Stem Cell Therapy
for
Hair Restoration & Regeneration

Adipose-derived stem cells (ADSCs) are one the latest scientific breakthrough in the field of aesthetic surgery. For many years, doctors have discarded the fat tissue removed during cosmetic surgery such as tummy tuck, liposuction and breast reduction. However, it was recently found that adult stem cells can be isolated from the fat tissue and over the past decade, stem cells have been studied for their therapeutic potential in many medical fields including hair and skin treatments. There has been much hope and hype for a realistic treatment for baldness using stem cell technology. During the last years it evolved rapidly especially after the use of adipose derived mesenchymal stem cells (SVF & ADSCs) READ MORE

 

Conventional modalities for hair refurbishment include medications, laser and hair follicle transplant surgery. However, ineffective in all patients and sometimes disappointing as the medication has unsatisfactory result plus side effects and their effect never long lasting. The surgery is not treating the problem as never increase the numbers of hair follicles but just redistribute from one area to other. For that, contemporary therapies with promising result are required that should be effective in both sexes and outcomes should be long lasting.

ADSCs based treatment as stromal vascular fraction SVF or Cultured ADSCs can open a new avenue for the development of therapies for hair restoration.

The Scientific Evidence Behind Using Stem Cells Therapy in treating

“Hair Loss Problem”

A variety of studies have been published examining the effects of adipose derived stem cells and therapies based on stem cells collected from fatty tissue, in relation to the reversal of male and female pattern hair loss. The early results published are promising.

  • George Cotsarelis, a professor of dermatology at the University of Pennsylvania, published a study showing 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 and 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.
  • A ground-breaking report from Yale (Horsely, et. al.) demonstrate the efficacy of adipose derived stem cells in activating these dormant hairs follicles & growing new hair. They examined the role of intradermal adipocytes on follicular stem cell activity. They observed a dynamic process of adipogenesis that parallels the activation of hair follicle stem cells. Additional functional analysis revealed that immature adipocyte cells are necessary and sufficient to drive follicular stem cell activation and they attributed this relationship to the production of platelet derived growth factor (PDGF) by immature adipocyte lineage cells. Horsley’s team also, 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.

They ultimately established that adipose tissue plays a crucial role in the normal hair cycle and even went as far as to suggest that telogen may be the result of a localized absence of adipose tissue. They 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 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 

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.

  • A 2013 study by He et al. examined the involvement of adipose derived stem cells in the hair cycle. Their study revealed that CD34+ cells may be involved in blood vessel formation by differentiating into endothelial cells, besides the differentiation to adipocytes.

The combined findings of Festa et al. & He et al. suggest a strong relationship between adipose, adipose-derived stem cells and the hair growth cycle.

The findings suggest that both adipose and adipose derived stem cells have a potential therapeutic application for hair growth which deserves further exploration.

In Conclusion; the body of evidence in favour of the use of adipose derived stem cells therapy for male/female pattern hair loss is steadily growing. These therapies offer the benefit of reduced side effects compared to the current treatment modalities and appear to be effective in both males and females. With relatively no new formally approved treatments for hair loss in the last 20+ years, the future of hair restoration may lie in adipose derived stem cells therapies.

How to isolate stem cells from your fatty tissue?

Technically is a simple procedure that requires:

  • Fat Collection; the collection of small amount of adipose tissue that can harvested in a simple outpatient session. Usually best fat from lower abdomen or patient may choose an area that very stubborn fat tissue to weight loss.
  • Isolation Process of Stem Cells from Fatty Tissue: depend on which technique that we are going to use for the patient.

Non-expanded, Ready-to-Use ADSC Pellet- Crude (SVF): we are separating the cells from freshly harvested, we do wash it with specific solution to remove blood cells, saline and local anaesthetic drugs.  fat on same session by using specific centrifuge, then separate the ADSCs as SVF from the lipoaspirate either by Enzymatic Method or Mechanical Isolation one of 2 ways, depend on the case demand. More effective if the extracted adipose tissue treated by collagenase digestion to obtain the crude SVF.

The SVF is highly heterogenous and contains many cells types, including mature adipocytes, a mixture of endothelial cells, smooth muscle cells, fibroblasts, mas cells, pericytes, a reservoir of immature stromal cells, and hematopoietic cells (up to 20% of total fraction). The SVF is a complex fraction that contains ADSCs (5%-10% more or less) but cannot be defined as a stem cells or mesenchymal stem cell fraction. The ADSCs should be named only the fraction containing the isolated & expanded ADSCs.

Cultured-Adipocyte-derived Stem Cells-  Cultured- ADSCs;

The harvested fat will send to specific biological certified lab (Bioscience Institute at Dubai Healthcare City) they are doing all process of preparation, separation of specific ADSCs and expanding their number by culturing it in lab for a period of time. The delivered ADSCs put in in specific protein medium with growth factors “Liposkill” the prepared number of ADSCs for hair treatment can vary from 6-30 x 106 with high percentage viable and specific mesenchymal stem cells (usually the viability cell in liposkill above 97%). This method assures the quality of prepared ADSCs but do need 2-stages treatment for first one session of treatment only. Any further sessions. No need to harvest the fat again as the primary MSCs store in the lab which is like tissue bank and able to store ADSCs for more than 25 years without changing in its specification or viability.

The time that cultured ADSCs needed to prepare ADSCs may be influenced by:

  • Donor age
  • Type & location of the adipose tissue
  • Harvesting procedure.
  • Injection in the scalp, eyebrow or beard area: depend on which technique that we are going to use for the patient.

Most Frequent Questions:

  • 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.

  • 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.

  • 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. 

  • Who is the good candidate for this treatment?

Any man or women suffering from hair loss, thinning of hair, wiry hair of eyebrow. from mild to severe case. Typically used for those patients who are not surgical candidates because they are too young or are in the early phase of hair loss. In severe cases who do need hair transplant, preparation the recipient bed for transplanted hair follicles to increase percentage of survival follicular grafts area by increase its blood supply and stimulate the original stem cells in the bed. At the same time strengthen the hairs in the donor area and help the donor area to heal faster.

  • What result to expect from this treatment?

ADSCs is the most advanced and promising treatment for hair restoration. Effective and safe method based on your own healing power of your own stem cells. It is a biological product and the results vary from patient to patient according to biological age of the patient.

  • What types of hair loss that best respond to this therapy?

It has effectively grown hair in the following patients group:

  • Male and female pattern hair loss
  • Alopecia areata
  • Eyebrow or beard hypotrichosis
  • Metabolic causes of hair loss, such as medication induced or iron deficiency.
  • 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:

  • Stem cells itself will activate stem cells in the area to do their role and differentiate into mature cells that can form hair follicles.
  • 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,
  • 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

References

  1. Bouhanna, P. (2015). The Alopecias: Taylor & Francis.
  2. Budamakuntla, L., Loganathan, E., Suryanarayana, S., & Dongre, A. (2015). Neonatal derived mesenchymal stem cell mesotherapy in androgenetic alopecia: a retrospective observational study and review of literature. International Journal of Scientific Reports, 1(1), 32.
  3. Cao, W., Li, L., Kajiura, S., Amoh, Y., Tan, Y., Liu, F., & Hoffman, R. M. (2016). Aging hair follicles rejuvenated by transplantation to a young subcutaneous environment. Cell Cycle, 15(8), 1093-1098.
  4. Darwish, N. M. M., Marzok, H. F., Gaballah, M. A. M., & Abdellatif, H. E. (2017). Serum level of vitamin D in patients with alopecia areata. Egyptian Journal of Basic and Applied Sciences, 4(1), 9-14.
  5. Desai, V., Malhotra, S., & Sehgal, V. N. (2017). Instant Follicular Hair Unit Transplantation (IFHUT) in androgenetic alopecia – The evolving scenario. Journal of Dermatology & Dermatologic Surgery, 21(2), 41-47.
  6. Dinh, Q. Q., & Sinclair, R. (2007). . Clinical Interventions in Aging, 2(2), 189–199.
  7. 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 CyclingCell, 2011; 146 (5): 761-771 
  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
  9. Fukuoka, H., Narita, K., & Suga, H. (2017). Hair Regeneration Therapy: Application of Adipose-Derived Stem Cells. Curr Stem Cell Res Ther, 12(7), 531-534
  10. Fukuoka, H., Suga, H., Narita, K., Watanabe, R., & Shintani, S. (2012). The Latest Advance in Hair Regeneration Therapy Using Proteins Secreted by Adipose-Derived Stem Cells. The American Journal of Cosmetic Surgery, 29(4), 273-282.
  11. Hirotaro Fukuoka, H. S., ; Keigo Narita, Rei Watanabe, , & Shintani, S. (2012). The Latest Advance in Hair Regeneration Therapy Using Protein secreted by ADSCs. The American Journal of Cosmetic Surgery.
  12. Hirotaro Fukuoka, M., PhD, and Hirotaka Suga. (2015). Hair Regeneration Treatment Using Adipose-Derived Stem Cell Conditioned Medium- Follow-up With Trichograms,. e-plasty.
  13. Inoue, K., Aoi, N., Sato, T., Yamauchi, Y., Suga, H., Eto, H., . . . Yoshimura, K. (2009). Differential expression of stem-cell-associated markers in human hair follicle epithelial cells. Lab Invest, 89(8), 844-856.
  14. Li, J., Jiang, T. X., & Chuong, C. M. (2013). Many paths to alopecia via compromised regeneration of hair follicle stem cells. J Invest Dermatol, 133(6), 1450-1452
  15. Luis A. Garza, C.-C. Y., 2,3 Tailun Zhao,1 Hanz B. Blatt,Michelle Lee, Helen He,David C. Stanton,4 Lee Carrasco,4 Jeffrey H. Spiegel,5 John W. Tobias,6 and George Cotsarelis. (2011). Bald scalp in men with androgenetic alopecia retains hair follicle stem cells but lacks CD200-rich and CD34-positive hair follicle rogenitor cells.
  16. Minjuan, W., Jun, X., Shiyun, S., Sha, X., Haitao, N., Yue, W., & Kaihong, J. (2016). Hair Follicle Morphogenesis in the Treatment of Mouse Full-Thickness Skin Defects Using Composite Human Acellular Amniotic Membrane and Adipose Derived Mesenchymal Stem Cells. Stem Cells Int, 2016, 8281235
  17. Nagpal, A., Choy, F. C., Howell, S., Hillier, S., Chan, F., Hamilton-Bruce, M. A., & Koblar, S. A. (2017). Safety and effectiveness of stem cell therapies in early-phase clinical trials in stroke: a systematic review and meta-analysis. Stem Cell Res Ther, 8(1), 191.
  18. Perez-Meza, D., Ziering, C., Sforza, M., Krishnan, G., Ball, E., & Daniels, E. (2017). Hair follicle growth by stromal vascular fraction-enhanced adipose transplantation in baldness. Stem Cells Cloning
  19. Shin, H., Won, C. H., Chung, W. K., & Park, B. S. (2017). Up-to-date Clinical Trials of Hair Regeneration Using Conditioned Media of Adipose-Derived Stem Cells in Male and Female Pattern Hair Loss. Curr Stem Cell Res Ther, 12(7), 524-530
  20. Toyoshima, K. E., Asakawa, K., Ishibashi, N., Toki, H., Ogawa, M., Hasegawa, T., . . . Tsuji, T. (2012). Fully functional hair follicle regeneration through the rearrangement of stem cells and their niches. Nat Commun, 3, 784.

 

 

References

  1. Lockhart, R., S. Hakakian, C., E. Birnbaum, Z., & A. Aronowitz, J. (2016). Adipose derived stem cell based therapies or male/female pattern hair loss. Journal of Stem Cell Research and Medicine, 1(2). doi: 10.15761/jscrm.1000109
  2. Bouhanna, P. (2015). The Alopecias: Taylor & Francis.
  3. Budamakuntla, L., Loganathan, E., Suryanarayana, S., & Dongre, A. (2015). Neonatal derived mesenchymal stem cell mesotherapy in androgenetic alopecia: a retrospective observational study and review of literature. International Journal of Scientific Reports, 1(1), 32.
  4. Cao, W., Li, L., Kajiura, S., Amoh, Y., Tan, Y., Liu, F., & Hoffman, R. M. (2016). Aging hair follicles rejuvenated by transplantation to a young subcutaneous environment. Cell Cycle, 15(8), 1093-1098.
  5. Castilla el al, Adipose-derived stromal cells: Their identify and uses in clinical trials, an update. World J Stem Cells, 2011;3(4):25-33.
  6. Darwish, N. M. M., Marzok, H. F., Gaballah, M. A. M., & Abdellatif, H. E. (2017). Serum level of vitamin D in patients with alopecia areata. Egyptian Journal of Basic and Applied Sciences, 4(1), 9-14.
  7. Desai, V., Malhotra, S., & Sehgal, V. N. (2017). Instant Follicular Hair Unit Transplantation (IFHUT) in androgenetic alopecia – The evolving scenario. Journal of Dermatology & Dermatologic Surgery, 21(2), 41-47.
  8. Dinh, Q. Q., & Sinclair, R. (2007). . Clinical Interventions in Aging, 2(2), 189–199.
  9. Fukuoka, H., Narita, K., & Suga, H. (2017). Hair Regeneration Therapy: Application of Adipose-Derived Stem Cells. Curr Stem Cell Res Ther, 12(7), 531-534
  10. Fukuoka, H., Suga, H., Narita, K., Watanabe, R., & Shintani, S. (2012). The Latest Advance in Hair Regeneration Therapy Using Proteins Secreted by Adipose-Derived Stem Cells. The American Journal of Cosmetic Surgery, 29(4), 273-282.
  11. He J, Duan H, Xiong Y, Zhang W, Zhou G, et al. (2013) Participation of CD34-enriched mouse adipose cells in hair morphogenesis. Mol Med Rep 7: 1111-1116
  12. Hirotaro Fukuoka, H. S., ; Keigo Narita, Rei Watanabe, , & Shintani, S. (2012). The American Journal of Cosmetic Surgery.
  13. Hirotaro Fukuoka, M., PhD, and Hirotaka Suga. (2015). e-plasty.
  14. Inoue, K., Aoi, N., Sato, T., Yamauchi, Y., Suga, H., Eto, H., . . . Yoshimura, K. (2009). Differential expression of stem-cell-associated markers in human hair follicle epithelial cells. Lab Invest, 89(8), 844-856.
  15. Li, J., Jiang, T. X., & Chuong, C. M. (2013). Many paths to alopecia via compromised regeneration of hair follicle stem cells. J Invest Dermatol, 133(6), 1450-1452
  16. Minjuan, W., Jun, X., Shiyun, S., Sha, X., Haitao, N., Yue, W., & Kaihong, J. (2016). Hair Follicle Morphogenesis in the Treatment of Mouse Full-Thickness Skin Defects Using Composite Human Acellular Amniotic Membrane and Adipose Derived Mesenchymal Stem Cells. Stem Cells Int, 2016, 8281235
  17. Nagpal, A., Choy, F. C., Howell, S., Hillier, S., Chan, F., Hamilton-Bruce, M. A., & Koblar, S. A. (2017). Safety and effectiveness of stem cell therapies in early-phase clinical trials in stroke: a systematic review and meta-analysis. Stem Cell Res Ther, 8(1), 191.
  18. Shin, H., Won, C. H., Chung, W. K., & Park, B. S. (2017). Up-to-date Clinical Trials of Hair Regeneration Using Conditioned Media of Adipose-Derived Stem Cells in Male and Female Pattern Hair Loss. Curr Stem Cell Res Ther, 12(7), 524-530

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This document is designed to supply useful information but is not to be regarded as advice specific to any particular case. It does not replace the need for a thorough consultation and all prospective patients should seek the advice of a qualified physician

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