Hair Restoration Blog

Q:

Thanks for the serious information.

I hope they find the hair cloning or something that generates hair follicles in a near future. My question is if this cloned hair would fall or if it is going to be like the donor hair that doesn´´t fall because of it imunnity to dht. I would aprecciatte your answer.

A:

This is a great question and unfortunately we still don’t have a clear answer to it. The problem is most research projects on this topic have been limited in terms of numbers and long term follow up. Intercytex is a biotechnology company that probably has the most promising project on hair multiplication at this point. They have done some studies and finished phase I of a hair multiplication study. Unfortunately the details of their research have not been announced quite clearly. However they announced that they will release some more information in September of 2008. Let’s wait and hope that they clarify some of those issues and answer the questions like yours on the quality and durability of multiplied hair.

Best,

Dr. Mohebi

Autologous Hair Regeneration - ICX-TRC (Intercytex)

ICX-TRC is an autologous hair regeneration system. ICX-TRC project is an ongoing research program that uses a suspension of human dermal papilla cells (one of the stem cells of the hair follicle which is involved in the growth and cycling of hair follicles. The system is claimed to be used for the treatment of male and female patterned baldness. The intention of ICX-TRC is to provide a technique to restore hair in patients who do not have adequate supply of donor hair on scalp for the hair transplant process and maybe for everyone with baldness.

Both types of patterned hair loss have significant genetic influence. It was claimed that with the ICX-TRC procedure, the process of hair restoration would be less problematic than conventional hair transplants. The proposed idea is to remove a few normal hair follicles from the donor area and harvest their active cells called dermal papilla (DP). These active cells are cultured and multiplied by different techniques and eventually the multiplied cells from this culturing process could be used to produce multiple hair follicles. The goal is to grow the hair follicles that are produced with this method while keeping the original characteristics of donor hair.

The cultured cells are supposed to be injected to the bald areas of skin. Interaction between the DP cells and normal epithelial cells in the skin can potentially generate new hair follicles under a certain circumstances. The process of culturing the DP cells and getting the new cells may last around three weeks.

Intra-dermal injections of new DP cells in the scalp could be done under local anesthesia with the current techniques of hair transplantation. It is claimed that some sort of hair growth could be seen after 3 months. However the condition and characteristics of the new hairs have not completely elucidated.

ICX-TRC clinical trial

Every new medication or medical technique needs to be examined closely through a systematic process for evaluating its effectiveness and safety. Intercytex has announced that they have finished their phase I (for safety and tolerability of the system) on volunteer patients and it has been successful. It means that the procedures did not have a serious or lethal side effects, at least in short term.

They also announced that they started phase II in Manchester to optimize the delivery of the DP cells and to refine their techniques, which is completed as well. They have obtained hair and measured the growth by shaving and taking photos of the transplanted area with cultured DP cells. On the phase II of the study they used 19 volunteer. They describe few different techniques that were used including pre-stimulation of the skin before injection of the cultured cells. Unfortunately, there is not much information available on the technique and methodology of the studies.

Here is what is stated in Intercytex web site for the result of the phase 2 of this experiment:

• Eleven subjects have now passed the 24-week time point since treatment and specialized image analysis at this time point showed
• Of the group of six patients without stimulation of the scalp, three had an increased hair count and two had a reduced hair count; one has been lost to follow-up
• Of the five subjects with pre-treatment scalp stimulation, all had increased hair count at 12 weeks and the three who were evaluable at 24 weeks all had an increased hair count at that time point

They are still looking for the 24 week data on all subjects in September 2008. At that time if it is all promising we should expect to see the phase III started on a larger group of patients who try this treatment for a longer period of time (years) to rule out any long term complications.

Intercytex is also claimed that they are working on an automated device that can facilitate the injections of cultured grafts, which could be used for the transplantation of cultured hair cells.

Conclusions:

1. The progress of Intercytex research and the released results are not quite clear yet
2. The safety of this system has not yet evaluated for long term potential side effects of cultured human cells such as increased risk of cancer or other dermatologic or systemic abnormalities
3. If proven safe and effective after completion of the phase III, we should have an estimate of the cost for this procedure. It is unclear whether or not this is going to be affordable and something that could be used for everyone or it should be reserved for patients with special needs.

We will follow the progress of ICX-TRC project along with other similar projects on hair stem cell and hair multiplication studies and keep our readers posted.

Q:

Is Hair cloning or multiplication being done anywhere yet?

A:

Hair cloning or multiplication has been in the news in the last few years. I prefer to use tem “hair multiplication” rather than cloning because cloning refers to production of genetically identical organisms. Dolly the most celebrated sheep was the product of first cloning. When it comes to hair, we do not really clone the cells, but we culture them and try to get a whole organism from cultured cells. Unfortunately the process of culturing hair follicle cells has not been as simple as some other tissues in human body. The complexity of hair physiology is due to participation of many different stem cells in development of each hair follicle. In this process, we do not multiply genetic material or DNA of cells.

Hair cloning news

Hair multiplication if become a reality could bring about a great opportunity for bald people with violated donor scalp who cannot be good candidates for hair transplantation with current techniques. Despite our enthusiasm about hair multiplication, hair cloning news in last few years has not been filled with many success stories.

Hair cloning 2007

Year 2006 intercytex company announced that they are going to start phase 3 of hair multiplication study soon. Hair cloning has been in the news and many people are eagerly following that news to see when and how they can get a full head of hair using hair cloning techniques. Unfortunately, cloning hair has not been going that well and in last few years we only had limited research results on hair multiplication in animal models and in human. Here is the question that people usually ask me:” Is hair cloning being done anywhere yet?” My answer is: Not except on experimental levels. Several investigations are in process on hair multiplication field and hair stem cell research.

Hair cloning 2008

Hair multiplication or as people call it hair cloning is a method that allows us to culture hair follicles and multiply it so we can increase the final number of hairs. So far, we know that it is doable on animals, and there are some reports of its feasibility on human volunteers. Safety has been one of the biggest questions on any research involved with stem cells. Stimulating growth of stem cells has always raised the flag for possible tumor formation. In year 2008, we should witness some results of the phase 3 studies on the procedure. During this year or in next few years, we should have a better understanding of the effectiveness and safety of hair multiplication. I know many of my patients are following hair cloning news carefully. Unfortunately, hair multiplication news has not been very fruitful in last year, but the process is complex and one way or another it will become clear in next few years that we can or cannot use hair multiplication methods in hair restoration surgeries.

Question:

Hello,

I’m very interested in learning about the future methods and advancements in the science of hair restoration as you may have guessed. Is there an “on line” information source you could direct me to, in order to keep of with the current work on stem cell progression, and the like? I have ushairrestoration.com site, of course, because it’s on your card. But am at a lose as how to get more information. Is there a site that publishes research papers and cases studies of new developments?

Answer:

I am not aware of any site that is dedicated to the advancements on stem cell research, but there are some sites that you can get good information on hair restoration and possibly get yourself familiarized with the new surgical and medical methods to restore hair. One that I recommend is the website of the International society of hair restoration surgery. It may not be updated very often, but is being fed through many different sources and could be a good source of information for someone like you to get some general information. Of course if you are interested in more scientific articles, you can use the National Center for Biotechnology Information, which gives you the most recent publication in most medical journals. This site is searchable for different criteria so you can put your keywords in and see what new information is out there.

Cicatricial alopecia refers to a group of rare skin diseases in which hair follicle get destroyed and replaced by scar tissue. It is one of the rare causes of hair loss. Hair loss could be gradual or sudden. Hair loss could be without any symptoms or it could present with sever itching, burning and pain. There is usually no visible scar, because the inflammation is below the level of skin. Cicatricial alopecia could occur in otherwise healthy men and women of all ages.

Cicatricial alopecias could be primary or secondary. This discussion is confined to the primary cicatricial alopecias in which the hair follicle is the target of the destructive inflammatory process. In secondary cicatricial alopecias, a non-follicle-directed process or external injury, such as severe infections, burns, radiation, or tumors could cause destruction of the hair follicle.

The causes of the cicatricial alopecias are not completely known. However, all cicatricial alopecias involve inflammation directed at the hair follicle, the upper part of the follicle where the stem cells and sebaceous gland are located are generally involved. Permanent hair loss occurs when the stem cells and the sebaceous glands are destroyed. This type of hair loss is usually irreversible.

Cicatricial alopecias can affect both men and women. The majority of patients with cicatricial alopecia have no family history of a similar condition. Central centrifugal cicatricial alopecia is a type of cicatricial alopecia that is more prevalent among black woman. Frontal fibrosing alopecia on the other hand is seen most commonly in post-menopausal women and could be seen in association with chronic skin conditions such as lupus erythematosus and in people with personal or family history of autoimmune disorder. A scalp biopsy is necessary for diagnosis of cicatricial alopecia. Presence of inflammatory cells and scarring could be diagnostic and essential for determining the type of treatment.

Treatment of the lymphocytic group of cicatricial alopecias involves use of anti-inflammatory medications such as steroids, cyclosporine, hydroxychloroquine. When hair follicle destroyed, hair will not grow back. However in some cases using minoxidil solution can help to stimulate growth of some of the remaining hair.

Hair transplant could only be used in the patients who have normal healthy hair on donor area without any microscopic or macroscopic evidence of cicatricial alopeica activity.  If hair multiplication becomes a reality it might potentially be a good option for patients who lost their scalp hair extensively as result of cicatricial alopecia.

I met an internist friend today and he asked me whether or not I do hair cloning for my patients. Obviously my answer was no. He mentioned that Dr. X does offer cloning to his patients and in fact plans on doing it for one of his current patients. My comment is this: The field of hair transplant surgery is a buyer beware market; just like any other fields in cosmetic surgery.

I have heard many doctors calling themselves a pioneer on this and that technique. If your doctor told you that he or she is the inventor of some popular method, make sure to ask for a published article from him or her on the topic in a peer reviewed medical journal. In medicine, we don’t keep secrets. When any inventions are formulated they are presented in scientific meetings or published in peer reviewed journals.

Hair cloning (as it is being called by people) or hair multiplication has been studied extensively in America and Europe over the past few years. There are some reports on the success of culturing hair and making new hairs from one in animals and human. There are also claims that phase 3 of clinical trials has started, but we do not know much about the success of this procedure since we don’t have any published articles as of yet. We don’t know anything about the possibility of mass production of hair through hair multiplication nor its feasibility and safety on human.

It is very likely that hair multiplication will be available in the future, but as of now we can not make any comments on the timing and quality of it.