Official Hair Loss Breakthroughs and Future Treatments Tread (Check for Updates!)

[Blake Bloxham]

Navigating the world of “futuristic” treatments and hair loss “breakthroughs” is a daunting task. It seems like each week a new story about a “miracle hair loss cure” hits the internet and causes a flurry of excitement, confusion, and hope. Unfortunately, many of these “cures” eventually disappoint or are exposed as journalistic sensationalism. However, others are backed by legitimate science and appear promising. So how can hair loss sufferers weed through the miracle promises, complicated science, and media hype, and determine which future hair loss treatments and new findings are actually promising?

 

Hopefully by reviewing this thread!

 

I want to use this thread as a means of updating our forum members on hair loss news and future hair restoration treatments. I plan on sharing the newest research studies, news stories, proposed future treatments, and updates on ongoing projects. When appropriate, I will also share my opinion and thoughts on the updates as well. What’s more, I encourage other forum members to do the same. If a member comes across a new story about future treatments, please share it in the thread (while keeping our Terms of Service in mind). Also, any member who has a question about a future treatment can post it in this thread and I will do my best to answer in a timely manner.

 

As stated above, I will do my best to keep the thread up-to-date, so please check back frequently for updates. I really hope the thread helps us all navigate the confusing world of future hair loss treatments and creates a better understanding of what is on the horizon!

[Blake Bloxham]

Hair “Multiplication” or Hair “Cloning:” Where are we Today?

 

(Please note: this overview is a bit simplified and in no way covers all aspects of hair multiplication.)

 

Hair “multiplication” or hair “cloning” is, essentially, the “holy grail” of hair restoration treatment. The theory behind hair multiplication is simple: remove the crucial stem cells from hair follicles, culture (“clone” or “multiply”) these cells in a lab, and either inject the cells back into the scalp or allow them to create new follicles (cell aggregates) and implant them into the scalp. This creates thousands of new follicles from a very small amount of donor tissue and allows for complete restoration in patients with high Norwood balding patterns. Unfortunately, the actual science behind the procedure initially proved much more difficult.

 

Researchers quickly realized there are two crucial regions of stem cell activity in hair follicles: the “bulge” stem cell follicles, which are epithelial (ectodermal) in origin and found in the outer root sheath (ORS) of the follicle; and the dermal papilla cells, which are mesodermal in origin and found in the bottom of the hair follicle. Eventually, researchers found a reliable way to multiply the epithelial bulge stem cells. However, multiplying the dermal papilla cells proved much more challenging.

 

Research groups tried – for years – to multiple these cells. These groups extracted the cells and tried to culture them in a traditional flat, two-dimensional cell medium. They found that the cells consistently failed to appropriately multiply. A few teams were able to multiply the cells, but quickly discovered that these dermal papilla clones lacked the ability to mimic normal follicle function and grow hair.

 

Fortunately, this all changed in 2013 when hair follicle research Dr. Colin Jahoda made a crucial discovery: Jahoda realized dermal papilla cells are naturally cultivated and function in a spherical, three-dimensional environment. By culturing (“cloning” or “multiplying”) dermal papilla cells in a 3-D model, the cells appropriately multiplied and retained the genetic ability to function and grow “pseudo hairs.” Dr. Jahoda took his work to Columbia University and replicated his experiment with fellow hair loss researcher Dr. Angela Christiano in late 2013. Jahoda and Christiano cultured the dermal papilla cells in a “hanging droplet” 3-D format and found that the cells retained 22% of the genetic material of natural dermal papilla cells and possessed the ability to grow colorless, wiry pseudo hair. This 3-D culturing method proved to be a huge breakthrough and is now an integral part of all hair multiplication studies.While 3-D culturing solved a huge piece of the hair multiplication puzzle, Dr. Jahoda himself admitted that there was still much to understand and the method was not yet ready for human testing.

 

However, this did not stop several groups from integrating the 3-D culturing method and working toward a true hair loss treatment. In particular, two groups – one in China and one in Taiwan – are now using Dr. Jahoda’s method to advance the process of hair multiplication. A research group at the National Taiwan University Hospital is actively seeking 400 research participants for a new experiment where dermal papilla cells grown using Jahoda’s 3-D method are inserted into the subject’s scalps. This will be the first time dermal papilla cells cultured in the 3-D model have been injected into the scalps of living humans. The other group, working at the Southern Medical University in China, used a 3-D culturing model called the “Matrigel Culturing Method” to culture cells and found that combining these cells with hair matrix cells resulted in the growth of a hair-like fiber. The cells grown with this model retained important genetic characteristics (which may be greater than the 22% seen by Jahoda and Christiano), and this shows that Matrigel culturing may be a reliable method for hair multiplication in the near future.

 

These two groups are not the only ones currently researching with the 3-D growth model. In May 2014, the 8th annual World Congress for Hair Research will take place in Korea, and at least 6 additional researchers are presenting the results of their 3-D culturing studies during the meeting.

 

While the recent hair multiplication findings are very exciting, an actual treatment using these new methods is likely still far away. First, no group has yet grown normal hair with the modern hair multiplication methods. Several groups have succeeded in growing “hair-like” structures or “pseudo hairs,” but not “real hair.” Many believe this problem could be partially solved by cloning (and integrating) the oil-secreting sebaceous gland (which is an integral part of the pilo-sebaceous model of the hair follicle). What’s more, when a model of easily reproducible hair multiplication is discovered, it still must pass all clinical safety and efficacy trials. Because the process involves the culturing of stem cells (and the use of growth factors to make these cells divide and multiply quickly), it possess the potential for unregulated or abnormal cell growth (i.e. cancer) and must be thoroughly evaluated. Finally, it is likely that this process will be very expensive in the beginning and it would take some time before it was affordable to the average hair loss sufferer.

 

Altogether, hair multiplication is a promising therapy. Several recent breakthroughs have also greatly accelerated hair multiplication research and could make it a realistic treatment in the distant future. Unfortunately, the several missing pieces of the hair multiplication puzzle and the approval process make the timeline uncertain. Please check back for more hair multiplication updates in the future!

Edited March 14, 2014 by Future_HT_Doc

[Blake Bloxham]

Plastic Surgeon Believes Gravity May be Responsible for Hair Loss:

 

Although androgenic alopecia (male pattern baldness) is a complicated condition, scientists have understood the mechanism behind this type of hair loss for a number of years: In androgenic alopecia, genetically susceptible hair follicles are exposed to high levels of dihydrotestosterone (DHT) hormone, which causes abnormal cycling and eventually permanent loss of function in these follicles. This process causes a gradual hair thinning and eventually leads to permanent patterned baldness. For years, the inciting factor or underlying cause of androgenic alopecia was cited as simply genetics; however, Turkish plastic surgeon Dr. Emin Tuncay Ustuner recently proposed a new theory to explain the underlying cause of male pattern baldness: gravity.

 

Yes, gravity! As strange as it sounds, Dr. Ustuner believes the effect of gravity explains not only male pattern baldness, but also why body hair and scalp hair react differently to DHT and why females experience more hair loss after menopause. According to Dr. Ustuner, the force of gravity on the scalp puts excessive pressure on hair follicles and eventually causes hair loss. In younger individuals, the layer of fat under the superficial scalp is thick and “well hydrated,” and this creates a cushion that prevents the hair follicles from being suffocated as gravity forces the scalp down toward the skull. However, as individuals age, the amount of fat decreases and gravity begins to cause follicle damage and hair loss. The hair follicles in the back and sides of the scalp – those normally spared in androgenic alopecia – aren’t affected by gravity because they don’t lay under the top of the scalp and do not experience the increased pressure from gravity. What’s more, because the female sex hormone estrogen promotes fat building, Ustuner believes the association between female hair loss and menopause (cessation of normal estrogen cycling) can be explained by a decrease in scalp fat with decreasing levels of estrogen.

 

Dr. Ustuner believes his “hair loss gravity theory” explains another alopecia phenomenon: why body hair follicles and scalp hair follicles respond differently to DHT. Unlike scalp hair follicles, which shrivel and eventually stop cycling when exposed to DHT, body hair follicles experience increased growth and development when exposed to the hormone. According to Ustuner, all hair follicles (body and scalp) respond to stress by signaling for greater levels of testosterone and its potent DHT derivative. This is because Ustuner believes all hair follicles actually experience growth and development from testosterone and DHT. However, these hormones also cause a breakdown and decrease in the level of body fat. So, when the scalp hormones begin to experience increased pressure from a loss of scalp fat with normal aging, they signal for testosterone and DHT to help grow and function properly. However, the increased levels of testosterone and DHT in the scalp end up causing a greater thinning of the scalp fat and, subsequently, more crushing gravitational pressure on the hair follicles. This phenomenon is not seen in body hair follicles where direct gravitational force is not an issue, and helps explain why scalp and body follicles seem to react differently to testosterone and DHT.

 

Dr. Ustuner is the first to admit that many will be skeptical of his latest theory. Obviously, the theory conflicts with years of hair loss research and does not explain the phenomenon of donor dominance or why scalp hair follicles survive after being transplanted to areas of balding scalp. However, it is an interesting theory and may be researched more seriously in the future.

[Blake Bloxham]

Update on Aderans' Hair Multiplication Research:

 

Aderans Research Institute (ARI) – a sub-division of the Aderans organization – began researching hair multiplication/hair cloning in 2002. After a variety of different approaches and applications, ARI began to work exclusively with what they called the “Ji Gami” process. During the Ji Gami procedure, a small strip of scalp containing follicular units is removed and broken down into individual follicles and follicular stem cells. These stem cells are then extracted, cultured in a growth medium, multiplied, and injected into balding scalp where they were expected to mature into fully functioning hair follicles.

 

Initially, ARI expected this technique to create true hair multiplication/hair cloning, and began clinical research trials. ARI completed the phase I safety trials, and moved forward with the phase IIa and IIb efficacy trials. During these clinical experiments, the results revealed that the Ji Gami process may not cause actual hair multiplication, but instead revitalize hair follicles and permanently prevent these follicles from future loss. Though the treatment was now slightly different, ARI was pleased with the results and continued with late phase II trials in 2011 and 2012.

 

Despite this optimism, Chief Executive Officer Dr. Ken Washenik announced in 2013 that Aderans decided to no longer fund the ARI division or its hair multiplication research. Dr. Washenik explained that while Aderans will no longer fund the project, there is still a possibility it may continue with outside funding.

[Blake Bloxham]

Coming up: an update on "donor doubling;" a discussion about new hair loss medications including topical anti-androgen treatments "CB-03-01" and "RU58841;" and information about "dermarolling," scalp wounding, and the new "Pilox II" device.

[garethbale]

Aderans are pretty much dead aren't they? I can't see anyone funding such a risky venture, particularly in this economic climate. Aderans' results were obviously poor hence the trials have been discontinued.

 

As regards to donor doubling, pretty much ever doubling patient of Nigam's has failed. Either that or they appear to have disappeared and we have no idea what their results are.

 

And yet Nigam is speaking at the World Congress for Hair Research in May. Go figure!

[Blake Bloxham]

Gareth,

 

At the moment, it seems that way. Dr. Washenik said the research could potentially continue with outside funding, but raising this type of capital in this scenario would (likely) be a monumental task.

 

I have seen a few failed donor doubling cases from Dr. Nigam. However, in my opinion, I find it difficult to label these cases as examples of donor doubling "failures," simply because Dr. Nigam seems to include doubling, multiplication, and growth factor injection with each case. I'm still waiting to hear Dr. Mwamba's assessment. Frankly, I still think strict donor doubling deserves further research.

 

I was surprised to see he was presenting at the congress as well. I'm curious as to what he will present. Either way, I feel like it will be interesting to review!

[lucldh]

Thanks Blake. Much appreciated.

[lucldh]

Blake, any idea about availability of topical version of finasteride internationally?

[Blake Bloxham]

Luc,

 

From what I know, topical finasteride is hampered by absorption problems. While it can obviously be better dissolved and absorbed with certain vessels, there doesn't seem to be much push for topical finasteride. However, there is definite interest in other topical anti-androgen agents. Two, in particular, are CB-03-01 and RU58841.

 

The buzz around RU was high for a while, but many patients reported side-effects similar to oral anti-androgens and I haven't heard much about it for quite some time. I also haven't heard any push for formal trials with this drug. However, CB-03-01 may be a bit different. Many patients believe - because of the way it works - that it will not be associated with the potential anti-androgen side effects. It is also being investigated by an Italian pharmaceutical company called Cosmo. Unfortunately, the company chose to move forward with trials testing the drug as a topical acne treatment and not an androgenic alopecia treatment and it isn't certain when - and if - they will test it. Some are trying to find an appropriate vehicle to use the treatment on an amateur level, but I haven't seen many successful cases yet.

 

I hope this helps!

[lucldh]

Thanks Blake.

 

Luc,

 

From what I know, topical finasteride is hampered by absorption problems. While it can obviously be better dissolved and absorbed with certain vessels, there doesn't seem to be much push for topical finasteride.

 

vessels means? What do you mean by absorption? Was it not absorbed by the scalp properly?

 

 

The buzz around RU was high for a while, but many patients reported side-effects similar to oral anti-androgens and I haven't heard much about it for quite some time.

 

Was RU required to be applied locally or consumed orally? I believe that it should be orally, but still confirming.

[Blake Bloxham]

Luc,

 

"Vessel" is the same thing as a vehicle or solution. Essentially, most of these chemicals come in powder form and they must be dissolved in a liquid with the correct pH, affinity for water/fats, and ability to absorb through the scalp. Which brings me to the next point: absorption. Yes, I meant absorption through the scalp. If molecules are not broken down in a liquid properly or if they aren't the correct pH or an appropriate size, they cannot be adequately absorbed through the scalp.

 

As far as I know, RU is a topical. This means that it is applied physically to the scalp and is not taken orally.

 

Hope this helps!

[lucldh]

Thanks for explaining that, sufficiently clear now.

 

Luc,

 

As far as I know, RU is a topical. This means that it is applied physically to the scalp and is not taken orally.

 

Hope this helps!

 

Now wondering how a topical solution has the same side effects as the oral finasteride. Can this be explained?

[lucldh]

Update please, Blake.

[Blake Bloxham]

Luc,

 

A topical would have the same side effects of an oral medication if the topical solution was able to get from the scalp circulation into the systemic cicrulation. If it was absorbed through the scalp and stayed solely in the scalp, it would not affect other areas of the body and would not - in theory - cause systemic side effects (decreased libido, erectile dysfunction, body hair loss, et cetera). However, if it absorbed through the scalp and did not stay local and instead spread to other areas of the body via the systemic circulation, it could cause side effects.

 

Hope this makes sense!

[lucldh]

Luc,

 

A topical would have the same side effects of an oral medication if the topical solution was able to get from the scalp circulation into the systemic cicrulation. If it was absorbed through the scalp and stayed solely in the scalp, it would not affect other areas of the body and would not - in theory - cause systemic side effects (decreased libido, erectile dysfunction, body hair loss, et cetera). However, if it absorbed through the scalp and did not stay local and instead spread to other areas of the body via the systemic circulation, it could cause side effects.

 

Hope this makes sense!

 

Yes, it does not. Thanks.

[Blake Bloxham]

It doesn't make sense? Let me know how I can clarify further! Sorry for any confusion.

[lucldh]

It doesn't make sense? Let me know how I can clarify further! Sorry for any confusion.

 

Hey Blake, I am sorry. Don't know how that 'not' was appended. It absolutely does make sense. Sorry for confusion.

[Blake Bloxham]

Luc,

 

No problem. Also, I wanted to ask you a question: What future hair loss treatment topics are you interested in reading about? I want to make sure the thread is interesting and helpful for our members, so I'd like to "get a feel" for what people want to read about.

 

Thanks!

[lucldh]

Luc,

 

No problem. Also, I wanted to ask you a question: What future hair loss treatment topics are you interested in reading about? I want to make sure the thread is interesting and helpful for our members, so I'd like to "get a feel" for what people want to read about.

 

Thanks!

 

Blake, thanks for being so humble. Your willingness to share information promptly is really really much appreciated. And the hair loss treatment that I will be mostly interested in will be probably hair cloning/multiplication. Apparently, because I am a diffused NW6 thinner and have very limited donor, the best bet for me will be hair cloning/multiplication. I have read your initial posts regarding both of them and regarding the hurdles posed before both techniques. Will be great if you can keep updating us with both of them.

 

Also, what I think about the people who are NW5 and below is that they are not bald if they have money to afford HT. For them, the treatment is already available!! Having said so does not mean that they should not be eying at more hair.

[Pale_Rider]

Did anyone heard anything about this? I have heard that the Chinese made some progress that were troubling Jahoda and Christiano. Hoax or what?

 

http://online.liebertpub.com/doi/abs/10.1089/ten.TEA.2013.0547

[lucldh]

Blake, I came across Coen Gho's donor regeneration procedure - very expensive though. But if the donor really regenerates, is it not a bliss for Norwood 6-7 patients and those who have DUPA or retrograde alopecia too because if beard donor also regenerates, then it can be used for unlimited donor supply? Can you please share you views on this?

[Blake Bloxham]

Pale_Rider,

 

The new Chinese research is interesting. In fact, I mentioned it in my hair multiplication/cloning write-up in the beginning of the thread. Dr. Jahoda and Dr. Christiano discovered how to retain inductive potential in dermal papillae cells by culturing them in a 3-D droplet model. The Chinese, in my opinion, researched a more commercial model of 3-D culturing and re-confirmed the inductive potential of the Jahoda droplet culturing model. The research group didn't really discover anything "new," but they did further the work of Jahoda and Christiano.

[Blake Bloxham]

Luc,

 

Dr. Gho's procedure remains controversial. His clinic claims the "Hair Stem Cell Transplant" (HST) achieves 80% donor regeneration. He also published an impressive paper on the procedure in a legitimate dermatology journal.

 

Unfortunately, there are several important questions which remain unanswered: First, many patients believe the 80% donor regeneration claim may be too high. Some patients even claim that the appearance of donor regeneration is only an illusion created by "splitting" larger follicular units - i.e. extracting a single follicle from a double unit or two follicles from a triple unit. Second, Dr. Gho treats his partial grafts (containing only the bulge hair follicle stem cells) with a secretive serum. He has not shared the contents of this serum, and many take issue with the secrecy surrounding the graft treatment and how it relates to the growth of the partial follicular unit grafts. Third, despite the fact that he's performed hundreds of the HST procedures, very few matured cases have been shared. The cases that have been shared are also, in the opinion of many online members, very conservative.

 

Beard follicular units, in theory, could be used in donor doubling procedures. These follicles - as far as I know - contain both the dermal papillae and bulge region stem cells and, therefore, should be able to achieve donor regeneration. However, I do not know of any doctors currently attempting doubling with beard hair follicles.

 

Donor doubling procedures may prove important in the future. However, today they are still an experimental and unproven treatment. Similar proven treatments, like Follicular Unit Extraction (FUE), are likely more reliable options for the time being.

[damnyoudht]

Hi All,

 

I thought I would post this here, as I guess it's the right place for it.

 

I was recently in contact with Gail Naughton @histogen so I could find out what's happening there.

 

I asked whether they were still on for the 2014 release in Asia that they and Ziering mentioned on their respective sites. I received the following reply;

 

"No, due to fund raising being slower than anticipated we have not yet started a Phase III trial in Asia.

Please stay in touch.

Thanks and take care,

Gail"

 

So there it is, in case anyone wanted to know.

I don't know if you can do it on this site, but please don't bother PM'ing me anyone - I don't know any more than the response I've posted.

 

On a separate note - Does anyone know whether it's possible to get standalone PRP + Acell injections in the UK? I see a few in the US doing it, but barely anyone speaks of it, apart from the surgeons trying to sell it?