Can New Research on Mice Hold the Key to Combating Hair Loss?

Research to Combat Hair LossWhen it comes to dealing with hair loss, the current solutions range from combovers to hair loss medications and transplants that are way too way to spot. However, research continues in the scientific community on new solutions for hair loss. Scientists have recently discovered some hair loss can be treated by blocking certain enzyme activities. In fact, in a new study bald mice underwent certain enzyme blocking treatments and they started showing new hair within 10 days.

Researchers at Columbia University Medical Center spent time last year searching for new treatments for alopecia areata. The research team studied how well certain drugs inhibit a family of enzymes that is in hair follicles. The enzymes are known as Janus Kinase (JAK). Their research showed the drugs actually turned off a signal that started autoimmune attacks. The drugs also showed potential to restore the growth of hair when given orally to some subjects as well as when it was applied to the skin. These findings indicate that the JAK drugs seemed to be preventing the autoimmune attack as well as having a direct interaction with the hair follicles.

Simply put, the research team established that the JAK inhibitors help to bring the hair follicles out of their resting state. (They normally put the follicles into a resting phase.) The act of suppressing its normal activity allows the drugs to help any hair in the sleeping state return to the active cycle. In the research on the bald mice, the JAK drugs were applied to their skin for five days and then they started to grow new hair within ten days. The mice regrew almost all of their hair within three weeks while another group of mice left untreated remained bald.

In the past, there have been some similar mice studies trying to manipulate the growth cycle.  I have done some studies on mice hair growth after electroporation (a technique used in gene therapy) in mice model at Johns Hopkins Medical Institute. However, most of these studies are limited by their focus on hair cycles and not changing the course of miniaturized hairs that are going through the process of baldness. This innovation would be great for human body hair that has a longer resting phase and shorter growth phase. If they apply it on human body hair, a person can potentially have more body hair. I am not sure if anyone wants this though.  When it comes to human scalp hair, they behave differently than mouse hair since they already have a very long growth phase. Plus, more than 95% of scalp hair is in a growth phase at any one time.  Keeping them longer in growth phase may help a person grow scalp hair longer but, if they have follicles that are falling because of male patterned baldness, they shouldn’t be affected as much.

Hair Cloning News 2013

hair cloningQ:

Hello Dr Mohebi,

I recently read an article on the web that you commented on Harvard research for hair cloning.  I am in my early 40’s, fairly broke, and eagerly awaiting the day that hair cloning is successful and available to the market.  For the past decade, I keep hearing the same promises that it will arrive in 5 years, but still no luck.  Can you comment on why it is not here yet, and perhaps when we will see it.  Thanks in advance.

A:

Hair multiplication also referred to as “Hair Cloning” is a hot topic in hair restoration over the last few years it is garnering more and more attention.  The research for multiplying hair (hair cloning) has been going on for years now in several centers around the world over the past few years.  The study that we performed with collaboration with some scientists in Cedar Sinai is only one of the many steps that need  be taken to successfully multiply hair.

Hair multiplication would offer superior benefits to patients and represent a significant advance for medical science and hair restoration. Still the march towards this being a medical reality moves slowly for a several different reasons:

  1.  Although hair loss has detrimental effects on patients’ lives, is yet to be recognized as a burning issue in medical field to warrant more funding for hair loss research.
  2.  Hair multiplication studies are usually done in private setting without the support of larger institutions such as universities and NIH (National Institute of Health).
  3. The growth rates of the hair stem cells are extremely slow in cell cultures.  That makes the overall period of hair multiplication timelier and adds exponentially to the cost of these studies.

The combination of above three factors and other obstacles in this process has made progress of hair multiplication very slow.  My best estimation of current research is that hair multiplication is probably at least 8 years away from practical medical application.  The reason for this is that any new medical treatment or device needs to go through different phases to obtain FDA approval for its use in the U.S.

The last phase necessary in development of a new treatment is ‘clinical trials’. The phase three is done on volunteer patients to find out more about long term complications that might be associated with the treatment. At this time no study has reached the clinical trials stage this makes it unlikely that we can have hair cloning available to public within the next eight years.

The Best Technique for Recipient Hair Transplant Sites

Recipient sites are the very fine incisions made in the balding scalp to receive the follicular unit grafts extracted from the donor hair of the permanent zones of the scalp. Hair transplant surgeons utilize variation in technique when making of these sites during hair transplant surgery.

 

The use of ‘premade sites’ and the termed ‘stick and place’ have been used harmoniously in hair transplant surgeries for years.  In our practice at Parsa Mohebi Hair Restoration centers we primarily utilize pre-made sites rather than stick and place. This is because in our perform a substantial number of ‘Gigosession Hair Transplants’ and the use of stick and place would unnecessarily prolong the procedure; while also increasing the duration in which grafts are out of the body. Recently, we have started to making recipient sites even before removing the grafts in many of our hair transplants (strip and FUE). We do this for two important reasons:

  1. Making the sites before hands minimizes the time that grafts have to stay out of body and technicians can start implanting grafts as soon as we are done with removing the grafts (in FUE cases or strip procedures).
  2. There are some evidences that an incision (wound) that is made a few hours earlier contain more growth factors and would healing associated cells than a fresh wound.  So we can assume that the process of healing is already started by the time we are inserting the grafts. This can accelerate the healing of the transplanted grafts. (1)

It is important to recognize that the best hair transplant surgeons incorporate surgical techniques and procedures that are best suited to the success of a particular patients surgery.

1. View Reference Here

The 19th Annual Meeting of The International Society of Hair Restoration Surgery (ISHRS)

 

The 19th Annual ISHRS meeting for 2011 was held in Anchorage, Alaska. It was my first trip to Alaska and I was looking forward to seeing the beauties of the largest state in America.  Being very busy with many different activities, it made my time for sightseeing nearly impossible. I was required to be available one day prior to the opening day of the conference to get prepared for the many different events which were to come.

Hair Transplant Workshop

Dr. Parsa Mohebi, faculty in Hair Restoration Surgery meeting
Dr. Mohebi and other faculties teach Hair Transplantation Techniques in ISHRS Meeting Anchorage, Alaska

I was one of the faculties for the surgical workshop. There were many new hair transplant surgeons who came from around the world to this annual scientific meeting to learn more about the art and science of hair restoration. The workshops included topics such as hair line design, cutting, placing, anesthesia, and donor harvesting and I was there to teach the latter course. There was great interaction between the faculties and students as they got the chance to learn the hands on techniques of surgical hair restoration.

Latest techniques of Hair Transplantation

The main thrust of the conference was the lecture series which gave a forum to many lecturers covering multiple topics regarding the many different areas of hair restoration. Since hair transplant surgery is still a relatively new field in the medical world, the greatest emphasis was on new technologies in hair transplantation, the latest techniques of hair transplant surgeries, devices, tools and methods of diagnosis and the treatment of hair loss.

Hair Transplant New Surgical Techniques
ISHRS 19 Meeting: New Hair Transplant Surgical Instruments and Techniques Panel, Drs. Parsa Mohebi, Alan Bauman, Sara Wasserbauer and Kongkiat Laorwong

 

This year I was the moderator for the Giga-Session Hair Transplantation Panel. The panel included 2011 Golden Follicle Award winner Dr. Jerry Wong and Doctors Sharon Keene, Arthur Tykocinski, and Akaki Tsilosane. The discussions included properly choosing the best candidates for large number of grafts hair transplant surgeries (Giga Session Hair Transplants), planning for surgeries, as well as the full spectrum of Giga-Session Hair Restoration.

The Laxometer II was one of the newest innovative technology devices presented by me. The Laxometer was developed as a response to the need within the hair restoration industry for a measuring device for calculating the scalp laxity or skin mobility before hair transplantation surgeries. The Laxometer precisely measures the mobility of the scalp giving greater accuracy for larger surgeries or if a patient has a tight scalp. This device was introduced to the market for increasing the safety, precision, and efficiency of the hair transplantation.Laxometer

Another device presented at the 19th Annual ISHRS Scientific Meeting was the upgraded Restoration Robotics, now called ARTAS System. This machine is now FDA approved for use in the United States and several lectures were presented about this new hair transplant technology. ARTAS was developed to help meet the need for increased precision and speed for scoring the follicular grafts in Follicular Unit Extraction (FUE) hair transplants. This is considered a very new technique in hair transplantation, but the robot currently only assists in one step of hair restoration. That is scoring the follicular grafts.  We still do not have a perfect automated system to extract and transplant the hair grafts. This device will need more time for testing and post-operation, long-term patient results.

Other New Technologies for Hair Restoration

In last few years, we have witnessed emergence of several new tools in hair transplantation that carried the claim to be the latest technologies and ground breaking tools for the field.  A lot of devices claimed they could change the way hair transplantation was done. However, many of those new tools did not deliver on their promise.  This has been a trend which has continued to be repeated for several years now. One of these devices was the NeoGraft that was sold to many non-hair transplant doctors with the promise of the simplicity of use and the minimal need for a surgeon’s involvement. The company has stated that the technicians can run the machine for the most part. One major issue the NeoGraft company forget to point out to these new costumers is the fact that hair transplant surgery requires experience and proper training in order to deliver great result. No machine, especially in the wrong hands, can substitute for lack of experience and expertise.

There were a number of lectures presented regarding the problems involved in hair multiplication, auto-cloning, hair stem cell research, and others important topics. Like years previous, there were several debates about Strip FUT vs. FUE,  manual FUE vs. automated FUE, also sharp vs. blunt punches for Follicular Unit Extractions.

Controversies in Hair Restoration

This year we had many controversial lectures such as lasers for hair restoration and growth factors, as well as mesotherapy and PRP (Platelet Rich Plasma).  The ISHRS allows for an open forum for hair transplant surgeons to share their innovative ideas, work, and theories that they can be giving constructive criticism and analysis by other experts in the field. This has been effective in keeping members of the society updated with new ideas and methods for hair restoration. It is unanimously agreed by members of ISHRS that hair restoration surgery is a progressing science and art which is rapidly growing into more advanced technologies and cellular level manipulations. It is well accepted that greater research is needed in order to thrust the industry forward in these new innovative areas for the art and science of hair restoration

Hair Transplant New Technology – Laxometer II

 

 

Laxometer II

Often times we receive inquiries at Parsa Mohebi Hair Restoration about the latest hair transplant technology, and we feel obligated to spread the news about the latest hair transplant technology.  We are excited about the new generation of Laxometer, the newest hair transplant device invented by Dr. Parsa Mohebi. The Laxometer II is a handheld device which revolutionizes the art and science of hair restoration. Being in the growing sector of the cosmetic surgery arena, progressive updates on hair transplant new technology is critical.

Applications

The revolutionary Laxometer II increases the number of hair grafts which can safely and precisely be transplanted in one surgery. A hair transplant of more than 3500 hair grafts once upon a time took two or more surgeries to complete, but with this latest technology in hair transplantation, it can be done in only one procedure.

The Laxometer II, the new technology in the hair transplant industry, is basically a measuring device which is used to calculate the laxity of one’s scalp. An accurate measurement of scalp laxity is critical when determining how large the donor strip can be. This latest breakthrough hair transplant technology gives a precise measurement which can be increased as a result of patients actively doing daily scalp exercises. The larger the available strip, the more grafts can be made available for transplantation.

At the International Society of Hair Restoration Surgery’s 19th Annual Scientific meeting in Alaska in September 2011, Dr. Mohebi unveiled his new invention for purchase to all hair transplant surgeons. This latest technology in hair transplant surgery was welcomed with anticipation and applause as it will help to continue the industry progressing forward.

Hair Transplant with Delayed Growth

The growth cycle of hair follicles differs between each individual.  For that reason, transplanted hair grafts also may not follow a universal pattern.  We generally schedule follow up visits for our hair transplant patients on the day 1, day 10, month 5 and month 10 following their hair transplant surgery.  Our five month follow up is to make sure patients are having a smooth early growth without any problems or complications.  In most cases, early growth is seen at five months post op.   In some people who started growing hair earlier we may even see something close to their final result.  However, we have had some cases that we did not see impressive results at month five and patients experienced delayed growth of their transplanted grafts following the procedure.

After Hair Transplant Growth
Delayed hair growth after hair transplant. Left to right – Day of hair transplant – after 6 months – after 12 months

Most of these patients do not have anything wrong with their transplanted hair and will only have to be more patient with their hair growth.  We bring all hair transplant patients back in month 10 after their surgery and the results at that time are much better.  This group of patients may see their final result more than 10 months from the time of their hair transplant and it may take 12 to 18 months to see full result.  If the results are still poor at month 10, more diagnostic tests such as a scalp biopsy may be needed to rule out other causes of hair loss that might have been involved with the growth of their transplanted hair.

Double Edged Trichophytic Closure

Double edged trichophytic closure is a new approach to donor wound closure.  Double edged or two sided trichotomy can help to minimize the complications of trichophytic closure based on the width of epithelium that is being removed and inability of some the hair follicles or oil glands to find their way out to the skin surface.

Parsa Mohebi Hair Restoration is evolving rapidly and we are consistantly refining our approach on a regular basis to improve the quality of transplanted hair while at the same time minimize the possibility complications.

Double edged trichophytic closure helps us to minimize the width of the top skin layer (epithelium) that is being removed from each edge of the donor wound.  This approach allows hair to grow into the wound from both edges and thus minimize the contrast between scar (with no hair) and surrounding scalp (with 100% hair density).

By employing double edged trichophytic closure we constantly have results of less detectable donor scars and are able to minimize the risk of folliculitis or ingrown hairs in the donor area, which are the two common complications of trichotomy with the traditional methods.

FUE Hair Transplants – Who is the Best Candidate for Follicular Unit Extraction?

It is about 8:00 Pm and we just finished performing a big FUE procedure and I thought I write this post on, a patient who is a candidate for FUE procedure‚ before going home.

Follicular Unit Extraction or FUE hair transplants is one of the methods of hair transplantation with Follicular Unit Transplant (FUT) technique. The biggest advantage of FUE is that, the linear scar in the donor area on the back is eliminated.

FUE has been around for a few years now. Many people ask about the advantages and disadvantages of FUE when they are considering doing a hair transplant surgery. People always ask; whether or not FUE hair transplant is the right procedure for them. There are many articles on hair transplant techniques including FUE and its different methods that compared FUE with regular techniques of strip hair transplant. Hair transplant surgeon has to consider patient’s needs when planning for a hair restoration procedure. Many surgeons don’t do FUE on a regular basis. This needs to be explained to the patient. Unfortunately some doctors talk patients out of this procedure simply due to their inability to perform one. That is the same for mega session surgeries that many people are told that grafts won’t survive if place too densely only because they can not perform one. This might be due to not having enough skilled personnel or any other limitations.

The most important factor that people consider when they consider doing a FUE is elimination of linear scar on the back with FUE hair transplant surgery. It might be because they want to wear their hair short on the back or shave it at some point. FUE by far is the only method that can completely eliminate the linear scar on the donor area. Have more comfortable post-op period is the other reason for choosing FUE.

All patients need to be tested before performing an FUE procedure for their candidacy. At the Los Angeles office of Parsa Mohebi Hair Restoration, Dr. Mohebi tests all patients who are considering this method for their hair restoration. FUE test (FOX) is easily done in the office with to extra charge to the patients. We perform a mini FUE procedure under local anesthesia to test feasibility of removing intact follicular unit grafts with different FUE technique and see which method is the right one for each patient. If patients are FOX negative then other options should be discussed with them. Even if patient’s are FOX positive, they have to understand that they may have a much better yield and superior final outcome with regular strip technique. For some patients, not having scar on the donor area is more important than having higher density in recipient area and they can live with thinner hair in the recipient area, but they don’t want any line of scar at all. These patients are the best candidates for FUE if they are tested positive for that.