Hair loss in women is endured in silence. That is the sentence every conversation on this subject should start with - because shame is the reason a woman waits a year and a half before seeing a doctor, and an early diagnosis is precisely what helps most.

Lately one name has been circulating in writing about female hair loss: VDPHL01. It has been presented as a breakthrough. It is not - at least not in the way it sounds.

Not a new drug, but a new delivery

Dr Carmen Polanco, trichologist and aesthetic physician at the DEMYA hair unit in Madrid, puts this plainly from the start: VDPHL01 is not a new active substance. The drug is still minoxidil, only formulated in an entirely different way.

Low-dose oral minoxidil has been used in clinical practice for years for various types of hair loss, but no tablet is specifically approved for female pattern hair loss. The difference with VDPHL01 lies in extended-release technology. Conventional oral minoxidil quickly reaches its peak blood concentration after being taken, then falls off just as fast. That peak is precisely what is linked to the side effects - palpitations, tachycardia, swelling or a drop in blood pressure.

The new formulation is meant to smooth that behaviour out: slow, steady release, more constant exposure for the follicle, lower peaks. Dr Alba Gómez, director of the hair medicine unit at the Ricart Institute, explains that this could mean fewer side effects and perhaps higher doses for some patients - but only once studies confirm it.

The most important part of the whole story is what VDPHL01 does not promise. It does not promise more hair than the minoxidil we already know. It promises the same result with better tolerability. „It is expected to be an even safer minoxidil, without it yet being clear whether it is more effective,” Gómez says. Polanco calls that „cautious optimism” and adds that we have not reached the point where clinical practice changes - that requires larger studies, solid comparisons and long-term data.

Why there is no single drug for everyone

„Female hair loss is not the same disease in every woman,” Polanco points out. Hormones, genetics, inflammation, metabolism, the age of the follicle, stress, comorbidities and life stage - all of it plays a part. That is why she expects the real change to come through personalised medicine: identifying which mechanism dominates in a given patient and combining therapies strategically, instead of everyone receiving the same thing.

Among the lines she singles out are more selective antiandrogens - spironolactone and finasteride are already used in certain patients, but options with greater efficacy and fewer side effects are being sought. The second line targets the biology of the follicle itself: instead of broad growth stimulation, more specific molecular pathways that extend the growth phase and delay miniaturisation.

Gómez adds that in androgenetic hair loss many molecules are tested in men first, with some later applied in women too. She mentions PP405, a molecule being studied in both sexes that works through metabolic mechanisms rather than hormonal ones. In autoimmune hair loss - alopecia areata, frontal fibrosing alopecia and lichen planopilaris - anti-JAK drugs targeting specific inflammatory pathways occupy a special place.

When it actually arrives in the consulting room

Here the figures are damper than the headlines. Anti-JAK drugs for alopecia areata are the closest reality. For frontal fibrosing alopecia and lichen planopilaris, Gómez expects new molecules from that family within two to five years. In androgenetic hair loss she mentions the possible commercialisation of topical clascoterone in 2028, first for male pattern hair loss, and speaks of four to ten years for other molecules.

Cell therapies and hair cloning are further off still - at least ten years, and that optimistically. The follicle is a complex mini-organ with many cell types and metabolic processes, and reproducing it in a laboratory remains a major challenge. Platelet-rich plasma is already used in selected patients, with variable results. Exosomes and stem cells, which the internet writes about loudest, are still waiting for quality clinical studies.

So what is left of all this? That many women with androgenetic hair loss achieve good stabilisation with today's options - if the diagnosis comes early and the therapy is personalised. Not in 2028. Now. That is the part the miracle-ampoule industry has no interest in stressing.