Hair transplantation decreases scar tissue, may explain why repairs might need multiple surgeries

[Bb111]

I came across this article and thought it might be interesting to some of you. The researchers transplanted hair into scar tissue on the scalp and took biopsies of that area over time. The biopsies showed that over time the scar tissue looked more like healthy skin. 

I have not had a chance to review the article in detail yet. On quick glance my thought is that this is why repairs may do better if staged. Implant some hairs into the scar tissue, let it remodel and get healthier, then implant more hairs into healthier skin. 

 

https://www.nature.com/articles/s41536-022-00270-3

Abstract

Despite the substantial impact of skin scarring on patients and the healthcare system, there is a lack of strategies to prevent scar formation, let alone methods to remodel mature scars. Here, we took a unique approach inspired by how healthy hairbearing skin undergoes physiological remodelling during the regular cycling of hair follicles. In this pilot clinical study, we tested if hair follicles transplanted into human scars can facilitate tissue regeneration and actively remodel fibrotic tissue, similar to how they remodel the healthy skin. We collected full-thickness skin biopsies and compared the morphology and transcriptional signature of fibrotic tissue before and after transplantation. We found that hair follicle tranplantation induced an increase in the epidermal thickness, interdigitation of the epidermal-dermal junction, dermal cell density, and blood vessel density. Remodelling of collagen type I fibres reduced the total collagen fraction, the proportion of thick fibres, and their alignment. Consistent with these morphological changes, we found a shift in the cytokine milieu of scars with a long-lasting inhibition of pro-fibrotic factors TGFβ1, IL13, and IL-6. Our results show that anagen hair follicles can attenuate the fibrotic phenotype, providing new insights for developing regenerative approaches to remodel mature scars.

[NikosHair]

Interesting study - thanks for bringing it to the forum.

WOW - Not only does transplanted hair grow successfully in scars but it may even help to regenerate the scarred skin.

Quote

hair follicles transplanted into STSG scars have a survival rate of 70–90%, which is similar to that of secondary scarring alopecia^50,51,52. This is also comparable to the survival rate (80–90%) of follicle grafts transplanted into strip scars⁵³.

 

Edited January 7, 2023 by NikosHair

[NikosHair]

This hasn't gained a lot of interest on the forum🧐

• Imperial College London is a serious player in UK research.
• It has the potential to be a gamechanger.
• FUT could be the go to option for hair transplants.
• We know there are advantages to FUT in terms of quantity of grafts and lower transection rates( in the right hands).
• The big disadvantage is the scar. 
• A small FUE procedure implanted into the scar to heal the wound could make FUT an attractive option.

Has anyone had hair planted into their FUT scar? Did you know notice any improvement?

Here is a article for non-scientists on the findings:

Quote

The researchers found that the follicles inspired profound architectural and genetic shifts in the scars towards a profile of healthy, uninjured skin.

https://www.imperial.ac.uk/news/242531/scars-mended-using-transplanted-hair-follicles/

 

Edited January 8, 2023 by NikosHair

[beak]

Thanks for breaking down why this is important @NikosHair otherwise I would not have understood the implications of this. Very interesting!

[Gatsby]

One of the main The main reasons I had grafts placed in my donor scars was to vascularize the scar tissue or at least attempt to.

[NikosHair]

3 hours ago, Gatsby said:

I had grafts placed in my donor scars was to vascularize the scar tissue or at least attempt to.

You were ahead of your time in that respect.

The researchers are trying to understand the mechanism for the improvement.

It would be interesting if they are able to find a 'sweet-spot' post surgery to get the FU's planted into the scar.

Early days, but a promising study nevertheless.

[NikosHair]

Another thing that springs to mind from these findings:

• One of the concerns of implanting hairs near native hair is the perceived risk of killing off miniaturized hairs.
• Given the profound improvements in tissue found in the study.
• Could it actually new breath life into the native hair in normal tissue(?)

[sunfire]

On 1/9/2023 at 3:12 AM, Gatsby said:

One of the main The main reasons I had grafts placed in my donor scars was to vascularize the scar tissue or at least attempt to.

I definitely believe this. The first few months after implanting grafts into my scar I could feel something happened back there like the tissue was brought back to life. I'm super encouraged by my results so far. Looking forward to my next fade

[Needhelpwithscar]

@sunfire did you have fue into your scar? How is it looking now and how many grafts ？ how big and long was your scar? I have the same need thank you for answering appreciate it.

[sunfire]

12 minutes ago, Needhelpwithscar said:

@sunfire did you have fue into your scar? How is it looking now and how many grafts ？ how big and long was your scar? I have the same need thank you for answering appreciate it.

Vast improvement it used to be that if I cut at #3 it was very clear for almost a week. Now I cut #2 and it's barely visible for a day or two. And really it's no so much the scar that's visible at #2 but that there's a strip of hair between my scar and my fue donor area that is thicker than both. So my scar is actually about the same thickness at my fue donor area now. Here's a pic to show what I mean

[Needhelpwithscar]

@sunfire yeah I see what you meant. The line above the scar and the higher density below the scar is what makes it noticeable.

have you try shaving it down to 1 guard or 0 guard? Maybe it won’t be that obvious if it is shorter? What is the percentage of grafts that survive in the scar ? 
 

i sent you a DM to discuss if that’s ok!

[Al - Moderator]

On 1/7/2023 at 3:21 PM, NikosHair said:

Interesting study - thanks for bringing it to the forum.

WOW - Not only does transplanted hair grow successfully in scars but it may even help to regenerate the scarred skin.

 

This isn't something new. It's been done for ages. Hair transplants used to consist of first having scalp reductions and then coming back at a later date to transplant grafts over the scalp reduction scars. I had 5 scalp reductions in the late 80s and early 90s. Those scars were all transplanted over. It's been known for 40 to 50 years that you can transplant hair over scars.