Hair Restoration Blog

I found another interesting case report on a very unusual location for hair growth recently published in the Journal of Oral Surgery and Oral Medicine the other week.  The case study was reported by Femiano et al. at the Second University of Naples, in Naples, Italy.

He reported a woman who was found to have hair growing inside her mouth due to a medical condition.  Nasal-like hair.  Scientists said it had to do with the the high level of testosterone in her system. They called it “oral hirsutism”, which I guess should be considered a new term in medical terminology.

Numerous conditions and serious diseases can result in high levels of circulating testosterone, although the most common cause of hirsutism is polycystic ovary syndrome (PCOS).  In the future, maybe someday scientists specializing in hair follicle growth may utilize hormonal manipulations to grow hair on the scalps of men and women who qualify for  hair loss treatment.

In the study of hair growth and hair elongation, there’s a new kid on the block. He goes by “TRH” or, to be more specific, Thyrotropin-Releasing Hormone. TRH has the potential to play a major role in Hair Restoration and Hair Transplants.

This month, a new discovery in hair growth and the hair growth cycle was published in the Journal of the Federation of American Societies for Experimental Biology. The study was done in Germany by Dr. Gaspar at the University of Lübeck, Department of Dermatology and Department of Internal Medicine.

Thyrotropin-Releasing Hormone (TRH) has proven to be one of the factors involved in the hair follicle growth cycle. Thyrotropin-Releasing Hormone is in closest proximity to the hypothalamic-pituitary-thyroid axis, which regulates thyroid hormone synthesis.

Since transcripts for members of this axis were detected in normal cultured human skin cells, and because it’s been found that when human hair follicles (HFs) are stimulated with thyrotropin, they respond, researchers have decided to study whether human hair follicle functions are also modulated by thyrotropin-releasing hormone. They report that the epithelium of normal human scalp hair follicles expresses not only TRH receptors (TRH-R), but also TRH itself at the gene and protein level.

Stimulation of micro-dissected, organ-cultured hair growth with thyrotropin-releasing hormone promotes hair shaft elongation, prolongs the hair cycle growth phase (anagen), and antagonizes its termination by TGF-beta2. It also increases proliferation and inhibits the apoptosis of hair matrix keratinocytes. These Thyrotropin-Releasing Hormone effects may be mediated in part by reducing the ATM/ATR-dependent phosphorylation of P53. By microarray analysis, several differentiated up-or down-regulated TRH-target genes were detected (e.g., selected keratins).

Thus, human scalp follicles are both a source and a target of thyrotropin-releasing hormone, which operate as a potent hair-growth stimulator. Human hair follicles are an excellent discovery tool for identifying and dissecting non-classical functions of thyrotropin-releasing hormone and TRH-mediated signaling, which emerge as players in human epithelial biology.

Q:

Hi,

How soon after a FUE procedure could I expect to see some growth?
Thanks

A:

The growth after a FUE transplant would be the same as that for a strip technique.  When the telogen (resting) phase of the hair follicles is finished and the anagen (growth) phase begins, you ought to be able to see some growth after two to three months. To start with, young hair shafts are fine; it takes a few months for the hair shafts to grow to their final thickness. To see optimal results, you may need to wait up to one year (from the time of your hair transplant surgery) as that is the amount of time it takes for transplanted hair to reach its final thickness and length.

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

We know that direct sunlight and ultraviolet radiation can affect the growth of hair follicles negatively. There is new research resulting on profiling the response of human hair follicles to ultraviolet radiation that was published in the Journal of Investigative Dermatology this month (January 2009). The joint effort work Department of Dermatology at the University of Lübeck in Lübeck, Germany and Zhejiang University in Hangzhou, China showed that excessive UVR ranks among the most harmful environmental influences on human skin.

The research was mainly done on organ-cultured human anagen hair follicles in vitro were irradiated with UVB (one of the two main types of Ultra Violet light), and reduction of hair shaft elongation, premature catagen entry, and reduced hair matrix keratinocyte proliferation were observed.

Upon irradiation with UVB at lower powers apoptotic cell death prevailed, whereas at higher power, necrotic cell death was predominant. These investigators concluded that UVR differentially modifies hair growth and cycle, promotes cell death, and induces complex regulatory events in human hair follicles in vitro. The leads from this human organ model, which is a living and human tissue interaction system under physiologically relevant in situ conditions, may encourage its use for general investigation of UV-induced effects as well as for testing possible agents for their UV-protective agents.

We can see that some patients who are exposed to sunlight for extended periods of time experience hair loss on unprotected parts of their scalp skin. I personally have a no sun exposure policy for 6 months after hair transplantation for all my patients at our Los Angeles hair transplant clinics.  Now it is becoming even clearer that both native hair and transplanted hair could get hurt by being exposed to direct sunlight.