DrTBarghouthi

Hi guys. I apologize for being out of the loop for the last while, but I had to cut down on my clinical duties temporarily and thankfully I’m back at it this month full time. I will be scheduling a biopsy of our patient and testing a full FUE case using adjusted doses that we worked out. Still some interest from some colleagues especially for FUT- so hopefully more on that soon. We are still dedicated to this research and in fact we have some interest from various funding entities that may be willing to further advance this and other projects. Will keep you updated. 

1 hour ago, Square1 said:

Of course there are still a lot of question marks around this, but let's say it would indeed be the case that 30% of the extracted grafts regenerates and these follicles are not weirdly disappearing after some months and carry the same amount of hairs, that would be amazing for a first trial. If the process could be repeated (transplanted hairs re-transplanted grow back at a rate of 30% as well) that would already be a functional cure for baldness. Of course, in a transplant, some grafts don't survive, but that number would then easily be outmatched by the extra hairs verteprofin creates. Leaving the patient with more hair after each procedure.

But of course, we are not there yet. Hopefully further research will answer these questions and generate interest from the surgeon-community so they will actually use this in clinics.

Anyways: shukran ealaa kuli shay! (excuses for the google translate :))

 

 

I totally agree. 

4 hours ago, SkyeBelcher said:

Hey Dr Barghouthi,

The website has a donation section? Do those donations go to you to help further the trials?

Yes absolutely. It is not solely for donations, it was just thought that as we hopefully involve more clinics etc then a unified place for updates may be more appropriate. Ofcourse I personally would still be available for interactive conversations here or on other channels whenever possible. We have also been approached by several individuals about how best to help and contribute- that’s why we setup a section for anyone wishing to contribute. It just becomes more transparent and easier to execute. It can also help encourage colleagues to join in as it can help cover part of the costs that a trial entails. 

30 minutes ago, Ganderson said:

Dr. B - 

this experiment, the way that you share the information so consistently and answer our questions - THIS - is how you push forward science and THIS is how we as individuals can make serious progress in hair loss over the next few months - few years. There’s an actual chance that we could be radically improving (and in a far off chance, the stepping stones for CURING our ailments).

i looked at the website. It looks great. I will be donating. I will try to encourage others to donate too. This is it. Imagine if we were able to have TWO, THREE weekly results from FUT patients, FUE with different dosages and combinations, maybe you could even enlist other doctors globally to think about this together and collaborate. 
 

im 100% donating. I believe everyone should!!!!!!!!! 

Thank you very much for the kind words. I will definitely be engaging colleagues and I already made contact with a good friend to help with this too. 

Just now, DrTBarghouthi said:

Hi guys,

A group of individuals have thankfully helped in setting up a Verteporfin related website - www.verteporfin.org

The purpose of that is to have a reference site for the updates but also to channel everyone interested in supporting the ongoing progress of future trials. You can also use the site to reach out to us via whatsapp or email to register your interest in being in future trials. I am seeking the assistance of colleagues in having trial clinics in the US and Europe to make it easier for travel and to hopefully run simultaneous trials, as there are few different variables to test. I hope to have definite news on that soon. Thank you again for all your support across all channels and I would ofcourse keep this updated too. 

@Melvin- ModeratorI’m sorry Melvin if I referenced an outside website. I forgot that this might be against the forum rules. If it is please feel free to delete and you can let me know how to best let the community know. 

Hi guys,

A group of individuals have thankfully helped in setting up a Verteporfin related website - www.verteporfin.org

The purpose of that is to have a reference site for the updates but also to channel everyone interested in supporting the ongoing progress of future trials. You can also use the site to reach out to us via whatsapp or email to register your interest in being in future trials. I am seeking the assistance of colleagues in having trial clinics in the US and Europe to make it easier for travel and to hopefully run simultaneous trials, as there are few different variables to test. I hope to have definite news on that soon. Thank you again for all your support across all channels and I would ofcourse keep this updated too. 

13 hours ago, Square1 said:

Thanks again for your update

Is there a percentage of regrowth, or at least a range, that we can derive from the experiment till now? Is it like 1%, 10%, 30%? Any word on that?

 

Hard to scientifically put a number. Nonetheless, I feel that test areas have somewhere in the region of 30% improvement on average. The important question to seek an answer for is that if we had some improvement in T areas, then how far more can we get if we make adjustments? 

On 11/19/2022 at 1:13 AM, alopeciaphobia said:

@DrTBarghouthi If you don't mind me asking another question, what injection method did you use in this experiment, and how would you imagine improving it in a future one?

I used the 30g needles commonly used with prp or mesotherapy and at the same depth we use. I’m just considering injecting at a smaller interval and having a uniform depth across all injections. 

On 11/18/2022 at 11:12 PM, Jay Dunman said:

I think any dosage will do. 0.4 seems fine but I think consistent injections is key rather than just one time. That means multiple trips to Jordan boys. At least the weather is warm 

Dr. Barghouthi did you use laser to activate the Verteporforin or is laser only used when verte is injected into eyes for muscular degeneration? 

No laser was used. It is used to activate it for eye disease use. I don’t think there is a need for repetitive injections. Just possibly adjusted and uniform depth and also trial of higher doses. 

1 hour ago, Melvin- Moderator said:

We’re you able to speak to Dr. Farjo? I know he mentioned it in out podcast last month. 

Unfortunately not yet as I had to cancel my Panama trip last minute for reasons beyond my control. I will arrange a meeting with him online. There are also other doctors willing and we should have an FUT strip done by one of them soon hopefully. 

1 hour ago, SkyeBelcher said:

Do you have any update for the next trial? 

I remember you saying you had someone lined up for a full transplant but they ended up leaving the country?

I’m sorry I thought I replied but not sure where it went. Yes I still have the volunteer ready - I just want to use an updated dose on him to make sure we get the best out of it. Such volunteers are hard to find and so I want to make the best of it. It will be soon though.
I’m also waiting to make sure I have enough verteporfin supply for a full FUE. 

Yes some sort of marking it is important I agree. Will aim to do so for the next trial. 

Thanks a lot. Yes I am discussing with some doctors and hopefully we will have different trials going soon. Testing higher doses will also be soon. I just want to make sure the supply is there and improve the protocol further this time. 

Other treatments are used frequently (such as PRP) and in many cases we hardly see any skin or density improvement similar to this. 

Yes I’m glad you share some of my observations as well. I think future attempts and adjustments are definitely worth pursuing because even the slightest difference between control and test areas is worth questioning and exploring.

Hi guys.
So for this update I started with a zoomed out photo to try and make a more generalized idea about what’s going on. On the zoomed images - which I will also share, you can still see some potential hair growth around punch sites or within them as compared to control areas. You can also appreciate the difference in the punch area skin texture in between some of the test and control sites. Nonetheless, what is more interesting is the overall look of test vs control areas in the zoomed out photos. I particularly think that 0.4 mg gave an overall better healing and potential regrowth than others. You can hopefully appreciate how the area to the right of the blue line i marked shows a generally better looking donor healing than the same 0.4 control area. Again I do appreciate that limitations of this early trial and photography and I do think that some areas within the test areas healed better due to the injection technique or drug delivery method. This is something we have to improve as mentioned before. I will take histology in December of various sites to histologically compare test and control areas.

Please note that the top left corner of the T area just happens to be part of an older scar that he had too.

Here I can just see that the T has possibly less defined scarring borders and islands where healing seems to be better. It is not uniform throughout the box but that might show that vert was not active throughout the entire area.
 

Again punch sites in T show better looking skin texture even with no hair growth it seems.

Hi guys. Apologies for the delay. I met the patient and will update the photos today or tomorrow at the latest. 

4 hours ago, Magic City said:

Thanks for the update, continues to look very promising. In the zoomed out pictures, is it the control sites on the left and the test sites on the right? If so, the results like good so far in verteporfin areas compared to control. 

Yes correct. 

On 10/15/2022 at 1:45 PM, TheManeMan said:

I'm curious about this too.

 

Anyone have any thoughts on this?

 

Doc?

It’s not 0.24’per graft but per cm2

5 hours ago, alopeciaphobia said:

Thank you so much for including these shots! They give a much better big picture of the regrowth and scarring.

Was the top left photo taken from a different angle than the others? Itooks like it shows significantly better hair coverage, but it may be due to how the shot was taken.

Also very excited about the dosage increases and recipient area injections!

Thank you. I took photos from the same distance as it it the only distance that enabled me to show the scarring with some detail and not too blurry. Any noticeable change in angle is mainly due to the fact that the areas are just curved along the donor area. 

Hi guys. Here is the update after 119 days (17 weeks). I continue to see distinct hairs around or within punched areas in the test areas across all doses. I continue to see clearly scarred areas in the control group. It is hard for me to track every single hair that grew before, some are indistinguishable but I am tracking any that seem within a scar and look distinctly shorter or still newer relative to surrounding hairs. I do think the 0.4 and 0.32 doses are best. If we look st zoomed out pics of both we can appreciate a difference in healing and possibly the contribution of new hairs giving better coverage and appearance in the test areas. The 0.24 dose did not heal as well in my opinion- possibly due to either the dose or because of using tumescent within the actual areas. It may have suppressed the mechanism somehow. I will keep up with the follow ups and would hopefully do a biopsy at 6 months. I think I will now need to test new doses within 0.4 and above or increase the concentration. I also need to find a more uniform injecting technique to establish great uniformity in injections. I will also proceed with injections in the recipient area and a linear scar injection. These are all still in the pipeline. 
 

Hi guys. Here are the updated photos. As you can see, there is scarring in both control and test areas. The test area is a bit more pigmented and I think that the scarring is slightly better. Maybe it needs more time or a dose adjustment. Nonetheless, the tiny hairs in the test areas across the 3 dosages is becoming more of an obvious feature in comparison to control areas. 
 

Thanks for tagging. I don’t see anything of major concern. It mostly is some case of folliculitis as hairs maybe trying to break through skin. I would continue to use any topical medication that seems to be working. May I also suggest trying some warm towel pads twice a day over the areas affected. Keep us posted. 

On 9/1/2022 at 5:11 PM, Magic City said:

Hey Dr Barghouthi, just want to say that it is very refreshing and encouraging to see a doctor willing to take the bold step of trying this in actual patients. Thank you. The initial results are looking promising. 

In terms of follow ups with the patients and updates, I think I remember in your chat with Melvin that the patients would be followed up post surgery for 6 months and possibly longer if you can. Is the next follow up and update at 90 days with the first patient? 

Thanks again for your efforts and looking forward to see how this develops! 

 

Thank you very much. The next follow up is in less than a week actually. I’m currently doing a follow up every 4 weeks with this patient, but this is only for the purposes of the study. Once we have a working protocol or we get implemented as part of surgery, then I think less frequent follow ups will be the standard. 

47 minutes ago, WhereIsMyMind said:

Verteporfin is fully FDA approved drug and is literally injected in eyes with no dangerous side effects. 

It doesn't really need that much more investigation to conclude verteporfin is better than no verteporfin with an almost 100% guarantee for any transplant procedure. Soon enough most HT doctors would come to this conclusion anyway.

Of course should follow good practices and follow up, but the comments about safety are overly exaggerated for a drug that is already proven safe by very meticulous trials and has been used for over 25 years now.

This is no random molecule rat-trial situation at all.

I agree. However, off-label use is always better to be approached with caution, and not everyone would be happy to get injected with a drug that was not approved for that purpose. For example, minoxidil tablets have never been approved for hairloss- but the drug has been present in oral and topical preparation for longer than Verteporfin- yet only in recent years the uptake increased. Same applies for Finasteride in post menopausal females- a drug present for many years for male loss and enlarged prostate- and yet females are still hesitant in taking a “hormone” reducing medication that is off-label.