Adipose-Derived Stem Cells-ADSCs For Hair Restoration In Men & Women

Advanced Stem Cells Therapy for Hair Loss

Using stem cells to treat baldness, and to slow process of hair loss, is the latest and most exciting development in the medical field of hair loss treatment for men and women. Hair loss is a condition that affects 35 million men and 21 million women in America alone. Stem cells has the ability to activate the cells already present on the scalp (progenitor cells) and hair follicles.

How does Stem Cell Therapy work for hair loss?

Stem cells are un-specialized cells found naturally within the human body that maintain and repair tissues. Stem cells are unique because they are the only cells that have the potential to develop into a wide range of other cell types. The advanced regenerative medicine; use of stem cell therapy  in treating medical disease including helping men or women suffering from hair loss, this means thin hair follicles can start growing again and the hair can become thicker and healthier.  Stem cells help tissue to regenerate by stimulate cell around them to grow healthier, the same with hair loss, thinning hair and baldness by having the stem cells to stimulate the cells around hair follicle and cause changes that lead to new cellular growth and healthier hair follicle life cycle, but this effect can vary from person to other depends on cause of hair loss and other multiple factors.

We are using the stem cells from your own fatty tissue (Adipose-Derived Stem Cells) to address the symptoms of thinning hair, loss hair in men and women in the scalp and eyebrow plus baldness for different causes.

One of the best things about using stem cells from fat is that the stem cells are a guaranteed match for the patient, since they were harvested from their own body removes the worry about the stem cell therapy being rejected by the body, and also drastically speeds up healing.

The process of Adipose-derived Stem Cells Therapy

Stem cell therapy is a term used to define the process of isolating adult stem cells from the host tissue, and then reintroducing them to the area of the body that needs healing or regeneration and in this case the treatment area, is the hair loss area (eyebrow, beard, moustache or scalp) The process gets started by locating the ideal place to harvest the adipose stem cells (stem cells that are stored in the fat deposits just below the skin). The extraction is only a limited amount of the fat that stores the stem cell reserves and needs only a local anaesthetic during the procedure.

Once this is harvested, the stem cells are isolated depend on the program that has been selected to you according to hair loss or baldness case and its chronicity and severity of the hair loss condition. and then re-introduced to the body for more localized treatments. In using stem cells to treat baldness, the treatments we perform for our hair loss patients are outpatient procedures and are conducted utilizing state-of-the-art equipment. The procedure is minimally invasive, very safe and there is no need for post-procedure recovery or downtime

When stem cells are injected, they trigger the cells already present in the follicles to stimulate chemical signals to nearby follicle cells that have deteriorated during the aging process, due to a pathological condition or systemic disease that causes the hair loss then the follicles will regenerate and once again produce healthy and strong hair as a response to these chemical signals.

Stem cells has the ability to build or reinforce the hair follicle papilla which is essentially a base of hair follicle bulb and made of connective tissues and capillary loop.

The ability of stem cells to activate hair follicle papilla regeneration and repair is depend on the age of the patient, severity of the case, chronicity of the condition, underlying pathology.

The published medical data has established that a combined program with the help of stem cells therapy that directly administered to the balding area. The stem cells that we are using is adipose derived stem cells, which has been taken from your body (fat tissue) and reinjected back to treat your hair loss area (scalp or eyebrow).

Learn More about hair physiology, hair loss problem in men and women and all evidence based modalities of treatment

About Human Hair

The growth of human hair is extremely complex process and hair loss is based on a number of factors including genetics, hormonal influence, environmental issues. Health condition like; infection, iron or vitamin D deficiency, autoimmune disorders and metabolic problems can also have a role in hair loss. Nutrition also plays an important role in whether or not the body is able to produce healthy hair. Hair grows at an average rate of approximately 1-1.5 cm per month. The average person has 100,000 – 150,000 hairs on their scalp at any given time. One single strand of hair is comprised of multiple components; all of which contribute to the body’s ability to grow and maintain healthy hair. Human body produce three different types of hair, the one on the scalp is known as terminal hair. 

Hair Growth Cycle

The human being is constantly in a state of growing and losing hair, the scalp sheds hair that is dead or damaged on a daily basis. Most of our hair are in the anagen phase, the active growing phase. Only small proportion are in one of two remaining phases of hair growth cycle. The duration of anagen is on average 3-4 years but can in some cases be as long as 9 years. the people who complain of their hair becoming finer and thinner with less colour are usually due to shortened anagen phase. The catagen phase or hair loss lasts about 3-4 weeks. The third phase known as telogen phase and lasting few months, during this phase the hair is resting or sleeping as neither growing nor falling out and for that called sleeping phase.

Hair Fall Problem

 Most people shed between 75-100 scalp hairs every day from their scalp. These hairs are lost to make way for new growth hair that will soon appear. Sometimes these hairs shed during brushing or hair wash by shampoo. Unbiased study among healthy men, aged 18-49 years to evaluate the incidence of moderate to extensive hair loss (Male Pattern Baldness MPB) shows that the hair loss increased with increasing age ranging from 16% for men 18-29 years of age to 53% of men 40-49. Excessive or abnormal hair loss is known as “Alopecia”, and there are several kinds. What all hair loss has in common, whether it’s men or women, is a symptom of something that’s gone wrong in your body. That can be hormonal imbalance, disease, or could be due to having a gene that makes you susceptible to male or female pattern baldness or one of the forms of alopecia areata. Although the follicular changes that lead to alopecia are similar between men and women, clinical presentation and response to antiandrogen therapy are different. 

The strongest evidence of genetic involvement in the development of baldness in the men Male Pattern BaldnessMPB” comes from studies involving the AR gene in men. A change that found in 98% of men with premature baldness and in 92% of men with late baldness, it was found in 77% of men without baldness. These elements suggest that other changes are necessary for developmental of Male Pattern Baldness, such as hormonal changes, medications, and environmental stimuli. In women, beside genetics, external factors may also be important for development of Female Pattern Hair Loss (FPHL). A US study conducted in 2012 with 98 female identical twins, raised several environmental factors possibly related to FPHL. These included: testosterone levels, psychological stress, hypertension, diabetes mellitus, smoking, multiple marriages, lack of photoprotection, higher income and little physical activity. However, the actual role of these factors in the causal model of FPHL still need be determined.

Hair Loss in Women

Long, short, bouncy, or sleek, for most women hair is way more than a bundle of fibers. It’s an expression of women style, personality and some places can even reflect the cultural background.  women lose hair the same way men do and called Female Pattern Hair Loss “FPHF”. Hair loss is annoying experience for any woman, and It might thin all over, or the center part get wider and wider. It may appear as bald spot at the crown of the head. One thing women rarely have: a receding frontal hairline. Fortunately, hair loss can be a symptom of a short-term condition as stress, pregnancy, disease, medication, malnutrition or after chemotherapy. In these situation, hair will grow back when the occurrence or the illness is addressed, hairs go back to their pattern of growth and shedding, and the problem of hair fall will be under control. 

 

Types of FPHL

Androgenic (Androgenetic) Alopecia: Most women with androgenic alopecia have diffuse thinning on all area of the scalp (men rarely have diffuse thinning but instead have more distinct patterns of baldness). Androgenic alopecia in women is due to the action of androgens, male hormones that are typically present in only small amount and it can be caused by a variety of factors related to the actions of hormones, including some ovarian cysts, taking high androgen index birth control pills, pregnancy and menopause. Just as in men, the hormone DHT appears to be at least partially to blame for the thinning (miniaturization) of hair follicles in women suffering with female pattern baldness. Heredity plays a major factor in the disease. 

Telogen Effuvium: When woman goes through something like traumatic; severe infection, major surgery, childbirth or extreme stress it can impact on hair growth cycle, 90% of hair are in growing (anagen) phase can under this stressful condition shift all at once into resting (telogen) phase.

Causes of Hair Loss in Women

  No single cause that trigger hair fall, they are as many as 30 or more. Most common ones mentioned by researchers are genes, aging play a role, along with hormonal changes of menopause, pregnancy, polycystic ovarian syndrome (can be thinning hair is the obvious sign of PCOS) and thyroid problems. Some women noticed that their hair seems fuller during pregnancy due to hormone levels keep resting hairs from falling out but, as the woman deliver, and hormonal level readjusted to normal levels, those strands of hair will fall out quickly. Women may lose a lot of hair at once and may take up to 2 years to go back to normal level of hair falling. The same effect can be seen when stop taking contraceptive pill specially if there is family history of hair loss. Extreme stress due to serious illness or major surgery, trauma involving blood loss, severe emotional distress or even, high level physical stress can cause suddenly hair fall of huge amount. The process may last 6-8 months. Immune system can cause alopecia areata by attacking healthy hair follicles by mistake (hair fall out in big patches), In most cases the damage is not permanent and may grow back in 6 months to a year. Fungal infection like ringworm fungus which can affect the scalp, it triggers a distinct hair loss pattern, itchiness, round bald patches, and might look red and scaly. This need dermatological treatment and can be contagious, so check your family members for the same symptoms. Drugs has shown increase incidence of hair fall like blood thinners medication. Other drugs may have related to increase hair fall or thinning of hair like some high blood pressure, heart diseases, arthritis, and depression. Malnutrition whether due to fad diet to lose more weight or after bariatric surgery to treat morbid obesity. Both groups may show hair fall few months down the road due to protein and/ or vitamin deficiencies. this can be temporary, and hair will return back to normal when the women be on healthy diet. Chemotherapy and radiation therapy are both known to cause hair fall as these treatments may target the hair follicles, but almost always short-term and once the treatment is finished, hair usually grows back. Other factors which are known to cause hair fall but, not proven by researchers like tight hairstyles like wearing cornrows or tight ponytails can irritate the scalp and cause hair to fall out. the same goes for using tight rollers, this type of hair fall is reversible except when it is used for very long time as these types can scar the scalp and end with permanent hair loss.

Hair Loss, Current Treatment Concepts

There are many hair restoration therapies, techniques and cosmetic hair procedures available today. Efforts are made to match hair loss treatment type with the causes of hair loss to get optimal result. Early diagnosis of the form of Hair Loss, as well as the early introduction of therapy may promote better clinical results than those achieved in more advanced cases or even stop the progression of the disease and this can improve the quality of life of patients affected by this disease. 

Currently, Rogaine and Propecia are the only two medications for baldness approved by the FDA. They are more effective for maintaining hair already on the scalp than they are in re-growing hair. 

For male pattern baldness, MPB  5% minoxidil lotion, and 2% minoxidil for female baldness FPB. The first signs of improvement generally appear after 3 months of therapy. The side effects of minoxidil are minimal, but include itching, eczema, and hypertrichosis (the later is more common in female patients) . for male baldness, finasteride taken orally and daily (1 mg) works by inhibiting the 5α-reductase from forming DHT. The decreased DHT levels allow some intermediate follicles to enlarge and regrow normal terminal hairs. Side effect may include decrease libido. Cyproterone acetate (in Europe) can effectively block the increased levels of male hormones that cause hair loss in some women. Spironolactone (in USA) appears to be a competitive inhibitor of DHT-receptor binding.

The medial treatment has to be daily, and if patient stops, the enhancement soon disappears. Also, many dermatologists do not agree to long-term prescriptions with hormonal therapy. Corticosteroid can help regrow hair for alopecia areata when there is immunological underlying cause. If the reason is other underlying medical problem or malnutrition, the hair mostly grows back on their own once the pathological reason become under control. 

Recent research has focused on Vitamin D and the Vitamin D receptor to stimulate hair follicle growth. 

There has been some recent interest in hair restoration by the uncontrolled injection of Platelet Rich Plasma (PRP) (mostly growth factors and a few stem cells). PRP does not generate new follicles, it just helps to recover and stimulate follicles in apoptosis. This is the  reason why this treatment must be started early (at stage 3 for men and stage 2 for women).

The PRP is an interesting alternative for patients who cannot benefit for classical treatment (side effects) or do not want to take long-term hormonal therapy.

New interest in preventing hair loss and baldness has been stimulated by stem cell therapy ADSCs, which normalized hair loss and reverses hair miniaturization of male and female baldness. The actual protocol is two sessions with 3 months between then and then once every year.

Physical treatment for hair loss, Devices that emit low-energy laser light may help new hair grow and available in clinics and for home use. studies approved its effect for women and men but, it might take 2-4 months before seeing the outcome of treatment. The long-term testing for effect and safety these devices are not known yet. 

All treatments need to be continued to maintain the effect. An initial therapeutic response often takes 12 or even 24 months. Given this delay, monitoring for treatment effect through clinical photography or standardized clinical severity scales is helpful. An adjunctive nonpharmacological treatment modality such as counselling cosmetic camouflage and hair transplantation are important measures for some patients. 

The Scientific Evidence Behind Using Stem Cells in Treating Hair Loss

Over the past decade, there has been much hope and hype for a realistic treatment for baldness using stem cell technology. For years, scientists had thought that people suffering from hair loss had a depletion of hair follicles and follicle stem cells, which are necessary to grow hair. Dr. George Cotsarelis, a professor of dermatology at the University of Pennsylvania, published a study showing that bald people have the same number of follicle stem cells as those with hair.

 

For years, scientists had thought that people suffering from hair loss had a depletion of hair follicles and follicle stem cells, which are necessary to grow hair. Dr. George Cotsarelis, a professor of dermatology at the University of Pennsylvania, published a study showing that bald people have the same number of follicle stem cells as those with hair. The study was published early 2011 in the Journal of Clinical Investigation. Cotsarelis and his team analysed skin cells from the bald and non-bald parts of the scalp of people with androgenetic alopecia. By using different markers to distinguish between stem cells and hair follicle progenitor cells, they were able to count the number of each type and they found that there was the same number of follicle stem cells in the skin from bald scalps as there were in the skin from the non-bald scalps. An inability of stem cells in the scalp to develop into the type of cells that make hair follicles may be an underlying cause of male-pattern baldness. So, if researchers could identify the signals that stimulate the stem cells into producing more hair follicle progenitor cells, then it would be possible to generate bigger hair follicles that could grow hair. Such studies have shown that men with male pattern baldness still have stem cells in follicle roots, but these stem cells lose the ability to initiate hair regeneration. Scientists have known that these follicle stem cells need signals from within the skin to grow hair, but the source of those signals has been unclear.

A recent ground-breaking report from Yale (Eric Festa, Jackie Fretz, Ryan Berry, Barbara Schmidt, Matthew Rodeheffer, Mark Horowitz, Valerie Horsley. Adipocyte Lineage Cells Contribute to the Skin Stem Cell Niche to Drive Hair Cycling. Cell, 2011; 146 (5): 761-771) appears to demonstrate the efficacy of adipose derived stem cells in activating these dormant hair follicles and growing new hair. Horsley’s team observed that when hair dies, the layer of fat in the scalp that comprises most of the skin’s thickness shrinks. When hair growth begins, the fat layer expands in a process called adipogenesis. Researchers found that a type of stem cell involved in creation of new fat cells — adipose precursor cells — was required for hair regeneration in mice.

These precursor cells are the same stem cells isolated in stromal vascular fraction by the process used at the select affiliates within the Cell Surgical Network. The Yale investigators also found these cells produce signal molecules called PDGF (platelet derived growth factor), which are necessary to produce hair growth in the mice. It still remains to be shown that PDGF has the same chemical signal effect on human hair growth. We do know that PDGF is a powerful activator of human adult mesenchymal stem cells

The neoangiogenesis could be the rationale of the efficacy of ADSCs plus exhibiting their beneficial effects through the paracrine actions of various cytokines and growth factors among these; VEGF & FGFb are the most important (VEGF: regulate the proliferation and inhibits the apoptosis of endothelial cells, FGFb: stimulates angionesis). From these data, it has been rational to try to use ADSCs and SVF in hair treatment.

The immunosuppressive effects of ADSCs besides neoangiogenesis could be the therapeutic pathway of treatment alopecia areata.

In clinical trials on patients suffering for androgenic alopecia & alopecia areata shows: “Cultured ADSCs gave a significant result over SVF with MPB & No side effect. But, No significant differences between cultured ADSCs above SVF in alopecia areata

Two clinical controlled study, both published 2017, considered, ADSCs-conditioned media using protein secreted by ADSCs for hair treatment, represents a highly effective and a promising alternative therapeutic strategy for hair loss.

Most Frequent Questions:

  1. What is the “Stem Cells Therapy” for hair loss?

Stem cells have been studied for their therapeutic potential in many medical fields, and in hair loss treatment. Stem cells applications increased rapidly during the last years, especially after discovering the adipose-derived stem cells (as SVF and Cultured ADSCs).

The Adipose(Fat)-Derived Stem Cell Therapy is an innovative treatment recommended for a wide variety of conditions from physical injuries to hair loss and even Diabetes. Yet, many people are just learning about it now for the first time. These are not embryonic stem cells or cells from foetuses, but these regenerative cells come straight from your own body, from fatty tissue that you are already wanting to get rid from it. Separation of these active cells and re-inject it back into your body and put to work to heal disease or dysfunction that affect the body area and in this case is your scalp, beard, moustache or eyebrow.

  1. Why the stem cells from fatty tissue and not bone marrow?

Many studies have found that adipose-derived stem cells ADSCs have surface markers and gen profiling similar to bone marrow-derived stem cells BmSCs (the most effective mesenchymal stem cells). ADSCs have their own capacities of multidirectional differentiation, week immunogenicity, lack of morbidity at the donor site, contrary to BmSCs. Adipose tissue is rich source of stem cells and higher than bone marrow, besides, its abundance and its easy sampling, performing a small liposuction from the lower abdomen, love handle or thighs, for that, represents a significant alternative to bone marrow mesenchymal stem cells.

  1. What is the advantage of stem cells therapy over the hair transplant surgery?

With stem cell therapy, we are trying to treat the bald area and help to recover the stem cells that naturally embedded in your scalp to covert to hair follicle and start near normal hair growth cycle, we are actually trying to increase the number of the hair follicles that you have in your scalp while with surgery which supposed to be the last option of treatment modality, we are not treating the baldness problem but, mostly camouflage it by redistribute the amount of hair follicles that you have by removing it from donor area which the back of your scalp and transplant it to where is the baldness patch on the scalp, beard, moustache or eyebrow. So, numbers of hair is same or even less due to fact that in hair transplant not all transplanted hair follicles are going to survive but percentage of it will be lost. 

  1. What will happen if I have done the stem cells therapy and after it still want to do hair transplant. Is that possible?

Yes of course but, you are going to get much better result if hair transplant done after stem cells therapy for many reasons:

  1. Stem cells itself will activate stem cells in the area to do their role and differentiate into mature cells that can form hair follicles.
  2. ADSCs has known role increasing the blood supply by increase the number of blood vessels in the area to support sufficient oxygen and nutriments to the newly transplanted hair follicle. Also,
  3. The immunosuppressive effects of ADSCs will decrease the inflammatory reaction after surgery and that by itself will improve the recovery and percentage of follicle survival.

All above will give advantage to the recipient area and increase percentage of follicle graft survival plus improve the quality of hair and shorten the time of growth.

It is important to remember that, as with all medical treatments and procedures, there is no single protocol nor single outcome for how treatments will go and what the results will be like. However, most patients are satisfied with the results of their stem cells therapy combined with other modalities of baldness treatments. Most say the researchers consider the results from using stem cells to treat hair loss have gone above and beyond what they had hoped for. Using stem cells to treat hair loss and baldness is promising to be a life-changing new field for many people in short coming future

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References

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  8. Festa, E., Fretz, J., Berry, R., Schmidt, B., Rodeheffer, M., Horowitz, M., & Horsley, V. (2011). Adipocyte lineage cells contribute to the skin stem cell niche to drive hair cycling. Cell, 146(5), 761-771
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Individual patient results may vary. As each patient’s problem is different, each treatment must be tailored around your specific needs

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