Hair restoration and the economics of great expectations
Earlier this month the Japanese Dermatological Association released the results of a study on the effects of various commercial treatments for baldness, and industry that’s worth about ¥60 billion. The association estimates that some 8 million men in Japan “worry” about thinning hair, and the number of complaints about seemingly bogus baldness cures has been on the increase, even if the absolute number of complaints is pretty low, given the size of the market. The National Consumer Affairs Center received 153 complaints about baldness cures in 2009, which is 2.5 times as many as it received in 2005. The JDA decided to lend its expertise to the issue, but rather than conduct its own experimental study into the efficacy of various products and treatments, it basically studied documentation submitted by manufacturers and then compared it to scientific papers published here and abroad.
Consequently, the results were hardly conclusive in a way that would probably make a difference; and, in fact, efficacy was closely related to cost. The JDA ranked treatments into five categories, with “A” being “strongly recommended,” “B” being simply “recommended,” “C1” being possibly effective but lacking in scientific proof, “C2” not recommended, and “D” possibly harmful.
What makes the results a bit eyebrow-raising is that the two products that earned “A” ratings were both mentioned by brand name: the hair tonic RiUP, made by Taisho Pharmaceutical, and the orally administered prescription drug Propecia, made by Merck and distributed in Japan by Banyu. The only treatments that earned a “B” rating were hair transplant methods that utilized the patient’s own hair, while products categorized under “C1” and “C2” were only mentioned in terms of their active ingredients, so if you want to find out which products actually use those ingredients you would have to do your own research. Obviously, the JDA’s obligations to balding men (and women, for that matter) is limited when it comes to hurting the feelings of some of the companies who make their living off of them.
As far as the “A” winners go, apparently you get what you pay for. Since Propecia can only be purchased with a doctor’s permission, it’s difficult to gauge its cost-effectiveness, but it’s probably expensive and, in any case, you can’t use National Health Insurance to buy it. RiUP is classified as a Type 1 OTC drug, which means that, technically speaking, though you don’t need a prescription you still need to buy it from a credentialed pharmacist and thus presumably receive his/her consultation at the point-of-purchase. The RiUP line has various products, but the standard size is a 60 ml bottle that costs ¥5,500.
According to the directions, in order for it to be effective the subject should apply at least 1 ml of lotion to his scalp twice a day for six months before he will see any results. One bottle of RiUP would thus last about one month, so in six months the purchaser would spend ¥33,000 to find out whether or not the stuff actually worked. He’d probably spend more since 1 ml is a very small amount and if balding men are as desperate as the advertising would have it then they likely slather the stuff on in the hope that the more they use the faster the effect. Those people should obviously buy the 120 ml bottle, which is cheaper.
But what’s even more likely is that the balding individual will spend much more, because the JDA recommends that he use C1 products or a combination of the two A-rated products “for one year.” If that fails then he should continue on to hair transplantation using his own hair. The JDA does not recommend hair transplantation using synthetic hair, which has been shown to cause inflammation, though the president of one company that offers such a service told Asahi Shimbun, anonymously, of course, that his company has many “repeaters” who have used this treatment for as long as thirty years with no adverse reactions. The JDA also does not recommend lotions that used cepharanthine, a quasi-drug taken from plant roots that research has shown has no effect on hair growth. The Asahi also found the president of a company who sells a product using cepharanthine and he said that his company’s “animal testing” found it to be effective. Now which animal would that be?