why has no one truly solved male pattern baldness (particularly as the commercial incentives must be huge)
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So making drugs for conditions like this is harder but not in the way you think. Baldness is an esthetic issue, not a health issue. That being the case any treatment you make cannot have any major side effects that adversely affect health. In a nutshell it has to be really really safe to stand a chance of getting FDA approval. This makes it much more difficult to make treatments.
Compare that to cancer for example. Cancer in most cases will kill you, you are already going to die. So using a really toxic drug that may adversely affect your health, yet successfully keep you alive, is an acceptable trade off, in that scenario. An equally toxic drug that prevents baldness would never in a million years be approved. The balding patient is not dying, he is not even sick, so that drug better not make him sick in the process of treatment. Lot harder to do.
No drug to treat it would be covered by insurance, and it would need to be super low-risk to get approved. This means high development costs, and upper limits on revenue.
I imagine the first real “cure” will be cloning your hair cells – the ones that aren’t affected by MPB – the hair you’ll be growing til you die. You go in, they take a sample, and x-weeks later you return and they have a zillion hair follicles to transplant in your head – and it will likely be done by some sort of robotic arm-thing. Problem is, hair follicles are difficult to clone.
I do believe there would be a big market for it, but like any marketing thing, it’s about price vs. value. If it’s truly permanent, looks natural and can be done without multiple visits and tons of recovery time – what’s the price point at introduction? $10k for a full head of hair? People will pay that to get perfect white teeth. How long until you go through the $10k crowd and start dropping the price? What’s the break-even for all the R&D and service infrastructure that would have to be accomplished?
Proscar (finesteride, aka Propecia) is a prostate medication that is also marketed as a treatment for male pattern baldness. It doesn’t significantly regrow lost hair but it halts the progress. It is cheap when purchased as a prostate medication (it can be pill cut into the smaller doses needed for hair loss). It’s not a messy topical like Rogain, just a pill to take every day. If you start taking it when you first notice the signs of hair loss it’s essentially a cure.
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