Is this the hair loss breakthough that we’ve been waiting for?
The arrival of less invasive techniques could mean a cure for baldness is finally in sight, says
Are we witnessing a new dawn for hair-loss treatments? Amid increasing evidence that baldness can have a severe impact on the mental health of both men and women, scientists are pushing forward with a raft of new hair loss techniques.
There has been a sudden spike in demand over the past year, says Coen Gho, founder of the Hair Science Institute, one of the world’s leading hair transplantation clinics with a centre in London, and multiple locations around the globe.
“With all the lockdowns, some people have saved a lot of money, and so they’re now spending it on the most valuable asset they have – themselves,” says Gho. “People are really investing in their looks. I would say the current demand is three or four times higher than before Covid.”
Gho says that younger people, in their 20s and 30s, are more conscious about their appearance than ever before, partly, he thinks, because of the trend towards getting married and settling down much later than in previous decades.
“Every single week, I get these very sad emails from people all around the world, looking to get on one of our clinical trials,” says Diana Harbort, CEO of Cassiopea, a Us-based pharmaceutical company, looking to develop novel treatments for hair loss. “I think that’s just a testament to the high levels of unmet need.”
But this surge in demand for hair-loss treatments is also helping to foster new ideas. Gho has pioneered a technique called partial longitudinal follicular unit extraction.
Most transplants remove entire hair follicles from “donor areas” at the back and sides of the scalp, and relocate them to bald patches, but the main downside is that this incurs a risk of scarring, as well as leaving the donor areas relatively sparse.
The success rate from one transplant to another can also vary substantially. One study found that anywhere from 10 to 80 per cent of the transplanted hairs will grow back over the course of three to four months.
Gho’s method attempts to avoid the issues of scarring and thinning in the donor area by only using part of the follicle. It works by stimulating the
stem cells within that small piece of tissue to generate new hairs. At the moment, this yields two hairs from a single fragment of a follicle, but he is now developing a separate technique that could potentially generate 10 hairs.
This could make transplants much more viable for women who suffer from female pattern baldness because they require a certain degree of density to achieve natural hairstyles. According to NHS statistics, an estimated 8 million women in the UK experience a form of hair loss.
“Right now, a typical treatment involves taking grafts from 1400 hair follicles, which means 3000 new hairs,” says Gho. “Can you imagine what we can achieve if we could use those same grafts to generate 10,000 hairs? This is very important as right now, the big hurdle in hair transplants for women is creating sufficient density.”
Gho has just gained approval to test the technique on female patients. If all goes well, he hopes that it may be possible to offer this as a treatment in the next four to five years.
However, Gho’s is not the only new technique; scientists around the world are attempting to move hair-loss treatments to the next level. Earlier this year, researchers at the Riken research institute in Japan found a way to increase human hair follicle stem cells by 100-fold in the lab, a breakthrough that was published in the journal
In the future, this could enable scientists to extract hair from donor areas of the scalp, and use that to grow an entire new head of hair in a dish, which would then be transplanted back to the patient. This would potentially allow surgeons to perform far more extensive transplants than those Gho and other hair-loss specialists are currently able to perform, and to treat patients who are almost completely bald.
“The potential to take 100 hair follicles and amplify them to generate 10,000 hair follicles with our technology would mean that even patients with extensive alopecia would never have pattern baldness again,” says Takashi Tsuji, leader of the project.
However, the technique is not yet ready for the clinic, as it has so far only been performed in a petri dish, and in mice. Tsuji now plans to perform the treatment in clinical trials, which will be a complex and costly process likely to require 500 million yen (approximately £3.2 million) in funding. He has turned to crowdfunding in an attempt to raise money from the public, as well as appealing to investors and start-ups around the world.
“As soon as we can get the funding, a clinical study could be started within a few months, and a pay-to-participate clinical programme could begin within two years in Japan.”
But hair transplants still hold some disadvantages. Ke Cheng, a professor of regenerative medicine at North Carolina State University, points out that the procedures are invasive, and can involve an element of discomfort, while not all the transplanted hairs are guaranteed to survive.
“There are a few drawbacks,” he says. “It’s a tedious process because you’re literally digging out those follicles and redistributing them one by one. And even if you transfer those follicles from the back of your head to your scalp, not all of them will remain.”
An alternative to hair transplantation that has gained traction in recent years is platelet-rich plasma (PRP) therapy, a three-step treatment process in which the patient’s blood is drawn so that platelet concentrations can be extracted and then re-injected into the scalp.
A number of studies have found that PRP can reduce hair loss, as well as increasing both the diameter and density of hairs. However, this is not a cure and maintenance injections tend to be recommended every three to six months, which can make it an expensive long-term solution. Side effects, ranging from headache to scalp tenderness, have also been reported.
Instead, Cheng is investigating another potential injectable therapy using exosomes; tiny, fluid-filled sacs that are secreted by all cells, including those in hair.
Cheng’s idea is to take exosomes from cells in healthy hair follicles, which contain this microrna, and inject them into affected regions of the scalp. “Once those exosomes are injected, they’re sending messages to
One day scientists may be able to grow an entire head of hair in a petri dish
the hibernating cells to actually promote the hair regrowth.”
So far, Cheng has tested this approach in mice and found that it can achieve a six to seven-fold increase in hair growth compared with traditional hair-loss drugs such as minoxidil. He is now conducting experiments to determine whether the same results can be achieved in human hair cells in the lab.
“We’re cautiously optimistic that we can bring this to the clinic in the next five years,” he says. “If the lab experiments work, we will probably collaborate with one of the dermatology of cosmetic medicine schools to run a clinical trial.
“We’re also actively speaking to a few venture capital firms who are interested in this technology and believe it may have a good future.”