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New Frontiers in Hair Restoration

Posted on September 19, 2019

There are few problems more embarrassing than hair loss. It can damage appearance, undermine confidence, and generate social anxiety that can interfere with relationships. But there is a new reason for hope. “In the last 5 to 7 years, there has been a boom in the understanding of hair loss,” according to Dr. George Cotsarelis, director of the Hair and Scalp Clinic at the University of Pennsylvania in Philadelphia. While the treatments aren’t quite ready for the market, they are well on their way. 

Anatomy of the Follicle

Hair follicles are spread out all over the surface of the skin, except for the lips, palms of hands, and soles of feet. At the base of each follicle is a bulb, in which matrix cells become hair. Further up the follicle is a bulge filled with stem cells that allow the follicle to regenerate.

Stages of Hair Growth

Anagen: An unknown signal activates the stem cells, while a message from the dermal papilla, the permanent part of the follicle, tells the matrix to begin production of hair. Hair cells occupy this stage about 90% of the time.

Exogen: The new hair shaft pushes out the old, dead one, and the hair falls out.

Anagen Ends: The new hair extends past the surface of the skin and grows further. The hair is now fully mature.

Catagen: The lower 2/3 of the follicle shrivels and is destroyed, while the dermal papilla remains attached. 

Telogen: The withered follicle lies dormant, waiting for a signal to initiate the cycle again. 

Losing hair is a natural part of a repeating cycle. But sometimes the cycle doesn’t repeat as it should. 

Androgenic Alopecia

Most men experience receding hairlines, and most women will experience thinning hair. In the case of male pattern baldness, also called androgenic alopecia, the cause is a byproduct of testosterone called DHT. This chemical leads the hormone-sensitive follicles on the front and sides of the head to stay dormant longer. The telogen phase lengthens and the anagen phase shortens. 

Telogen Effluvium

Telogen Effluvium is a fancy way of saying “shedding.” It may be induced by chemotherapy, or by an immune system overreaction called alopecia areata. The good news is that this type of hair loss is usually temporary. 

Today’s Treatments

Minoxidil: This is the most commonly prescribed hair loss treatment today. It slows hair loss and promotes growth to some extent, though it’s unclear how much growth it can generate or how it even works. 

Propecia: A hair-loss treatment for men, it works by blocking testosterone from producing DHT. It may cause a temporary loss of sex drive.

Spironolactone: Spironolactone is a type of medication used to manage female pattern hair loss caused by androgenic alopecia. The medication works by slowing the production of androgens, the male sex hormones responsible for hair loss.

Surgery: Hair follicles can be transplanted from the back of the head to the sides and front. Since this method became available in the late 1980s, more closely arranged transplants have given the hair a more natural look.

PRP Therapy: PRP (platelet-rich plasma) therapy involves taking the patient’s own blood cells and placing them into the scalp where hair loss is present. The growth factors in PRP help to restore the hair follicle, resulting in fuller hair without the need for surgery.

The drugs can be combined with each other and with surgery for maximum effect. Scalp reduction and transplant have largely gone out of vogue. 

Tomorrow’s Treatments

A breakthrough has been made in a number of labs throughout the world, including the Hair and Scalp Clinic mentioned previously. Follicle stem cells have been stimulated to grow in the test tube. This means that the ultimate goal of stimulating dormant follicles may be available on the market in as little as 10 years! 

Learn More

For all men and women who experience hair loss, it is very important to be seen by a board certified dermatologist for an accurate diagnosis and to exclude scarring forms of hair loss. Contact CDAM at 312-767-5113 for more information. We’ll help you set up a consultation to determine which hair loss treatments may be right for you.