H14: From antiquity to the present day: a brief history of balding

E. Keeling

Galway University Hospital, Galway, Ireland

The search for an effective treatment for balding dates back to 3000 bc. The oldest medical text ever to be discovered, the Ebers Papyrus, written in 1552, was located in Luxor, Egypt. This describes a treatment of its time for hair loss: a mixture of iron oxide, lead, onions, alabaster, honey and animal fat, which was to be ingested after a prayer to the Sun God. Hippocrates (c. 460–c. 370 bc), the father of medicine, made numerous attempts to combat hair loss with topical applications, including opium mixed with pigeon droppings, before turning his mind to a surgical solution. On noting that eunuchs in the Persian army appeared to be exempt from balding, he hypothesized (in part, correctly) that a link existed between hormones, sexual drive and hair loss. He considered that castration might prove an effective treatment for male hair loss; however, volunteers to trial this option were not forthcoming. Camouflage has been a used for many centuries in those suffering from hair loss. Julius Caeser wore a wreath of laurel as camouflage, while King Louis XIII of France wore a wig and is credited with popularizing this as a fashion trend in the 1600s. In more recent times, in 1925, the Thermocap device was introduced. This machine applied static electricity, magnets, heat and vibration to the scalp in an attempt to increase circulation. This did not prove successful. However, on the other side of the world, a major advancement was made in 1939. A Japanese dermatologist, Dr Shoji Okuda, began using hair transplantation to treat burn victims. Owing to World War II, this knowledge did not become widely known for many years. Indeed, it was not until 1959 that Dr Norman Orentriech began using hair plugs in the USA. In 1978, minoxidil – which had previously been used as an antihypertensive – was noted to reduce and prevent hair loss. This was approved as topical Rogaine by the Food and Drugs Administration in 1988 to treat androgenetic alopecia. In 1995, follicular unit transplantation was introduced by Drs Bernstein and Rassmann. This was based on Dr Limmer’s newly described dissection technique and significantly improved outcomes. In 1998, a medication used to treat benign prostatic hyperplasia – finasteride – became available to prevent and reverse androgenetic alopecia. In the twenty-first century hair cloning has become the most novel area of interest. And so the search continues.