Natural history of androgenetic alopecia

Twenty-two men with patterns III-Va androgenetic alopecia were entered into a 10-month study aimed at establishing information on the natural progression of hair loss over a period of time typical of studies of hair growth promoters. The methodology employed was the same as that in published clinical trials of topical minoxidil, but the men refrained from application of either active drug or vehicle to their scalps. As one of the potential explanations for the observed 'placebo-effect' seen in non-vellus hair counts in the topical minoxidil trials was a learning curve of novice hair counters, we were particularly interested in evaluating this in our 'no-treatment' trial. To that end, both a novice (Observer I) and an experienced (Observer II) hair counter independently performed the hair counts. There was a mean decline in the number of vertex target area non-vellus hairs (-17.2 +/- 80.3 for Observer I and -26.6 +/- 63.5 for Observer II) at the end of 10 months; this was not significant. The novice's hair counts were lower than the experienced observer's counts at baseline, and the difference remained relatively constant during the study. Without the application of a placebo, there was no increase in hair growth, making it unlikely that the methods of hair counting led to the 'placebo-effect' seen in prior topical minoxidil studies.