A REAL HEAD-SCRATCHER
Fixes for baldness may be on the horizon, but it’s a costly and complex conundrum
Why do we care so much about hair? If we’re not trying to wax it, pluck it, shave it, dye it or otherwise forcibly remove it, we’re popping pills, paying for surgery or desperately trying to put it back on. Anything rather than admit that it’s gone. Baldness has an insidious power.
“It has a massive psychological effect,” says Mike Marsh (not his real name). He’s not someone who generally crumbles at the first challenge and served for almost two decades in an elite branch of the armed forces. “Some of the guys (in my unit) were fine with it, they would just shave their heads. But I felt very self-conscious. It has that emotional effect. People like me, we will do anything.”
That includes freezing follicles in hair banks, much like some women might choose to preserve their eggs. The Manchester-based biotechnology firm HairClone has just been approved by the Human Tissue Authority to store follicular units (FU). The idea is that 50 to 100 FUs will be taken from patients and used to clone dermal papilla cells (DPCs) found in abundance in the roots of healthy, thick hair. It is an experimental treatment, which will ultimately involve making the clones into a solution and injecting that into the scalp, repopulating the roots of thinning hair follicles.
There is no guarantee it will work. Even if it does, Dr. Bessam Farjo, HairClone’s medical director, concedes that it will require repeating every few years to top up DPCs.
The global hair loss market is currently worth about $4 billion, with sufferers like Marsh willing to pay many thousands for the prospect of a renewed, lush mop. According to estimates from the International Society of Hair Restoration Surgery, there were more than 600,000 surgical hair restoration procedures performed worldwide in 2016 — almost triple the figure of a decade before.
Such lack of progress seems incredible. We live in an age in which organs are routinely implanted. A paralyzed Polish man recovered movement after his severed spine was patched up with cells from his nose.
And we can’t cure baldness? Very difficult, it turns out.
“Hair is far, far more complicated than it appears,” says Farjo. “Every week, someone publishes another research paper that describes a compound or chemical that is supposed to play a role in hair growth and loss.”
From stress and genes to hormones and inflammatory conditions, the causes are many and interwoven.
“Hair is a whole system within the body,” says Farjo. “It’s very complicated.”
So while the money and the motivation has long been there, much of the hair replacement industry has remained more or less the same for 70 years, since surgical transplants were first offered in the ’50s.
Techniques back then were unpalatable and are a testament to the desperation of patients. Surgeons used 4-5mm borers to extract FUs from the back and side of the head to reimplant on top. To allow the skin to heal, the tiny discs of hair couldn’t be placed too close together, so a colander effect was produced. Two or three repeat visits were required to fill in the grid. And even then, it hardly had the feathery feel of the original follicles.
“Esthetically, it didn’t look good,” says Farjo.
More recently, surgeons started removing strips of scalp to harvest FUs. The average human has 100,000 such units, and the most such procedures could transplant without leaving livid scars was 4,000. Even with several operations, the results were never perfect.
Now there is follicle freezing. Yet Farjo admits that technologically sexy as it sounds, freezing can only hope to rejuvenate existing, if thinning, hair.
“We’re not close to growing hair from scratch,” he laments. “We don’t have the full answer about the interaction between hormones and enzymes and proteins to create hair, and even if we do, mechanically it can be hard to deposit in the tiny space and keep it there. We’re years away. It’s like nature has a protection to stop us curing baldness.”
Not everyone is so downcast. In the U.S., the Stemson Therapeutics company is trying to clone not just dermal papilla but also hair follicles. Implanting such follicles is hard, as hair risks sprouting in all directions. Stemson hopes to overcome this by using a “scaffold” for cloned follicles.
And in December, another researcher, Angela Christiano, a professor of genetics and dermatology at Columbia University, described using 3D printed follicle moulds. These were implanted in mice, which proceeded to sprout human hair.
She imagines hair farms, in which cloned DPCs “seed” thousands of 3D-printed moulds, with the follicles created implanted into the scalp.
Finally, we might all have access to an infinite supply of thick youthful hair, cloned from our own cells. “(Use of) this new technology by hair researchers, hair restoration surgeons and the pharmaceutical and cosmetic industries will have overwhelming implications in the maintenance and regeneration of this complex human tissue,” Christiano wrote in Nature magazine.
To Marsh that sounds like a dream. He is all for being “baldness positive.” He has long tried to reconcile himself to losing his hair. But he just can’t.
He knows that failing to do so has exposed him to charlatans.
“There is a lot of smoke and mirrors out there,” he says. “People get exploited. But I started losing my hair aged 25. Now I’m 39. And I know now that it is a mental health thing. It’s linked to that.”
London Daily Telegraph
It has a massive psychological effect ... I felt very self-conscious. It has that emotional effect. People like me, we will do anything.