Unlimited Donor with Verteporfin - Should We Be Experimenting?

[Lightmare]

Super interesting thread, and indeed if it were to work I wonder why not just put it directly on the bald areas in the first place.  It indeed sounds hyped but I like your phrasing the question as a 'would you please take a closer look' type of question.  I believe for any type of advancement it is good to raise overall awareness.

However if I had to take a guess I'd think the first folks that'd offer this type of option 'off the menu' to informed patients wouldn't necessarily be world class surgeons.  Why?  Because they have a reputation they want to keep clean and already have plenty of patients coming to them to help them with their hair.  It could definitely be risky and cause backlash in the advent of unforeseen side effects even with the right legal protections in place.  That said, hearing their opinions on it is really helpful as people look up to these surgeons for their leadership.

I'd guess that it'd be offered by some upstart surgeons/clinics that want to differentiate themselves that have yet to get the years of successful results under their belts.  Sort of like a startup idea.  Analogously, I am curious as to the first HT surgeon that started pairing HT with PRP, exosomes etc.  These would also likely be the type of surgeons that'd take the lead on this, and some important people to ask these questions to.

Edited January 20, 2022 by Lightmare

[DrTBarghouthi]

1 hour ago, HairRun said:

I think it's worth looking into just for the scar reduction possibilities alone. I feel a lot of people would be willing to drop a few extra Ks for the drug as long as the risk is low enough. 

 

3 hours ago, Fox243 said:

@DrTBarghouthiHi dr., just following up again. This would really be great for people who’s hair transplants don’t end up working out, and the clinic could simply advise them to shave. Would also help people who don’t want to take finasteride, as they could shave if too much loss of native hair occurs.

Apologies for not getting back earlier. So yes this medication is FDA approved for some types of wet macular degeneration which is an age related retinal disease. This was the drug of choice to that condition years ago but has been abandoned with newer agents like Avastin etc. 

I spoke to some colleagues and it seems there is or has been recent delay or even shortage in production (possibly due to reduced demand?) 

I know it is hard to source here where I practice because ophthalmologist are no longer using it. It is around 1800 usd per vial but I’m not sure how much donor will this cover. 
I will try to source it and maybe get help from some of my ophthalmologist colleagues in preparing it and possibly testing it on some FUT scars as well as FUE scars hopefully. I just need to see what the requirements might be along with doing more reading about it (has been quite a busy period lately to do an extra reading unfortunately). 
Will keep you posted with how things go hopefully.

[Fox243]

Tagging @BeHappy@Gatsbyand some others who are unhappy with their scars. Maybe you or you can tag others who would be happy to allow the Dr to try on your FUT scars if he determines that it’s safe? Since it’s been FDA approved, I don’t imagine any problem though. 

Edited January 20, 2022 by Fox243

[DrTBarghouthi]

9 minutes ago, Fox243 said:

Tagging @BeHappy@Gatsbyand some others who are unhappy with their scars. Maybe you or you can tag others who would be happy to allow the Dr to try on your FUT scars if he determines that it’s safe? Since it’s been FDA approved, I don’t imagine any problem though. 

Yes assuming we can get some insight about the safe dosage in areas such as skin/ scalp. Remember this has been injected previously in tiny amounts in the retina, so I assume a bigger amount is needed in skin or to cover a donor. 

[Fox243]

56 minutes ago, DrTBarghouthi said:

 

Apologies for not getting back earlier. So yes this medication is FDA approved for some types of wet macular degeneration which is an age related retinal disease. This was the drug of choice to that condition years ago but has been abandoned with newer agents like Avastin etc. 

I spoke to some colleagues and it seems there is or has been recent delay or even shortage in production (possibly due to reduced demand?) 

I know it is hard to source here where I practice because ophthalmologist are no longer using it. It is around 1800 usd per vial but I’m not sure how much donor will this cover. 
I will try to source it and maybe get help from some of my ophthalmologist colleagues in preparing it and possibly testing it on some FUT scars as well as FUE scars hopefully. I just need to see what the requirements might be along with doing more reading about it (has been quite a busy period lately to do an extra reading unfortunately). 
Will keep you posted with how things go hopefully.

More generally, I don’t see cost being an issue. A NW6 may need 8k grafts each costing $6-$7, leading to a grand total of $50k. If it even takes under 20k to get rid of the scars to allow for a shaved head, many who could afford transplants will pay for this.

Furthermore, it’ll encourage a lot more people to get HTs when they know that worst case scenario, they can minimize their scars. 

 

 

Edited January 20, 2022 by Fox243

[SLA]

16 hours ago, DrTBarghouthi said:

I will try to source it and maybe get help from some of my ophthalmologist colleagues in preparing it and possibly testing it on some FUT scars as well as FUE scars hopefully. I just need to see what the requirements might be along with doing more reading about it (has been quite a busy period lately to do an extra reading unfortunately). 
Will keep you posted with how things go hopefully.

This is great @DrTBarghouthi- You mention here about testing on some FUT or FUE scars, however, my understanding was that it might help reduce or eliminate scarring in FRESH wounds rather than those who have had previous FUT or FUE procedures.

Was that your understanding as well?

[DrTBarghouthi]

19 hours ago, Fox243 said:

Tagging @BeHappy@Gatsbyand some others who are unhappy with their scars. Maybe you or you can tag others who would be happy to allow the Dr to try on your FUT scars if he determines that it’s safe? Since it’s been FDA approved, I don’t imagine any problem though. 

Yes exactly. If it will be tried first it will be trialled on new scars. However, I read some role in old scars so that might be a possibility too. Again, this will need to be properly looked into before even attempting it as you know. 

[HairRun]

Looks promising. I bet there's plenty of people willing to put in 2-5k extra for a potentially scar reduction, bonus if it also restores hair. 

[Dillpickle123]

What if someone who recently got an fue purchased a vial and tried it out? I’m assuming it would need to be put on fresh wounds multiple times?

[tripleg]

6 hours ago, Dillpickle123 said:

What if someone who recently got an fue purchased a vial and tried it out? I’m assuming it would need to be put on fresh wounds multiple times?

Absolutely DO NOT do this without your doctor's agreement and supervision! Yes, the wounds would likely need to be fresh. In the procedure on mice Verteporfin was injected around the edges of the wound immediately after creating the wound. Repeated injections on day 4, 8 and 12 didn't improve outcomes and had detrimental effects.

Again, if you're considering doing this without your doctor - please don't!

[Dillpickle123]

On 1/25/2022 at 11:11 PM, tripleg said:

Absolutely DO NOT do this without your doctor's agreement and supervision! Yes, the wounds would likely need to be fresh. In the procedure on mice Verteporfin was injected around the edges of the wound immediately after creating the wound. Repeated injections on day 4, 8 and 12 didn't improve outcomes and had detrimental effects.

Again, if you're considering doing this without your doctor - please don't!

Yes, sometimes the finest break throughs are found this way oddly enough 

[Fox243]

@DrTBarghouthiWondering if you have any updates. 

[Britanium]

20 minutes ago, Fox243 said:

@DrTBarghouthiWondering if you have any updates. 

+1 👍🏽

[Sarita]

If I did a hair Transplant last year, that’s mean I wouldn’t be able to use verteporfin for my donor area in the future? 

Edited March 4, 2022 by Sarita

[NARMAK]

2 hours ago, Sarita said:

If I did a hair Transplant last year, that’s mean I wouldn’t be able to use verteporfin for my donor area in the future? 

There's no official treatment or clinical study underway to even know what effect that this drug may have on scars caused ages ago. 

It's all theoretical if it could even work but hypothetically i don't see why it couldn't regenerate hair down the line if it worked at all. 

[tripleg]

Recently Stanford filed patents on using Verteporfin for wound healing and hair follicle neogenesis:

"Methods of promoting healing of a wound in a dermal location of a subject are provided. Aspects of the methods may include administering an effective amount of a YAP inhibitor composition to the wound to modulate mechanical activation of Engrailed-1 lineage-negative fibroblasts (ENFs) in the wound to promote ENFmediated healing of the wound. Also provided are methods of preventing scarring during healing of a wound in a subject and methods of promoting hair growth on a subject. Aspects of the methods may include forming a wound in a dermal location of a subject and administering an effective amount of a YAP inhibitor composition to the wound to modulate mechanical activation of Engrailed-1 lineage-negative fibroblasts (ENFs) in the wound to promote ENF-mediated healing of the wound. Also provided are kits including an amount of a YAP inhibitor composition and a tissue disrupting device."

https://patentscope.wipo.int/search/en/detail.jsf?docId=WO2021021607

It seems they see some promise.

[Sarita]

The regeneration of the hair follicles by verteporfin in the donor area would be 100% or 50%?

[DrTBarghouthi]

On 3/4/2022 at 5:37 PM, JC71 said:

+1 👍🏽

I currently have no update and this is mainly due to the shortage of the medication globally. It doesn’t seem to be available here yet and this is delaying the chance of me trying it. I am still keen however and have made some enquiries today about it. Will keep you all posted. 

[tripleg]

On 3/6/2022 at 2:27 PM, Sarita said:

The regeneration of the hair follicles by verteporfin in the donor area would be 100% or 50%?

We don't know. It might be 0% or it might be 100%. We'll know more as different doctors begin to experiment.

[quantumhair]

Has anyone heard of TrichoStem. I don't know if it's legitimate. But he uses the similar terminology. "non surgical alternative......using regenerative medicine technology". See the linked video. He also talks about healing medicine.

https://youtu.be/04zuFKFUBVY?t=112

 

Edited March 10, 2022 by quantumhair

[Sarita]

On 3/10/2022 at 10:58 PM, quantumhair said:

Has anyone heard of TrichoStem. I don't know if it's legitimate. But he uses the similar terminology. "non surgical alternative......using regenerative medicine technology". See the linked video. He also talks about healing medicine.

https://youtu.be/04zuFKFUBVY?t=112

 

No it’s not similar..

I just read The Limitations of TrichoStem® Treatment

• TrichoStem® cannot bring back lost hair follicles, nor can it activate “dead” hair follicles. It can only work on existing hair follicles that are still active and present on the head, as well as thicken thinned out hair that is almost invisible.
• TrichoStem® is more effective on patients experiencing hair loss and hair thinning, as opposed to severe hair loss patients who exhibit a completely smoothed scalp and total frontal hair loss”

https://www.trichostem.com/why-trichostem-hair-regeneration/trichostem-technology/
 

Trichostem doesn’t regenerate lost or dead follicles like the hair follicles in the donor area it’s like plasma (PRP) there is a limitation 

Edited April 7, 2022 by Sarita

[Sarita]

I saw this video on YouTube about verteporfin 

he said that verteporfin is not gonna work out with old scars, like those who had hair transplant plants, it works at the the same time of the operation, what do you think? Because no one has used this drug till now! 

Edited April 7, 2022 by Sarita

[MrFox]

Kevin seems a little misinformed on that particular part. Michael Longaker (the doctor heading the Stanford Studies) has stated in several interviews that he believes the mechanism will work with preexisting scars. There would need to be a scar revision surgery, where they excise all of the existing scar tissue, and then inject verteporfin into the wound. Verteporfin has the potential to prevent/reverse scars from hair restoration surgeries and to regrow hair in balding areas for multiple forms of alopecia. It's unfortunate that more clinics and doctors are not willing to or have not shown interest in trying the drug off-label. The drug has a great safety profile and has been FDA approved for 20 years so the risk seems minimal for patients. If the drug is ineffective, the end result would be a scar, which was already the outcome of hair restoration surgery. Yes there are questions to what amount of hair would regrow as a result of the drug, anywhere from 50-100% of hair regeneration, but that is still a whole lot better than 0%! Additionally those numbers also came from a porcine study using a different but similar drug, where they were not selecting for the optimal amount of hair regeneration. In the mouse study there was practically 100% regeneration of follicles. 

[NARMAK]

23 minutes ago, MrFox said:

Kevin seems a little misinformed on that particular part. Michael Longaker (the doctor heading the Stanford Studies) has stated in several interviews that he believes the mechanism will work with preexisting scars. There would need to be a scar revision surgery, where they excise all of the existing scar tissue, and then inject verteporfin into the wound. Verteporfin has the potential to prevent/reverse scars from hair restoration surgeries and to regrow hair in balding areas for multiple forms of alopecia. It's unfortunate that more clinics and doctors are not willing to or have not shown interest in trying the drug off-label. The drug has a great safety profile and has been FDA approved for 20 years so the risk seems minimal for patients. If the drug is ineffective, the end result would be a scar, which was already the outcome of hair restoration surgery. Yes there are questions to what amount of hair would regrow as a result of the drug, anywhere from 50-100% of hair regeneration, but that is still a whole lot better than 0%! Additionally those numbers also came from a porcine study using a different but similar drug, where they were not selecting for the optimal amount of hair regeneration. In the mouse study there was practically 100% regeneration of follicles. 

Hopefully the Doctor here will get their supply soon of the treatment to be able to conduct a trial with patients that sign up for it 

Personally i think there's a few exciting potential options on the line and Stemson manage to create a well of unlimited grafts and Vertoporfin etc. might not be necessary at all. 

I think within the next 10-15 years hopefully we can once again move the needle of progress forward again for hair loss and restoration. 

[HairRun]

Would love to see @Melvin- Moderator ask this directly in his interviews. I would imagine someone like Hassan/Wong who are currently developing next gen techniques might be interested in developing a protocol around this. 

As long as there are no bad side effects, I would be willing to pay extra money during my procedure for the scar treatment. Even if it ends up doing nothing, it would be worth the financial risk.