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Hair Loss News Archives
September 2010
Cloning expected to represent future of hair transplantation
Research under way to determine whether cloning could create thousands of "copycat" hairs from a single harvested hair
Sept 2010
Cloning will represent a major advance in hair transplantation when
it is ready for prime time. It remains elusive for now, but new
clinical therapies — along with older standbys — are helping hair
loss patients in the meantime, according to a leading specialist in
hair transplantation.
One of the factors limiting hair transplantation is donor density.
Individuals without good donor density can be less-than-ideal
candidates for hair transplantation, notes Nicole Rogers, M.D.,
F.A.A.D., dermatologist and hair transplant surgeon and clinical
professor, Tulane University, New Orleans. The potential for cloning
leaves physicians hopeful for now.
"That would be the Holy Grail," Dr. Rogers says. "It would be great
if we could harvest a single hair from the back (of the head) and
create thousands of copycat hairs from that. There is significant
research ongoing in that area, but we are not there yet. It's still
going to be a while before it is ready for Food and Drug
Administration approval."
When cloning comes to fruition, there would still be challenges with
controlling the caliber and angle of hair growth. Researchers also
would have to be sure cloning did not trigger other skin conditions
such as skin cancers, she says.
Combination approach
"There are other variables that need to be investigated," Dr. Rogers
says.
When patients present with a condition such as central centrifugal
cicatricial alopecia (CCCA), Dr. Rogers may prescribe therapy such
as doxycycline or intralesional steroids to control inflammation
that is present, and then focus on hair transplantation. For male
pattern hair loss, doctors can use medical therapy such as
finasteride as an adjunct to hair transplantation.
"We (transplant surgeons) have found it is a wonderful complement to
the procedure," Dr. Rogers says. "We can start patients when they
are just noticing hair loss, so they can hold on to what they have
and regrow a good amount of hair. In conjunction with surgery,
finasteride can even reduce the number of procedures that a patient
needs."
Dr. Rogers's practice in younger male patients is to prescribe
medical therapy for about six to 12 months, and then evaluate
whether the patient would still like to undergo transplantation.
"Medication is a good option, because we can't predict their hair
loss," she says.
New advances
The NeoGraft hair transplant machine (NeoGraft) is a new device used
to aid in the process of follicular unit extraction (FUE). The
technology allows clinicians to harvest individual follicles from
the back, which must then be dissected. The follicles are removed
from the donor area using a punch of less than 1 mm. According to
Dr. Rogers, a vacuum-assisted suction device makes harvesting a
little easier for doctors.
"Still, it is operator-dependent in terms of how the hairs are
placed in the frontal area and what the final outcome is," Dr.
Rogers says. "With this device, a prerequisite to success and a very
natural result is its use by an experienced hair transplant
surgeon."
Clinical therapies
Another development is the use of diabetes medication to treat hair
loss. According to report published in the December 2009 issue of
Archives of Dermatology, oral pioglitazone, a peroxisome
proliferator-activated receptor (PRAR) gamma, demonstrated
improvement in patients with lichen planopilaris, a rare disorder
that leads to permanent hair loss.
"Scarring alopecias are irreversible, and you have to make sure
there is no evidence of inflammation before you transplant these
patients," Dr. Rogers says. "This impact of the medication is
exciting, because it gives us another understanding to help conquer
a difficult condition."
Patients should be advised of potential side effects with therapy in
the form of the agonist of pioglitazone, she says.
"It increases the body's sensitivity to insulin, so theoretically,
patients could develop hypoglycemia," Dr. Rogers says. She notes
there is also a risk of peripheral edema and congestive heart
failure associated with use of the medication.
Another new clue to the etiology of hair loss is the recent
identification of a gene in the development of hereditary
hypotrichosis simplex, Dr. Rogers says. This gene, which helps
researchers to better understand follicular miniaturization, may
also be used to understand male and female pattern hair loss. If
this development offers solutions to other types of hair loss,
patients and physicians alike will be better off.