Novan, Nitric Oxide, Acne and MPB

Recently, reader “John Doe” brought to our attention a US-based biotechnology company named Novan. Their work in developing a topical nitric oxide based product for male pattern baldness (MPB) seems quite unique and is worth a post.

Novan, SB204, Acne and Hair Loss

Novan (sometimes also called Novan Therapeutics) is developing a number of dermatological products. Per its pipeline, their acne vulgaris product SB204 is already in stage 3 clinical trials. This is the same product that can also be used for hair loss.

However, unlike Cassiopea (Breezula for MPB and Winlevi for acne), Novan is not undertaking separate trials for its hair loss product. The company does list androgenetic alopecia as a potential therapeutic application of nitric oxide at the bottom of its pipeline page.

Perhaps the assumption is that if Novan’s topical nitric oxide (NO) based SB204 product for facial acne is proven safe, it can also be used on heads? And this can be done without necessitating FDA approval for such off-label use? In any event, who can prevent someone for getting a prescription for SB204 for acne, but then using it on their head instead?

Initially, I thought that Novan was a new company. However, it seems like they have  been working on NO based drug candidate products since 2010.

Novan Pipeline Acne and Hair Loss
Novan’s nitric oxide based dermatological products pipeline.

Nitric Oxide and Hair Loss

Over the years, I have read about Sildenafil (Viagra) impacting nitric oxide pathways and temporarily curing erectile dysfunction. The vasodilatory effect from Sildenafil relaxes and widens blood vessels. I have also heard about nitric oxide’s important cardiovascular impact. In 1992, NO was voted as the molecule of the year.

However, I have not paid much attention to nitric oxide levels on the scalp and their impact on hair loss. One clinical trial in China that ended in 2013 compared the safety and efficacy of nitric oxide gel in promoting hair growth in men. No results were posted.

According to this excellent paper from Novan’s Dr. William Kelce, nitric oxide on the scalp or skin can inhibit skin steroidogenesis. This results in reduced levels of key androgens testosterone and dihydrotestosterone (DHT). Nitric oxide also reduces sebum levels.

Even more interesting than its anti-androgenic effects, nitric oxide levels can inhibit prostaglandin D2 (PGD2) synthesis. See my past posts on the connection between PGD2 and balding.

It has been postulated that one of the ways in which laser hair growth devices benefit scalp hair growth is via stimulating increased nitric oxide levels. Moreover, it is thought that Minoxidil has the chemical structure of nitric oxide and may be a nitric oxide agonist.

25 thoughts on “Novan, Nitric Oxide, Acne and MPB”

  1. The fact they aren’t running a proper trial for this product on hair really confuses me admin. Should we put something on our heads having no idea about its efficacy nor safety when used on scalp? What if it made things worse even. By the way any news is always appreciated, and I’m also starting to lose the count on all the products that are supposed to be released in the not so.distant future, hopefully one of them will.make a difference

    1. If the acne product gets released, you will have to talk to your dermatologist to see if its worth using off-label on the scalp (and risking any potential side effects). The company might even warn people not to use on the scalp.

      Although perhaps some people do get scalp acne!!

  2. Guys what did I say about ips cells. Japan/china are the only countries that screens these cells. They’re basically embryonic cells from your own body. I think theirs been like 10 different trials so far in Japan/china using these cells. Hundreds of people have been tested. There was one case where ips cells where used to cure blindness. 4 of the 5 people tested were cured. 1 of the 5 had the body reject the cells. All they did was spray a topical steroid in the eye and she recovered fine. I stand by my claim that trials already happened.

    “Two men in China were the first people in the world to receive an experimental treatment for heart disease based on ‘reprogrammed’ stem cells, and they have recovered successfully one year later, says the cardiac surgeon who performed the procedures. In May last year, the men were injected with heart muscle cells derived from induced pluripotent stem (iPS) cells, the surgeon told Nature — the first known clinical application of iPS-cell technology for treating damaged hearts.”

  3. After reading this I thought maybe we should just rub Viagra (ie: sildenafil) on our heads? Apparently there’s a study form 2018 that has concluded: “our study demonstrates for the first time, the significant therapeutic potential of sildenafil on hair growth and its potential use in treatment of alopecia.”


    1. It doesn’t sound much, but what if they try it and they all get their norwood 1 hair back? It’s possible! Stranger things have happened in the medical world.

    2. Seems like they finally solved the business-side of them.

      Merger with Conatus is through and new CFO installed.

      All together very encouraging news – I always thought the product is superior to many others.

    1. Dave, tell me where please. I would buy this in Russia and try it out instead of topical finasteride.

    1. Sorry for the mean comment, it’s better to remove it. I was just disappointed to not find any advance in hair loss treatment.

  4. @Aurelien. I sympathise with you. We all do. However, if the time comes, wearing a wig wouldn’t cut it for me. As a mad keen surfer, I don’t think it’d be a good look having it peel off after the first duck-dive! Try and stay positive. You never know what the tide might bring? (Apart from old peeled off wigs) ;-)

  5. sooner or later something will come out and at this point after a wait of more than 20 years I am sure that soon we will have something even if another 5 years have to pass… it’s all right;)

  6. Nice to see the press release of Puretech Health, Follica phase 3 is going to start this year with 280 patients due to the convalidation of pahse 2 data by FDA. So in 2020/2021 we will see at leat 3 company in phase 3: Follica, Cassiopea and Samumed.

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