The Future is HAIR: Emerging Therapies for Hair Loss

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In a world where appearance often dictates confidence and self-esteem, hair loss stands as a significant challenge for millions. Numerous treatments exist, but we’re not at the point of finding a cure – yet. Dr Cathy Davies gets to the root of hair-loss therapy, unpacking what technologies are and aren’t available, as well as what’s on the horizon in this evolving field.

Whether it’s a receding hairline, a widening parting, or the dreaded bald spot, the impact of hair loss can be profound. And while the hair-loss industry rakes in billions of dollars annually, one glaring reality persists: there’s still no actual cure for inherited hair loss, known as Androgenetic Alopecia (AGA).

Despite the vast array of shampoos, serums, supplements, and surgical procedures promising miraculous results, those battling AGA find themselves engaged in a perpetual search for a permanent solution. This condition, which affects both men and women, is deeply ingrained in genetics and hormonal factors, making it notoriously difficult to treat effectively.

AGA is not merely a cosmetic concern; it can have profound psychological effects, leading to feelings of embarrassment, anxiety, and even depression. As a result, individuals affected by AGA often embark on a desperate journey, navigating an ocean of products and procedures in search of the Holy Grail: a cure.

In this article, we’ll explore the current limitations and the latest available technology and speculate on what the future may hold.

Hair technology that is not here

This is one time I sincerely hope to be proven wrong! We have many current limitations. At present, in 2024, we are not able to do the following in humans… yet:

• Take a tablet that permanently cures AGA.
• Transplant hair from one person to another successfully.
• Clone hair in a laboratory.
• Transplant hair from an animal to a human successfully.
• Permanently reverse grey hair.
• Receive gene therapy that treats AGA.

Latest available technology for hair that is here

While the above limitations exist, great strides have been made in the treatment of hair and hair loss. New combinations of active ingredients, pharmaceutical compounds, and regenerative compounds have been formulated to target and prevent further hair loss, as well as bring back as much hair as possible.

Exosome technology:

Regenerative treatments to promote hair growth are a burgeoning area of research. Exosomes, which are tiny vesicles secreted by cells, are emerging as a promising treatment for hair loss due to their potent regenerative properties. These microscopic particles act as messengers, delivering proteins, lipids, and genetic material between cells, thereby promoting cellular repair and growth.

In the context of hair restoration, exosomes derived from stem cells are particularly effective. They are injected into the scalp, where they stimulate dormant hair follicles, enhance cell proliferation, and reduce inflammation. This process not only fosters new hair growth but also improves the density and thickness of existing hair.

Unlike traditional hair-loss treatments that often focus on hormonal factors, exosome therapy targets the underlying cellular mechanisms, offering a potentially more effective and less invasive solution. The innovative use of exosomes is gaining traction as a cutting-edge approach in the fight against hair loss, reflecting the broader trend of harnessing the body’s own regenerative capabilities for medical treatments.¹

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Platelet concentrate treatments:

Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) treatments have been standardised, and the latest protocols have been developed to optimally stimulate hair follicles. This concentrated plasma, rich in growth factors and other bioactive proteins, is injected into the scalp in areas experiencing hair loss or thinning.

The growth factors present in PRP help to rejuvenate dormant hair follicles, encouraging them to enter the active growth phase and produce thicker, healthier hair strands. This can lead to increased hair density and improved scalp coverage over time. Additionally, PRP therapy can improve the overall health of the scalp and hair follicles.

The growth factors in PRP promote blood flow to the scalp, delivering essential nutrients and oxygen to the hair follicles. This enhanced blood circulation can help revitalise damaged or weakened hair follicles, leading to stronger, more resilient hair growth.²

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Hair transplant surgery:

Hair transplant techniques have become significantly more advanced in recent years, offering more natural-looking results and minimal scarring compared to traditional methods. Among these advancements are follicular unit extraction (FUE) and new tools to perform this technique.

The Devroye automated punch is a cutting-edge tool revolutionising advanced hair transplants by significantly enhancing precision, efficiency, and patient outcomes. This innovative device automates the FUE process, ensuring consistent and accurate graft harvesting. Its advanced technology minimises the risk of follicle damage and reduces the time required for the procedure, leading to quicker recovery and less discomfort for patients.

Additionally, the Devroye automated punch enables practitioners to achieve higher graft survival rates and more natural-looking results, making it a valuable asset in the field of hair restoration.

Needle-free injections:

Utilising needle-free injections for scalp treatments offers several distinct advantages, making it an attractive option for individuals seeking hair restoration or scalp therapies.

First and foremost, needle-free injections eliminate the discomfort and anxiety associated with traditional needle injections. Many people have a fear of needles, and the prospect of multiple injections into the scalp can be daunting. With needle-free injections, this concern is alleviated, as the treatment is administered using pressure or compressed air, delivering the medication or solution directly into the scalp without the need for needles. This not only improves the patient experience but also increases compliance with treatment, as individuals are more likely to undergo therapy without fear or hesitation.³

Multistep scalp treatments:

The scalp is viewed as an extension of the skin, so certain skincare approaches are now being adopted. New seven-step scalp treatments in South Korea are revolutionising haircare by addressing scalp health as a foundation for beautiful hair.

This comprehensive regimen includes an array of meticulously designed steps: cleansing, exfoliating, massaging, applying scalp packs, using scalp toners, providing intensive treatments, and incorporating protective serums. Each step is tailored to rejuvenate the scalp, remove impurities, stimulate circulation, and nourish hair follicles. Products often feature natural ingredients like tea tree oil, ginseng, and green tea, renowned for their soothing and invigorating properties.

This holistic approach not only enhances hair growth and strength but also promotes overall scalp wellness, reflecting the broader Korean beauty philosophy of maintaining a healthy base for long-term results.⁴

Bioprogramming technology:

Thanks to amazing Japanese bioprogramming technology, such as the Bioprogramming Repronizer 27D, we can now curl, straighten, and blow-dry hair without needing heat-protecting products to prevent damage. This new tech causes no damage to the hair and brings about an actual improvement in hair condition, which is unheard of among heat-based treatments.

The downside? It comes at a hefty price and is only available abroad.

Clinical trials underway: Future hair technology that may be available for hair 

So, what’s on the cards for the future of hair-loss therapies?

Gene therapy: Hair follicles are attractive candidates for gene therapy targets because they are easily accessible and can be removed and genetically manipulated in culture. Hair follicles are of special interest because our understanding of hair follicle biology has progressed significantly recently, and we now have a much more profound understanding of how genes, encoding transcription factors, growth factors, and cytokines regulate hair cycles and development. In future, hair follicles may be an accessible target for gene-based therapies in alopecia and other conditions.⁵

Additionally, many companies have various compounds and techniques in trial to treat AGA. There are a few standout ones at present, which are in various stages of clinical trials:

• Pyrilutamide is a potent topical androgen receptor antagonist currently in development for AGA.
• Epibiotech is a biotechnology company from South Korea targeting effective dermal papilla cell therapy.
• Moogene Medi is a South Korean company developing topical therapeutics, with its current treatment approach called HUTERA.
• Replicel has a hair growth treatment, RCH-01, which involves culturing a person’s own hair follicle cells and then reinjecting them back into the scalp. First, a small punch-biopsy is removed from the healthy hair follicles. A specific cell is dissected, cultured and replicated, then injected back into the scalp. It is not yet available.

In summary

Although we are some way off from rendering hair loss a thing of the past, remarkable strides are being made in terms of treatment methodologies – with both the range and efficacy of these therapies improving exponentially. Additionally, with various new approaches being trialled and planned, the future of hair appears bright, where tales of baldness may one day be nothing but a follicular fable.

References:

1. Kost Y, Muskat A, Mhaimeed N, Nazarian RS, Kobets K. Exosome therapy in hair regeneration: A literature review of the evidence, challenges, and future opportunities. J Cosmet Dermatol. 2022 Aug;21(8):3226-3231. doi: 10.1111/jocd.15008. Epub 2022 Jun 2. PMID: 35441799.)
2. Abdin R, Zhang Y, Jimenez JJ. Treatment of Androgenetic Alopecia Using PRP to Target Dysregulated Mechanisms and Pathways. Front Med (Lausanne). 2022 Mar 16;9:843127. doi: 10.3389/fmed.2022.843127. PMID: 35372424; PMCID: PMC8965895.
3. Bekkers VZ, Bik L, van Huijstee JC, Wolkerstorfer A, Prens EP, van Doorn MBA. Efficacy and safety of needle-free jet injector-assisted intralesional treatments in dermatology-a systematic review. Drug Deliv Transl Res. 2023 Jun;13(6):1584-1599. doi: 10.1007/s13346-023-01295-x. Epub 2023 Mar 8. PMID: 36884194; PMCID: PMC10126042.
4. Trüeb RM, Henry JP, Davis MG, Schwartz JR. Scalp Condition Impacts Hair Growth and Retention via Oxidative Stress. Int J Trichology. 2018 Nov-Dec;10(6):262-270. doi: 10.4103/ijt.ijt_57_18. PMID: 30783333; PMCID: PMC6369642.
5. Manabu Ohyama, Jonathan C. Vogel, Gene Delivery to the Hair Follicle, Journal of Investigative Dermatology Symposium Proceedings,Volume 8, Issue 2,2003,Pages 204-206,SSN 1087-0024,https://doi.org/10.1046/j.1087-0024.2003.00810.x.