Verteporfin HAIR REGENERATION HUMAN TRIAL Dr. Barghouthi *OFFICIAL THREAD

[Jonathan]

6 hours ago, alopeciaphobia said:

Folks, Dr. Barghouthi said the biopsies were 4mm punches. To put that into perspective, for FUE, the most common punch size is 0.8-0.9mm. So it's very much expected to have mutiple hairs left over after FUE in that biopsy.

So now the question would be how many hairs does this patient have on average in a 4mm site. If 10 then the regrowth rate would be 100% if 15 then 50% regrowth right? Or am I missing something?

[Thrillhouse]

Realistically how close is this technique being adopted by other doctors if it works as well as people hope? Is it possible that other surgeons could start using this in a year, or is it more like a 5/10 years off sort of thing?

I just booked an FUE+FUT combo surgery in May to maximize my lifetime donor but I just discovered this verteprofin news and now I'm wondering if I should hold off.

[sr1486]

Good news about the scarring. Maybe I can fix my fut keloid that sticks out like a sore thumb 

[alopeciaphobia]

10 hours ago, Jonathan said:

So now the question would be how many hairs does this patient have on average in a 4mm site. If 10 then the regrowth rate would be 100% if 15 then 50% regrowth right? Or am I missing something?

We can calculate how many follicles we'd expect. The surface area of a 4mm diameter circle is: 4 * pi = 12.5mm². Thats 0.125 cm². A cm² of healthy scalp has about 85 follicular units with 2.3 hairs per unit on average. So if taken from a healthy scalp, a 4mm biopsy would be expected to have 85*0.125 = 11 follicular units or 85*2.3*0.125 = 25 hairs.

But that doesn't add up. In the sample with 5 hairs, it's very unlikely that the Dr removed 20 out of the expected 25 hairs.

Of course, the donor area can also thin (slightly), the biopsy may have transected a bunch of hairs, or the pathologist may have counted follicular units rather than hairs... Or maybe my math is off?

[MrFox]

1 hour ago, alopeciaphobia said:

We can calculate how many follicles we'd expect. The surface area of a 4mm diameter circle is: 4 * pi = 12.5mm². Thats 0.125 cm². A cm² of healthy scalp has about 85 follicular units with 2.3 hairs per unit on average. So if taken from a healthy scalp, a 4mm biopsy would be expected to have 85*0.125 = 11 follicular units or 85*2.3*0.125 = 25 hairs.

But that doesn't add up. In the sample with 5 hairs, it's very unlikely that the Dr removed 20 out of the expected 25 hairs.

Of course, the donor area can also thin (slightly), the biopsy may have transected a bunch of hairs, or the pathologist may have counted follicular units rather than hairs... Or maybe my math is off?

The pathologist is most likely referring to follicular units rather than hairs. Otherwise the control would have had 80% of the follicles harvested, which did not happen. I think if that is the case, then 10 hair follicular units per the punch site would be practically speaking full regeneration. 1 follicular unit off could be down to multiple reasons, including personal genetics or randomness of your own hair growth density. What I noticed is how many grafts are in the catagen phase from the test area. I wonder if more time is going to yield better visual results? Doesn’t that mean that the hairs must be cycling? Any thoughts?

[takuma]

26 minutes ago, MrFox said:

The pathologist is most likely referring to follicular units rather than hairs. Otherwise the control would have had 80% of the follicles harvested, which did not happen. I think if that is the case, then 10 hair follicular units per the punch site would be practically speaking full regeneration. 1 follicular unit off could be down to multiple reasons, including personal genetics or randomness of your own hair growth density. What I noticed is how many grafts are in the catagen phase from the test area. I wonder if more time is going to yield better visual results? Doesn’t that mean that the hairs must be cycling? Any thoughts?

If we are seeing full regeneration, then that could possibly mean that anyone can get their full donor back also by wounding previous fue scars and applying verteporfin to allow functional normal skin to grow in it's place, as underneath the fue scarred skin may lay dormant dht resistant hair follicles that are blocked from sprouting back from underneath the dermis due to scar formations. It may be that the only thing that was stopping hair follicles from growing back after an extraction was the formation of scar tissue where the follicles were extracted... 

[NegativeNorwood]

20 minutes ago, takuma said:

If we are seeing full regeneration, then that could possibly mean that anyone can get their full donor back also by wounding previous fue scars and applying verteporfin to allow functional normal skin to grow in it's place, as underneath the fue scarred skin may lay dormant dht resistant hair follicles that are blocked from sprouting back from underneath the dermis due to scar formations. It may be that the only thing that was stopping hair follicles from growing back after an extraction was the formation of scar tissue where the follicles were extracted... 

 

That would be mind blowing. It would also put an end to scalp to beard transplants, since all the donor hairs could be taken from the beard itself in unlimited quantities (due to the regeneration). Same with eyebrow transplants, it would make the use of scalp hair redundant, since thanks to regeneration the surgeon should be able to use eyebrow hairs too.

Basically, not only the cure to hair loss but also a massive improvement to hair transplants of all kind, not just for the scalp.

[Jonathan]

3 hours ago, alopeciaphobia said:

We can calculate how many follicles we'd expect. The surface area of a 4mm diameter circle is: 4 * pi = 12.5mm². Thats 0.125 cm². A cm² of healthy scalp has about 85 follicular units with 2.3 hairs per unit on average. So if taken from a healthy scalp, a 4mm biopsy would be expected to have 85*0.125 = 11 follicular units or 85*2.3*0.125 = 25 hairs.

But that doesn't add up. In the sample with 5 hairs, it's very unlikely that the Dr removed 20 out of the expected 25 hairs.

Of course, the donor area can also thin (slightly), the biopsy may have transected a bunch of hairs, or the pathologist may have counted follicular units rather than hairs... Or maybe my math is off?

I don’t think your math is wrong, the part that might be wrong is a “healthy scalp has X amount of hairs” I don’t think that matters, we should be comparing this exact patients results. I think it’s most likely the pathologist counted units rather than hairs. 

[Square1]

34 minutes ago, Jonathan said:

I don’t think your math is wrong, the part that might be wrong is a “healthy scalp has X amount of hairs” I don’t think that matters, we should be comparing this exact patients results. I think it’s most likely the pathologist counted units rather than hairs. 

The size of the area is too small I think to base meaningful conclusions on. Ideal would be to mark a spot of, say, 4 cm2, count the hairs / grafts before the procedure, record how many grafts are taken out and then do a recount 6 /12/ 24 etc months after te procedure. That way you can have an insight in how many grafts were regenerated and how many of them remain after the 6/12 months mark

[MrFox]

10 hours ago, takuma said:

If we are seeing full regeneration, then that could possibly mean that anyone can get their full donor back also by wounding previous fue scars and applying verteporfin to allow functional normal skin to grow in it's place, as underneath the fue scarred skin may lay dormant dht resistant hair follicles that are blocked from sprouting back from underneath the dermis due to scar formations. It may be that the only thing that was stopping hair follicles from growing back after an extraction was the formation of scar tissue where the follicles were extracted... 

That’s sort of right. I think absolutely you would be able to use it on existing scars, but there are not dormant follicles under the scar tissues. The follicle has been completely removed during the original transplant. You would need to remove the scar tissue completely and administer Verteporfin. So for FUE scars that would require a larger punch than the scar. In theory the skin regenerates a by product of which is hair follicles. 

[MrFox]

Wasn’t there talk about using a computer imaging machine to map and the follicles? That seems like the most accurate way to tell.

[MrFox]

8 hours ago, Square1 said:

The size of the area is too small I think to base meaningful conclusions on. Ideal would be to mark a spot of, say, 4 cm2, count the hairs / grafts before the procedure, record how many grafts are taken out and then do a recount 6 /12/ 24 etc months after te procedure. That way you can have an insight in how many grafts were regenerated and how many of them remain after the 6/12 months mark

Wasn’t there talk about using a computer imaging machine to map and the follicles? That seems like the most accurate way to tell.

[takuma]

5 minutes ago, MrFox said:

That’s sort of right. I think absolutely you would be able to use it on existing scars, but there are not dormant follicles under the scar tissues. The follicle has been completely removed during the original transplant. You would need to remove the scar tissue completely and administer Verteporfin. So for FUE scars that would require a larger punch than the scar. In theory the skin regenerates a by product of which is hair follicles. 

I'm a little confused then why verteporfin is growing hairs, because not all skin has hair...for example forehead skin is without hair and there are parts of our bodies with skin but no hair. So why would hair follicles be a natural by-product of normal skin formation if that's the case.

[mr_peanutbutter]

2 hours ago, takuma said:

I'm a little confused then why verteporfin is growing hairs, because not all skin has hair...for example forehead skin is without hair and there are parts of our bodies with skin but no hair. So why would hair follicles be a natural by-product of normal skin formation if that's the case.

 i still dont get it that much either. if it really works then some real axolotl stuff is going (you know, these animals that can regrow missing limbs or even eyes for some reasons)

[MrFox]

10 hours ago, takuma said:

I'm a little confused then why verteporfin is growing hairs, because not all skin has hair...for example forehead skin is without hair and there are parts of our bodies with skin but no hair. So why would hair follicles be a natural by-product of normal skin formation if that's the case.

Well we now know that scarring is a late stage evolutionary adaptation. Dr. Longaker and others research has indicated this. So it may be that the skin has an inherent ability to regenerate but is being overridden by the scarring adaptation. If it is following your own genetic blueprint, it would stand to argue that the skin would regenerate hair in the areas that have hair and perhaps not in the areas that do not have hair. Verteporfin is overriding the scarring signaling. Ultimately it will take testing on those areas to know for sure. 

[alopeciaphobia]

It's an interesting point. For those unfamiliar, basically the benefit of scarring is supposed to be faster healing. Although aesthetically displeasing, it's an evolutionary advantage to recover faster from lacerations and such. Verteporfin may "remove" this evolutionary advantage in favor of an anesthetic advantage, so to speak.

A whole bunch of pages back, it was discussed that with verteporfin, skin elasticity improves slower after injury, i.e. from a mechanical standpoint, the skin seems worse during the first few months, but catches up and improves compared to placebo after a couple months. That makes sense given the purpose of scarring.

 

Edit: just realized it was probably you who mentioned that @MrFox

Edited March 21, 2023 by alopeciaphobia

[MrFox]

1 hour ago, alopeciaphobia said:

It's an interesting point. For those unfamiliar, basically the benefit of scarring is supposed to be faster healing. Although aesthetically displeasing, it's an evolutionary advantage to recover faster from lacerations and such. Verteporfin may "remove" this evolutionary advantage in favor of an anesthetic advantage, so to speak.

A whole bunch of pages back, it was discussed that with verteporfin, skin elasticity improves slower after injury, i.e. from a mechanical standpoint, the skin seems worse during the first few months, but catches up and improves compared to placebo after a couple months. That makes sense given the purpose of scarring.

 

Edit: just realized it was probably you who mentioned that @MrFox

Hey let’s move the discussion over here, so we keep this open for updates frond Dr. B! 

[mr_peanutbutter]

42 minutes ago, MrFox said:

Hey let’s move the discussion over here, so we keep this open for updates frond Dr. B! 

good idea. maybe @Melvin- Moderator could edit the op accordingly and put in the link there

[alopeciaphobia]

On 3/4/2023 at 7:47 PM, DrTBarghouthi said:

I’m looking at the 18th of March as a possible date for the second trial. I’m looking at either an FUE or at the possibility of injecting into the recipient area. 

@DrTBarghouthi Did the second trial happen on the 18th, or has it been planned on a another date?

[Fox243]

1 hour ago, alopeciaphobia said:

@DrTBarghouthi Did the second trial happen on the 18th, or has it been planned on a another date?

Would also love to hear about possible ways to improve upon the first trial, i.e. higher dosage, more uniform injection, computer imaging/tattooing to better see potential regeneration, etc. I think it’d be especially interesting if you extracted ALL follicles in a small (say 5 mm) area so we can see if any follicles undoubtedly grow in that area after injecting Verteporfin.

Edited March 23, 2023 by Fox243

[takuma]

@DrTBarghouthi

Dr. Barghouthi is it possible that you can take a picture of the full scalp again like you did at the very beginning of the trial immediately after extracting the hair follicles and applying the verteporfin to the test areas, so we can see if the growth is visible from distance. And so we can also see the scars on the control sections and the test sections and see what the improvement is in the test sections. It might give a better idea of the amount of regrowth and scarring in the different test areas where verteporfin was used in doses 0.25, 0.32, and 0.4 vs the control 

[alopeciaphobia]

17 hours ago, Fox243 said:

Would also love to hear about possible ways to improve upon the first trial, i.e. higher dosage, more uniform injection, computer imaging/tattooing to better see potential regeneration, etc. I think it’d be especially interesting if you extracted ALL follicles in a small (say 5 mm) area so we can see if any follicles undoubtedly grow in that area after injecting Verteporfin.

It's an interesting point, but one runs the risk of having had follicles in exogen/kenogen phase showing up as "false positives". The bigger the meaured area, the more you cancel out the probability of randomness like that.

The most ideal way (other than increasing subject count) that I can think of would be a temporary tattoo demarcating one or preferably multiple areas, and doing a phototrichogram before and after.

[MrFox]

On 3/7/2023 at 12:58 PM, Melvin- Moderator said:

We’re scheduling a podcast to discuss the results live. Stay tuned!

Is this still in the works?

[Melvin- Admin]

24 minutes ago, MrFox said:

Is this still in the works?

Yes, it will happen this weekend. Still trying to get the time down. 

[Fox243]

18 hours ago, Melvin- Moderator said:

Yes, it will happen this weekend. Still trying to get the time down. 

Would love if you could get the Dr’s opinion on how it looks visually – like were the hairs regrown terminal or vellus hairs? Does this actually look like a cure?