Dr. Kevin Most: Hair loss
It is estimated that 50 million men and 30 million women suffer from complete balding or partial hair loss in the US alone. You can’t drive on the highway now without seeing an ad for hair restoration. Hair loss can be caused by many reasons, simple aging, hormone imbalance, stress and chemotherapy to name a few. We know that men are thought to look younger with a full head of hair, some think it also shows confidence and attractiveness. We know that many companies have attempted to find medications that slow or halt hair loss, minoxidil ( Rogaine ) and Propecia.
Hair growth is interesting, the body regulates and adjusts to have hair density different in different parts of the body. In animals, we know that hair growth is important for their survival as it keeps them warm and protects them from insects and other predators. Humans needed hair to prevent heat loss in the cold as well. Remember your grandmother telling you to put a hat on or you would catch a cold? Well you would not catch a cold but you would lose a lot of heat thru the scalp as it has great blood flow, so it is able to shed heat. That is important as we want to cool down but also important as we want to stay warm.
It is thought that hair follicles, which grow independently actually communicate with other follicles around it. Hair follicles are thought to be active for a period of time and then go silent before being reactivated. We have over 100,000 hair follicles on our head. Unfortunately thinning of the hair is noted when the hair follicles go into a resting stage and are not reactivated to a growing cycle.
Common male pattern balding affects the frontal and crown of the head but not the back of the head. This is thought to have genetic as well hormonal causes. We know that a male hormone DHT is responsible for some action in hair growth.
Hair follicles are unique, they produce hair but they also communicate with each other to make sure growth is appropriate in volume and location.
Treatment currently is not all that great, Rogaine is a non-prescription medication that is rubbed into the hair twice a day. It does not start new hair growth but has been shown to slow hair loss in many individuals. Propecia is a medication that comes in a pill form and also works in retention of hair but has also been shown to increase growth in some individuals.
Other treatment options include surgery. Hair transplantation, moving hair follicles from the back of the head to the crown. It essentially is taking plugs of hair and moving them to areas where hair loss has been noted. This has been popularized recently with Brian Urlacher and Ryne Sandberg showing how it has worked for them. The cost of this ranges from $3,000 to over $10,000.
A new study out USC medical school this week shows promising work with skin stem cells and the ability to teach the stem cells how to be functioning hair follicles. The study has shown that they are able to take stem cells, manipulate them and place them on shaved mice. They took time lapsed photos that showed the cells formed hair follicles and were soon producing hair. We know the power of stem cells will be the future of many diseases and it appears that this is another area.
Studies are also being done with stem cells and hair growth at Yale and Sanford Medical Research in LaJolla.
It is unclear when these will be ready for human trials but the concept would be that skin stem cells would be placed on areas of baldness and the new cells would develop into hair follicles and baldness would be curable without medication or surgery, it would be with cells directly from you.