Dr. Jerry Cooley, M.D

Redistribution, also known as hair transplantation, is where doctors try to diminish the appearance of hair loss by spreading the available follicles around in an artful manner.

Rejuvenation is where miniaturized hair follicles are rejuvenated using topical or oral medications like finasteride (Propecia) and minoxidil (Rogaine).

Regeneration of follicles is the dream of cell therapy (often referred to as “cloning) and offers an unlimited supply of hair follicles offering relief not only for those suffering with Androgenic Alopecia, but for burn victims as well.

The possibilities for cloning were first revealed in groundbreaking research in the 1980’s by Scottish researcher Roy Oliver and his student Colin Jahoda which showed that cultured dermal papilla from rat whiskers could be implanted into the slits in their ears and regenerate a hair. Dr. Jahoda has been tight lipped about human research but a 1993 symposium discussion published in the Journal of Investigative Dermatology revealed that he had been successful in reproducing this in humans. Dr. Norman Orentreich, the father of modern hair transplantation, predicted at the time that hair restoration procedures in the future would consist of implanting cultured dermal papilla not whole hair follicles.

Although hair follicle ‘cloning’ is an exciting possibility, little in the way of actual progress is publicly reported at conferences or in journals. Conversations at medical conferences reveal that at least half a dozen groups worldwide are seriously pursuing “cloning” and that some are meeting with at least limited success.

Dr Jim Vogel and I carried out similar research in the mid-‘90’s in Baltimore. I reported our preliminary results at the 1996 ISHRS meeting in Nashville. In the spirit of self-experimentation I implanted my cultured dermal papilla into my own arm and was able to observe an atrophic hair that grew in one solitary site for a short while and was later shed. Others have claimed to have also reproduced Jahoda’s work but nothing has been published in medical journals.

Even if the basic technique is proven to be consistently reproducible, many other issues present roadblocks. Dr. Jahoda obtained a patent on implanting cultured papilla for hair restoration but subsequently this patent was allowed to expire for various reasons. Any group wishing to mount a successful commercial “cloning” venture must face challenging intellectual property and patent protection issues. The scientific obstacles to implementing this technology are no less daunting. To my knowledge, no one has shown that these regenerated hairs are cosmetically equivalent to native or grafted hairs. Will they look normal? The caliber, curl, or color may be unnatural. Will they grow and cycle normally? Will they give rise to benign or malignant tumors?

The potential application of tissue engineering for treating human hair loss is obvious and exciting. By analogy, cell therapy treatment for burns and ulcers consists of taking a postage size area of skin and growing it in the laboratory to create enough cells to cover an entire football field. These cells can then be used to treat several patients. If the cells of the hair follicle could be multiplied in the laboratory and placed back into the balding scalp, it may be possible to create thousands of hair follicles from that original follicle. In fact, this phenomenon has already been proven feasible in humans. However, this research is currently still in the most preliminary of stages and there are indeed many obstacles to making this treatment safe and effective.

The most important consideration for government regulators such as the Food and Drug Administration (FDA) will be ensuring the safety of cell therapy for hair loss. The chief worry with using laboratory grown cells is that they might cause tumors when placed back into the skin. So far cell therapy for other applications has not been known to be associated with tumor formation. Before granting approval, the FDA would require adequate proof that implanted hair follicle cells did not give rise to any tumors.

Despite these obstacles, tissue engineering and cell therapy holds great promise. They are already being used for a growing list of human diseases and conditions. Successes in these areas may have applications in hair restoration. For example, stem cells in liposuction aspirate may be genetically reprogrammed and stripped of immune system identifiers to give us off-the-shelf designer hair. In this futuristic scenario, anyone walking into our offices might immediately receive implanted hair cells after browsing through various hair samples.