A novel topical hair loss treatment from UCLA might just be the ticket to waking up dormant hair follicles— but is there a catch?

A topical hair growth treatment that works by reprogramming follicle metabolism? Meet PP405, the buzzworthy molecule now in human trials. Image by Freepik.

Could we be on the verge of a cure for baldness? 

Lately, that’s what my patients have been asking me: are the rumours true? Is there really a new molecule in town that can cure baldness (also where can they get it?). 

And for the first time in a very long time (1990s), the answer might actually be… 

Maybe?

A research team out of UCLA recently announced some early results from clinical trials on PP405, a topical compound designed to stimulate hair regrowth by reactivating dormant hair follicles. And, unlike finasteride or minoxidil which slow hair loss through inhibition of DHT and encouraging vellus maturation, PP405 acts through an entirely new cellular mechanism.

And a new mechanism alone makes PP405 a potentially fascinating entry into what’s been a two-team group since the 1990s. 

The science is promising. The early trial results? Even more so. I even filmed a dedicated video on the PP405 here.

So what exactly is PP405 and what could it do for your hair?

 

PP405

Though the name makes it look a bit like a secret James Bond-style compound, PP405 is simply a lab designation given to a topical mitochondrial pyruvate carrier (MPC) inhibitor—and the folks at UCLA and their pharmaceutical partner (Pelage) are tentatively optimistic that they hold the start to a new era in medical hair restoration. Developed by UCLA researchers and commercialized by Pelage Pharmaceuticals, this compound works by targeting the metabolic state of hair follicle stem cells — in simplest terms it alters the way these stem cells generate energy.

 

Is Pelage Pharmaceuticals on the verge of revolutionizing the world of hair loss treatments? They’re confident they have something, and the research is promising. Remember that drug development is a long game and PP405 is still in trial phase. Image by Freepik.

 

In most cases of androgenetic hair loss, the hair follicles aren't dead—they’re asleep, or another way to put it is that their stem cells are metabolically inactive. The theory behind PP405 is simple (even if the metabolic pathway is decidedly not): by applying the correct dose of PP405 to the scalp, the metabolic switch can be flipped from "dormant" to "growth."

 

The Science — or What Does Cell Metabolism Have to Do With Hair Growth? 

 

Mitochondrial pyruvate carrier (MPC) is a protein complex that shuttles pyruvate (a very important molecule produced through glycolysis — or sugar breakdown) into the mitochondria (the cellular organelle that makes energy) to be used in aerobic (with oxygen) cellular respiration. By inhibiting MPC, PP405 forces stem cells to switch from aerobic respiration to glycolysis—a less efficient energy pathway that, paradoxically, mimics the energy state of hair stem cells during growth.

We know PP405 switches the cell to glycolysis because we see the reprogramming in real time: 

• Increases lactate dehydrogenase (LDH) activity (to convert pyruvate into lactate for glycolysis)
• Change in ‘redox state’ or a higher NAD+/NADH ratio (as a result of LDH activity — not the same as NAD+ therapy). 

The result? Proliferation and new hair growth, measured in preclinical models by looking for an increase in Ki67, a marker of cellular activation.

And it’s not theoretical. PP405 has worked in mice to induce hair growth and — at least in the early phases of human clinical trials — it’s tentatively working in humans too.

So, the excitement over this new drug is warranted… to an extent and with some important caveats. 

 

How It Differs from Finasteride and Minoxidil

We already have some solid therapies for hair loss—particularly finasteride (which prevents DHT-related follicle miniaturization) and minoxidil (which extends the growth phase of existing hair). But PP405 stands out because it’s reactivating dormant hair follicles — which finasteride and minoxidil don’t do. What people don’t realize is that dormant follicles aren’t ‘dead’ or ‘lost’ — they’re in a dormant state. So yes, in theory this could be the first therapy that actually ‘regrows lost hair.’

• Finasteride (DHT inhibition prevention of future hair loss)
• Minoxidil (Vasodilation, growth cycle modulation to thicken vellus hair and encourage maturation)
• PP405 (Metabolic reprogramming of hair follicle stem cells to reactivate dormant follicles)

Another very exciting aspect of PP405 is that unlike finasteride, PP405 doesn’t impact androgen levels, making it a more accessible option—especially for women.

 

One of the most undiscussed (and promising) aspects of PP405 is that it could become an impactful tool in treating women’s hair loss — one that doesn’t affect androgens. Image from cookie_studio for Freepik.

So what about those human trials?

 

Phase 1 (2023):

• 20 male participants with androgenetic alopecia
• Daily topical use for 1 week
• No significant side effects
• No detectable levels in systemic circulation (a major safety milestone)
• Evidence of stem cell activation via Ki67 markers
• Reports of improved density even after just 7 day

 

Phase 2a (2024–ongoing):

• 78 participants (men and women)
• Placebo-controlled, double-blinded (meaning researchers and patients don’t know who is taking the drug)
• Applied once daily for 4 weeks, with 12-week follow-up
• 31% of men saw >20% increase in terminal hair density vs. 0% in placebo
• No reported systemic effects, hormone changes, or safety concerns reported

 

So We Should Get Excited?

Yes—and also, not quite yet. 

There are a few catches. 

First off, no before/after photos have been released yet. That’s not unusual at this stage—companies often keep visual results under wraps until they apply for regulatory approvals—but it does mean we should stay skeptical and patient.

Secondly, PP405 is not the first MPC inhibitor investigated for hair loss.UK-5099, a compound that did wonders in mouse models to grow hair, was found in 2024 study on human follicle stem cell cultures, to trigger metabolic stress and proliferation arrest. Altering metabolic pathways can be tricky, and what works in a mouse model might not always translate to humans.

 

Inexpensive Prescription Hair Loss Medication Delivered To Your Door.

The good news is that PP405 appears to be more targeted, better tolerated, and optimized for topical use. Still, the field is watching closely for longer-term data and high-resolution imaging from the Phase 2 trial, expected later this year (2025).

 

Where Do I See PP405 Fitting into Clinical Practice?

If the trials continue to be successful, I could see PP405 being used in several ways:

• As a standalone therapy for mild to moderate androgenetic alopecia
• As a complement to hair transplant surgery to improve density
• As part of a combination protocol with finasteride, minoxidil, spironolactone (women), microneedling, PRP, and red-light therapy

Think of it as joining the "stimulation bucket"—alongside treatments that attempt to kickstart hair regrowth from follicles that are still biologically viable, just metabolically dormant.

That said, it won’t replace DHT blockers for those actively losing hair. Prevention and stimulation work best together, not in isolation.

 

Final Thoughts

If PP405 continues to show efficacy in larger and longer-term trials, we could see FDA approval by 2028. That’s not tomorrow but it’s not that far off either.

As always, I’m cautiously optimistic. The mechanism makes sense, and the safety profile is strong so far. The early results—though not visually documented yet—are also really promising.

But we need more data. And time.

Until then, don’t ditch your current medical therapy, but stay tuned—this one could be a game-changer.

Curious about how medical hair loss therapy fits into your hair journey? Head to feelconfident.com so we can explore your options together. 

 

The content of this newsletter is for entertainment and educational purposes only. This content is not meant to provide any medical advice or treat any medical conditions. Patients must be evaluated by an appropriate healthcare provider on an individual basis and treatment must be tailored to meet that patient’s needs. Results and particular outcomes are not guaranteed.