Category Archives: Latisse

Bimatoprost Results are Finally Out

At the beginning of this year, I published a detailed post on Allergan’s Bimatoprost product. In that post, I stated the following:

My feeling is that Bimatoprost may result in slightly superior results to Minoxidil, but nothing extraordinary.

I am pleased as well as disappointed to say that I was correct (read the rest of this post). At the end of January 2015, Allergan finished its phase II clinical trials regarding using Bimatoprost to treat scalp hair loss.

Update: January 18, 2022 — Preparation of topical Bimatoprost with enhanced skin infiltration for hair growth.

Bimatoprost Hair Growth
Bimatoprost hair growth mechanism. Source: FASEB Journal, Randall et al, Feb 2013.

Allergan Releases Bimatoprost Results

On November 4, Allergan published two interesting pdfs on its website (can no longer be downloaded). On pages 16 and 17 of one of those pdfs, there is a surprising and unexpected summary of the initial results of using Bimatoprost to treat people with hair loss. I am assuming that these results are from the earlier mentioned clinical trials.

Update: March 2016 official safety and efficacy clinical trial results.

It seems like Bimatoprost 1% and Bimatoprost 3% both result in slightly superior hair growth in comparison to Minoxidil 5%. This is based on an “Expert Panel Review” and based on an “Investigator Global Assessment.”  Hopefully the experts and investigators involved in those reviews are unbiased and not employed or funded by Allergan.

Funnily enough, Bimatoprost 1% has slightly better results than the higher dose Bimatoprost 3% according to the “Expert Panel Review”. However, the “Investigator Global Assessment” finds the opposite to be true as one would have expected. When it comes to actual volunteer opinions based on non-scientific self-assessments, Minoxidil results seemed to be slightly better than Bimatoprost results.

We Have Become Spoilt

The overall mood of hair loss forum members regarding this news has been slightly pessimistic per my analysis. This is a bit surprising considering that to date there have only ever been two FDA approved drugs to treat hair loss on the market: Finasteride and Minoxidil. Bimatoprost will match or slightly exceed the results of one of those two (Minoxidil), and work via a different mechanism.

Just a few years ago, millions of people around the world were delighted that Minoxidil (Rogaine brand) was finally released in a foam version. The old liquid version was extremely irritating for many people and often dripped down people’s foreheads. Last year, women were also pleased that Rogaine had finally released a 5% version for females. All in all, there are numerous people out there who find Minoxidil to be very useful to slow their hair loss progression and sometimes even halt it entirely. I hope that Bimatoprost finds similar success.

At the same time, I can also understand some of the pessimism. In today’s extremely fast paced world, groundbreaking medical and technological advances are announced on a weekly basis (and popular smartphone brands come out with new versions every year). Many hair loss sufferers expect a 100 percent foolproof hair loss cure immediately. Nothing less is worth getting excited over.

While not particularly impressed by these results, I am still pleased that we could finally have a third FDA approved weapon in the fight against hair loss. And one that acts via an entirely different mechanism (prostamide F2α analog) to Finasteride or Minoxidil. With hopefully even fewer side effects.

Bimatoprost and Allergan Notes

— Even if Bimatoprost does consistently produce superior results to Minoxidil with no significant side effects, we are still at least 2-3 years away from actual product release. However, lower dose versions of Bimatoprost have already been in use for eyelash growth (via the brand name Latisse) for a few years now. I am guessing that some hair loss forum members will continue to try to make their own higher dose versions and play around with topical delivery mechanisms for the scalp. Do note that the current cost of Bimatoprost makes it very prohibitive at higher doses.

— In my post on Allergan from a month ago, I was thinking that it was worth buying the company’s stock. Since then, AGN has gone up by 10 percent. The main reason for this is due to the fact that the world’s largest drug company, Pfizer, has recently expressed interest in purchasing Allergan for $160 billion.

The primary reason given is that Pfizer would then benefit by drastically lowering its tax bill by adopting Allergan’s headquarters in Ireland. The US corporate tax rate is 35%, while Ireland’s corporate tax rate is 12.5%. However, it remains to be seen if the US government will allow Pfizer to get even bigger than it already is and also pay far less taxes to Uncle Sam. Update: Merger plans cancelled in 2016.

— Allergan plans to commence further clinical trials for Bimatoprost on scalp hair in the first quarter of 2016.

Bimatoprost and Hair Growth

It is 2015, so finally a good time to write about Bimatoprost. The main reason for this is that at the end of January 2015, Allergan will end its phase II clinical trials for the use of Bimatoprost for hair loss in humans. It is expected that results will be announced shortly thereafter.

What is Bimatoprost?

Bimatoprost is a synthetic prostamide (= prostaglandin-ethanolamide) analog. It is sometimes mistakenly called a prostaglandin analog, since prostaglandins and prostamides are structurally similar to each other. Bimatoprost is increasingly being used in dermatological applications, including off-label for hair growth and pigment related skin issues.

Prostaglandins were originally named due to the mistaken assumption that they were derived from the prostate gland and its secretions. I have written a number of posts on this blog regarding prostaglandin D2 (PGD2) and prostaglandin E2 (PGE2). PGD2 is especially important when it comes to hair loss. Bimatoprost is a prostamide F2α analog. Latanoprost and Travoprost are examples of prostaglandin F2α analogs.

Current Uses

While approval for use to grow scalp hair will depend on the upcoming phase 2 clinical trial results (and hopefully Allergan will decide to fund further phase 3 clinical trials), Bimatoprost has already been FDA approved for use in humans for:

  1. Glaucoma and ocular hypertension treatment, approval in 2001 (brand name Lumigan). Dosage = 1 drop of Lumigan 0.01 percent or Lumigan 0.03 percent depending on source, once daily.
  2. Eyelash growth (lengthening) treatment, approval in 2008 (brand name Latisse). Dosage = 1 drop of Latisse 0.03 percent, once daily.

Bimatoprost Side Effects

Although there are some significant side effects (e.g., darkening of iris, undereye, eyelash and eyelid), that can occur when using Bimatoprost for the above applications, most seem to be reversible.

It is also great to know that people have been using this product in such a sensitive areas as the eye for over a decade now without any large-scale reports of major injuries, nor any class action lawsuits against Allergan.

Will Bimatoprost be a Miracle Treatment for Hair Loss?

Initially when I first read about Bimatoprost a few years ago, I felt that it was going to be inferior to Minoxidil and not worth researching. For one, eyelash growth type results on scalp hair would be a joke in my opinion. More significantly, I thought that all Bimatoprost was doing was keeping scalp hair in anagen (growth) phase for a longer duration.

So once the androgens and dihydrotestosterone (DHT) killed the scalp hair, Bimatoprost would no longer have any positive effect. So my feeling was that all you were getting was a temporary spike in the amount of your hair that was in anagen phase. Also implying lengthier hair for a short time.

However, I have started to doubt my initial skepticism about this product. In 2013 Dr. Valerie Randall and a number of other co-authors published a great study on the successful use of Bimatoprost to grow human hair (in organ culture) and mouse hair (in vivo). The most interesting aspect of the study was that it seems like Bimatoprost stimulates intercellular signaling pathways and causes keratinocytes to produce increased hair growth as well as melanocytes to produce increased pigmentation. The whole process seems to start in the dermal papilla (which ties in to my recent posts on the University of Calgary’s and Replicel’s work related to dermal sheath cup cells).

It seems like Bimatoprost is not just temporarily keeping scalp hair in anagen phase longer. It is actually altering scalp biology at the cellular level and changing paracrine signaling (cell to cell communication) that may end up increasing protection against the ravages of DHT. According to the study:

Bimatoprost caused individual isolated scalp hair follicles from 10 different people to stay in anagen longer in organ culture, and about one-third more new hair was synthesized over 9 d with 100 and 1000 nM.

Note that the 100nM and 1000nM are dose measures, and much higher than the 0.03% present in Latisse and Lumigan. Another part of the study concludes that results from 100nM were better than from 10nM, but results from 1000nM were essentially the same as from 100nM. This is kind of the same phenomenon that we see in studies that show the negligible gains from higher and higher doses of Finasteride or Dutasteride.

My feeling is that Bimatoprost may result in slightly superior results to Minoxidil, but nothing extraordinary. Will this be sufficient for Allergan to fund final stage 3 clinical trials? I would hope so, considering how well the company has done recently.