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.
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, 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 ACell, an excellular matrix, extends the effects of PRP for much longer. Injections of PRP + ACell need only happen bi-annually or annually to maintain the effect.
Hair growth and greater hair diameter, however, is not the same as follicular regeneration. The origins of such can be found in minimally invasive FUE, follicular unit extraction, and the addition of ACell.
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 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 ACell, 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.
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 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.
Stem cell infusions are an exciting new procedure that will likely grow in popularity. There is a 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.
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