Graph 3. Female subjects reporting noticeable reduction in hair loss.

As shown in the graph above, a majority of women (67%) reported reduction in hair loss after the first two weeks of treatment. This number increased to 83% after the third and fourth weeks of treatment. Significantly, a singular female participant over the age of 40 years with severe hair loss prognosis reported a very positive result of almost complete cessation of hair loss after four weeks of treatment. This suggests that Retane treatment may be similarly effective in stopping the onset of alopecia in women over middle age as it is in men.

One man reported that his hair loss resumed after a period of about half a week after he failed to remember to apply Retane. This suggests that the beneficial effect of the topical application in reducing hair loss requires continuous use.

Stimulation of New Hair Growth
In addition to the weekly qualitative evaluation of their hair loss, the subjects were asked to assess whether there was noticeable new hair growth after Retane treatment.

Graph 4. Subjects reporting noticeable new hair growth.

No subjects reported any noticeable new hair growth in the first week, and only a minority (21% of men and 14% of women) reported new growth after the second week. This number steadily increased to 50% of men and 57% of women after the third week, and reached a maximum of 57% of men and 71% of women after the fourth week of treatment.

Graph 5. Male subjects reporting noticeable new hair growth.

Upon closer inspection, it is apparent that the majority of men reporting new hair growth are those under the age of 40 years. After the second week of treatment, 38% of men under the age of 40 years reported noticeable new hair growth. This number increased to 75% after the third and fourth week. In comparison, after three weeks of treatment, only a minority of men over the age of 40 years (17%) reported noticeable new hair growth. This number increased to 33% after the fourth and final week of treatment in this study.

The delayed stimulation of new hair growth in men over the age of 40 years is similar to the delay exhibited in the reduction of hair loss. While it is not unexpected for men under the age of 40 years to have new hair growth, the fact that some men over the age of 40 years reported new hair growth is significant as it is often noted that in this age group new hair growth is less frequent and more limited.

Graph 6. Female subjects reporting noticeable new hair growth.

Similar to the effect in men, a majority of women under the age of 40 years reported noticeable new hair growth after Retane treatment. About 17% of women reported new growth after the second week of treatment. This number increased to 67% after the third and fourth week.

Although it seems that Retane treatment resulted in noticeable hair growth in both males and females, it should be noted that these generally occur in those under the age of 40 years, where new hair growth is normal and expected, and may not be completely attributable solely to the treatment.

The case for the beneficial effect of Retane in stimulating new hair growth is more convincing for men over the age of 40 years. Here, it is less common for men to have significant amounts of new hair growth. Indeed, it has been suggested that the onset of baldness in some men is not due to an increase in the rate of hair loss, but rather to a decrease in the rate of new hair growth. Over time, as more hair strands are shed than are growing, this results in pattern baldness.

Absence of Serious Side Effects
Participants of this study were asked to evaluate the presence of adverse side effects of the Retane treatment, shown below:

Graph 7. Subjects reporting side effects

Approximately 36% of the participants of this study reported no adverse side effects of Retane treatment. Of those who reported side effects, 23% reported that their hair became more oily than usual, whereas 27% reported that their hair became drier. Approximately 14% of the subjects reported other side effects, namely itchiness of scalp, although this condition turned out to be temporary and did not seem to be caused by the use of Retane. The subjects that experienced side effects reported that they are generally mild, and did not elect to stop the treatment.

CONCLUSION
Recently, given serious side effects of chemically synthesized drugs, more and more people are looking for alternative herbal or natural treatments for pattern baldness or alopecia. Moreover, people are becoming increasingly aware that it is easier to stop the thinning or balding process than to regenerate hair after the onset of alopecia.

This study focuses on the effect of a proprietary topical preparation called Retane on the hair loss and new hair growth in 22 men and women. After a period of four weeks of treatment, this study found that Retane is effective in reducing hair loss and may contribute to the new growth of hair. Approximately 86% of both male and female participants of the study reported a noticeable reduction in hair loss after four weeks of daily use of the topical application. Significantly, this effect is seen in both age groups (under and over 40 years of age), although the effect is delayed in men over 40 years of age.

After four weeks of treatment, a significant portion of men (57%) and women (71%) reported a noticeable increase in new hair growth. This effect, however, seems to be more pronounced in men and women under 40 years of age: only 33% of men over the age of 40 years reported noticeable new hair growth. There is a possibility that more men over the age of 40 years would report noticeable new hair growth had the study period been longer than 4 weeks, due to a delay factor observed for hair loss reduction. Caution should also be employed as most of the men who reported new hair growth had not been diagnosed with alopecia. Nevertheless, this result suggests the need for a subsequent study to evaluate quantitatively the effect of the treatment on the regeneration of hair in alopecia patients.

ACKNOWLEDGEMENT
The authors of this study would like to thank PT Teguhsindo Lestaritama, Indonesia and Nutrica, Inc., United States of America for supplying the topical product Retane.

REFERENCES
Birch MP, Lalla SC, and Messenger AG. Female pattern hair loss. Clin Exp Dermatol 2002, 27:383-8.

Ellis JA, Stebbing M, and Harrap SB. Genetic analysis of male pattern baldness and the 5-alpha-reductase genes. J Invest Dermatol 1998; 110:849-53

Harris H. The inheritance of premature baldness in man. Ann. Eugen 1946, 13:172

Khandpur S, Summan M, and Reddy BS. Comparative efficacy of various treatment regimens for androgenetic alopecia in men.
J Dermatol. 2002 Aug;29(8):489-98.

Kuster W and Happle R. The inheritance of common baldness: two B or not two B? J Am Acad Dermatol 1984, 11:921-6

Ludwig E. Classification of the types of androgenetic alopecia (common baldness) occurring in the female sex. Br J Dermatol 1997, 97:247-54.

Sawaya ME. Steroid chemistry and hormone controls during the hair follicle cycle. Ann NY Acad Sci 1991, 642:376-83.

Sawaya ME and Price, VS. Different levels of 5-alpha-reductase type I and II, aromatase, and androgen receptor in the hair follicles of women and men with androgenetic alopecia. J Invest Dermatol 1997, 109(3): 296-300.

Smith MA and Wells RS. Male type alopecia, alopecia aerate and normal hair in women; family histories. Arch Dermatol 1964, 89:95-8.

Snyder LH, and Yingling HC. Studies in human inheritance XII. The application of the gene-frequency method of analysis to sex-influenced factors, with especial reference to baldness. Human Biol 1935, 7:608-15.

Takashima I and Montagna W. Studies of common baldness of the stump-taled macaque (Macaca speciosa). VI. The effect of testosterone on common baldness. Arch Dermatol 1971, 103:527-34.

Van Neste MD. Assessment of hair loss: clinical relevance of hair growth evaluation methods. Clin Exp Dermatol 2002, 27:358-65.