Snake Gall Bladders Ditched for Drugs by Balding Chinese

After raw-ginger scalp rubs and walnut snacks failed to counter Shi Yang’s receding hairline, the 26-year-old Shanghai engineer says he’s ready to ditch his mother’s advice and give Western drugs a go.

Traditional herbal remedies for male pattern baldness are losing ground to treatments such as Merck & Co.’s Propecia and Johnson & Johnson’s Rogaine in China, where a full head of black hair on a man is a sign of health and virility. Shi, a slim, bespectacled college graduate, has a better chance of landing a girlfriend with a thick thatch of hair like President Xi Jinping or Premier Li Keqiang, both of whom are in their 50s, he said.

Sales of Western hair-loss treatments doubled in China the past five years, growing almost twice as fast as the broader hair-product segment, according to Euromonitor International. The hair-loss market is still small because baldness is only now being seen as a problem requiring pharmaceutical help, and Western companies have only recently begun to seize on the concern.

“China’s hair loss treatment market is still in the development stage, and patients have many misconceptions about the treatments available,” said Jane Wu, Merck’s communications director for China. The Whitehouse Station, New Jersey-based drugmaker started a program with the China Association of Health Promotion and Education two years ago to promote the use of doctor-prescribed hair loss treatments.

Bald Love

“When we started our hair-loss clinic in 2000, we probably saw three patients a day, and now I get about 30,” Yang Shuxia, a dermatologist at the Peking University First Hospital, said in an interview in Beijing. “There is increasing awareness that baldness is a medical condition that can be treated.”

Yang commonly prescribes Propecia and generic versions of Rogaine for her male patients and generic forms of Pfizer Inc.’s Aldactone for women, she said. Her patients are typically college students who feel losing their hair “affects their chances of getting jobs, finding a girlfriend, or successful match-making,” Yang said.

Propecia, approved in China since 2001, is “one of Merck’s important, innovative drugs” there, Shanghai-based Wu said in an e-mail. The drug, also known by the chemical name finasteride, was required in April 2012 by the U.S. Food and Drug Administration to include warning labels linking it to sexual dysfunction that can occur after patients stop using it.

Post-Finasteride Syndrome

The Post-Finasteride Syndrome Foundation was established in July 2012 to support research into the biologic mechanisms of the condition that would lead to effective treatments or cures, according to the non-profit group based in Somerset, New Jersey. Post-finasteride syndrome is characterized by sexual, neurological, hormonal and psychological side effects that persist in men who have taken Propecia, the group said in e-mail.

China’s market for hair-care products expanded 51 percent to 33.6 billion yuan ($5.5 billion) in the five years to 2012, according to Euromonitor, a London-based researcher. Sales of hair-loss treatments, most of which contain Rogaine’s active ingredient, minoxidil, jumped 90 percent to 100.7 million yuan over the same period.

Snake Gall Bladders

The China Association of Health Promotion and Education, a government-supervised body, surveyed 1,280 balding men in Beijing, Shanghai, Guangzhou and Chengdu last June and found 47 percent of respondents had sought help from hair-growth shampoos, visited hair-loss centers, or even swallowed snake gall bladders. More than 80 percent said they were “dissatisfied” with those treatments, the association said in a report.

BaWang International (Group) Holding Ltd., the Chinese maker of herbal shampoos endorsed by movie star Jackie Chan, posted three straight years of losses after a 2010 report of a cancer-causing substance in its hair-loss remedy caused a plunge in sales.

The top-selling treatment for hair-thinning in China last year was Da Fei Xin, a minoxidil solution made by a unit of Shanxi province-based Zhendong Pharmaceutical Co. Ltd., with a 23 percent market share, Euromonitor said in a May 23 e-mail.

L’Oreal SA, the world’s largest cosmetics maker, is trying to challenge with products such as Arginine lotions touted to reduce fall-out by strengthening the hair, and the Krastase line, including shampoos for thinning hair.

L’Oreal Strategy

The Paris-based company is pushing to expand its products beyond Beijing and Shanghai to lower-tier cities in China, which “gives us a huge reservoir of growth for the years to come,” L’Oreal Chief Executive Officer Jean-Paul Agon said on a Feb. 12 teleconference, according to a Bloomberg transcript of the call.

Cellmid Ltd., a Sydney-based drugmaker, also plans to start selling in China this year a plant extract-based treatment to which it acquired the rights through its purchase of Advangen Inc. Japan last month.

“When I looked at the numbers, I was astonished,” said Chief Executive Officer Maria Halasz, referring to China’s market potential. Cellmid is looking for a distributor, she said in an interview.

Halasz said she suffered from excessive hair loss herself in the past and is counting on women being her main customers based on her observations of hair-thinning in cities such as Shanghai.

“Going up and down the escalators, you really see women, even 30-something women, where there’s thinning on top of the head,” she said.

Three-quarters of men and two-thirds of women will encounter hair-thinning by age 80, researchers at the University of Melbourne found in a study published in the Journal of Investigative Dermatology in 2005. The hormone-driven phenomenon, which doctors call androgenetic alopecia, follows different patterns in men and women.

Men, Women

Men experience recession of the hairline, starting above the temples and the uppermost surface of the head and progressing to complete hair loss, in extreme cases. In women, it causes diffuse thinning at or behind the hairline, Oklahoma City hair transplant doctor O’tar Norwood reported in a study in the Dermatologic Surgery Journal in 2001.

About 21 percent of adult males and 6 percent of females have the condition in China, a study by the Peking University People’s Hospital published in the British Journal of Dermatology in 2010 found. The research was based on a survey of 17,886 people.

Hair loss may be more prominent among Asian women because they have thicker strands of hair, but fewer hair follicles, said Rod Sinclair, professor of dermatology at the University of Melbourne and director of dermatology at the city’s Epworth hospital.

Comb Over

“Because their hair is very strong, it sits up away from their scalp,” Sinclair said in a telephone interview. “When they have diffuse hair thinning, it’s instantly noticeable, whereas in Caucasians, they can comb it over and conceal the hair loss much better for longer.”

For Shanghai engineer Shi, who studied and worked in France, returning to China in 2011 has made him feel self-conscious about his thinning scalp.

“I have no idea why, but most of my French colleagues, especially the engineers, were bald,” he said. “You will definitely stick out more back in China because it’s much less common.”