Androgenetic alopecia or pattern hair loss is the most common cause of hair loss, affecting both men and women. Androgenetic alopecia has a clear genetic predisposition mediating an excessive response to androgens.
As we will understand, hair loss is notoriously difficult to treat and treatment options for hair loss are unfortunately very limited. Topical minoxidil solution and oral finasteride 1 mg are treatments commonly used, but unfortunately can come with unwanted side-effects. Minoxidil efficacy is limited, and studies suggest that only one-third of the patients experience a mild success or moderate hair regrowth after 1 year of use. Scalp irritation, dryness, itching, dermatitis and hypertrichosis are commonly reported after topical minox- idil use. Oral finasteride for males has been frequently associated with decreased libido, erectile dysfunction and ejaculatory problems. In addition, both minoxidil and finasteride require a long- term commitment by the patient on a daily basis, most likely for an individual’s life. It is also frequently reported that this continued use or fluctuation of use can lead to increased hair loss.
Furthermore, in the advanced stages hair loss, minoxidil and finasteride have limited effectiveness, and surgical hair transplantation would be the only option for the majority of these patients. Hair transplant also comes with limitations, like limited donor supply, which is not sufficient to cover full area. Also, many females are not ideal candidates for hair transplant surgery.
This highlights the significance of finding effective new treatment for hair loss, which are more natural and have limited side effects. Since androgenetic alopecia is characterised by defects in hair progenitor cells, while hair follicle stem cells remain viable, transplantation of multipotent stem cells has become a popular treatment option. Autologous cellular micrografting is a method that obtains mature stem cells from scalp biopsies of a patient.
The mechanisms of action in the autologous micrografting treatment for hair loss include the enhancement of hair follicle regeneration by transplantation of mature multipotent stem cells, besides the reactivation of existing stem cells and progenitor cells of miniaturised hair follicles. This is achieved by restoring hair growth signalling via the injection of bioactive protein growth factors, and A process called neo-angiogenesis which basically means the stimulation of new blood vessel formation. It is understandable that this is a relatively new technology. This being said, published studies so far are providing promising results, reporting increased hair density and thickness in a high percentage of patients.
In this new 2021 study, it is reported that the clinical efficacy of a single application of the autologous micrografting treatment for hair loss in both men and women.
What causes androgenetic alopecia?
Mature and follicle stem cells play a key role in the regeneration of hair follicles. They have the ability to self-regenerate between the telogen and anagen phases of the hair cycle. They also have the potential to migrate to become progenitor cells, forming the internal hair follicles and hair stem. The activation of these stem cells is controlled by the surrounding micro-environment. Progenitor cells further contribute in regulating hair growth by secreting hair growth stimulating factors
The most supported and understood mechanism of androgenetic alopecia involves the suppression of progenitor cells via dihydrotesterone (DHT). It has been shown that although progenitor cells are damaged in androgenetic alopecia, the hair follicle stem cells remain well preserved, which explains the potential of reversibility of the hair loss condition.
This recent study concluded that two-thirds of patients with hair loss caused from androgenetic alopecia would respond favorably to a single treatment session with autologous micrografting in the first 6 months following treatment. The post treatment analysis has shown significant improvements in hair regrowth, hair thickening, promotion of follicular units and reduction of hair follicle miniaturisation. In combination, these effects result in an increase in the hair area coverage, improved preservation and hair follicle strength.
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