Genetic Tests and Gene Therapy as Hair Loss Treatments?

Dear Dr. Rassman,

Recently there has been a lot of hype in the media regarding new genetic screening tests for androgenetic alopecia. Is the research behind this reliable and if so what are your thoughts on how gene therapy will affect how we treat hair loss in the future?

There indeed has been much hype of genetic screening for androgenic alopecia. First off, you do not need a screening test to be diagnosed with androgenic alopecia. If you have the gene, it does not mean that you will bald… and if you are already balding then you do not need the test. Genetic balding is relatively easy to assess, especially with a miniaturization study.

One might argue that the utility of the genetic screening test for androgenic alopecia may be for someone who does NOT show any signs of balding, but would like to start some form of medical treatment (such as Propecia), but I am personally against starting any medication (no matter how safe it may be) if you do not have signs of balding. Answering thousands of questions over the years on this site has taught me that the general public is scared and preoccupied with the 1 to 2 percent of the potential side effects of Propecia. They are so scared that lots of men don’t even start Propecia despite the fact that they are balding. Now imagine telling a non-balding man to start a medication that may give them sexual side effects. I realize in the end it is all about the education process. However, as a general rule doctors do not like to put patients on medications if they do not need it.

With respect to gene therapy, that is entirely another ball game. We are barely understanding genetics of hair loss and are still years away from gene therapy to cure hair loss.