Hair restoration theory and practice continue to progress at an impressive rate.
Nonetheless, the past 40 years have emphasized actual transplantation: the removal of follicles from a donor scalp area and their placement into a recipient scalp area.
This is beginning to change thanks to new advances in stem cell treatments. Such treatments are improving the rate of hair growth and overall follicular health. A new method and technique, researched in Italy with Dr. Cole’s input, is particularly showing great promise: Follicular Stem Cell Suspensions.
Background: Current Stem Cell Options and Benefits
Stem cell treatments are becoming far more prevalent.
Perhaps the greatest example is platelet-rich plasma (PRP), a serum derived from the patient’s own blood. This concentrated serum, rich in stem cell growth factors and cytokines, stimulates impressive hair growth.
However, maintaining such growth and hair health requires regular injections.
The addition of ReyaGel, an extracellular matrix, extends the effects of PRP for much longer. Injections of PRP + ReyaGel need only happen bi-annually or annually to maintain the effect.
Hair growth and greater hair diameter, however, are not the same as follicular regeneration. The origins of such can be found in minimally invasive FUE, follicular unit extraction, and the addition of ReyaGel.
Minimum Invasiveness and Stem Cell Remnants
The 2000s saw the growing spread of FUE, a method far superior to its predecessor, follicular unit transplants (FUT).
Already offering fewer scars and more convincing hairlines than FUT, FUE hair restoration continues evolving thanks to innovations and techniques.
Minimum depth invasion, for instance, leads to significantly less scarring while leaving stem cell remnants in donor areas.
The addition of ReyaGel, an extracellular matrix, spurs these stem cell remnants in donor areas to regenerate follicles by 30% to 40%.
1000 single extractions using the method, for instance, typically yields 1,300 to 1,400 follicles.
Stem cell remnants repairing and reactivating in donor regions is marvelous, but it also underscores the potential of transfusing literal stem cells, not growth factors of such, into balding areas: hence the excitement around stem cell infusions.
Types of Stem Cells Used in Hair Restoration
Not all stem cells are the same. Different sources offer unique advantages for hair restoration, and understanding these options helps patients make informed decisions.
Adipose-Derived Stem Cells (ADSCs)
Adipose-derived stem cells come from fat tissue, typically harvested through a minimally invasive liposuction procedure from the abdomen or thigh.
These cells are a type of mesenchymal stem cell (MSC) known for their ability to differentiate into various cell types essential for follicular regeneration.
ADSCs secrete growth factors that stimulate angiogenesis (new blood vessel formation) and dermal papilla cell activation, both critical for hair growth.
Research shows adipose tissue contains 100 to 300 times more stem cells than bone marrow, making it an abundant and accessible source.
Hair Follicle-Derived Stem Cells (HFSCs)
Hair follicle stem cells are harvested directly from the bulge region of hair follicles, which is rich in multipotent stem cells.
These cells closely mimic the native environment of hair follicles, making them uniquely suited for regenerating or strengthening existing follicles.
Because they come from the same tissue type they’re meant to repair, HFSCs may offer advantages in compatibility and effectiveness.
Bone Marrow-Derived Stem Cells (BMSCs)
Extracted through bone marrow aspiration from the hip, BMSCs offer potent regenerative properties.
However, this method is more invasive than adipose harvesting and yields fewer cells.
Studies comparing bone marrow and adipose sources have found similar effectiveness, though adipose extraction is generally preferred due to its ease and higher cell counts.
Stem Cell Infusions: A Promising Treatment
Italian researchers, headed by Pietro Gentile, and with Dr. Cole’s input, have made great headway in finding a way to reactivate follicular activity without a single transplant.
The procedure, as is, offers impressive results.
11 patients, all without any other treatment or procedure active, enjoyed hair thickness of 34% to 24% and some follicular regeneration, within 23 weeks of transfusion.
The Procedure
The procedure started with a punch biopsy to extract stem cells from the patient.
Researchers then sliced the punches into 2mm by 2mm strips. Adipose tissue is then cut away, and stem cell containing areas undergo disaggregation, the separation of the stem cells and tissue, through centrifugation, a process to separate two different materials, at 80 rpm.
This creates a cell suspension containing human follicle stem cells that number between 4,300 and 3,100 stem cells according to cytospin and immunocytochemistry.
Of these stem cells, 5.7% to 4.3% were CD44+ cells, while 2.9% to 2.3% were CD200+ cells. Both are essential to hair growth.
A section of patients’ balding areas were then injected with the cell suspension and, subsequently, injected again 60 days later.
A different balding section was injected with a saline placebo for contrast.
What the Latest Research Shows
The field of stem cell hair restoration is advancing rapidly. A 2024 meta-analysis of 8 studies involving 221 patients treated with stem cell-derived conditioned medium showed a mean increase in hair density of 14.93 hairs/cm² and an increase in hair thickness of 18.67 micrometers compared to untreated areas.
Currently, there are over 4,700 National Institutes of Health (NIH) sponsored clinical trials underway exploring stem cell applications, including pathways relevant to hair restoration.
Research at UCLA identified drugs that activate dormant hair follicle stem cells by increasing lactate production, which drives follicular activation and hair growth. At the University of Virginia, researchers discovered a previously overlooked stem cell population in the upper and middle sections of the hair follicle. When these cells are depleted, hair growth stops, suggesting that replenishing or activating them could restore growth.
The Future of Stem Cell Infusions
Stem cell infusions are an exciting new procedure that will likely grow in popularity.
There is very little precedent for this exciting new procedure.
There is a very feasible chance that cell suspensions, with further research, will contain more and more beneficial stem cells. This, in turn, will generate more growth, greater hair diameter, and a better chance of follicular regeneration.
Where Stem Cells Are Most Active
The trick may be location rather than mass.
There is growing evidence that stem cells are most prevalent at the bulge.
Harvesting at the right stage of hair growth may also be important: especially the early anagen phase when the hair bulge is most active.
At ForHair we will continue to research this exciting new development and may soon begin offering this exciting new treatment.
Visit our Stem Cell Treatments page to learn more about this developing science.
Limitations and What Patients Should Know
While results are promising, patients should understand current limitations.
Stem cell treatments for hair loss are not yet FDA approved. The FDA has issued consumer alerts about clinics making unfounded claims regarding stem cell treatments.
Study protocols vary widely. There is no standardized preparation method, optimal cell quantity, or established treatment interval.
Most positive results have been observed in patients with early-stage hair loss. Advanced baldness may require combination therapies including transplantation, PRP, microneedling, or laser treatment.
Results are not guaranteed, and multiple treatments may be necessary to maintain effects.
Frequently Asked Questions
What are stem cell treatments for hair restoration?
Stem cell treatments use the body’s own regenerative cells to stimulate hair follicle activity and growth. These include PRP (platelet-rich plasma), stem cell infusions, and combinations with extracellular matrices like ACell. The goal is to reactivate dormant follicles and promote thicker, healthier hair without surgical transplantation.
How is this different from a hair transplant?
Hair transplants physically move follicles from donor areas to balding areas. Stem cell treatments aim to reactivate dormant follicles and stimulate new growth without surgical extraction and placement of grafts. Many patients use both approaches together for optimal results.
Where do the stem cells come from?
Stem cells can be harvested from your own adipose (fat) tissue, bone marrow, or hair follicles. Adipose tissue is most commonly used because it’s minimally invasive to collect and contains high concentrations of mesenchymal stem cells.
Is stem cell hair restoration FDA approved?
No. As of 2024, stem cell treatments for hair loss are considered investigational and have not received FDA approval. While PRP is widely used, stem cell infusions are still in clinical study phases. Patients should be cautious of clinics making exaggerated claims.
How long do results last?
Results vary by individual and treatment type. Some patients see sustained improvement for 12 to 18 months, while others may need periodic maintenance treatments. Combining stem cell therapy with other treatments like PRP or ACell may extend results.
Medical Disclaimer
This information is for educational purposes only and does not constitute medical advice. Stem cell treatments for hair restoration are evolving rapidly, and results vary by individual. These treatments are not FDA approved and are considered investigational. Consult with a qualified hair restoration specialist to determine if these treatments are appropriate for your situation.
References
- Anudeep TC, Jeyaraman M, Muthu S, et al. Human Stem Cell Use in Androgenetic Alopecia: A Systematic Review. Cell Transplantation. 2023;32:9636897231151528.
- Gentile P, Scioli MG, Bielli A, Orlandi A, Cervelli V. Stem cells from human hair follicles: first mechanical isolation for immediate autologous clinical use in androgenetic alopecia and hair loss. Stem Cell Investigation. 2017;4:58.
- Chien WY, Huang HM, Kang YN, Chen KH, Chen C. Stem cell-derived conditioned medium for alopecia: A systematic review and meta-analysis. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2024 Jan;88:182-192. doi: 10.1016/j.bjps.2023.10.060.
- Owczarczyk-Saczonek A, Krajewska-Włodarczyk M, Kruszewska A, et al. Therapeutic Potential of Stem Cells in Follicle Regeneration. Stem Cells International. 2018;2018:1049641.
- Talebzadeh AT, Talebzadeh N. Stem Cell Applications in Human Hair Growth: A Literature Review. Cureus. 2023;15(4):e37439.
- Egger A, Tober M, Getz A, Engelman D, Tosti A. Advances in Stem Cell-Based Therapy for Hair Loss. CellR4. 2020;8:e2894.
