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• New Crinagen Formula, Now More Potent With 5% Azelaic Acid

• HairSite Editorial - 5/23/99

• HairSite, Dr. Razack & British Journal of Dermatology

And to top it off, the new Crinagen with 5% azelaic acid is an alcohol free lotion, one of the very few in the market. We all know that alcohol can be very damaging to skin tissue when used constantly.   For example, people who have been using Rogaine (an alcohol based lotion) for an extended period of time always complain about conditions such as scalp inflammation (the so called "minoxidil burn"), severe itch, excessive flakes, crustings and dryness and hardening of scalp tissue. This is really an added blessing that Crinagen does not contain alcohol and thus the side effects from this treatment can be minimized. 

While Dr. Razack suggests that 5% azelaic acid would be sufficient to activate his formula and be effective, I have known people who pursue a more aggressive approach and  include Skinoren (20% azelaic acid cream) in their regimen. Some feel that the ideal treatment would be to use the new Crinagen formula all over the scalp and then apply Skinoren to areas that are known to be the most difficult to treat, eg: hairlines. However, I think this is all theory. You should consult your doctor before you try any products for your hair and scalp. 

The new formula appears to be safe for women too, as reported from Dr. Razack's office.  Female hair loss sufferers have traditionally been left in the dark when it comes to hair loss treatments. For example, while the introduction of Propecia and Rogaine 5% have been great news to a lot of people, they mean nothing to women who are losing their hair. Women are advised against using either Propecia or Rogaine 5% because of potential side effects. Now the new Crinagen formula has changed the landscape somewhat. The products is safe to use for both men and women. Crinagen is now one of the very few topical treatments that can safely address the issues of DHT for female hair loss sufferers.  For those who cannot use Propecia, Crinagen would be the alternative.

If you have trouble finding the Skinoren azelaic acid cream or the new Crinagen formula, please email HairSite@aol.com

Please be sure to check with your doctor and dermatologist to see if this product is suitable for your conditions.

The following are some background info about the introduction of the new Crinagen with 5% azelaic acid

Azelaic acid (first draft 3/11/99)

Azelaic acid (pronounced az-uh-LAY-ic) is a simple molecule ( HOOC(CH2)7COOH, CAS Number 123-99-9, also known as 1,9-Nonanedioic acid) that is found in some whole grains and in trace amounts in human bodies. Although it is an acid, it is an extremely weak acid - much weaker than vinegar. It's current use in medicine is in Azelex, which is a cream base containing azelaic acid as 20% of its weight. Azelex is available by prescription in the USA and is used in the treatment of acne. More description of its medical properties, including cautions, can be found here:
http://www.nursespdr.com/members/database/ndrhtml/azelaicacid.html

Azelaic acid may promote healthier hair growth. A research report by Stamatiadis in 1988 suggested that azelaic acid (and combinations of it and zinc ion and vitamin B6) was a strong type I 5-alpha reductase (5-AR) inhibitor. The enzyme 5-AR (both types I and II) convert testosterone to dihydrotestosterone (DHT). DHT has been shown to contribute to male prostate enlargement (benign prostatic hyperplasia, BPH) and to damage hair follicles. The abstract of that article is further down this page.

We have not seen research that directly links the use of topical azelaic acid (or azelaic acid with zinc and B6) with hair growth. We feel that there is sufficient literature backing (in the Stamatiadis study and others) to include it in a Crinagen preparation.

Some people have obtained Skinoren azelaic acid cream (which is 20% azelaic acid) from New Zealand and are spreading thin layers of it on their scalps - either before or after applying Crinagen. We don't know what success they are having. We have not had sufficient feedback from these subjects at this point. Because 20% azelaic acid is a very potent strength, we are suggesting that these people use it only with a physician's supervision. At the very least, they should consider diluting the 20% azelaic acid to 5% or less by mixing it with neutral creams.

Abstract of Stamatiadis' 1988 study:

Br J Dermatol 1988 Nov;119(5):627-632 Inhibition of 5 alpha-reductase activity in human skin by zinc and azelaic acid.

Stamatiadis D, Bulteau-Portois MC, Mowszowicz I

Laboratoire de Biochimie B, Hopital Necker-Enfants-Malades, Paris, France.

The effects of zinc sulphate and azelaic acid on 5 alpha-reductase activity in human skin were studied using an in vitro assay with 1,2[3H]-testosterone as substrate. When added at concentrations of 3 or 9 mmol/l, zinc was a potent inhibitor of 5 alpha-reductase activity. At high concentrations, zinc could completely inhibit the enzyme activity. Azelaic acid was also a potent inhibitor of 5 alpha-reductase; inhibition was detectable at concentrations as low as 0.2 mmol/l and was complete at 3 mmol/l. An additive effect of the two inhibitors was observed. Vitamin B6 potentiated the inhibitory effect of zinc, but not of azelaic acid, suggesting that two different mechanisms are involved. When the three substances were added together at very low concentrations which had been shown to be ineffective alone, 90% inhibition of 5 alpha-reductase activity was obtained. If this inhibition is confirmed in vivo, zinc sulphate combined with azelaic acid could be an effective agent in the treatment of androgen related pathology of human skin.

PMID: 3207614, UI: 89087983

The reservations one might have regarding the Stamatiadis study are (1) that the study was done on rats, (2) that is was done on prostate tissue (and not on hair tissue) and (3) that it was done "in vitro" (essentially means, "not in a living organism"). Cells in living tissue generally show a considerable ability to protect themselves from invasion. Treating pure 5-AR directly with azelaic acid in a lab flask is somewhat different from exposing the living cell to azelaic acid. Nevertheless, what happens "in vitro" often reveals clues as to what might happen "in vivo" (in a living organism).

If you have trouble finding the Skinoren azelaic acid cream or the new Crinagen formula, please email HairSite@aol.com