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What's New in Hair Restoration? Dr. TK's Blog

What's new in the world of hair restoration? Come check out my blog periodically for new development in medical and surgical hair restoration.

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Time: 8/4/2010 11:08:49 PM   Last Updated: 8/4/2010 11:09:38 PM
Subject: Initiation of study for treatment of chemotherapy-induced hair loss
Message: From a patient¡¦s perspective, hair loss from chemotherapy is one of the most dreaded side effects in cancer treatment. We have successfully treated someone currently undergoing chemotherapy who lost a significant portion of his hair shortly after chemo started. While this single case is by no mean conclusive of the validity of our treatment, it is worth investigating for the millions suffering from chemotherapy-induced alopecia. If you or someone you know is losing hair from ACTIVE chemotherapy and wish to be part of our study, please go to our CIA treatment study page to learn more detail.
Time: 11/16/2009 4:33:13 AM
Subject: Low Level Laser Therapy for Female Pattern Hair Loss (FPHL)
Message: Two presentations at the ISHRS 17th Annual Scientific Meeting (July, 2009) are particularly interesting to those suffering Female Pattern Hair Loss (FPHL).

Dr. N.S. Sadick, Dr. C.M. Margo, and Dr. A. Rossi, Jr. reported their findings on 15 patients with classic clinical features of female pattern hair loss. All patients are thoroughly investigated to rule out other etiologies. Each patient’s scalp is biopsied and examined with multiple methods. In 13 of the 15 cases, lymphocytic folliculitis was observed. This implication of this observation is it opens new possibilities for treatment of female pattern hair loss, targeting the inflammation. Some examples include class 1 topical corticosteroid, oral NSAID, high intensity red light LED, and low lever laser therapy.

Dr. G. Koher presented a clinical study using 650nm low level laser to treat female pattern hair loss. In this study, subjects receiving 52 scheduled treatments of 20-minute duration, over a period of 26 weeks, with an 82-laser system. 82 subjects were enrolled in the study, 58 of them completed the full 26 weeks. After 52 treatments, 97% presented an increased hair count > 20%, with 77% presenting a hair count increase of > 51%. Two subjects presented increased hair counts of 16% and 18% respectively. In conclusion, this study showed scheduled low level treatment can provide a medically significant treatment of female pattern hair loss by promoting hair growth and/or reduction of the rate of their hair loss.

Hopefully, the study underway from Transdermal LASERCAP will provide a definitive answer for LLLT.

Time: 9/25/2009 7:02:38 PM
Subject: Breakthrough Innovation – Transdermal LASERCAP
Message: During this year’s major hair transplant conference - ISHRS 17th Annual Scientific Meeting (July, 2009), Dr. Michael Hamblin from Harvard Medical School discussed the mechanism of action of low level light therapy and Dr. Grant Koher presented his study showing successful treatment of many female pattern hair loss sufferers using low level laser. The most exciting practical finding for me, however, was the Transdermal Lasercap jointly developed by Dr. Bob Haber, a well-known hair restoration surgeon and Dr. Michael Rabin.

There are three major areas where the Lasercap stands above the rest.

1. A large array of 224 lasers provides more lasers than most large systems that cost $30-60,000, yet it is designed for personal budget. Note: the wavelength (650nm) and power specification (5mw) of each laser match those from the lasers in Hairmax Lasercomb, which received FDA approval for treating hair loss.

2. This cap can be worn under any head cover (cap, hat, etc.). It provides complete scalp coverage so that the user can simply leave it in place while receiving treatment. Furthermore, it comes with a rechargeable battery pack so that one can remain mobile and continue one’s usual daily activity.

3. A rental program that can be fully credited towards the purchase price should the user decides it is effective for treating his or her hair loss.

I was never a strong proponent of low level laser therapy, primarily because compliance issues. I could not imagine myself using any of the existing low level laser systems for the long haul. However, my immediate reaction when I saw the Lasercap was “I could use this.” For the time being, the Lasercap is not yet commercially available, but I will receive a demonstration unit by the end of this month (Sept) and I look forward testing it.
Time: 8/18/2009 8:51:42 PM
Subject: Duplicative Surgery – An Alternative to Cloning?
Message: The finite supply of donor hair has always been a limiting factor in hair transplant. There are up to 10,000 follicular units (FU) in the appropriate donor area (number varies from person to person, can be as low as 6,000). Even if we can take 6,000 FU from the donor area, they can only cover 150 cm2 if placed at 40 FU/cm2. 150 cm2 may sound like a big area, but a person with Norwood Class 6 male pattern hair loss can easily have 250 cm2 of deficiency. A recent study published by a group of physicians and researchers from Italy discussed a very interesting procedure that potentially could double the amount of donor hair.

By intentional transecting (cutting into two sections) about 100 follicles after harvesting, they transplanted each portion (upper & lower) and compared the survival rate of these transected follicles to the survival rate of intact follicles on 28 patients. They found the graft survival rate for the transected follicles to be only slightly less than that of the intact follicles at 6 and 12 months (providing a net hair count gain of 81% when compared to intact follicles).

Unfortunately, the caliber of the hair grew from the transected follicles suffered some and averaged slightly less than that of intact follicles (~75% for transected follicles vs. 96% of intact follicles). The authors also failed to translate calibers into cross-sections, which is directly proportional to the volume of a hair shaft. If we compare the cross sections extrapolated from the calibers, we find that hair from transected follicles only has ~60% of the cross section as hair from intact follicles.

My conclusion based on this study:

By taking a follicle, cutting it into two and transplanting each portion, we can get 1.81 hairs but each with only 60% of the cross-section. Since 1.81 x 0.6 = 1.09, there is a small net gain of 9% in hair volume. Such gain is probably not worth the effort and expense to perform this procedure. However, this study was concluded at 12 months and additional gain is possible at 18 months. Also, the protocol did not include minoxidil. Minoxidil may be able to increase the hair shaft caliber. With additional refinement of the technique and protocol (we are doing some trials ourselves), this and similar methods have the potential to provide an effectively increase on the number of hair and provide a solution for those with significant hair loss.
Time: 8/18/2009 8:15:42 AM
Subject: “Hair Cloning” status review – update from the ISHRS 17th Annual Scientific Meeting (July, 2009)
Message: Dr. Bassam Farjo, the principal investigator for Intercytex Phase II Cell Therapy Research Trial in UK, gave an update on the current status of follicular stem-cell therapy, commonly referred as “hair cloning” by the general population.

There are two major organizations, Intercytex and Aderans, working on cell therapies, each using a slightly different approach. Intercytex just completed its Phase II trial but couldn’t successfully grow human hair follicles. Hence there is no plans to move onto Phase III at this time. Aderans is still in the midst of its Phase II trial.

When asked a time frame one can expect these treatments to become commercially available, Dr. Farjo said “a long time.”

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