41.    Hair restoration and anti-gray hair effects by topical roxithromycin. 
Taisuke Ito, Natsuho Ito, Naohiro Seo, Hiroaki Yagi, Hideo Hashizume, Masahiro Takigawa Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.

There are still few effective topical substances for androgenetic alopecia (AGA). In this study, we found that roxithromycin (RXM) has anti-apoptotic and anti-gray hair effects on AGA in vitro, and indeed, clinically improved or prevented hair loss of AGA. RXM is a 14-member new macrolide antibiotic and has been extensively used for prevention and treatment of systemic and local infection. In addition, recent studies revealed RXM also has various modulatory bioactivities to many kinds of cells, such as Langerhans cells, keratinocytes and T cells. The human hair follicles, obtained from plastic surgery with the informed consent, were cultured for 6 days. In the control group, hair elongation was 1.96 mm ± 0.19. On the other hand, it was 3.4 mm ± 0.20 and 3.32 mm ± 0.19 in 5 microM RXM and 10 microM RXM treated group, respectively in vitro. The groups treated with 5 microM CLM (2.17 mm ± 0.13), 10 microM (1.93 mm ± 0.18), 5 microM EM (2.85 mm ± 0.13), 10 microM EM (2.05 mm ± 0.19) showed no significant hair elongation compared with control group. Next, 11 male individuals suffered from AGA topically applied 8ml RXM at 0.5% in alcoholic solution once a day for 6 months with informed consent. Then, the photographs were scored. 4 patients apparently showed improvement of hair restoration. 4 patients were more than slight improvement, and 3 patients were no improvement. The topical RXM used under these conditions was safe without any local and systemic adverse effects. The beneficial effects of RXM seem to result from prevention of apoptosis of matrix cells and melanocytes in human hair follicles. RXM is the promising candidate of effective and safe substance for AGA.