Efficacy of imiquimod in the treatment of alopecia areata

Note from HairlossTalk – Aldara can be an extremely potent immune system modifier. Do not try this product without consent of your physician. It can be very dangerous if applied to large areas of skin.

Authors:

Chantal Bolduc, Harvey Lui , David McLean, Jerry Shapiro
University of Montreal, Montreal, Quebec
University of British Columbia, Vancouver, British Columbia

Study Information and Results:

Alopecia areata is a relatively common, non-scarring type of hair loss. The pathophysiology of alopecia areata is still unclear, but an autoimmune mechanism is the most widely accepted theory. Based on current available data, Alopecia Areata appears to exhibit a TH1 cytokine profile. IL-1 has been found to be associated with alopecia areata, and is a potent inhibitor of hair growth in vitro.

Furthermore IL-1 appears to induce histologic changes similar to those seen in alopecia areata. Imiquimod (Aldara) is a topical immune response modifier that stimulates the secretion of different cytokines, most of which are associated with a TH1 response.

Although Alopecia Areata is potentially associated with IL-1 and a TH1 cytokine profile, imiquimod, which most likely enhances TH1 response, has been used anecdotally for alopecia areata with some success. The aim of this pilot study was to assess the potential efficacy of imiquimod in the treatment of alopecia areata.

The study had a prospective, open-label, left-right half-head controlled design. Only half the scalp was treated 3 times a week for 4 months, while the other side was left untreated. Hair loss was graded semiquantitatively and photographs were taken at baseline and serially every 4 weeks throughout the study.

The treatment was very well tolerated. Six patients with extensive Alopecia Areata (40-99%) were included in the study.

One patient experienced bilateral regrowth. One patient worsened on both treated and non treated sides. His condition was active when he entered the study and his course was most likely unrelated to imiquimod. The other four patients did not grow hair and kept a similar score from baseline to the end.

In conclusion, this pilot study shows that imiquimod applied 3 times/week is unlikely to have efficacy in severe Alopecia Areata.

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The effect of taurine and its derivatives on the hair follicle cell

Authors:

T. Magara, C. Hamada, T. Takahashi, A. Ishino and M. Tajima
Shiseido Basic Research Center, Yokohama, Japan.

Study Information and Results:

Taurine is the most abundant sulfur amino acid in mammals, and may have important functions in several tissues and organ.

It was demonstrated in the adult mice that a high density of taurine was found external root sheaths just below the insertion of the sebaceous glands by radioautography. However, no report has been known about the function of taurine on hair follicle.

We investigate whether taurine and its derivatives have an effect on the proliferation of the outer root sheath cells (ORS) and dermal papilla cells (DP). The cell line of human ORS and DP was established by infection of a recombinant adenovirus vector containing T antigen.

The ORS was cultured in the serum free medium on Type I collagen coated dish with taurine, N-methyltaurine and beta-alanine. Addition of taurine, N-methyltaurine and beta-alanine show the significant increase on the proliferation of ORS, but not on that of DP. These results suggest that distribution of taurine around hair follicle may affect the cell growth.

The proliferation by taurine and beta-alanine indicate the mechanism on that glycine receptor is activated and that then the proliferation of epithelial cells may be due to the opening of the ion channel.

The post How Does Taurine Affect the Hair Follicle? appeared first on HairLossTalk.

All content credit due to our forum member hellouser for putting all the painstaking time and effort into attending the conference, and gathering all the audio and video content presented here.

9th World Congress for Hair Research 2015 – Miami, FL

Dr. Andy Goren’s presentation is below (and above).  Several important questions are addressed in his presentation:

– Is it possible to know if minoxidil will work for you, before you try it?
– What are the factors that differentiate a responder to minoxidil from a non-responder?
– How does Minoxidil grow hair in the first place?
– Do higher concentrations of Minoxidil really work better?
– Can you grow hair on a bald spot, or hairless area of scalp?

We encourage you to follow along with the video, and discuss his findings in our forums:
Dr. Andy Goren – Minoxidil Response Testing in Females with Androgenetic Alopecia

Presentation: Minoxidil Response Testing in Females with Androgenetic Alopecia

Dr. Andy Goren – President, Chief Medical Officer of Applied Biology, Irvine CA

Speaker:

“We will have discussions for other talks after these presentations. I’m now happy to invite Andy Goren. Very great that we have him, and we switch a little bit back to the question of androgenetic alopecia and responsiveness to therapies. Andy Goren is president and CEO of Applied Biology and has a professorship at Rome.”

Dr. Andy Goren:

“Thank you. So, I’m going to talk about a subject that we sort of touched on, and I’ve heard over the years people have been talking about minoxidil response and drug response, in general, for growing hair. We started this project several years ago just trying to find some sort of marker that predicts hair growth.

This started as a project with plucked hair, and it’s turned out to be a little bit messy of the business with plucked hair. And that’s why I why mentioned this whole idea about normalization and the amount of hairs.  People like me are losing hair, and don’t like a lot of plucking going on.  And then, also it seems kind of cool to be in the laser. Doing something with laser. Might as well be in that, too. I have a lot of conflicts in general, but not in this particular case here.

I’m going to start with just: Topical minoxidil is the only FDA approved drug for female pattern in hair loss anywhere in the [inaudible]. Clinical response is about 24 weeks with the latest drug. 5% is the maximal approved concentration by FDA. Response is, at most, 30-40% anyways. When I say “response”, a lot of people come and say, “Well, works on a lot more women than that because it maintains hair growth,” but the response is actually defined as hair regrowths, not maintenance of hair. That’s the FDA label for this particular drug.

Because of the time that it takes, to actually get a response from this drug. And because it affects only; a very small amount of women would actually benefit (I think the 30% is probably on the higher side), it seems more for the male responders to that.

And, potentially, some other therapies that could be beneficial, including, as I mentioned, higher dose of minoxidil, which I’ll talk about during this talk. It would be great if there was some sort of response test ahead of time that we can just tell a woman, “Hey, this is going to work or not work.” We’re probably better at saying somebody is a nonresponder or a responder.
At least I don’t know, and I think most people don’t know what is the mechanism of actual minoxidil. There is some theories about it, but what we do know is minoxidil is actually not the active that causes the hair growths. It’s minoxidil sulfate. And minoxidil gets sulfate in the hair follicle on the outer root sheath, where the sulfotransferase SULT1A1 is expressed. With staining, you can see it’s there. And that’s probably, by the way, why a bald spot will not grow hair.  You have to have some hair somewhere in order to get the sulfation working with minoxidil. This is the theory.

So we conducted several clinical studies actually for FDA in order to demonstrate the clinically [inaudible] validity of the sulfotransferase 1A1 as a marker for predicting response to minoxidil. We had 131 females. It was a prospective study with endpoints of plus hair counts and of, as I further said, primary endpoint. Secondary endpoint was global photography with expert assessment.

The subject used a 5% minoxidil topical foam, 24 weeks, once a day. And we utilized the assay that we recorded before and published several times which is colorimetric assay, where you immerse plucked hairs into the assay, and the sulfotransferase in the plucked hair converts minoxidil to minoxidil sulfate via PAP/PAPS system. And that you can read with a spectrophotometer and look at the optical density.

We used 8 plucked hair. Earlier, you mentioned we used 30 plucked hair. We used eight. The reason we used eight, is we found people who are losing hair were very reluctant to give us hair to begin with. Most of them think it won’t grow back. Probably does, but they don’t think it is.

The rationale, actually, for the eight plucked hairs: That was the minimal for the detection limit of 13.7. And where’d this 13.7 come from? So as far as I know, we’re the first one to actually have shown (and it’s not any rocket science) but: “What is the responder actually to minoxidil?” Because that’s another question: What does it mean you’re responding? Okay, you’re growing hair. How much hair are you growing?

According to the J&J studies, the last one they have done for minoxidil topical foam in women, you’ll see that one standard we chose, one standard deviation from the mean, for the placebo group was they don’t just report that any other way: this 13.7% increase in hair.

So what we have done is we have decided that if you are less than 13.7% increase in hair counts, then you’re a nonresponder. If you have more, then you are a responder. It’s a 0/1 type of thing. Primarily, okay.  We have done 1 cm² photography with two of the patients and just the standard self with the global photography. We also investigated, rating was either one for hair regrowth or zero, which means they maintained hair loss. This is just a picture of the before and after.

So when we actually stratified the data – and this is an example of a scatterplot for that – if you see on – is it on this? Does this show on the screen? Wow, it’s very sophisticated.  When you do this, we selected a biomarker here. This is with the sulfotransferase based on the optical density for the spectrophotometer. We just chose a number 0.4, which is any number other than one. But when we choose 0.4, you can see that most of the blue dots, which are the dots actually that relate to nonresponders, fall below the 0.4. What does that mean? That means we have a line here that shows we can probably find the nonresponders. And if we took that 0.4 and use some sophisticated Bayes’ Theorem, all sorts of mathematics, what we can find is that we can actually rule out, almost 98% of the time, subject will not nonresponse in minoxidil.

Now, we’re not very good at telling you if you’re going to respond. But it would make sense that if minoxidil sulfate is limited, if the sulfotransferase is a limited thing to produce minoxidil sulfate, then you don’t have enough of it or it doesn’t metabolize fast enough to minoxidil before it gets absorbed in your body. It will probably not work for you (minoxidil) in regrowing hair. So that’s what we’ve kind of show in this whole project.

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All content credit due to our forum member hellouser for putting all the painstaking time and effort into attending the conference, and gathering all the audio and video content presented here.

9th World Congress for Hair Research 2015 – Miami, FL

Dr. Annika Vogt’s presentation is below (and above).  This presentation covers the following topics:

An analysis of the chemical, structural, and functional differences between scalp that has already endured hair loss, versus unaffected scalp.  Also the establishment of new processes for doing this type of research was covered.

The need to understand the causes of the “disease process” in hair loss is of primary importance.  Current methods for examining various aspects of the hair follicle functioning and how it is affected by Androgenetic and other Alopecia’s are inefficient.  Likewise, being able to test whether a treatment works efficiently is difficult due to the need for multiple facets of the testing process, including hair counts, biopsies, and other inconvenient, manual steps.

Novel methods were discussed for examining the effectiveness of topical treatments for hair loss, including Optical Coherence Tomography, experimental methods, readouts, and molecular processes.  An initial trial of 6 and then 12 individuals was conducted to run these analysis methods on the effectiveness of Minoxidil.  The approach was to use RNA markers which they hoped to find consistent across multiple patients, which could be monitored as a new standard in future clinical trials.  The ability to collect hair samples from patients in a non-invasive way that could be used in future trials was also examined.

We encourage you to follow along with the video, and discuss this presentation with others in our forums:
Dr. Annika Vogt – Differences Between Affected and Clinically Non-Affected Scalp

Speaker: We’ll change a little bit from the order that was presented in the agenda, and we’ll have our next speaker, and then we’ll take some questions. Then we’ll have our remaining speakers who are going to take some more questions. So if we can have the next presentation. Our next speaker is Dr. Annika Vogt. She’s a senior physician at the Hair Competence Center and Pediatric Dermatology unit, as well as the Scientific Director of the Experimental & Translational Research on the Department of Dermatology at Charité-University of Medicine in Germany. She is also a faculty member in Paris at the University of Pierre et Marie Curie. So Dr. Vogt.

Dr. Vogt: We are very pleased to see that our session attracted so many participants. After this very impressive and exciting talk, we are now shifting more towards clinical focus and trying to understand a little bit of the disease process. And I think we already illustrated very nicely that it’s complex to understand this organ, and see how we can play with the organ to really reach a level where we don’t focus on only one facet, and are really able to regenerate, in this case, hair follicles or, in our case, to really understand the disease and also the drug action.

I will now talk a little bit about protocols we developed in our lab to improve the way we conduct our clinical trials and also speed up our readouts. And I have to say that a lot of the work I’m presenting now is part of an investigative initiated research project, where we received funding from Johnson & Johnson.

But the starting point, I mean, those who have been following my work over the past years know that I’m mostly interested in targeted drug delivery and packaging target active molecules to create in other ways photonic dermatotherapy. So we found ourselves in a position where we felt that it’s really hard to have fast screenings of novel compounds and also novel formulations. And also like when it comes to studying the molecular processes and identifying novel targets, we can only always look from the very specific questions.

What we want to see is the whole disease process at the follicle, but there we really rely on the patient biopsies. So this limits the way or the things we can do with our patients because we are not free to take biopsies in as many numbers as we want, and it’s not that cosmetically accepted. Like we have scarring alopecia, for example. People are not very happy to have [inaudible] scars after a clinical trial. So we do a lot of work on organ cultures. And with the cell culture, we can prove certain signaling pathways and certain questions. But it would be really nice if we could add molecular markers to our current understanding of what we see in the clinical trials.

Because the typical situation is that what we have – and over here will focus on androgenetic alopecia – as a typical situation for a drug efficacy trials. You will see here a male patient. And what we usually want to look at is those who participated in our Ulrike’s session this morning, we are now able to do mini-zone trials. We have certain areas we want to focus on, but then we still have the situation that we have to wait for many weeks to sit there and have global expert panels and negotiate numbers of hair follicles and micrometers of thickness. And so we felt that we wanted to look at different ways of improving the way we do these trials.

So we designed a set-up where we wanted to get ready to have efficient androgenetic or testing of topical treatments for androgenetic alopecia. And we felt that we wanted to look at frontal, vertex, and occiput using the clinical methods: adding to our panel things like optical coherence tomography (I will show in a minute) and adding experimental methods and readouts that will tell us a little bit about the scalp/skin milieu, which is really hard to mimic in vitro, and also molecular processes. And I will now guide you a little bit through those complex studies set-up that we created and tested in six individuals, until we then repeated the whole procedure in 12 individuals and monitored the effectiveness of minoxidil treatments, as Ulrike presented this morning.

So we were trying to generate protein material that helps us to look at scalp milieu, and we decided to look at RNA material from plucked hair follicles. Because if you pluck the hair follicles and there’s [inaudible] – and we also had discussions – of course, you don’t remove these entire compartments, but it would be so nice to be able to pluck hair follicles, get a molecular readout, and then, over time, go back to the same area or, at the same time, look at different sites to get a more comprehensive view of what’s going on with this patient. So the idea was to look if we can generate robust RNA microarray data that allows us to set up a panel of selected molecular markers that we could then use in multiple upcoming trials.

The post Differences Between Hairless and Hair-Bearing Scalp appeared first on HairLossTalk.

More than a decade ago most people believed that hair cloning would become a practical reality by now.  This belief was based on research that was done on animal models. Oliver showed that removal of a specific type of cells called dermal papilla cells from the rat hair follicle could induce new hair follicles when implanted in the rat¹.  Dr. Colin Jahoda took this research one step further and showed that removing these dermal papilla cells and multiplying them in a cell culture before implanting them in the rat, could also induce new hair growth². This research initiated the interest to develop cell-based treatments for hair loss.

Last decade we have seen that two major commercial ventures: Aderans and Intercytex, tried to bring cell therapy forward to the public for hair loss. Unfortunately they both failed in doing this. Their clinical research showed that some hair regrowth was seen in patients, but no new hair follicles were formed. This huge disappointment led to both companies abandoning their work.

Tsuji Kyocera Organ Technologies Partnership

Recently however huge news arrived of a partnership between KYOCERA, RIKEN and Organ Technologies that aims to develop regenerative medicine to treat hair loss. Till date there is still no treatment available that can actually increase the amount of hair follicles we have. This partnership is going to try to tackle that problem, so that one day many types of hair loss might benefit from this endeavor.

This partnership in Japan formed, based on the research of Dr. Tsuji, who is the team leader of the laboratory for organ regeneration at the RIKEN Center for Developmental Biology.  His research back in 2012 showed that by removal of two types of stem cells from a human hair follicle it was possible to induce a brand new fully functional human hair follicle in a rodent model³.

This is particularly exciting when you consider that these two types of stem cells used are the same type of cells that develop our hair follicles in the prenatal period.  These two types of cells, the epithelial and mesenchymal cells clump together in the skin in the prenatal period and communicate together to form a hair follicle.  This process is known as hair follicle morphogenesis.  Many studies have elucidated the central role of the epithelial and mesenchymal cells in this process^4,5.

Hair Follicle Morphogenesis

It is exactly this process that they are going try to mimic. How are they going to do this?  Well first it will require a small specimen sample of the back of the head. The hair follicle will be then dissected to obtain these 2 types of stem cells. After this they will be put in a culture to let both cells multiple. When that is done these cells will be put together in a 3D environment to mimic the skin.

Just like in the prenatal period these cells should then communicate with each other to form the very beginning of a hair follicle, a so called “follicular primordium”. A ton of these hair follicular primordiums would then be ready to be delivered into the scalp where they should grow into a fully functional healthy hair. This way even a Norwood 6 or worse should be able to get back to a full head of hair.

It is also noteworthy to mention that the hair follicle is also unique as an organ that it can regenerate. In fact is the only one organ known to regenerate repeatedly after birth. To top it all of the hair follicle can regenerate completely when it is cut in half horizontally outside the body and implanted in the scalp again. Both halves of the hair follicle have been shown regenerate and induce hair growth6. Yes that’s right, we can actually already clone hair follicles by cutting a hair follicle in half, although it grows back thinner and the success rate is far from 100%. That particular study actually suggests that the hair follicle has stem cells in both halves as both portion were able to regenerate.

That suggestion is actually correct, both halves of the hair follicle have stem cells. Guess why? The cut was done below the hair follicle bulge (epithelial stem cells located there) and above the bulb (mesenchymal stem cells located there). Exactly the two type cells that are going to be used in the treatment of the partnership between KYOCERA, RIKEN and Organ Technologies!

It remains to be seen if this treatment will prove to be the solution we all have been waiting for. One thing is for sure it is based on some very solid scientific observations. This is cutting edge regenerative medicine and with such a great partnership it is hard to not get excited about this!

References:

1. Oliver RF. The experimental induction of whisker growth in the hooded rat by implantation of dermal papillae. J Embryol Exp Morphol. 1967 Aug;18(1):43-51.
2. Jahoda CA, Horne KA, Oliver RF. Induction of hair growth by implantation of cultured dermal papilla cells. Nature. 1984 Oct 11-17;311(5986):560-2.
3. Takashi Tsuji, Akio Sato, Akira Takede, et al. Fully functional hair follicle regeneration through the rearrangement of stem cells and their niches. Nat Commun. 2012 Apr 17;3:784.
4. Michael Rendl, Lisa Lewis, Elaine Fuchs. Molecular Dissection of Mesenchymal–Epithelial Interactions in the Hair Follicle. PLoS Biol. 2005 Nov; 3(11): e331.
5. Rachel Sennetta, Michael Rendl. Mesenchymal-epithelial interactions during hair follicle morphogenesis and cycling. Semin Cell Dev Biol. 2012 Oct; 23(8): 917–927.
6. Toscani, Rotolo S, Ceccarelli S, et al. Hair regeneration from transected follicles in duplicative surgery: rate of success and cell populations involved. Dermatol Surg. 2009 Jul;35(7):1119-25.

The post Kyocera to Begin Regenerative Hair Loss Treatment Research appeared first on HairLossTalk.

We’ve all heard about Rogaine.  It’s been around for decades.  And there seems to be a decent amount of uncertainty as to what exactly it does for hair.  Opinions abound and facts relatively unavailable.   But there have been studies examining this exact question, right down to the hair counts.

Even with studies on hand, its important to note that everyone will respond differently to Minoxidil (the active ingredient in Rogaine, Regaine, and other similar brands).  We recently published a presentation by Dr. Andy Goren examining whether its possible to know ahead of time if it will work for you.  But let’s assume someone does respond to this topical medication initially.   What about long term?  Let’s look at some studies.

Long Term Effectiveness of Minoxidil

A study was done that took an interesting approach¹. They took a group of people who had Androgenetic Alopecia (typical Male and Female Pattern Baldness) and tested the basic Minoxidil, which has a 2% strength.  They compared it to the 5% Minoxidil.  But they also included a Placebo group that thought they might be taking Minoxidil, but weren’t.  To make it even more interesting, they monitored hair counts on people who took nothing at all.

They followed this group of people for a period of 2 years, and found that both Minoxidil groups had an initial period of hair-growth. However following this, the rate of hair loss was comparable to the people who were not even taking Minoxidil at all.

This is illustrated in the graph to the left. The blue line indicates the hair growth period when the topical Minoxidil was applied.  This happened in the first 3 1/2 months.  As you can see, during this same time period, the people who used no Minoxidil continued to lose hair, and of course saw no increase in hair counts.  However after the initial hair growth period, the rate of hair loss is about the same as the control groups. These findings are further strengthened by a study of Olsen et al²:

Again we can see below that after the initial growth period (roughly 16 weeks), the rate of decline between the control group and treated group, is similar.

Does Rogaine Alone Work Long-Term?

You might be viewing these graphs and thinking:  “So it doesn’t work longer than 3 months?”  On the contrary, as with most things, devil is in the details.  The first thing to remember is that Rogaine is in the class of hair loss treatments known as “growth stimulants”.  This means it was never intended to actually stop the hair loss process in the first place.  Its primary purpose is to stimulate new hair growth despite the continued degradation of the hair follicles, for as long as possible.

And that’s exactly what it does.  And this is exactly why combining treatments can be so important.  The act of using Rogaine actually buys you at least 2 years of increased hair counts from baseline.  That’s great, but it can be dramatically increased if you add a DHT-inhibiting treatment like Propecia (Finasteride) or other topical Antiandrogens.   This is because such treatments stop the further degrading of the hair follicles, which synergistically allows Rogaine to continue stimulating new hair growth.

How long you will be able to maintain your hair with minoxidil will probably depend on several factors. For example how well you respond to the medication and how fast your personal balding process is taking place. It might be 1 year or 2 years.  Perhaps even 5 years if you are lucky, as shown in a study³.

Your Personal Rate of Hair Loss

Now you might ask yourself how it is possible that some people might keep their hair above baseline for  a long period as 5 years? Well again it depends completely on the individual.  One could react very well to the medication while and also have a slow rate of balding.

Imagine for example that someone with no hair loss would apply minoxidil and show increased hair counts. Because he isn’t balding he will continuously stay above baseline as long as he is using it, simply because there will be no “decline period”. In that sense someone with no hair loss who would be using minoxidil could stay above baseline for even 20+ years.  Each individual experiences the reduction in hair quality and quantity at different rates.  So the duration will be different for everyone.

The Verdict on Minoxidil

Rogaine and similar treatments give you extra growth that can last many years even without other treatments.  But they don’t fundamentally do anything against the balding process itself. How long that extra growth will keep you above baseline will vary between individuals.  Five years is probably a little too optimistic if you are experiencing aggressive hair loss, and if you stop treatment, any gains will be lost.  But intelligently combining a growth stimulant with an antiandrogen or DHT inhibitor could easily keep that sexy mane front and center for a decade or longer.

References:

1. Price VH1, Menefee E, Strauss PC.Changes in hair weight and hair count in men with androgenetic alopecia, after application of 5% and 2% topical minoxidil, placebo, or no treatment. J Am Acad Dermatol. 1999 Nov;41(5 Pt 1):717-21.
2. Olsen EA1, Dunlap FE, Funicella et al. A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol. 2002 Sep;47(3):377-85.
3. Olsen EA1, Weiner MS, Amara IA, DeLong ER. Five-year follow-up of men with androgenetic alopecia treated with topical minoxidil. J Am Acad Dermatol. 1990 Apr;22(4):643-6.

The post Can Rogaine Stop Hair Loss Long-Term? appeared first on HairLossTalk.

Many patients who’ve had a hair transplant can become very concerned about the newly-transplanted hair.  In the months following the procedure, you might start comparing your own hair growth to other people’s pictures posted online, and realize that you are falling behind.  Are these emotions unfounded?  Very often they actually are.

Ugly Duckling Phase

When a harvested graft is transplanted into the recipient area, a process begins which takes several months, and it may not be what you’d expect.  In the first 3 days post-transplant, the grafts begin working to regain their blood supply¹,². Because of this, the hair shaft is shed after, starting from week 1 up until week 6 after the hair transplant surgery has been performed.  What’ comes next is often called the “ugly duckling phase”. Only a very small percentage of patients don’t shed their hair after hair transplant surgery. Earliest hair growth starts generally from month 3.

Before we continue it is important to realize that every patients transplanted hair grows at a different rate. Some might be quicker than others. Every patient is unique and the final result should not be evaluated until 12 months in. Yet, we can give out a rough estimation of hair growth following a hair transplant.

First of all we need to distinguish the actual hair shaft penetrating the skin surface and  “maturation” of the hair shaft. When a hair shaft has just has penetrated the skin it will still undergo many changes in overall appearance that will contribute to the end result. When the hair shaft will penetrate the skin it will often still be very fine, weak and very light in color. This will gradually get better and better as time passes until it is indistinguishable from your donor hair.

A very rough timeline would look like this:

Remember that this is on average and a very rough estimation of where a patient should be in a certain time period. While most people for example see their end result pretty much for the full 100% at the 12 month mark, some very late growers might actually see their final results later at around the 15-18 month mark. Like already said, the final result shouldn’t be evaluated for at least 12 months in.

What is important is to be really patient.  If you still don’t have the desired result by 6 months, don’t start panicking as your result will still most likely improve much.  Happy growing and hopefully this post has made it more clear how a hair transplant result develops as time passes by!

References:

1. Perez-Meza D, Leavitt M, Mayer M. The growth factors. Part 1: clinical and histological evaluation of the wound healing and revascularization of the hair graft after hair transplant surgery. Hair Transplant Forum Int.2007;17:173–5.
2. Perez-Meza D. Wound healing and revascularization of the hair transplant graft: role of the growth factors. In: Unger W, Shapiro R, editors. Hair Transplantation. 4th edn. New York: Marcel Dekker; 2004. pp. 287–94.

The post Transplanted Hair: What to Expect After the Surgery? appeared first on HairLossTalk.

Shiseido recently announced that they are moving forward with a study that will involve 60 men and women with thinning hair. This trial will take place at the Tokyo Medical University Hospital and Toho University, Ohasi Medical Center.

The method they plan to study is based on a new hypothesis in hair regeneration.  For many years scientists have evaluated ways to multiply the number of hair follicles, or stimulate native hair follicles using cellular methods.  Terms like Hair Multiplication, Follicle Cloning, and similar may ring a bell.  But no matter the method, the goal is the same:  The ability to create new hairs where there were only few.  If successful, having access to an unlimited amount of your own hair (whether it needs to be implanted surgically, or injected on a cellular level) could mean a practical cure for hair loss.  They will be evaluating both safety, and effectiveness based on hair fiber thickness and hair counts over a period of 3 years.

RCH-01 Hair Regeneration Technology

Shiseido acquired the exclusive license of Canadian bio-venture company Replicel back in July 2013 to use their hair regeneration technology “RCH-01” in the entire Asian region. Due to Japan’s unique regenerative medicine regulatory environment we might see this technology launched before 2020 on the Japanese market, sooner than anywhere else in the world.

RCH-01 technology is based on the research of Kevin J. McElwee et al¹. It is a form of autologous cell therapy based on dermal sheath cup cells.  These specific kind of cells, which are located in the hair follicle, will be extracted from the back of the head, just like during a first stages of a typical hair transplant procedure.  They will extract a 4-8 millimeter punch biopsy which will then be “multiplied” in the lab for a period of 3 months.  After the successful replication of these cells, they will be injected back into the scalp.

Replicel itself has already conducted a phase 1 clinical trial. While they only managed to increase hair density by about 10% in 70% of the participants, this was still a first step in the right direction.  It was also primarily a safety test so they bypassed some important steps including repeat injections, dose analysis, and using a sufficiently large treatment area.  These are all very influential factors that Shiseido can play around with during the upcoming 3 year trial in Japan.

Replicating cells is only part of the process.   They will then be injected back into the scalp, where they hope to literally grow a new crop of hair.  So the success of this upcoming trial will rely heavily on how these cells behave when injected. Will they secrete stimulative factors and cause temporary thickening of existing hair follicles? Or will they incorporate into the hair follicle structure itself and repopulate the dermal papilla? If it is the latter, the treatment may be a huge breakthrough with very long lasting or permanent effects.

Dermal Papilla’s Role in Hair Loss

To understand this a bit more we need to take look at the hair follicle.

The base of the hair follicle is where the “dermal papilla”  is located. This compartment of cells are crucial for the hair follicle, and this has been shown in many studies.  It plays a significant role in all phases of the follicle life cycle from before its beginning to the cycling out of growth.

Back in 1958 a study showed that the thickness of a hair is controlled by the amount of dermal papilla cells in that hair follicle². In androgenetic alopecia (typical male and female pattern hair loss) we see that the dermal papilla is diminished heavily too.

A recent study in 2013 showed that the removal of dermal papilla cells causes a type of follicular decline³ that matches the thinning and miniaturization process of androgenetic alopecia. The dermal papilla is also the main site of androgen action⁴.   The place where DHT does its dirty work, making your life miserable by giving you bad hair days for the rest of your life.  The androgens Testosterone and Dihydrotestosterone bind to the androgen receptor located at the surface of these very cells.

Another study showed that bald scalp in men with androgenetic alopecia retains hair follicle stem cells but lacks progenitor cells⁵. Progenitor cells are controlled by, and dependent on dermal papilla cells⁶,⁷.

This means that the Dermal Papilla is of huge importance in hair growth.  And it is no surprise that repopulating the dermal papilla in Androgenetic Alopecia may reverse miniaturization.  Likewise, replacing dermal papilla cells may pretty much make someone immune to the effects of hair loss!

Sheath Cup Cells and Dermal Papilla

So is this RCH-01 technology based on dermal papilla cells?   Nope.  Its based on sheath cup cells instead.  And the reason for this is simple:  it has been hypothesized that dermal papilla cells themselves come from somewhere else in the hair follicle.  And Replicel believes that mystery source may be dermal sheath cup cells.

However if the injected dermal sheath cup cells will just release stimulative factors and temporary stimulate native hair follicles then it remains to be seen if the treatment will be good enough for Shisheido. Who knows though, perhaps repeated dosages that simply stimulate the hair follicles will show very good results too. I guess we will have to wait for the data which will give the final answer.

1. McElwee KJ1, Kissling S, Wenzel E, Huth A, Hoffmann R. Cultured peribulbar dermal sheath cells can induce hair follicle development and contribute to the dermal sheath and dermal papilla. J Invest Dermatol. 2003 Dec;121(6):1267-75.
2. VAN SCOTT EJ, EKEL TM. Geometric relationships between the matrix of the hair bulb and its dermal papilla in normal and alopecic scalp. J Invest Dermatol. 1958 Nov;31(5):281-7.
3. Chi W1, Wu E, Morgan BA. Dermal papilla cell number specifies hair size, shape and cycling and its reduction causes follicular decline. Development. 2013 Apr;140(8):1676-83.
4. Randall VA1, Hibberts NA, Thornton MJ et al. The hair follicle: a paradoxical androgen target organ. Horm Res. 2000;54(5-6):243-50.
5. Garza LA1, Yang CC, Zhao T et al. Bald scalp in men with androgenetic alopecia retains hair follicle stem cells but lacks CD200-rich and CD34-positive hair follicle progenitor cells. J Clin Invest. 2011 Feb;121(2):613-22.
6. Morgan BA. The dermal papilla: an instructive niche for epithelial stem and progenitor cells in development and regeneration of the hair follicle. Cold Spring Harb Perspect Med. 2014 Jul
7. Clavel C, Grisanti L, Zemla R et al. Sox2 in the dermal papilla niche controls hair growth by fine-tuning BMP signaling in differentiating hair shaft progenitors. Dev Cell. 2012 Nov 13;23(5):981-94.

The post Shiseido to Begin Cell Hair Regeneration Trial appeared first on HairLossTalk.

A little more information about a new company known as HairCell, which HairLossTalk user Xaser94 previously posted a thread about in our forums: HairCell – Full Hair Regeneration. At this stage its difficult to tell if this is a genuine hair loss research effort or a marketing venture, but lets look at what’s on the table.

What is HairCell?

In their provisional patent, they describe the treatment as:  “A method and apparatus for producing hair growth stimulation using bioelectric energy, topical compositions, stem cell/growth factor micro infusions and combinations thereof. By using bioelectric signaling resulting from specific protein expressions and their cellular responses to exposure to specific micro voltages.”

So as you can see, its not just a bunch of electrodes taped to your scalp, but also includes growth factor infusions, which are currently being studied by several other teams on the “legit” front.  The device itself seems to be an electrical stimulating device, intended to have an activating effect on stem cells, and likely circulation, which they hope contributes to the growth of new hair.   Such devices have been attempted in the past (without the stem cell claim, and not in combination with growth factor infusions) and shown to be ineffective in the treatment of hair loss.  So people are keeping a cautious eye on this treatment, and waiting for reproducible study data before raising hopes.

As per Xaser, there also seems to be a very public money-making plan in place which may be based on first obtaining legit results from clinical trials they plan to perform:  “They happen to be trying to stimulate hair follicles using some of the same growth factors as Histogen, and are using their own novel delivery method.  I found this slide show they released recently, and they happen to say some interesting things:

https://app.slidebean.com/p/WAgrdJLeNM/HairCell#1

“On slide 5 headlined Business Model, they claim they will complete a pilot study of 20-100 patients. The same slide also says “Focus on patents, data, opinion leader endorsements and positive press and then with pilot study data on hand > sell.”

HairCell Hair Growth Treatment:  Business Plan

“Their goal seems to be to sell off the technology or partner with someone else, and then have a different company complete the clinical trials. On slide 10, they have a goal of presenting data on February 2017 of their fist 20 patients, and then complete 100 patient trial by July 2017. They also claim their potential competition is Samumed, citing “only 10% regrowth.”  Their goal however seems to be complete regeneration of a full head of hair and their willingness to put their weird looking contraption through clinical phase trials makes me think its not a scam like those laser helmets.”

Looking further into this company, you can see on their Vimeo page that the video is labeled:  “Calx Stars Business Accelerators” which is a name indicative of investment and money making goals.  More revealing however, may be the fact that this ‘XXXCell’ term isn’t just for a hair growth device.  They are apparently making the same claims for numerous other ailments, as can be seen in this listing of their videos:  CancerCell, AortaCell, PancreaCell.

Xaser went on to say:  “I found this on the parent company’s website (Leonhardt Ventures – Our Companies).  Simple Business Plan:

* Get as many patents as possible.
* Prove technology works hopefully in at least 20 human patients.
* Get opinion leader endorsements through educational showcases, one on one meetings and small panels.
* Get positive press.
* File with regulatory bodies to start Phase II clinical trials.
* THEN SELL = Begin auctioning off to strategic partners or buyers starting in May 2018 with intention to have all of them partnered or sold by the end of 2019.

The Science Behind HairCell

Purely looking at this from a scientific perspective, if they begin Phase 2 trials by the end of 2017 (around the time they plan to sell), then this device would be on track for release around 2020. It would be prudent to also question the study methods, and any conflicts of interest that may be present by those who conduct the study. Either way, a simple at-home solution would be better than current options like invasive hair transplants.  HairCell makes reference to several studies backing the effectiveness of the device:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC199257/
VEGF study concluding that improved follicle vascularization promotes hair growth and increases hair follicle and hair size.  The implication is that their device improves vascularization.

http://www.ncbi.nlm.nih.gov/pubmed/22052313
Study showing increased hair growth after injection of a solution containing Follistatin and other wound-healing growth factors.  How this relates to their electrical device, or what methods will be used for the aforementioned “infusion” is yet to be seen. We will keep you updated as to the status of this potential new treatment for hair loss, and of course will keep a critical eye on the claims being made.

The post A Look at HairCell: Company & Claims appeared first on HairLossTalk.

Hair loss research just got a big boost today, and there’s already a lot going on right now.  Its a very exciting time.  We recently announced the Kyocera partnership with Riken Technologies to begin testing a new hair loss treatment therapy aimed at increasing follicle counts (not just hair counts).  Soon after, we announced the very well-known cosmetics and research company “Shiseido” is to begin a 60-person trial on a new hair loss therapy also based on regenerative medicine known as RCH-01.

$6m Investment in Hair Loss Research

Today we received word that yet another company is heading full-steam into the regenerative medicine realm for the treatment of hair loss on a cellular level.  Histogen, Inc. is a regenerative medicine company which develops therapies using new technology, utilizing the products of cells grown under simulated embryonic conditions.  What this means is that newborn cells are encouraged to naturally produce proteins and growth factors which have been shown to stimulate new hair growth.  This is done by stimulating a patient’s own stem cells using these proteins which support stem cell growth and differentiation. That’s a lot of scientific jargon for “Really Cool”.

Today Histogen announced that Pineworld Capital Ltd (an affiliate of Huapont Life Sciences), has made a $6,000,000 private equity investment into the Company to continue development of their therapy known as “Hair Stimulating Complex” (HSC).

Hair Stimulating Complex (HSC)

If you’re wondering what “Hair Stimulating Complex” is, please make sure you’re subscribed to our newsletter (right sidebar) and you’ll be notified after we publish our interview with Dr. Gail Naughton this week.  Huapont’s affiliate will be the lead investor in Histogen’s Series D financing round. This funding will be used in part to further Histogen’s research on HSC in the United States, and to start preparations for their long-awaited Initial Public Offering (IPO).

“We are honored that the leading dermatology company in China has recognized the potential of Histogen’s technology,” said Dr. Gail Naughton, Histogen CEO and Chairman of the Board. “We are looking forward to a fruitful relationship, and to having Hayden Zhang as a valuable addition to Histogen’s Board of Directors.”

Huapont will have a right to name one director to the Histogen Board of Directors, and has certain participation rights to invest in future equity financings. Histogen and Huapont intend to enter a license and supply agreement for the development and commercialization of HSC in Mainland China, with terms and conditions to be announced.

About Huapont Life Sciences

Huapont Life Sciences is a China-based company with a current market capitalization of $3 billion.  They focus on the research and development of innovative healthcare products, the marketing of pharmaceutical products, and agricultural herbicides.  Their products include dermatology, cardiovascular, anti-tuberculosis agents, autoimmune-related products and oncology-related products. They tout current annual revenues of approximately US 1.1 billion, and have approximately 7,100 employees operating throughout Mainland China.

The post Histogen Secures $6m Investment in New Hair Loss Treatment appeared first on HairLossTalk.

Hair loss research is on fire right now, and Histogen is storming forward with its trials on a new injectable hair loss treatment that showed promise with only 3 individual treatments in initial phase trials.   This is clearly superior to applying a foam to your scalp daily, or popping a pill for the rest of your life.  To monitor and track all the ongoing research projects, we have established a Pipeline Page which we encourage you to bookmark and check often.

We had the pleasure of speaking with Dr. Gail Naughton (G) and her Director of Communications, Eileen Brandt (E) this week.

Time was very limited, and we had a lot of questions to go through, so just rattling everything off in shotgun approach was the method selected.  The audio is also highly edited so it flows a bit awkwardly at times.  Below is the text from the interview presented in the video above.

Histogen HSC Interview – Dr. Gail Naughton

E:  I thought it would be best if we can start by talking about what’s related to today’s announcement.  I know that at least one of your questions pertained to our potential partner in China, and then to Histogen’s additional financing needs.

G:  Just to give you an update:  We expect before the end of August to have the final license agreement for HSC for China announced, and then shortly after that, the same for Mexico.  So maybe we can do some of the questions today, and then wait for the licenses in a couple of weeks, to do more of an in-depth – you know what the business plan is for country by country.

H:  Announcement regarding partnership with China, late stage negotiations, did those negotiations go through, is there going to be a clinical trial in China, anything like that?

G:  Huapont Life Sciences is a leading dermatology company in China, so the fact that they’ve invested in Histogen with the use of proceeds to be used to further develop HSC in the United States is a very strong statement on their behalf, and their endorsing the approach and the technology.  We have a binding term sheet with them now that is focused on an exclusive license for HSC in China, and we hope to have that full license executed by the end of August.  And at that time we’ll be able to lay out the plan for how they plan to move forward with clinical trials and commercialization in mainland China.

H:  Recently the fund raising goal was raised to a goal of $18 million.  Is Histogen almost near their goal for fund-raising and is an IPO on the horizon?

G:  Our goal is to raise an additional $11 million in the next 12 months to be able to support the upscaling of the HSC product, to be able support further research and of course getting us to the point where we can be in a state to commercialize the product in Mexico and do a Phase 3 study in the United States.  So if everything stays on track with all of the research we are doing, we expect to have additional clinical data on HSC from the US and Mexico by the end of next summer, and positive data from those trials, will, we believe, absolutely support an IPO before the end of 2017, 2018.  [Editor note:  Timelines must include the possibility of unexpected delays.  In this case, new data by Fall 2017 and IPO by Spring 2018]

H:  Follicles that grow terminal hair have DP cell counts between 1400 and 3000 cells.  Has Histogen looked into the follicles after HSC injections to see if the DP cell-count has increased?  Wouldn’t it have to, considering as far as we know, the hair size is relevant to the size of the follicle which depends on the DP cell-count.

G:  That’s a really good question.  I would love to find out what methodology people use outside of biopsy (which is not possible in a trial like this) to count the DPC cells.  We were able to use the computerized technology to evaluate not only the thickness of the hair, but the stage of the hair cycle.  So we could show that we were taking a pre-anagen follicle and making an anagen follicle.  So we did that and that of course did correlate with the thickness of the hair and the amount of terminal hairs.  I would love input, if there’s some methodology that is non-invasive, to count the DP cells, I would love to incorporate that in our upcoming clinical trials.  So more data on that would be so welcome.

H:  If the DP cell count is higher, would that mean that Histogen has figured out a way to migrate DP cells back to the DP and the follicle.  He spoke with Dr. Claire Higgins and she mentioned that a simpler method for reversing hair loss would be to get the DP cells to come back to the follicle.

G:  Again, this is only hypothetical, so we believe that we have caused them to migrate back, but we have not had a methodology to assess that.  We do know that we are causing the cells from the bulge to migrate down to the bottom of the now-elongated shaft, and migrate up the shaft to convert a vellus hair to terminal, or to create a new terminal hair.  Or more terminal hairs per shaft.  But we do not know about the DPC’s and again would love to look at that.

H:  Have you filed for Phase 2 dose-ranging study for men in America yet, and when can we expect those trials to begin recruiting, if so.

G:  So we have not filed the IND (investigational new drug application) for men yet.  We are still answering questions on the Phase 1 for women, which is the first step.  We have identified the 3 clinical centers that will be doing the Phase 2, and we are hopeful that we’ll be able to start recruiting by the end of the 1st quarter of next year.  That’s our goal.

H:  Regarding Mexico …

G:  You can say that Histogen has identified a partner in Mexico and has had several meetings with the COFEPRIS.  We are hoping to announce the full license and the clinical plan from Mexico (soon).

H:  Has Histogen also secured a partner in Japan?  As per the Histogen fact sheet from 2015, you were seeking a partnership in Japan.  It would be favorable considering the new regulation for biotech and stem cell therapies in that country.

G:  We actually had an offer from a potential partner in Japan which our board did not accept, because they feel that after solidifying China and Mexico, our goal should be to go for the rest of the world (inaudible).   And that’s what we’re focused on right now.  If the perfect partner in Japan came by, we would certainly entertain it.  But the deal that we were offered, the board said, was not supportive of what they consider licensing the crown jewel of the company.

The post Histogen HSC – Clinical Research Update appeared first on HairLossTalk.

Shiseido Company, a Japanese corporation with over a century of experience in the beauty industry, recently filed two patents in the United States related to hair loss treatment. More than a cosmetics company, Shiseido has invested in innovation in a number of scientific areas, including raw material development, dermatological research, and brain science research. Shiseido has even focused on hair regeneration.¹ In fact, we recently reported on an upcoming clinical trial they are about to begin: Shiseido RCH-01 Asia.

Shiseido Hair Loss Research

The two patents that Shiseido applied for are titled “Method for Regenerating Hair Follicles Using CD36-Expressing Dermal Sheath Cells”² and “Cell Mass Capable of Serving as a Primitive Organ-Like Structure Comprised of a Plurality of Cell Types of Somatic Origin.”³ These patents are the latest in a long list of Shiseido hair regeneration-related patents that include regenerating sheath cell follicle composition⁴, a hair growth cell activator⁵, a hair follicle reconstitution system⁶, a hair growth stimulant⁷, a hair preserving tonic⁸, a method for hair growth that involves a cell-adhesion factor⁹, and a method for preparing transplant of hair papilla cells1¹⁰. According to their patent history, for nearly seventeen years, Shiseido has been investigating the means to reverse hair loss and preserve existing hair.

Somatic Cells Patent for Hair Loss

How do the new patents advance hair loss treatment research? Let’s break this down one patent at a time. First – the primitive organ-like structure of somatic cells. A somatic cell is any type of cell from the body that has been specialized to perform a function and is not an ovum, sperm, or stem cell. The patent describes a process to culture a cell mass containing two types of somatic cells: keratinocytes and hair papilla cells. The scientific innovation is in the use of a Wnt signal activator (mediating cell proliferation by controlling the cell cycle) and non-plate contact culturing (growing cells on a surface other than the bottom of a Petri dish).

The inventors point out that by using this method, a “cell mass useful for, for example, hair follicle transplant… can be efficiently and artificially produced.”³ Moreover, the cell mass could be used to evaluate hair growth drugs. The inventors detail their efforts to prove their claim. The cell staining figures included with their text indicate that their described method is plausible; however, the inventors reported producing only droplets of cultured cells.

Patent for Hair Follicle Regeneration

Secondly is the hair follicle regeneration method using transplanted dermal sheath cells in an animal model or three-dimensional skin model, such as the primitive organ-like cell mass described above.

The inventors used genomic sequencing to identify genes that were expressed more in dermal sheath cells compared to hair papilla or fibroblasts. Three hundred and four were found. Most of the genes were related to vascular processes, indicating a strong relationship between dermal sheath cells and blood vessels. Interestingly, a previously-known hair growth promotion factor, HGF (hepatocyte growth factor), was correlated with another gene that was highly expressed, CD36 (cluster of differentiation 36).

CD36 has been identified in fatty acid and sugar metabolism, in atherosclerosis, and even in Alzheimer’s disease; yet, there is currently no known relationship between CD36 and hair growth. By using CD36, scientists can identify and sort out hair sheath cells among a sea of other cell types. A dermal sheath-cell-enriched liquid can then be applied to animal skin or a skin-like organ according to current known transplant methods. The inventors provided evidence of CD36 expression and successful dermal sheath cell sorting, but they did not provide results of transplant and regeneration.

Possible Future Cure for Hair Loss?

Does this mean that they have found a cure for alopecia and hair loss? Not exactly. The purpose of a patent is to protect intellectual property. A patent can only be approved for processes or inventions that are novel, non-obvious, and adequately described. However, a patent does not undergo a rigorous scientific review where it is tested for utility or function. That’s why a cup that delivers an electric shock to a hiccoughing person was accepted as the patent “Device for the Treatment of Hiccups”.11 But, the patents filed by the Shiseido Company are compelling. The evidence contained within their applications points towards scientists invested in finding a treatment and a brighter future for hair regeneration.

References:

1.  Shiseido’s Research and Development | Innovation | Shiseido group website. Accessed August 20, 2016.
2.  Yoshida Y, Soma T, Fujiwara S. Method for Regenerating Hair Follicles Using CD36-Expressing Dermal Sheath Cells. March 2016.
3.  Fujiwara S, Kishimoto J, Soma T. Cell mass capable of serving as a primitive organ-like structure comprised of a plurality of cell types of somatic origin. July 2016.
4.  Yoshida Y, Soma T, Fujiwara S. Composition for regenerating follicle which contains cd36-expressing connective tissue sheath cells. April 2012.
5.  Hamada C, Tajima M, Nakama Y, Takahashi T. Cell activator. March 2002.
6.  Ideta R, Tsunenaga M. Hair follicle-reconstitution system and animal carrying the same. March 2003.
7.  Ishino ACOSCLK, Miyazawa KCOSCLK, Fujii SCOSCLK. Hair growth stimulant. May 1994.
8.  Uchikawa K, Miyazawa K, Nakanishi J, Ishino A. Hair revitalizing tonic composition. 1992.
9.  Yamanishi H, Soma T, Yoshida Y, Ishimatsu Y. Method for promoting hair growth or hair regeneration by maintaining or increasing expression of cell-adhesion factor. December 2012.
10.  Kishimoto J, Ehama R, Ideta R, Arai T, Yano K, Soma T. Method of preparing hair papilla cell preparation, composition and method for regenerating hair follicle and animal having regenerated hair follicle. April 2005.
11.  Ehlinger PC. Device for the treatment of hiccups. June 2006.

The post Shiseido’s Applies for Hair Loss Patents appeared first on HairLossTalk.

testing

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Perception of Hair Transplant for Androgenetic Alopecia

Author information:

Bater KL, Ishii M, Joseph A, Su P, Nellis J, Ishii LE.

What Does This Study Teach Us?

Men were perceived as being younger and more attractive by casual observers after undergoing hair transplant. Participants also rated post-transplant faces as appearing more successful and approachable relative to their pre-transplant counterparts. These aspects have been shown to play a substantial role in both workplace and social success, and these data demonstrate that hair transplant can improve ratings universally across all 4 domains.

Abstract:

Hair transplant is among the most common cosmetic services sought by men, with more than 11 000 procedures performed in 2014. Despite its growing popularity, the effect of hair transplant on societal perceptions of youth, attractiveness, or facets of workplace and social success is unknown.

Objectives:

To determine whether hair transplant improves observer ratings of age, attractiveness, successfulness, and approachability in men treated for androgenetic alopecia and to quantify the effect of hair transplant on each of these domains.

Design, Setting, and Participants:

A randomized controlled experiment was conducted from November 10 to December 6, 2015, using web-based surveys featuring photographs of men before and after hair transplant. One hundred twenty-two participants recruited through various social media platforms successfully completed the survey. Observers were shown 2 side-by-side images of each man and asked to compare the image on the left with the one on the right. Of 13 pairs of images displayed, 7 men had undergone a hair transplant procedure and 6 had served as controls. Observers evaluated each photograph using various metrics, including age, attractiveness, successfulness, and approachability. A multivariate analysis of variance was performed to understand the effect of hair transplant on observer perceptions. Planned posthypothesis testing was used to identify which variables changed significantly as a result of the transplant.

Main Outcomes and Measures:

Observer ratings of age (in number of years younger) and attractiveness, successfulness, and approachability (on a scale of 0 to 100; scores higher than 50 indicate a positive change).
Results:

Of the 122 participants in the survey, 58 were men (47.5%); mean (range) age was 27.1 (18-52) years. The initial multivariate analysis of variance revealed a statistically significant multivariate effect for transplant (Wilks λ = 0.9646; P < .001). Planned posthypothesis analyses were performed to examine individual differences across the 4 domains. Findings determined with t tests showed a significant positive effect of hair transplant on observers’ perceptions of age (mean [SD] number of years younger, 3.6 [2.9] years; P < .001), attractiveness (mean [SD] score, 58.5 [17.5]; P < .001), successfulness (mean [SD] score, 57.1 [17.1]; P = .008), and approachability (mean [SD] score, 59.2 [18.1]; P = .02).

The post Can a Hair Transplants Improve Your Social Perception? appeared first on HairLossTalk.

Androgenetic Alopecia: An Update of Treatment Options.

Author information:
Kelly Y, Blanco A, Tosti A.

Abstract:

Androgenetic alopecia (AGA) is characterized by a non-scarring progressive miniaturization of the hair follicle in predisposed men and women with a pattern distribution. Although AGA is a very prevalent condition, approved therapeutic options are limited. This article discusses the current treatment alternatives including their efficacy, safety profile, and quality of evidence. Finasteride and minoxidil for male androgenetic alopecia and minoxidil for female androgenetic alopecia still are the therapeutic options with the highest level evidence. The role of antiandrogens for female patients, the importance of adjuvant therapies, as well as new drugs and procedures are also addressed.

The post A Review of Treatments for Androgenetic Alopecia appeared first on HairLossTalk.

Minimizing injury to the donor area in follicular unit extraction (FUE) harvesting.

Author Information:

Zontos, Williams KL Jr, Nikiforidis.

What Does This Study Teach Us?

The process of harvesting donor follicles in FUE sometimes introduces fibrosis and discoloration after healing.  This study found that the injection of saline prior to harvesting improved the healing and minimized damaged to the tissue.

BACKGROUND:

Follicular Unit Extraction (FUE) is considered to be a minimally invasive procedure, and the injury to the donor area caused by a sharp punch may result in dermal fibrosis and clinically observed hypopigmentation.

OBJECTIVE:

To evaluate with advanced image processing the efficacy of using 0.9% normal saline in minimizing the injury to the donor area in FUE donor harvesting.

PATIENTS AND METHODS:

The term acute extraction (AE) is used to describe the donor harvesting technique, whereby a follicular unit (FU) is removed with a punch that is aligned parallel with the exit angle of the hair follicle. The term vertical extraction (VE) describes the technique where a FU is removed in like manner, but normal saline is injected intradermally prior to harvesting so the punch being perpendicular to the skin. Thirty-five patients were selected for this study to apply both harvesting techniques and then to compare the differences in wound surface size and skin mass removed by the punch.

RESULTS:

A significant reduction in the mean values of wound surface and skin mass was recorded in vertical extraction compared to those in acute extraction.

CONCLUSION:

The injection of normal saline prior to harvesting proved to be very efficient in minimizing skin injury in FUE harvesting.

The post Minimizing Donor Tissue Damage in FUE appeared first on HairLossTalk.

And not just Alopecia Areata.   Potentially also a treatment for Androgenetic Alopecia (hormone-related thinning hair seen in both men and women).  Aclaris Therapeutics has acquired the rights to a potential treatment for Alopecia Areata (AA) – and like the other treatments they’ve been working on, this one will be based on Janus Kinase (JAK) inhibitors.

The name of the newly acquired company might sound familiar. It’s Vixen Pharmaceuticals, the startup founded by Dr. Angela Christiano of Columbia University to develop her own JAK inhibitor treatment. This means Aclaris now has the intellectual property rights for a total of three potential JAK3 inhibitor treatments, potentially for both Alopecia Areata and Androgenic Alopecia (male and female pattern baldness).

Aclaris: Three New Hair loss Treatments?

As you might remember, back in November 2015, Aclaris acquired the rights to two other potential AA treatments based on JAK3 inhibitors – one that was being developed by JAKPharm LLC, and another under development at Key Organics.  According to our Hair Loss Treatments Pipeline page, those two potential treatments – known as ATI-50001 and ATI-50002 – are still in the pre-clinical trial stage; one as an oral treatment and one as topical. That was the last we’d heard about either of these treatments.

Aclaris hasn’t added the Vixen JAK3 inhibitor treatment to its pipeline page yet, but it’s likely they will soon. Dr. Christiano’s treatment is reportedly in the very early stages of pre-clinical trials, and no one’s spoken much about it, so we don’t know exactly what it involves.

There’s been some speculation, though. Dr. Christiano has spoken in the past about the potential use of a highly concentrated dose of JAK inhibitors, sent deep into the hair follicle, to trigger the process of hair growth cycling.  This may mean that the Vixen treatment now being developed at Aclaris will involve a super-concentrated dose of JAK3 inhibitors, and/or perhaps an application technique that gets them deeper into the follicle than before.

What are JAK3 inhibitors?

JAK inhibitors interfere with the activity of one or more of the Janus kinase family of enzymes (JAK1, JAK2, JAK3 or TYK2), which are involved in a chemical signaling pathway known as the the JAK-STAT pathway. One of the effects of the JAK-STAT pathway is to pull “Signal Transducer and Activator of Transcription” (STAT) proteins into hair follicles.

Under healthy conditions, STAT proteins would help protect hair follicles. But in people with Androgenic Alopecia, Alopecia Areata and related conditions, these proteins seem to trigger the immune system’s cytotoxic C lymphocyte cells to attack hair follicles themselves.

The idea of inhibiting the JAK-STAT signaling pathway to treat hair loss isn’t new. For years, researchers like Dr. Brett King have expressed optimism about the potential of JAK inhibitors to treat Alopecia Areata, as well as other disorders like Male Pattern Baldness (MPB).

JAK Inhibitors Effective for Alopecia Areata

But it was a team of researchers led by Dr. Angela M. Christiano at Columbia University who first demonstrated a conclusive link between the JAK-STAT pathway and Alopecia Areata. These researchers described the potential clinical efficacy of JAK inhibitors for Alopecia Areata patients in a 2014 Nature Medicine paper, followed by another paper on the specific mechanism by which JAK inhibition prevents cytotoxic T lymphocytes from attacking hair follicles.

In short, JAK3 inhibitors are well-researched, and there’s a lot of evidence to suggest that they may be able to prevent the body from attacking its own hair follicles. Look forward to some more definite results in the clinical trials that are sure to come soon.

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