Hair Restoration Blog

Q:

Comment or Question: is hair cloneing/multiplication currently available at your practice? please leave a voice mail

A:

Hair multiplication is not available at our hair transplant centers or any other hair restoration clinic for that matter because present-day technology has not yet been able to successfully multiply hair for the purpose of hair restoration.

But there have been numerous studies and publications on hair multiplication, also known as hair cloning. And there is one company, Intercytex, , which has been considered by many experts to be at the forefront of hair multiplication research.

Intercytex announced that their staff finished phase II of the study and started phase III (the stage in which scientists try their particular product and method on a large number of people and follow them for eight to 10 years and wait and see if there are significant long-term side effects and complications to take into account).

However, at the last annual meeting of the International Society of Hair Restoration Surgery (ISHRS), it was announced that Intercytex hadn’t even successfully completed phase II of the study, which means phase III hasn’t been started. We don’t know which specific obstacles impeded the progress of this work, but we are aware that it generally takes about eight years for phase III of most studies to be completed.

So, the research might get started in about eight years, maybe longer, after which we may find hair multiplication proven to be safe and effective.

People ask about hair multiplication, hair loss, stem cell hair regrowth, and hair cloning transplant all the time.  The last annual meeting of the International Society of Hair Restoration Surgery (ISHRS), where all authorities in medical hair restoration get together, did not have any good news for the people who are eagerly following the progress of hair multiplication research.  In fact, the newly disclosed information from Intercytex who is considered the leading group working on hair multiplication revealed that they never successfully finished phase II of their study on hair follicle multiplication.

This is contradicting with what they released previously regarding completion of phase II and the commencement of phase III.  This is considered a step back in the field of hair restoration and it means a longer waiting time for people who are impatiently waiting for hair multiplication to become a reality.

When any new treatment modality is being researched, scientists need to go through several phases to establish its effectiveness and safety.  Phase III of a study is when a few subjects (human) are being treated with the new modality on a longer period of time to assure the long term effect and safety of the new treatment.

The reason for the delay in completion of phase II of hair multiplication research was not fully disclosed.  However, knowing this fact leads us to believe that using multiplied hair won’t be possible at least in the next 8 years.  We at US Hair Restoration are collaborating with the academic center in some different stem cell hair research.  Our research is still in its early stages, but we will release our findings of this hair stem cell research as soon as they are available.

Yes, I am  back from Amsterdam.  I spent one week there and I was mostly involved with the meetings of the International Society of Hair Restoration Surgery.  The city of Amsterdam was beautiful and I still cannot believe in this day and age people still bike to work on a regular basis in a capital city in Europe.

As always of every year, we had a large number of hair transplant surgeons come from all over the world. My lecture this year was on a new application for the Laxometer and the title was Laxometer and Sequential Strip Removal for Increasing the Safety of Strip Removal in Mega-session Hair Transplants.  We will be placing a summary of the lecture in the hair loss library on our website US Hair Restoration soon.

The research results that was presented by the consultant of Intercytex for hair multiplication was disappointing and basically despite the fact that they announced they started Phase III of the study, this year they said they have not even finished the II yet.  They claimed financial problems to be the cause of that.  We will look closely as we were before to see what is going to be out in the horizon for hair multiplication or as it is often called “hair cloning”.

Several new automated techniques were also introduced for FUE harvesting but I was not impressed by any of those.  It seems like no one could come up with an ideal technique for the automated FUE that does not have significant problems.  We will continue with the manual methods for FUE hair transplant graft removal and placement at this time.

There were many nice discussions on new techniques in making sites, closing the donor wound and preparation of the hair transplant grafts.  The aesthetic aspects of hair restoration surgery was also discussed in many sessions and nice new concepts were introduced by several doctors.  Hairline design and temple points were again discussed and it seems that more doctors are realizing the importance of restoration on hair in the temple areas.  We at US Hair Restoration are very big in restoration of the temple points in the patients that need it and temple hairline is a necessary part of our hair restoration and hairline designs.

The comparison of the maintaining solutions is always part of the discussions.  This year there were a few nice comparative researches on densely packed hair and also the comparison of the grouping of the hair grafts in follicular unit form or isolate single hair groups.

Hair Restoration is one of the young fields of cosmetic surgery.  It has been revolutionized in the last 10 years with development of the idea of follicular unit transplantation and stereotactic microscopy that gave us the capability of producing such great results that are undetectable from the natural hair.  Presence of hair transplant doctors in scientific meetings of this kind help the hair transplant surgeon to be able to deliver the highest standard of hair transplant to his patient that can eventually guarantee both the doctor and the patient satisfaction.  I recommend the meeting of ISHRS to every doctor who performs hair transplant surgery as a big part of his practice.  In fact I do not understand how some doctors can afford not to be there while new findings are changing the face of hair restoration medicine on a regular basis.

Q:

I would like to ask Dr. Mohebi about hair stem cell research. If you can explain what it is, how long has it been in research, and in what phase it is at this moment? I’m 31and notice that I had AU, around the age of 29-30. At the time I was going through a lot of stress that made me feel like I’ve brought this on myself. I was taking treatment injections for my eyebrows to see if I can at least save my eye brows. Well, I got tired of the injections, and just left it in the hands of the Creator. Are there eyebrow and eyelash replacement that can be obtain and if so where? I just had a little girl and I really want to take some decent pictures with her and it bothers me at times that I can’t even do that, so I can relate to all who are going through the up’s an down’s and the fight within and without to BEAT-AU, and others. I guess only time will tell.

A:

Hair stem cell research is becoming very promising for treatment of many types of hair loss. Phase 3 of the study on hair multiplication was started about 3 years ago and it is still ongoing. The purpose of phase three study of any new treatment modality is to prove that there are no long term side effects on the volunteer patients who undergo any new treatment. Hair stem cell technology seems to be a real therapeutic option for many types of hair loss conditions for the next 5 to 10 years.

Having said that, some details about the process of hair multiplication is not quite clear yet. There is not much information released on the quality of multiplied hair and we are not quite aware about the final cost of the procedure. When it comes to AU (Alopecia Universalis) we cannot know for a fact that hair multiplication is the answer to this condition considering the mechanism of AU and the fact that the patient’s own immune system tends to destroy hair follicles.

It is likely that multiplied hair follicles have the same antigenic properties so they could be recognized by the immune system and destroyed the same way that the native hair was initially. A combination of some sort of anti-immune treatment and transplanting multiplied hair might be the answer, but we cannot know for sure before they are investigated thoroughly in the future.

Hair Growth with wound healing technique in animal models: Dr. Parsa Mohebi's research at Johns Hopkins Medical Institute

A new article was published in the most recent issue of the Journal of Internal Medicine Research (2009 Mar-Apr;37(2):583-6) “A very rare complication: new hair growth around healing wounds.”  This is aligned with Dr. Mohebi’s research on wound healing and gene therapy techniques on the growth of hair in animal models at Johns Hopkins Medical Institute.

The article discusses a finding on a patient who grew hair around a healing wound near Sun ZY, et al, from the department of plastic surgery, first affiliated hospital, Guangxi Medical University in Nanning, China.

The authors of this article discuss a case in which active hair growth occurred around a wound after the healing of a wound.  This is described as a rare phenomenon.  This phenomenon in humans has not previously been reported in their literature.  They proposed that after the epidermis and hair follicles have been damaged by wounding, it is possible for them to naturally heal and repair if provided with an appropriate chemical and physical micro-environment. They propose that their hypothesis may inspire new thinking in the management of hair loss, tissue engineering and the regeneration of other organs.

I did research on hair growth as an effect of wound healing when I was performing research in the wound healing laboratory of Johns Hopkins Medical Institute.  After observing the healing of a wound, some of our gene therapy techniques could stimulate the growth of hair in mice. I focused on hair growth itself and our study was confirmed with multiple studies of that kind from 2005-2006.  Dr. Cotsarelis at the University of Pennsylvania and his colleagues were the first group to publish the effect of wound healing on hair growth through activation of molecular pathway WNT.

The reports on this type are emphasizing that hair restoration through tissue engineering, hair multiplication and gene therapy might be a reality in the future and maybe even sooner than what we thought before.

Parsa Mohebi, MD
Medical Director
US Hair Restoration

“Formation of Hair Structures Suitable for Implantation” is the title of a newly published article from Intercytex. Hair multiplication, also known as hair cloning, has been discussed in our Hair Restoration Blog in many of our past posts and has been the subject of many studies in the past. Intercytex is one of the companies that have been reporting some progress in different levels of the study and have reported that they have finished phase II and are starting phase III of this study.

Their studies have shown that hair multiplication by hair culturing has been successful in animals and it is now being studied on humans. The following article tries to elucidate the process of hair multiplication on laboratory animals that have already been released.

The aim of the study was “to develop a construct through which implanted follicular cells will efficiently cause hair regeneration for the treatment of androgenetic alopecia.” They used follicular dermal and epidermal cells isolated from embryonic mouse skin which were formed into aggregates.

The aggregates were incubated in lab in culture for five to seven days and then implanted inside the skin into athymic mice, which does not have the capability of rejecting foreign tissue. They observed that during culturing, mixed cell aggregates developed into hair-like structures, termed “proto-hairs.” Proto-hairs contained structures that resembled normal hair components, such as dermal papillae, hair matrix and rudimentary hair shafts.

When implanted into mouse skin, they developed further into mature hair follicles capable of prolonged growth. The authors concluded that mixed aggregates of murine follicular cells have the ability to develop while in culture into proto-hairs that retain the ability to fully develop into hair follicles after implantation.

Proto-hairs from human hair stem cells could provide a convenient and practical means by which follicular cells could be implanted for efficient hair regeneration to treat hair loss. Although the study does not add to what we knew before, it elucidates the process of work for the other scientists who follow on the progress of hair multiplication (cloning) research.

We at US Hair Restoration California offices follow the progress of hair multiplication studies closely.  We are also involved in some hair multiplication studies and the results will be released when completed.

Q:

I have had alopecia areata since I was 3 years of age and now I’m 33. I have done as much research as I can to find the causes of this hair loss and there has not been any accurate information of the cause. But my question would be if you are cloning the hair and a patient has alopecia how successful will the procedure be if the hair growth from the patient is unhealthy in the first place?

This procedure is a billion to trillion dollar industry but the research has to be done extensively due to unknown side effects. Please keep posting more information as you go forward. There are many people waiting impatiently.

A:

Alopecia areata is one of those conditions that hair transplant, either from regular methods or through cloning, cannot help much. We have discussed the treatment options for alopecia areata on our website.  Alopecia areata is an autoimmune condition in which the immune system reacts against the hair follicles and destroys them.

If we were to transplant hair to an area with active hair loss due to alopecia areata, the chance of you losing the transplanted hair is very high due to the same mechanism in which native hair has been lost. We do not have much information on cloned hair, but the same phenomenon is likely to happen after transplanting cloned or multiplied hair.

I am in the Detroit airport on my way back to Los Angeles from the 16^th annual meeting of international society of hair restoration surgery (ISHRS) that was held in the beautiful city of Montreal in Canada last week. This five day meeting was filled with a variety of presentation on the clinical and basic science aspects of hair transplant surgery and medical hair restoration.

I gave a lecture on psycho-social impacts of hair restoration on men on the first day of the meeting. The lecture has been prepared based on my other article on Psychology of Hair Transplant that was previously presented and published on the Hair Transplant Forum International on April, 2008. In the current presentation on psycho social impacts of hair transplantation, I explored some other social and psychological aspect that hair transplant patients experience after their hair restoration procedures based on experience we had with our Los Angeles hair transplant patients and what we found in our research last year with New Hair Institute (NHI).

Several other interesting studies were presented on the aesthetic planning and designing of the hair line and frame of the face with hair transplantation. There were many articles on the hair transplant surgery techniques that could be used for optimization of the final appearance of a hair transplant.

Few articles were presented on hair stem cell research and hair multiplication. However based on the presented evidences, there were no signs of an upcoming solution for hair multiplication or hair cloning any time soon.

One article discussed an innovative method of hair graft harvesting that can produce more hair from an existing follicular unit. The result of this study, although interesting was very controversial among the experts and the author could not release the study details on the methodology to elucidate this matter.

I will publish the highlights of this meeting on the website of US Hair Restoration soon.

Intercytex has recently released some information on its hair multiplication experiments in a new article in the Journal of experimental dermatology. The title is “A graft model for hair development” and the article discusses what is done so far for hair multiplication experimentally. Intercytex has been involved with hair stem cell, hair culturing and hair multiplication, which is also known as hair cloning.

In this article follicular cell implantation (FCI) is discussed as an experimental cell therapy for the treatment of hair loss that uses cultured hair follicle cells to induce new hair formation. The process of culturing hair cells is based on the demonstration that adult dermal papilla cells (DPC) retain the hair inductive potential that they acquired during hair morphogenesis before birth. To obtain FCI, the investigators isolated hair inductive cells from scalp biopsies and then propagated them in culture media in order to provide adequate cells to generate several new follicles from a few hair follicles.

Following expansion of cells in culture, they implanted those cells into the scalp where they induce the formation of new follicles below the level of skin. They describe a consistent, reliable method in which they can test hair induction. Since the process relies on the ability to retain the potential for hair induction during the expansion of DPC in culture.

They go over a simple graft model that supports hair morphogenesis. In this experiment, they combine dermal cells with embryonic mouse epidermis that provides the keratinocyte (one of the skin cells) component of induced follicles. The grafts are placed under a protective skin flap in the host athymic mouse (a special mouse without capability to reject the transplanted grafts from human) where the cells will form a skin graft with hair if the dermal cells are hair inductive DPC.

Using the assay freshly isolated and cultured mouse embryo dermal cells as well as cultured dermal papilla cells from other species all induced hair formation. They also showed that induced hairs were aesthetically indistinguishable from those of the epidermal donor in length, thickness, and pigmentation. The investigators stated that the newly formed hairs were histologically normal and could resemble a complete natural hair.

We at Los Angeles hair transplant surgery centers of US Hair Restoration will closely follow up with the progress of hair multiplication and cloning techniques. Although the result of the cultured hair on animals has been released before, the current released article is interesting and elucidates more on the characteristics of cultured hair during the process of hair multiplication so called hair cloning. It seems like we still have a long way to go till we can practically use hair multiplication techniques in restoring human hair.

Recently published in the Journal of Medical Hypotheses was an interesting article on the treatment of alopecia by transplantation of hair follicle stem cells and dermal papilla cells (the cells of the bottom of hair follicles) in alginate gels (media used for cell transplantation).

A group of scientists at regeneration lab of tissue engineering, Department of Bioscience of life science in Northwest University of China authored this article. They proposed a system to use the two important hair stem cells to form mature hair in people with hair loss. They explain that the discovery of hair follicle stem cells (FSC) brings gospel to the affected individual of hair loss because of its capacity of generating new hair when they interact with mesenchymal dermal papilla cells (DPC).

The above two cells are known as the necessary cells for formation of new hair. Since both FSC and DPC have strong proliferative capacity and the patient’s own cells could be expanded considerably in vitro, they hypothesize that the microencapsulation of the two kinds of cells in alginate gels could be implanted into the bald scalp of the patient since alginate gels is effective in cell transplantation. They concluded that the strategy may provide a more convenient and valid alternative to hair loss if the hypothesis proved to be practical.

Here at Los Angeles hair transplant office of US Hair Restoration, we follow the most recent findings on the field hair hair stem cell research or hair multiplication also known as hair cloning. The above theory sounds logical and seems to be simple. However, until it is experimented in the lab and then on life creatures we cannot know how practical it may be. It seems like the race to use hair stem cell for the treatment of men hair loss is started.