Hair Loss Treatment History

1553BC: Ebers Papyrus Anti-Baldness Prescription: The Ebers Papyrus, discovered in Luxor, Egypt, is the oldest complete medical text ever found. It is devoted to treatments for skin diseases and cosmetic conditions, and includes the oldest known prescription for treating baldness. The prescription is for a mixture of iron, red lead, onions, alabaster, and honey which was to be swallowed, after first reciting a magical invocation to the sun god.

420BC: Hippocrates cures baldness: In Ancient Greece, Hippocrates, the Father of Modern Medicine, tried to formulate an anti-baldness treatment. One formula was a mixture of opium, horseradish, pigeon droppings, beetroot, and various spices applied to the scalp. It didn't work. Hippocrates eventually became so bald that extreme cases of baldness became known as "Hippocratic baldness".

In The Aphorisms of Hippocrates, a collection of his astute observations, he noted that eunuchs in the Persian army never experienced hair loss. In Aphorism XXVIII he states: "Eunuchs are not affected by gout, nor do they become bald". Castration before or shortly after puberty prevents baldness.

Approximately 2400 years later, In March 1995, researchers at Duke University published the same results. It was noted that "While castration may be a cure, it is not commercially acceptable". The search for hair loss cures went on.

Julius Caesar: In Rome Julius Caesar camouflaged his thinning hair by growing it long in the back and combing it straight forward over his bald spot. He also took to wearing a laurel wreath around his head. Cleopatra had her own hair growth treatments, perhaps taken from the Ebers Papyrus, but it seems she never shared these formulas with Julius Caesar.

King Louis VIII: When the King of England began wearing a wig to camouflage his own thinning hair, other members of the court followed, regardless of their own hair loss condition. Giant powdered wigs became the fashion in English courts, and the style was continued in the New World.

1800's "Snake Oils" for Hair Growth: Hundreds of hair loss treatments were marketed in the early 1800's. Even today many cosmetic products continue to imply that they may have some effect on hair growth. One of these products, "Barry's Tricopherous" (founded in 1801) was still being sold in Central America as recently as the 1970's when Dr. Panagotacos discovered a bottle for sale in a pharmacy there. The product: "Guarantees to Restore the Hair to Bald Heads and to Make it Grow Thick, Long and Soft". It contains alcohol, water, and food coloring.

1939 Dr. Okuda: A Japanese Dermatologist published in a Japanese medical journal his method for using hair transplant grafts to correct lost hair from the scalp, eyebrow, and moustache areas. His work went largely unnoticed in the West until after World War II.

1959 Dr. Orentreich : In the United States, Dr. Norman Orentreich published the "donor dominance" theory and popularized and refined full size graft hair transplantation techniques.  Full size grafts typically had between 7-15 hairs, and were about the width of a pencil eraser. A circular surgical punch tool was used to remove the donor tissue, and a slightly smaller punch tool was used to create the recipient sites for the full size grafts.

1969 Dr. Panagotacos Begins his Residency: Training with Dr. James Burks, one of the very first doctors to perform hair transplants in the United States. During his residency, Dr. Panagotacos performs hair transplantation procedures just about every week for 3 years.  Dr. Panagotacos has continued to remain current on the latest surgical and medical treatments for hair loss, and he often leads the advance with his own pharmaceutical treatments and surgical techniques.

1978 Loniten's (Minoxidil) "side effect": Results of minoxidil having the "side effect" of growing hair are published. After more than 5,000 years it is the first medication scientifically proven to actually reduce the rate of thinning hair, and help grow back hairs that have been lost.  Dr. Panagotacos begins using the medication on himself, and prescribing it for certain patients.  Ten years later minoxidil finally received FDA approval for hair loss treatment.

1980's Minigrafts and Micrografts: With improvements in transplantation techniques, minigrafts (4-5 hairs), and then micrografts (1-3 hairs) became increasingly popular.   Dr. Panagotacos incorporated minigrafting and micrografting into his hair transplantation practice. Micrografts are ideal for enhancing full-size transplant work performed many years earlier, as well as for those with thinning hair. In the 1980's Dr. Panagotacos used a variety of minigrafts and micrografts sizes for each patient, depending upon their individual needs.

1980's Dear Abby Presents "Hair Loss Cures": In a noteworthy column titled "Just Like Magic", Columnist Abigail Van Buren (Dear Abby) ran some of her reader's suggestions for hair loss cures. One woman from Louisiana found that improving her sex life cured her thin hair problem. . . but her husband soon developed a bad back. A 27 year old from Philadelphia explained that a visit to a psychiatrist identified stress, and after facing the stress-causing problems, the lost hair came back. A woman from Montana revealed that she fertilized her head with a plaster of sheep dung and castor oil each night, and then covered her head with a shower cap. Her husband said it reminded him of the days when he was a young child growing up on a farm.  Myths about hair loss treatment continue.

1988: Rogaine, the first medication proven to work: Minoxidil, a prescription medication approved in tablet form for the treatment of high blood pressure, was approved in a lotion form to help grow hair. The minoxidil lotion is called Rogaine. Rogaine helps to reverse the hair follicle shrinking that characterizes inherited pattern hair loss. Rogaine became the first pharmaceutical ever approved by the US Food and Drug Administration as being safe and effective for hair growth. A prescription was required initially, however in 1995 2% minoxidil lotion was approved for sale in the United States without a prescription.  Currently it is available over-the-counter in 5% strength, and can be used in lotion form by men or women.

1996: Follicular Unit Micrografts: Follicular Unit Micrografts are the current state-of-the-art technique in hair restoration surgery, and with the help of instruments he created, Dr. Panagotacos has been using this technique since 1996.  Follicular Unit Micrografting is based on the fact that many scalp hair follicles naturally grow in tight bundles of two or three hairs. With old style micrografting, these bundles of hair follicles were typically cut up to create one or two hair micrografts, in order to remove as much excess skin tissue as possible.  The problem was that all this cutting caused the loss of a percentage of donor hairs. Now, with advanced equipment such as back-lit stereo microscopes and highly skilled surgical preparation teams, Follicular Unit Micrografting leaves the naturally occurring hair follicle bundles intact, while still trimming away unwanted skin tissue.  The end result is a more natural appearance, with minimal loss of scarce donor hairs.

1998: Propecia: In the early 1990's finasteride, a prescription medication approved in tablet form for use to treat enlarged prostate glands, was discovered to have the "side effect" of preventing hair loss. With extensive clinical studies, it was determined that even at 1/5th the dosage used to treat prostate conditions, finasteride tablets can have a powerful effect on stopping male pattern hair loss, and with continuing use, there can be hair regrowth. In 1994 Dr. Panagotacos began using finasteride on himself.  in 1998 the US Food and Drug Administration (FDA) approved finasteride as a hair loss treatment, under the brand name Propecia. Now, with prescription Propecia available in convenient tablet form, he finds that many of his hair transplant patients choose to also take finasteride to "keep what they have".  Dr. Panagotacos requires an examination before prescribing Propecia tablets.  Propecia is for men only.

Our New Millennium: Some time in the future we will be able to use gene therapy to change hair follicle sensitivity to DHT, and prevent hair loss in the first place. Perhaps even sooner we will be able to clone certain of our own hair follicles having reduced sensitivity to DHT (typically those on the back and sides of the head). With cloning we could create an unlimited supply of "permanent" hairs to replace those that were genetically programmed to stop growing new hairs. Presently we can cut a hair follicle in half, and sometimes get the two halves to each grow back their missing halves. When successful, each follicle will grow a new hair. This is in essence a two-for-one deal. But often one of the halves does not survive, and sometimes only thin hairs grow from the surviving half. Eventually we will be able to grow entire follicles from a few cells cultured in a test tube. This will allow an unlimited supply of thick growing hair for everyone.

Dr. Gho of The Netherlands has already begun working on the cloning of hair follicles from stem cells. He first reported new follicles from stem cells in 1998. It is the opinion of Dr. Panagotacos that it will be a couple of decades before patients benefit from this research.