task of restoring lost hair might conveniently be divided
into three categories: redistribution; rejuvenation and regeneration.
Dr. Jerry Cooley, M.D
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.
is where miniaturized hair follicles are rejuvenated using
topical or oral medications like finasteride (Propecia) and
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.
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.
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.
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.
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?
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.
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.
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.