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New treatment could reverse hair loss caused by an autoimmune skin disease

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Researchers at MIT, Brigham and Women’s Hospital, and Harvard Medical School have developed a potential new treatment for alopecia areata, an autoimmune disorder that causes hair loss and affects people of all ages, including children.

For most patients with this type of hair loss, there is no effective treatment. The team developed a microneedle patch that can be painlessly applied to the scalp and releases drugs that help to rebalance the immune response at the site, halting the autoimmune attack.

In a study of mice, the researchers found that this treatment allowed hair to regrow and dramatically reduced inflammation at the treatment site, while avoiding systemic immune effects elsewhere in the body. This strategy could also be adapted to treat other autoimmune skin diseases such as vitiligo, atopic dermatitis, and psoriasis, the researchers say.

“This innovative approach marks a paradigm shift. Rather than suppressing the immune system, we’re now focusing on regulating it precisely at the site of antigen encounter to generate immune tolerance,” says Natalie Artzi, a principal research scientist in MIT’s Institute for Medical Engineering and Science, an associate professor of medicine at Harvard Medical School and Brigham and Women’s Hospital, and an associate faculty member at the Wyss Institute of Harvard University.

Artzi and Jamil R. Azzi, an associate professor of medicine at Harvard Medical School and Brigham and Women’s Hospital, are the senior authors of the new study , which appears in the journal Advanced Materials . Nour Younis, a Brigham and Women’s postdoc, and Nuria Puigmal, a Brigham and Women’s postdoc and former MIT research affiliate, are the lead authors of the paper.

The researchers are now working on launching a company to further develop the technology, led by Puigmal, who was recently awarded a Harvard Business School Blavatnik Fellowship.

Direct delivery

Alopecia areata, which affects more than 6 million Americans, occurs when the body’s own T cells attack hair follicles, leading the hair to fall out. The only treatment available to most patients — injections of immunosuppressant steroids into the scalp — is painful and patients often can’t tolerate it.

Some patients with alopecia areata and other autoimmune skin diseases can also be treated with immunosuppressant drugs that are given orally, but these drugs lead to widespread suppression of the immune system, which can have adverse side effects.

“This approach silences the entire immune system, offering relief from inflammation symptoms but leading to frequent recurrences. Moreover, it increases susceptibility to infections, cardiovascular diseases, and cancer,” Artzi says.

A few years ago, at a working group meeting in Washington, Artzi happened to be seated next to Azzi (the seating was alphabetical), an immunologist and transplant physican who was seeking new ways to deliver drugs directly to the skin to treat skin-related diseases.

Their conversation led to a new collaboration, and the two labs joined forces to work on a microneedle patch to deliver drugs to the skin. In 2021, they reported that such a patch can be used to prevent rejection following skin transplant. In the new study, they began applying this approach to autoimmune skin disorders.

“The skin is the only organ in our body that we can see and touch, and yet when it comes to drug delivery to the skin, we revert to systemic administration. We saw great potential in utilizing the microneedle patch to reprogram the immune system locally,” Azzi says.

The microneedle patches used in this study are made from hyaluronic acid crosslinked with polyethylene glycol (PEG), both of which are biocompatible and commonly used in medical applications. With this delivery method, drugs can pass through the tough outer layer of the epidermis, which can’t be penetrated by creams applied to the skin.

“This polymer formulation allows us to create highly durable needles capable of effectively penetrating the skin. Additionally, it gives us the flexibility to incorporate any desired drug,” Artzi says. For this study, the researchers loaded the patches with a combination of the cytokines IL-2 and CCL-22. Together, these immune molecules help to recruit regulatory T cells, which proliferate and help to tamp down inflammation. These cells also help the immune system learn to recognize that hair follicles are not foreign antigens, so that it will stop attacking them.

Hair regrowth

The researchers found that mice treated with this patch every other day for three weeks had many more regulatory T cells present at the site, along with a reduction in inflammation. Hair was able to regrow at those sites, and this growth was maintained for several weeks after the treatment ended. In these mice, there were no changes in the levels of regulatory T cells in the spleen or lymph nodes, suggesting that the treatment affected only the site where the patch was applied.

In another set of experiments, the researchers grafted human skin onto mice with a humanized immune system. In these mice, the microneedle treatment also induced proliferation of regulatory T cells and a reduction in inflammation.

The researchers designed the microneedle patches so that after releasing their drug payload, they can also collect samples that could be used to monitor the progress of the treatment. Hyaluronic acid causes the needles to swell about tenfold after entering the skin, which allows them to absorb interstitial fluid containing biomolecules and immune cells from the skin.

Following patch removal, researchers can analyze samples to measure levels of regulatory T cells and inflammation markers. This could prove valuable for monitoring future patients who may undergo this treatment.

The researchers now plan to further develop this approach for treating alopecia, and to expand into other autoimmune skin diseases.

The research was funded by the Ignite Fund and Shark Tank Fund awards from the Department of Medicine at Brigham and Women’s Hospital.

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MIT researchers have developed microneedle patches that are capable of restoring hair growth in alopecia areata patients, reports Ernie Mundell for HealthDay . The team’s approach includes a, “patch containing myriad microneedles that is applied to the scalp,” writes Mundell. “It releases drugs to reset the immune system so it stops attacking follicles.” 

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‘We’re not making new hairs, we’re rescuing’: could scientists reverse male pattern baldness?

The onset of hair loss can be devastating for some men. But research into experimental cell therapy is offering hope of keeping baldness at bay

P aul Kemp’s introduction to the issue of baldness came as a rude awakening while getting a haircut at the age of 20. “I remember my hairdresser looking down and saying ‘Oh my God, you’re going bald on top’.”

Kemp, now in his 60s, was dismayed at the discovery, but it also marked the beginning of a lifelong professional interest in the science of hair loss and how to stop it. Kemp is the co-founder and chief executive officer of HairClone, a company that is developing an experimental cell therapy treatment for male pattern baldness and whose tagline is “making hair loss history”.

Male pattern baldness affects around 85% of men by the age of 50 and losing hair can be a source of anxiety and low self-esteem . There are drugs that can slow hair loss, transplants to redistribute hair around the head, or strategic hairstyles to disguise receding hairlines and bald spots. Nothing exists to reverse the process, but that could be set to change.

In recent years, scientists have discovered that baldness has its origin in the loss of specialised skin cells, called dermal papillae, that line the base of hair follicles. These cells are crucial for regulating hair thickness, growth, texture and possibly even colour. But in some men, these cells are progressively killed off by dihydrotestosterone, the hormone that causes the male body to mature during puberty.

“You have about 1,000 of these dermal papilla cells per hair,” says Kemp. “The more dermal papilla cells, the thicker the hair shaft. When you get down to around half that number, you’ll notice the hair thinning.”

Baldness implies a lack of hair, but, technically, bald heads are not hairless. As dermal papilla cells are lost, the follicle shrinks and the hair shaft it produces becomes finer and spends longer in the dormant state. Eventually, the hairs become so fine and grow so slowly that they are effectively invisible.

HairClone is aiming to reverse this so-called miniaturisation process by allowing people to bank 100 or so youthful follicles or follicles from parts of the head that still have hair. After being taken from a patient’s head, the follicles are placed in a deep freeze container at -150C. Then, as and when required, the hair can be thawed and the dermal papilla cells can be cloned and multiplied in the laboratory to provide an almost unlimited supply.

The hope, based on experiments in mice and previous tests in people by an earlier company, is that injecting the cells back into the scalp will plumpen the follicles and return hair to a more youthful state.

“We’re not making new hairs, we’re rescuing miniaturising hairs,” says Kemp.

Around 200 clients have already banked hair, although none have yet been treated. The efficacy of the approach has not yet been established in a clinical trial, but the company is in the process of establishing quality controls that will allow it to manufacture cells to clinical standards. At that point – and the company is hoping that will be within the next 12-18 months – doctors will be able to offer it on an experimental basis to patients who they think could benefit.

One of those to have banked his hair is Tommy Smith, a 65-year-old planning consultant, who lives in Red Oak, North Carolina. Smith initially began losing hair in his 20s, possibly as a side-effect of powerful acne medications, including high dosages of prescription vitamin A.

He had a hair transplant in 1988, aged 30, which he says had “outstanding” results until he began to lose both his transplanted hair and original hair in 2015. He sees hair cloning as an insurance against further hair loss. “The concept of having hair follicles stored to address the potential of additional hair loss in the future is very encouraging,” he says. “I also think this could provide young men who have hair loss history in their family the opportunity to address future hair loss in a much less painful and complicated manner.”

Smith’s experience highlights the dilemma that hair surgeons and their patients are faced with when planning a transplant. Once transplanted, follicles retain their original identity and so need to be taken from a safe zone of the scalp that is not destined to go bald in future. Transplanting before the hairline has stabilised can lead to a “hair island” effect, requiring further transplants – and there’s also a question of whether the hairline will recede so far that there won’t be sufficient hair to spread over the whole head. “You’re chasing a moving target,” says Kemp.

However, scientists believe it may be possible to predict a man’s eventual hairline by analysing genetic markers hidden inside dermal papilla cells, meaning that in future men could make more informed choices about the most appropriate treatment.

“There’s always been this clear pattern of male hair loss, but no one’s really explained why it’s like that,” says Dr Claire Higgins, a lecturer in tissue regeneration at Imperial College London and scientific adviser to HairClone.

In a paper published in May , Higgins described evidence that the hairline of a middle-aged man could be traced back to the earliest stages of embryonic development. Around the third week of an embryo’s life, cells form three layers called the ectoderm, mesoderm and endoderm. Most organs in the body contain cells that derive from just one of these lineages: the endoderm gives rise to the internal organs, the mesoderm becomes the muscle and connective tissues, and the ectoderm becomes the central nervous system. “Normally a tissue is one lineage, but the [skin] is a bit of an enigma,” says Higgins. “The dermis [the skin’s lower layer] on the face is ectoderm and the dermis on your body is mesoderm, but the top of your head is not really known.”

Higgins argues that male pattern baldness traces out the boundary between skin cells that have taken two very different paths during development. This, she says, could explain why the cells on only certain parts of the head are oversensitive to dihydrotestosterone.

Kemp and colleagues are working to develop a test, based on the gene expression of dermal papilla cells, to establish whether the part of the scalp they come from is balding, destined to bald or will always retain its hair. “Ideally you want to be able to map the head,” he says. “We’re finding genetic differences between the hairs and we’re in the preliminary phases of doing that.”

Kemp says that after years of living with hair loss, he is comfortable with his appearance – and treatment is not for everyone. “At this stage, I’m used to looking like this,” he says. “But when I was 20, had they said, there’s something we can do about that, I would’ve done it. Our targets are younger people.”

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Studies Uncover New Approaches to Combat Hair Loss in Men and Women

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Two recent studies highlight novel ways to combat pattern hair loss in men and women using small molecules such as JAK inhibitors that reawaken dormant hair follicles, as well as stem cell therapies aimed at growing new follicles. 

In the first study, researchers led by Angela Christiano, PhD , the Richard & Mildred Rhodebeck Professor of Dermatology at Columbia University Vagelos College of Physicians and Surgeons, discovered previously unknown cells that keep mouse hair follicles in a resting state and show that inhibiting the activity of these cells can reawaken dormant follicles.

In a second study, Christiano’s team created a way to grow human hair in a dish , which could open up hair restoration surgery to more people, including women, and improve the way pharmaceutical companies search for new hair-growth drugs.

Study Discovers Cells That Put Hair Follicles to Sleep

Cross section of a hair follicle. Image: Angela Christiano / Columbia University Irving Medical Center.

In male and female pattern baldness, many hair follicles still exist but are dormant. The search for new drugs that reawaken follicles and induce hair growth has been limited by the field’s focus on finding drugs that work along the same pathways as finasteride and minoxidil, the only two drugs currently available for men with male pattern baldness. 

Christiano and her colleagues previously discovered a new pathway, called JAK-STAT, that is active inside the stem cells of resting hair follicles and keeps them in a dormant state. They previously demonstrated that JAK inhibitors applied to mouse skin are a potent way to reawaken resting hair follicles in mice. 

In their latest study, the researchers wanted to get a detailed picture of the natural processes that keep follicles dormant, so they looked for factors that controlled the JAK pathway activity in the hair follicle. 

New Cells Called Trichophages

The search revealed a previously unknown immune-related cell type that produces a substance known as Oncostatin M that keeps the follicles in a state of dormancy. “Rare subsets of immune cells were previously difficult to identify in whole skin, but this work was facilitated by our ability to sequence individual cells and pinpoint the ones making Oncostatin M,” says Etienne Wang, PhD, first author of the study. These cells are most similar to macrophages, which are scavenger cells of the immune system, and the team found them in close association with resting hair follicles.

The researchers named these cells trichophages, after the Greek word tricho for hair.

Targeting the trichophages can also turn on the hair cycle. By using small molecule inhibitors and antibodies to block Csf1R, a receptor on the trichophages, the researchers could block the flow of Oncostatin M and restart the hair cycle. 

Reawakening Dormant Hair Follicles with New Drugs

“Our previous studies implicated JAK-STAT signaling as one potential new therapeutic pathway for hair loss disorders by targeting hair follicle stem cells with JAK inhibitors,” Christiano says. (A biotech company recently reported results of a small phase 2 trial of a topical JAK-STAT inhibitor based on these studies.) “Here, we show that blocking the source of the JAK activating signal outside the hair follicle is another way to target this mechanism.”

Most drug development has focused on treatments for male pattern hair loss, and the majority of clinical trials are conducted exclusively in men.  

“These new pathways may lead to new treatments for both men and women suffering from hair loss, since they appear to be acting independently of male hormone pathways,” Christiano says. “Especially if treatments are used topically, that could avoid the related side effects seen with finasteride and minoxidil.”

Growing New Hair Follicles in a Dish

In a second study, aimed at using stem cells for hair growth, the Columbia researchers have created a way to grow human hair in a dish, which could open up hair restoration surgery to more people, including women, and improve the way pharmaceutical companies search for new hair growth drugs.

It is the first time that human hair follicles have been entirely generated in a dish, without the need for implantation into skin.

Using 3D-Printing to Stop Hair Loss

For years it’s been possible to grow mouse or rat hairs in the lab by culturing cells taken from the base of existing follicles. 

“Cells from rats and mice grow beautiful hairs,” Christiano says. “But for reasons we don’t totally understand, human cells are resistant.”

To break the resistance of human hair cells, Christiano has been trying to create conditions that mimic the 3D environment human hair cells normally inhabit. The lab first tried creating little spheres of cells inside hanging drops of liquid. But when the spheres were implanted in mice, the results were unpredictable: The cells from some people created new hair while others didn’t.

3D Printing Creates Patterned Hair Follicles

In the new study, Christiano’s team exploited the unique capability of 3D printers to create a more natural microenvironment for hair follicle growth. 

The researchers used 3D printing to create plastic molds with long, thin extensions only half a millimeter wide. “Previous fabrication techniques have been unable to create such thin projections, so this work was greatly facilitated by innovations in 3D printing technology,” says Erbil Abaci, PhD, first author of this study. 

After human skin was engineered to grow around the mold, hair follicle cells from human volunteers were placed into the deep wells and topped by cells that produce keratin. The cells were fed a cocktail of growth factors spiked with ingredients, including JAK inhibitors, that the lab has found stimulates hair growth. 

After three weeks, human hair follicles appeared and started creating hair.

Hair Farms Could Expand Availability of Hair Restoration

Though the method needs to be optimized, engineered human hair follicles created in this way could generate an unlimited source of new hair follicles for patients undergoing robotic hair restoration surgery.

Hair restoration surgery requires the transfer of approximately 2,000 hair follicles from the back of the head to the front and top. It is usually reserved for male patients whose hair loss has stabilized and who have enough hair to donate.

“What we've shown is that we can basically create a hair farm: a grid of hairs that are patterned correctly and engineered so they can be transplanted back into that same patient's scalp,” Christiano says. 

“That expands the availability of hair restoration to all patients—including the 30 million women in the United States who experience hair thinning and young men whose hairlines are still receding. Hair restoration surgery would no longer be limited by the number of donor hairs.”

The engineered follicles also could be used by the pharmaceutical industry to screen for new hair growth drugs. Currently, high throughput screening for new hair drugs has been hampered by the inability to grow human hair follicles in a lab dish. No drugs have been found by screening; the only two approved for the treatment of pattern hair loss—finasteride and minoxidil—were initially investigated as treatments for other conditions.  

The team hopes that cultured hair farms will open up the ability to perform high throughput drug screens to identify new pathways that influence hair growth.

The first study, titled “ A Subset of TREM2+ Dermal Macrophages Secretes Oncostatin M to Maintain Hair Follicle Stem Cell Quiescence and Inhibit Hair Growth ,” was published in Cell Stem Cell.

Other authors: Etienne C.E. Wang (Columbia University Irving Medical Center and National Skin Center, Singapore), Zhenpeng Dai (CUIMC), Anthony W. Ferrante (CUIMC), and Charles G. Drake (CUIMC).

The research was supported by the National Skin Center of Singapore, the National Medical Research Council of Singapore, the Locks of Love Foundation, and the National Institutes of Health (S10OD020056, P30AR069632, and P50AR070588).

Dr. Christiano is a consultant and shareholder for Aclaris Therapeutics Inc., a consultant for Dermira Inc., and recipient of grant funding from Pfizer Inc. Dr. Drake has served as a paid consultant for Agenus, Bayer, BMS, F-Star, Janssen, Merck, Pfizer, Pierre Fabre, Roche/Genentech, and Shattuck Labs. He has ownership interest in Compugen, Harpoon, Kleo, Potenza, Tizona, and Werewolf.

Columbia University has licensed intellectual property related to these studies to Aclaris Therapeutics Inc. 

The second study, titled “ Tissue engineering of human hair follicles using a biomimetic developmental approach ,” was published in Nature Communications. 

Other authors: Hasan Erbil Abaci, Abigail Coffman, Yanne Doucet, James Chen, Joanna Jacków, Etienne Wang, Zongyou Guo, Jung U. Shin (all from Columbia University Vagelos College of Physicians and Surgeons) and Colin A. Jahoda (Durham University, Durham, U.K.).

The research was supported by the NIH (National Center for Advancing Translational Sciences grant UH2EB017103; National Institute of Arthritis and Musculoskeletal and Skin Diseases grants K01AR072131 and P30AR069632); New York State Stem Cell Science (SDH C029550); an Ines Mandl Research Foundation Fellowship; and a CUIMC Precision Medicine Research Fellowship (with funds from NIH grant  UL1TR001873 ).

Dr. Christiano and Dr. Jahoda are founders of Rapunzel Bioscience Inc., which focuses on developing regenerative therapies for skin and hair disorders. The remaining authors declare no competing interests.

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A Hair Loss Study Raises New Questions About Aging Cells

Maksim Plikus loves talking about hair. The cell biologist from the University of California, Irvine rattles off obscure facts: Sloth hair has a green tinge thanks to symbiotic algae; African crested rats evolved hollow hairs, which they slather with a pasty bark-derived toxin to defend themselves; his last name comes from a Latvian word for “bald.” Growing up in Eastern Europe (he’s neither Latvian nor bald, despite his name), Plikus aspired to do biomedical research. He joined a lab that had him dissecting rat whiskers under a microscope. It was hard, and his hands would shake. But eventually he got the hang of it. “I started to appreciate just the beauty of the follicle,” he says.

Plikus interned at a hair transplant clinic before getting a PhD in pathology and starting his own lab that targets hormone-related hair loss. In pattern baldness, or androgenetic alopecia, stem cells in the follicle go dormant, meaning that they stop producing new hairs. Thick long hairs dwindle to smaller ones that shed more often and eventually vanish. “It's actually very exquisite, this micro-organ that most people don't really think is so complex,” he says.

Hair loss is underestimated, at least in terms of scientific research. It gets pegged as a cosmetic concern, not a medical one. “One does not die from hair loss. But our hair is part of our identity,” Plikus says. Losing hair takes a huge toll on mental health . Several studies have even reported that patients consider refusing chemotherapy over it.

Today, there are few treatment options. Two drugs (finasteride and minoxidil) can slow or stop loss, but show mixed results for regrowing hair—and results vanish when treatment stops. Another option is surgically transplanting follicles from the back of a person's head to the top. But this just shuffles existing hairs around. So Plikus pursued a new idea—and accidentally found himself exploring not just the mechanics of baldness, but of aging itself.

His journey began by investigating another cosmetic quirk: hairy moles, which form on the chest, arms, or elsewhere. Also called nevi, these dark spots grow long hairs, even though the skin around them is hairless. Over the past 10 years, Plikus’ team has delved into why hair grows here, hoping to pinpoint a protein that can do the same to the scalp. Now they’ve found it, he says: a protein called osteopontin.

In a battery of experiments described in June in Nature , the team reveals that osteopontin jumpstarts hair growth in mice. And in one test, the team achieved the same with human hair that had been grafted onto mice.

Jared Keller

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Brendan I. Koerner

Reece Rogers

That had obvious implications for hair regrowth, but it also raised some intriguing questions about aging cells. The osteopontin in moles comes from cells that appear to be senescent—not dead, but no longer dividing. Senescence is protective because it stops cell mutations from proliferating into cancer. But it comes at a cost: Aging researchers have long assumed that these cells stick around to the detriment of the younger cells around them. When they stop replicating, they may contribute to age-related diseases by secreting harmful molecules and increasing inflammation and dysfunction .

Senescence plays a key role in nevi development: Mutated pigment-producing cells called melanocytes stop replicating as a failsafe to prevent themselves from turning into aggressive cancers. But something in their environment causes small hairs from the surrounding follicle to grow long and thick—to keep growing, even when other cells are not. “What you see in the mole is the exact opposite of what you see on the scalp of a person going bald,” Plikus says. “I became obsessed.”

It surprised Plikus to find that such a potent rejuvenator could emerge from senescent melanocytes—something that was supposed to be dormant, if not harmful, apparently creates healthy growth. “We’re now the first ever to show that there are instances where molecules secreted by such aged cells are beneficial for hair growth,” he says.

Cells use signaling molecules, proteins, and hormones to communicate. A relatively small number of them account for thousands of functions throughout your body. For instance, the protein Wnt helps develop fat tissue and repair bones; the protein Shh ( for Sonic the Hedgehog, because why not? ) helps embryos develop fingers and a spinal cord. Both send cues to grow hair. But you can’t reawaken follicles by bombarding them with these proteins, because both can boost skin cancers. A signal that tells cells to grow isn’t limited to just healthy cells—dangerously mutated ones get the green light, too.

The objective for Plikus has been to find a signaling molecule that awakens follicles but not dormant cancer. He’s optimistic about osteopontin: Hair is generally a sign that a mole is not cancerous. And he points out that people can have hairy moles for decades, if not their whole lives, without danger.

Last year, Plikus’ team discovered that a protein called SCUBE3 was critical for regrowing fur in mice. SCUBE3 activated stem cells in mouse follicles, and Plikus envisions one day running trials to microneedle people’s scalps with SCUBE3 to encourage hair growth. However, he thinks that you can only learn so much from rodent hair. Hence: human mole hair. To find the right signaling molecule, his team carefully isolated melanocytes from nevus tissues to study individually. They sequenced their genetic material, then spent months analyzing the signaling molecules these cells produce, “and osteopontin came out of that,” he says.

In normal skin, osteopontin comes from dermal papilla, which sit at the base of hair follicles. In the new study, excessive osteopontin from melanocytes appeared to invade follicle stem cells, switching on hair growth.

To show that senescent melanocytes ooze out a molecule that reanimates follicles, the team engineered mice with nevi to not produce osteopontin. As expected, these moles didn’t become hairy. In a separate test, they confirmed that human hairy nevi overproduce osteopontin.

Their next step was to harness the effect: regrowing mouse fur. People grow hair continuously, but mice do it in bursts—so if you shave them, they’ll stay bald for a while. The team injected osteopontin into the skin of some of these newly-bald mice. Within 12 days, new hairs appeared on those that had received osteopontin.

Next, they got patients from a hair transplant clinic to donate follicles, then grafted those healthy hairs onto mice. Follicles normally undergo a sort of shock after a transplant, going dormant for a couple months. Plikus suspected that osteopontin could rouse the grafted follicles faster. Thirty days after grafting, some of these mice received osteopontin injections. Twenty days later, only those mice had sprouted human hair.

So far, the lab’s new paper has been well received—at least when it comes to the conclusions about growing hair. “It’s a really well-done and convincing paper,” says Valerie Horsley, a cell biologist at Yale University who was not involved in the work. Horsley likes that the team also pinpointed the follicle protein (CD44) that receives the signal from osteopontin. Without it, osteopontin has no effect. Tinkering with either could help regrow human hair, she thinks: “That would be cool. And we could inhibit it—stop hair growth in areas where we don’t want hair to grow.”

“It’s very exciting,” says Etienne Wang, a clinician-scientist specializing in hair at National Skin Centre Singapore. “We see hairy moles all the time. And no one ever really put two and two together.” He calls the results an important glimpse into what controls hair growth. “But I think we have to be quite cautious as well,” Wang says. It’s too early to tell whether this work will work as well on human scalps, or whether it could regrow dense hair. Most nevi only sprout a couple scraggly hairs. “It’s usually not a mole that’s got a full head of hair,” he says.

The takes on what this study might say about cell senescence are more mixed. “I was quite surprised,” says Claire Higgins, an expert in human hair biology at Imperial College London who was not involved in the work. “It challenges the dogma,” she adds, that dormant cells always damage their neighbors.

Higgins felt convinced by Plikus’ case, but others are more cautious. “Overall, I love the paper, which is something I don’t say very often,” says Horsley. But she points out that scientists don’t know much about how melanocytes affect their environment. Maybe they appear senescent but really aren’t. Or maybe the fact that they secrete osteopontin has nothing to do with being senescent. “That’s the link that they didn’t make,” she says.

Horsley is holding out for more compelling evidence. “There hasn’t been a lot of evidence for what senescence does in tissues,” she continues. “When anybody finds something, it’s a big deal.”

Plikus knows it’s a bold hypothesis. But recent animal research has offered a bit of support. He points to studies of zebrafish: If you amputate part of an adult’s fin, some of the remaining cells turn senescent. The fin naturally grows back, unless you remove the senescent cells. The same happens during mouse embryo development, and when researchers cut adult mouse livers and salamander limbs . All of these suggest that senescent cells can release proteins that help the body heal. For that reason, Plikus thinks it’s plausible that molecules from aged cells could help grow hair.

Plikus’ startup, Amplifica, began human clinical trials of a proprietary version of osteopontin in June. Participants will get it as a microneedle injection into the scalp. (He envisions it one day becoming a twice-a-year treatment, like Botox or a dental cleaning.) Amplifica is also continuing preclinical studies of SCUBE3.

It’s still not clear whether his lab has stumbled across a phenomenon common to all aging tissues, or whether nevi are simply unique. But Higgins thinks that figuring out how to kickstart hair growth is fascinating enough. “He’s shown how a thing we all know happens actually occurs,” she says. “It’s a testament to his foresight that he was able to take this observation and run with it.”

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You’re Not Imagining It: The Pandemic Is Making Your Hair Fall Out

Many doctors report an uptick in patients suffering from stress-related hair loss. Here’s what to do about it.

By Jessica Schiffer

With every month that passed in 2020, Samantha Hill’s part seemed to widen, the increasingly bald stripe of skin a representation of what she calls “a four-part terrible play” in her life. Reeling from the death of her father in January, Ms. Hill, a 29-year-old freelance photographer, had barely adjusted to her new normal when the pandemic hit and further upended her life.

After the death of a friend in June, when her hair appeared to thin even more, she created a folder on her phone titled Hairgate, featuring every selfie she’d taken in the last four years.

“I was trying to figure out where it all went wrong,” said Ms. Hill, who lives in the Williamsburg section of Brooklyn.

It’s a quandary many people, particularly women, have agonized over in recent months, as their brushes and shower drains filled with tangles of hair. Google searches for hair loss increased by 8 percent in the last 12 months, according to the data science firm Spate, with the topic being searched an average of more than 829,000 times a month in the United States.

The phenomenon is not all in our heads, according to experts, but is another frustrating byproduct of both immense stress and post-viral inflammation from Covid-19. Known as telogen effluvium in the medical world, temporary hair loss results from fever, illness and severe stress, pushing more hairs than normal into the shedding phase of the hair growth life cycle.

Although hair loss tends to be associated with men because of the prevalence of male-pattern baldness, telogen effluvium is more common among women, who often experience it after childbirth.

“Any type of severe stress can trigger it, whether it’s stress on your body from illness or emotional stress such as the death of a loved one,” said Dr. Abigail Cline, a dermatologist at New York Medical College who has conducted research on pandemic-related hair loss. “Even though not everyone has been infected with Covid-19, we’re all living with it.”

Tackling Hair Loss Holistically

For those who have had the virus, hair loss has become a common symptom of the recovery process, usually occurring three to four months after getting sick but sometimes experienced sooner. Dr. Jerry Shapiro, a dermatologist at NYU Langone Health who specializes in hair loss, said that while a healthy head of hair usually includes 90 percent anagen, or growing, hairs and 10 percent telogen, or resting, hairs, that ratio can shift up to 50-50 after experiencing a high fever or flulike illness.

For Misty Gant, a 35-year-old wellness coach living on the Lower East Side, the change happened fast. After being infected in March, Ms. Gant started losing handfuls of her long red hair in the shower and began to notice balding at her temples a few weeks after recovering.

“It was really hard because my hair is important to me — it’s part of my identity,” she said, noting that before it thinned, it was her most complimented feature.

Ms. Gant, who regularly dives into health and wellness research for clients, soon landed in forums full of people who had gone through similar post-Covid-19 hair loss. After doctors confirmed her suspicion that she was suffering from a post-viral inflammatory response, she readied an arsenal of holistic remedies to try to fix it.

Her first point of attack was an anti-inflammatory diet that cut out sugar, gluten, dairy and alcohol and incorporated colorful fruits and vegetables, oily fish and healthy fats like avocados and nuts. She kick-started a new supplement routine of Omega 3-6-9, turmeric with fenugreek, evening primrose oil and two tablespoons of aloe juice a day, a combination she believes to be anti-inflammatory and lubricating for the skin and hair.

She began giving herself daily scalp massages using Bumble and Bumble Tonic Primer , which includes rosemary oil, an ingredient that some studies have found to encourage hair growth. Two days a week she doused her hair in a mixture of coconut oil and pure rosemary oil and left it in for 24 hours. Though not a quick fix, it seemed to pay off: She now has tufts of baby hair growing in at her temples.

“I try to do everything the natural way, and as a wellness practitioner, I know that things take time,” Ms. Gant said.

A Less Intensive Approach

Although it can still take months to see a significant difference, many people have had similar results from a combination of supplements, thickening shampoos and illusion-creating haircuts.

After her husband noticed a few bald spots on the back of her head early in the pandemic, Martyna Szabadi, a 34-year-old business consultant who hasn’t had Covid-19, experimented with products said to promote hair growth, including various scalp scrubs, a hair serum from the Ordinary and a daily drink of flax seed water. Nothing helped until she began using RevitaLash Thickening Shampoo and Conditioner and taking four capsules of Nutrafol core supplement for women.

“After half a year of this combination, I finally have the hair issue under control,” Ms. Szabadi said.

Nutrafol supplements also seemed to help Ms. Hill get her hair back on track after she began taking them in July, leaving her with a slimmer part and new hair growth around the crown. It was a boom year for the company, with revenue increasing 60 percent in 2020 compared to 2019, according to Giorgos Tsetis, the chief executive and a founder of the company.

Mr. Tsetis said that 80 percent of the company’s sales increase can be attributed to its two core formulas for women: Nutrafol Women and Women’s Balance. They include ingredients like vitamin A, vitamin D, zinc and biotin, the last of which has become widely known as a hair growth supplement despite the fact that dermatologists disagree over its efficacy.

“No one’s really been able to prove it helps hair in a randomized controlled study, and they’ve had a long time to prove it,” Dr. Shapiro said.

But with wellness ruling the day, Nutrafol’s chemical-free, made-from-the-earth virtue has made it a popular option. Nutrafol bills itself as a “natural, holistic” alternative to old-school remedies like Rogaine, or minoxidil, which is a topical solution used to improve blood flow and stimulate hair growth.

Another treatment option is platelet rich plasma therapy, known as P.R.P., which involves the injection of a patient’s own blood into the scalp to stimulate hair growth. Priced between $500 and $1,800, P.R.P. doesn’t work for everyone and is best done alongside other treatments, according to Dr. Shapiro, who believes it’s a better fit for people experiencing female or male-pattern baldness, which has a genetic cause.

The Quicker Fix

If waiting three months for a shampoo or supplement to kick in doesn’t thrill you, consider a haircut that will make your hair look healthier than it is. Justine Marjan, a hairstylist whose clients include Kardashians and the model Ashley Graham, recommends a shorter, blunt cut to create an illusion of thickness.

“It’s best to avoid longer looks, as the hair can end up looking weak and frail at the ends,” Ms. Marjan said. If your hair loss is most noticeable at your hairline or part, she suggests using an eye shadow or root touch-up spray that matches your hair color to create depth and the appearance of fullness. Using headband-style extensions that you can easily pop on and off without damaging the hair is another favorite trick.

Most important, be gentle and strategic with your hair. Ms. Marjan recommends drying fragile hair with a soft microfiber towel and using a tool like the Tangle Teezer to prevent breakage. Sleeping on a silk pillowcase is also believed to minimize breakage. And, while many people resort to ponytails when their hair is limp, it’s best to avoid tight styling that could pull out more hair.

What’s definitely not great for hair growth? Constant panic.

“Stressing about it will only cause more hair loss,” Dr. Cline said, noting that a deep, six-month-long breath is a better prescription. “I reassure patients with telogen effluvium that their hair will grow back, but it’s going to take time.”

An earlier version of this article referred incorrectly to the phase during which hair grows. It is the anagen phase, not antigen.

How we handle corrections

More on Hair Loss and Balding

There are several factors that can affect our hair health..

Can stress really make your hair fall out? It can, but the good news is that it is usually temporary .

What happens to hair as we get older? Should you switch products?  We answered some pressing questions  about hair and aging.

An old and well-known hair-loss treatment drug , used in a different way, can be better for hair loss than many expensive and aggressively marketed remedies, dermatologists say.

Doctors saw an uptick in patients, particularly women, suffering from stress-related hair loss during the pandemic. Here’s what to do about it .

Until recently, there was no treatment for those with alopecia areata . A drug approved by the Food and Drug Administration could restore hair growth in many patients .

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Hair Loss Research: What’s in the Pipeline?

Written by Dr. Kris Sifeldeen / Medically reviewed by Dr. Ashley Steffens / Last update: Dec. 2021

Current Treatments   Emerging Treatments     Clinical Trials   Preclinical Trials   Hair Loss Cures   Research in 2020 Research in 2021

The Science of Hair Regrowth

Hair loss is a condition affecting men and women of all ages, and often comes with significant psychological and social impacts to those affected. Hair loss research is important not only for the general appearance and maintenance of hair, but also for a person’s psychological well-being. (1) Hair loss is caused by a number of factors, so treatments for hair loss also vary in their approach. 

Current Treatments for Pattern Hair Loss

Androgenic alopecia , or pattern baldness, is the most common form of hair loss. It is caused by various factors, one of the most important being a buildup of dihydrotestosterone (DHT). DHT is a hormone converted from testosterone by an enzyme called 5α-reductase. DHT is classified as an androgen and is important for male sexual development, but also present in women. While the exact mechanism remains unclear, it is thought that increased blood levels of DHT leads to shorter hair growth cycles and thinning of hair over time. 

Hair loss treatments approved for this condition include minoxidil, finasteride, LLLT, and dutasteride. Minoxidil, finasteride, and LLLT are FDA-approved treatments for androgenic alopecia. Dutasteride is currently only approved as a pattern hair loss treatment in Japan and South Korea.

Minoxidil (Rogaine®) acts as a vasodilator, expanding the blood vessels underneath the scalp and allowing more oxygen and nutrients to feed the hair follicles. Typically it is used as a foam or ointment and used topically on the affected areas of the scalp. Minoxidil is typically the first treatment option given to patients experiencing androgenic alopecia, and has been a staple in treating hair loss since 1988. (2)

Finasteride is a medication known as a 5α-reductase inhibitor, and it works by blocking DHT, the main culprit in AGA. Since 5α-reductase is the enzyme responsible for converting testosterone to DHT, blocking this conversion decreases levels of DHT in the body. As DHT levels decline, the hair growth cycle becomes more normal, and hair follicles can regain some of their thickness. 

Dutasteride is another 5α-reductase inhibitor, but is only approved for the treatment of hair loss in certain countries such as South Korea and Japan. Like finasteride, dutasteride is typically used to treat men with an enlarged prostate, but is also commonly used off label for AGA. A 2019 scientific review that compared the effectiveness of both finasteride and dutasteride found that while both drugs showed similar rates of side effects, dutasteride seemed to show better efficacy. (3)

Low-Level-Laser Therapy (LLLT) uses short wavelengths of light (in the red light range on the electromagnetic spectrum). This type of light has been shown to stimulate the growth of hair, and has evolved into its own hair loss treatment, known as laser hair therapy . The exact way this happens is not known, but the most widely accepted theory is that LLLT stimulates stem cells responsible for hair growth, moving them from a “dormant” phase to an actively growing phase. This is in addition to the increased blood flow to the area that LLLT provides. This treatment option provides a drug-free alternative for those in which medications have been unsuccessful, or as an add-on treatment to existing hair growth regimens. (4)

Emerging Treatments for Hair Loss

In addition to the above treatments, others are gaining in popularity, and while unapproved, they are being utilized more and more as either standalone or additive treatments to those above. These include: 

Platelet-Rich Plasma (PRP) is a treatment consisting of an injection of a patient’s own plasma (the liquid part of blood) that is rich in platelets (important in clotting and healing). PRP is not just used for stimulating hair growth. It is commonly used in sports injuries such as tendonitis and muscle and joint injuries, as well as to treat wrinkles on the face (more commonly known as a “vampire facial”). The nutrient-dense injection is thought to reduce hair loss in these patients while platelets provide healing growth factors that allow hair follicles to produce hair. Multiple treatments are typically required before patients begin to see results, and this method is considered more invasive than others previously mentioned. (5)

Microneedling is a treatment that harnesses the body’s own regenerative wound healing abilities. Using either a rolling device (a drum consisting of hundreds of tiny needles connected to a handle) or a pen device, tiny puncture wounds are made in the top layer of skin. The healing process follows which brings blood, nutrients , and growth factors to the area. During the process, hair follicles are stimulated to grow and mature, stimulating hair growth. The procedure can also be used to enhance drug absorption into the scalp, improving the effectiveness of existing treatments. More research is needed to determine how efficacious microneedling for hair growth is, but this option is gaining in popularity. (6)

Hair transplantation is a surgical approach to combat hair loss. In this technique, a surgeon takes hair follicles from areas of the scalp that are resistant to the effects of DHT such as the back of the head, and these are transplanted into areas of hair loss. The effectiveness of this procedure varies depending on differences in techniques and the skill level of the surgeon. For the most part, results are seen after 6 to 8 months, and other agents such as minoxidil sometimes need to be added to prevent further progression of the disease. (7)

Stem cell treatments for hair loss can be divided into 2 types:

Follicle-derived : This type of hair cloning involves harvesting hair follicles from a patient, growing them in a laboratory, and then re-implanting them across the affected areas of the scalp. This is still in its preclinical, experimental phase, with hair follicles currently being stored in a laboratory and grown in vitro. (8) 

Adipose-derived : In this option, stem cells are obtained from fatty tissue through liposuction, conditioned, and then injected back into the scalp to induce hair growth. This type is actively practiced and has seen success in people fighting hair loss. (8)

Adipose-derived stem cells are also known as adipose-derived regenerative cells (ADRC). Adipose, or fat tissue, is the body’s largest store of stem cells. These cells are also relatively easy to obtain via liposuction versus bone marrow harvesting. As well, fat tissue contains inherent anti-androgen and anti-inflammatory properties, which helps to target the believed causes of androgenic alopecia. Combined with its ability to create new blood vessels (neovascularization), this treatment presents a promising venue to combat hair loss. (9)

A new combination therapy is being researched, which combines ADRC with platelet-rich plasma , known as autologous fat transfer with PRP (AFTP). PRP provides growth factors from platelets as well as promotes the growth of stem cells. Adding PRP to adipose tissue also helps to ensure better survival of the graft with easier application due to PRP somewhat “liquifying” fat tissue. (9)

New Hair Loss Treatments

Many treatment modalities are also constantly being looked at in new ways, whether that entails a different formulation of an existing treatment, a combination of treatments into one delivery system, or the addition of a new class of medication. Baldness research is continuing to provide new and interesting pathways to treat those suffering from hair loss!

Improving Minoxidil Absorption

Minoxidil is FDA-approved as a liquid and foam. These formulations limit side effects and allow for targeted treatments. The downside is that these products have low absorption and therefore can also have low efficacy. 

Unfortunately, the issue isn’t easily resolved by simply using higher concentration products. Studies have shown that higher concentrations of minoxidil are no more effective than lower-dose FDA-approved options but cause far more side effects. Increasing absorption in an alternative way can help improve people’s response to minoxidil. 

In order for topical minoxidil to work, it must be converted into its active form, minoxidil sulfate. This is done mostly by SULT1A1 enzymes found in the scalp. 

SULT1A1 is a novel enzyme booster, meant to be used 5-10 minutes before applying minoxidil. When men with androgenic alopecia used both the enzyme booster and 5 percent minoxidil, 75 percent of them experienced hair regrowth after 60 days. Only 33 percent of men using minoxidil on their own saw the same effect. (10)

Minoxidil absorption may also improve when taken orally. While oral minoxidil is not FDA-approved as a hair loss treatment, it is not exactly new, either. Back in the 1980s, physicians noticed that an oral blood pressure medication, Loniten (brand name for oral minoxidil), was causing an interesting side effect: hair growth. 

The FDA approved topical minoxidil as a treatment for hair loss in men in 1988 and followed up with approval for women in 1991. (2) This topical formulation was the mainstay of treatment for people with alopecia, as the oral form’s dose, starting at 5 milligrams, would often bring unwanted side effects. Currently, low-dose oral minoxidil is being trialed as a hair loss treatment, as doses as low as 1 milligram have been reported to cause hair growth. 

A new formulation of low-dose oral minoxidil has shown success in females with androgenic alopecia and small studies have shown similar results in males. A 2019 clinical trial compared daily doses of 1-milligram oral minoxidil to daily applications of 5 percent topical minoxidil in females suffering from pattern hair loss. Over 24 weeks, this study showed a 12 percent increase in hair density in the oral minoxidil group compared to 7.2 percent in the topical group. This was found to be a statistically non-significant difference, meaning both formulations work as well as each other. This offers a possible alternative to those suffering from pattern hair loss who are seeking a non-topical treatment. (11) 

Topical DHT Blockers and Microinjections

5α-reductase inhibitors like finasteride and dutasteride are usually used as oral medications. However, these oral drugs often come with systemic side effects, such as decreased libido, sexual dysfunction, and breast tissue enlargement in men. Reformulating these 5α-reductase inhibitors into topical products like lotions and creams allows them to produce a more targeted effect while reducing these unwanted side effects. 

Dutasteride Microinjections

Dutasteride has a longer half-life and higher potency than finasteride in inhibiting 5α-reductase, reducing DHT by 90 percent. Unfortunately, this also means that side effects such as erectile dysfunction, decreased libido, etc. are just as likely for dutasteride users. (12)  

Dutasteride microinjections are currently being studied as a way of providing local therapeutic action while minimizing side effects. In a 2017 study, 6 patients with pattern hair loss were treated over 9 months. They were given injections of 0.01 percent dutasteride at 3-month intervals. The dutasteride microinjections resulted in significant increases in hair density and hair diameter in all patients, with no adverse effects. (13) 

A separate study evaluating 0.05 percent dutasteride injections showed increased hair density in 92.9 percent of patients receiving 7 injections spaced 1 week apart. Only 7.1 percent of people in the placebo group showed increased hair density. There were no significant differences in adverse effects between the two groups. (14)   

Topical Finasteride Combination Treatments

Finasteride began being studied as a topical formulation to treat pattern hair loss in 1997, as an alternative to oral formulations. This treatment was safe to use in women as well, as finasteride applied topically provides far less absorption and therefore little to no systemic side effects compared to oral, which for this reason was reserved for men only. (15) Scientists have developed a new combination of topical 3 percent minoxidil plus topical 0.25 percent finasteride as one solution. 

Researchers studied this combination in comparison to simply 3 percent minoxidil in 30 postmenopausal women with female pattern hair loss. By 24 weeks, they found the combination treatment to be superior to minoxidil alone in terms of hair diameter. The authors do note however that because some finasteride can be absorbed through the skin, this potential treatment should be reserved for post-menopausal women. (16)

Topical finasteride has also been combined with other hair loss treatments. NuH Hair is a new lotion that contains topical finasteride, dutasteride, and minoxidil! Combining these medications delivers triple-action against hair loss and was shown to stimulate hair growth within 3 months of use in one study assessing 15 patients with pattern hair loss. 

Participants in the study were also given the option of using Rogaine foam, ketoconazole shampoo , and oral finasteride. The people who used NuH hair along with all three medications saw hair regrowth in 30 days! (17) More research is being done to assess the effectiveness of this new treatment, but tackling hair loss via three different pathways that are known to work individually appears to be a promising option.

Spironolactone and Minoxidil Combination Treatments

Spironolactone is an oral medication that is usually used to treat heart failure and high blood pressure. However, this drug also acts as a DHT blocker. A novel combination gel consisting of minoxidil 5 percent and spironolactone 1 percent gel was tested against either of these treatments alone in 60 patients, both male and female, with androgenic alopecia. 

After 12 months, researchers found that while 90 percent of the minoxidil group and 80 percent of the spironolactone group showed hair growth, 100 percent of the combination group demonstrated improved hair growth! The idea behind this combination is to deliver a powerful combination therapy with decreased risk of side effects, as low-dose, topical spironolactone is thought to be well-tolerated compared to finasteride . (18) 

In addition, researchers studied a combined therapy of oral minoxidil plus oral spironolactone in adolescent girls with female pattern hair loss aged 13 to 18. They found objective improvement in 5 out of 6 patients after 13 months. (19)

Hair Loss Research: Current Areas of Interest

In addition to the novel hair loss therapies mentioned, there are areas that researchers and pharmaceutical companies are pursuing in the quest to treat hair loss. The chart below shows hair loss treatments that are still completing clinical trials.

Hair Loss Research in Clinical Trials

Company - product, next results in*.

*FDAAA 801 states that all clinical trials must submit their results within 12 months of the date on which the final subject was examined or received an intervention. ‘Next results’ is estimated based on this law and the completion date listed on the clinical trial’s page.

Biosplice Therapeutics’ Wnt Booster SM04554

Biosplice Therapeutics , based in California, is researching a topical therapy for pattern baldness (SM04554) that targets the Wnt pathway, a cell signaling system. The Wnt pathway is heavily involved in cell cycling. By developing a drug to activate it at key moments, hair follicles can be “turned on.” If successful, this treatment can help to stimulate hair growth via the body’s own cellular function. (20,44)

RepliCel and Shiseido’s Autologous Cell Therapy RCH-01

RCH-01 is another therapy being trialed in the treatment of pattern hair loss. It represents a treatment known as “autologous cell therapy,” where a patient’s own cells are grown and reimplanted to achieve the desired effect. 

The cells used in RCH-01 are known as dermal sheath cup (DSC) cells, which are the cells lost in androgenic alopecia. Implantation of these cells into the scalp has the potential to induce normal hair follicle function and produce hair growth. This research is being done by RepliCel , a Canadian regenerative medicine company, in collaboration with Shiseido , a Japanese cosmetics company. (21,22)

Follica’s Hair Follicle Neogenesis Device

Follica , headquartered in Boston, U.S.A., is trialing a proprietary medical device in combination with a topical growth formula to treat hair loss. Their method involves combining a topical medication with “micro-trauma” which is similar to microneedling. Their process aims to grow new hair follicles and stimulate growth where follicles already exist. (23)

Cassiopea’s Breezula®

Clacosterone , a topical solution used to treat acne, is also being researched as a hair loss treatment. Clacosterone (known as Winlevi®) is an FDA-approved drug used to treat acne. This medication is also being explored as a hair loss treatment. When used for pattern hair loss, this medication is known as Breezula® . 

This androgen receptor blocking drug was developed by Cassiopea , an Italian pharmaceutical company. The androgen blocking effects of this drug are now being investigated for the treatment of androgenic alopecia in both men and women. (24)

Kintor’s KX-826/Pyrilutamide

A Chinese pharmaceutical company, Kintor , is trialing its own androgen receptor blocker, known as pyrilutamide or KX-826. It is currently being studied in both China and the United States. Like clacosterone, it is also being studied separately as a treatment for acne vulgaris. (25)

In addition, Kintor has entered phase 1 trials of another compound, GT20029, which is an androgen receptor degrader. It is also being trialed for the treatment of alopecia and acne vulgaris. (25)

Energenesis Biomedical’s Cell Booster ENERGI-F701

Energenesis Biomedical , based in Taiwan, is investigating ENERGI-F701. This is a topical treatment meant to boost the cellular activity of specific enzymes to increase hair growth. ENERGI-F701 is currently being studied in phase 2 trials to assess its efficacy in treating female pattern hair loss. (26)

TechnoDerma’s Topical Small Molecule Drug

A novel topical “small molecule” therapy known as TDM-105795 is currently being trialed by the Chinese biotechnology company, TechnoDerma . While not much is known about the mechanism of action of this particular drug, phase 1 clinical trials are underway to assess the safety and adequate dosing of this “cutting-edge technology”, according to the company. (27)

Medical Life Care Planners’ Varin and CBD-Rich Hemp Oil

Medical Life Care Planners, LLC , a medical cost projection company that calculates life plans and medical costs for injury settlements based in the USA, are approaching the treatment of hair loss from another direction. They are currently recruiting for phase 1 trials, testing a topical hemp oil to treat androgenic alopecia, following a similar successful trial. (28) 

Hair follicles contain endocannabinoid system receptors which are believed to inhibit hair growth. This company is assessing the utility of this topical hemp oil to inhibit these receptors and induce hair growth via specific components of hemp oil called varins and CBD. These are specific components unlike those found in commonly seen hemp products. (28) 

What Can We Learn From the Latest in Hair Loss Research?

The above studies and trials provide interesting insights into not only the future of hair loss treatment, but our understanding of how hair growth and hair loss happen. Every year great strides have been made in the science of hair growth, and these studies provide us with an opportunity to look in-depth at how they chose to pursue their unique avenue of combatting hair loss. 

The Wnt Pathway Regulates Hair Regrowth

Research into utilizing the Wnt pathway for hair loss centers on the understanding of cell biology. Simply put, the Wnt signaling pathway is important for allowing certain signals into cells, but not others. This is done through specific cell surface receptors, and depending on the signal, cells can be stimulated to produce or stop producing proteins.

The development of multiple tissues depends on the Wnt signaling pathway. Biosplice Therapeutics’s research is based on Wnt signaling ​​— specifically, the way it initiates and maintains the anagen phase of the hair growth cycle. This is the phase when hair follicle cells rapidly divide and grow and new hairs are formed. Wnt activation also causes the development of new hair follicles, and the reduction of Wnt signaling is associated with progressive hair loss. (29)

SM04554 is an experimental, topical Wnt modulator being studied by Biosplice, and is currently undergoing phase 3 trials after proving safety and efficacy in Phases 1 and 2. In these studies, 49 patients were split between 0.15 percent, 0.25 percent, and placebo treatments.

After an active treatment phase of 90 days, both treatment groups saw statistically significant results over the placebo group, with more increased hair counts in the stronger treatment group (0.25 percent). After another 51 days of follow-up, both treatment groups had roughly equivalent results. Surprisingly, the lower strength treatment group saw a greater increase in both vellus hair count, which are shorter and lighter hairs sometimes called “baby hairs”, and terminal hairs which are the thicker, longer hairs. (30)

A second phase 2 study investigated 300 patients split into 3 groups, once again with one group receiving 0.15 percent SM04554 solution, one with 0.25 percent solution, and one with simply placebo. Subjects were investigated for clinical and imaging outcomes at 45, 90, and 135 days. 

By day 135, hair counts improved in treatment groups (10.1 per cm²   for the 0.15 percent group, 7.7 per cm²   for the 0.25 percent group) and decreased in the control group (-2.8 per cm ² ). This was true as well for hair density (336.4 µm per cm²   in the 0.15 percent group, 281.7 µm per cm²   in the 0.25 percent group, and -418.7 µm per cm²   in the control group). 

In terms of change from baseline, the 0.15 percent group had the greatest improvement, showing what scientists term the “goldilocks effect”. In this phenomenon, a “more is better” approach is not always best, as the group with the highest dosage wasn’t the one with the most improvements. Instead, another group with a lower dosage had better results. Sometimes, a medication’s dosage needs to be “just right” to work. (30) 

Dermal Sheath Cells Support and Stimulate Hair Follicles

Dermal sheath cells are found in the base of hair follicles. RepliCel is using these cells in their study to combat hair loss. In their technique, dermal sheath cells are isolated from a patient’s own hair sample. These cells are then grown in a laboratory and reimplanted into areas of hair loss. The idea behind this approach is that dermal sheath cells can both revert resting hair follicles into actively growing (anagen) hair, as well as produce new, fully functional hair follicles. 

RCH-01 is RepliCel’s autologous cell therapy that’s now entering phase 3 trials. It seeks to improve hair growth in those suffering from pattern hair loss. In their phase 2 study, 50 men and 15 women with pattern hair loss were randomly assigned to treatment with a one-time injection of 7.5 × 10 6 , 1.5 × 10 6 , or 3.0 × 10 5 dermal sheath cells, or a placebo. They were then followed up at 3, 6, 9, and 12 months. Similar to SM04554, the lowest dose injection showed statistically significant improvement in cumulative hair diameter and total hair density compared to higher doses. Adverse effects were mild and well-tolerated and included swelling, redness, and minor bleeding. (31)

Combining Microneedling With Topical Treatments

Another treatment modality utilizing a clinical device is also being examined. Follica’s proprietary device, the Hair Follicle Neogenesis (HFN) device, along with an unspecified topical treatment, was investigated in a phase 2b trial to determine efficacy in a small group of patients suffering from androgenic alopecia. This device is meant to be used in-office as a 5-minute treatment option to limit downtime. 

In this study, 48 patients with moderate grades of pattern hair loss were treated with the device, followed by a topical compound. No serious adverse effects were reported, while the combination therapy demonstrated a 44 percent improvement in visible hair count after 3 months. The HFN device functions very similarly to a microneedling device , introducing hundreds of tiny perforations in the upper layer of skin to promote collagen and growth factor release. (32)

Targeting Androgen Receptors in Different Ways

Androgenic alopecia is known to be hormone-driven, with DHT as the main culprit. DHT is known as an androgen or male sex hormone. These hormones perform their functions by interacting with specific receptors made uniquely for them, known as androgen receptors. Research into combatting hair loss therefore includes the investigation of medications that can block the androgen receptor, therefore mitigating DHT’s effects. Both Cassiopea and Kintor are trialing their own specific drugs for this purpose, but their modes of action are similar. 

Cassiopea’s drug Breezula®, also known as clascoterone, is a topical formulation that has performed well in phase 2 trials for safety and efficacy. In their trial, 344 men with mild to moderate pattern hair loss were randomly assigned to one of 5 groups: 2.5 percent solution twice daily; 5.0 percent solution twice daily; 7.5 percent solution twice daily; 7.5 percent solution once a day, and vehicle (placebo) solution twice daily. 

The researchers found that every treatment group exhibited a statistically significant increase in hair counts compared to members of the placebo group, who had decreased hair counts. The largest increase was in the 7.5 percent solution twice daily group. It also demonstrated a strong safety profile with no serious adverse events reported in any treatment group. This shows promise in treating those with mild to moderate androgenic alopecia while limiting adverse reactions. (33) 

Kintor’s second trial, studying the effects of GT20029, approaches the DHT avenue in a different way. Rather than a drug that competes with DHT and blocks the androgen receptor, this medication degrades the receptor itself, leaving nothing for DHT to bind to and exert its effects with. GT20029 is what is known as a proteolysis-targeting chimera (PROTAC), which simply means it is designed to target and bind to a specific protein, and “label” it for degradation by the body’s immune system. Phase 1 clinical trials are currently underway to assess this drug’s safety and tolerability in humans. (25)

Boosting Enzymes Prolongs the Hair Growth Cycle

ENERGI-F701 is an experimental treatment aimed at the biochemical processes which take place in the hair follicle cells. According to the Energenesis website , this compound increases the activity of AMPK, or AMP-activated protein kinase. Put simply, this is an enzyme that controls a cell’s ability to utilize glucose and fatty acids to produce energy when stores are low. By increasing ATP, the energy used by cells, this experimental treatment aims to prolong the hair cycle by expanding energy uptake by cells. (26)

Targeting Hair Follicles’ Endocannabinoid System 

Endocannabinoid system receptors are found in skin and hair tissue, and since their discovery they are believed to act as regulators of hair growth cycles, inhibiting the process when activated. Specifically, cannabinoid type 1 receptors (CB1) are found in high density in hair follicle cells. Cannabidiol, or CBD, is what is known as a “negative allosteric modulator” of these receptors, meaning it binds to CB1 and changes its normal function. 

In addition, the cycle of hair follicle growth is controlled by vanilloid receptor 1 (TRPV1), and a receptor of the same family, TRPV4, can cause premature hair shedding when cannabidiol levels are too high. Topical cannabidiol is an inhibitor of CB1, and an agonist of TRPV1 and TRPV4. As well, cannabidiol increases Wnt signaling, which as discussed above is important for hair growth via protein synthesis and differentiation of cells into functional hair follicles. 

In a study published in 2021, Medical Life Care Planners explored a new hair loss treatment targeting endocannabinoid system receptors. 35 patients with pattern hair loss underwent treatment with a topical hemp oil consisting of roughly 3-4 milligrams of cannabidiol per day for 6 months. After the study, they found that all subjects had some hair regrowth, with a statistically significant 93.5 percent growth on average for hair count in a defined area of hair loss. There were also no reported side effects. (34)

Which Clinical Trial for Hair Loss Shows the Most Promise?

Each of these treatments appears to show promise in one form or another. For some, such as the hemp oil formulation, Kintor’s androgen receptor degrader, or TechnoDerma’s small molecule system, it is still too early to tell as these clinical trials are still in their infancy. Similarly, Energenesis’ phase 2 trial results are not yet available, making it difficult to properly ascertain its potential. 

Cassiopea’s Breezula® and Kintor’s KX-826 phase 2 trials have been successful, indicating at the very least comparable efficacy to the currently available treatments for pattern hair loss. Both companies are expecting to begin phase 3 trials soon, and larger-scale results will shine even more light on the role of androgen receptor blockers in androgenic alopecia. 

Follica’s device has also shown 44 percent hair growth in its recent phase 2b trial, indicating its place as a contender in this booming space. Biosplice and RepliCel’s successful phase 2 trials have allowed them to enter phase 3, with Biosplice expected to release their results by the end of 2021. If larger-scale trials show further success, these treatments will likely enter the mainstream of pattern hair loss treatment.

What Is Next in Hair Loss Research?

Even further up the research pipeline are experimental hair growth therapies that are yet to begin clinical trials. These cutting-edge technologies are still in experimental, preclinical phases. They are either seeking or planning to begin clinical trials soon, and offer key insights into interesting approaches to treating hair loss.

Preclinical Hair Loss Research

Company / product, clinical trial starts in, dermal papilla cell transplant therapy.

Epibiotech , a Korean-based research and development group, is examining the effects of dermal papilla cell therapy. Dermal papilla cells are found at the base of the hair follicle and are important for hair growth and cycling. 

Similar to RepliCel’s dermal sheath cell therapy, Epibiotech is looking into obtaining these cells, replicating them, and injecting them back into areas of hair loss to stimulate the formation and growth of hair in areas of hair loss. They are now able to create samples of these cells for clinical and non-clinical purposes, and phase 1 clinical trials to assess safety and efficacy are scheduled to begin in 2022. (35) 

Another company working in the dermal papilla space is HairClone , based in the United Kingdom. Their research focuses on obtaining hair follicles, which are then cryopreserved in the world’s first “Hair Bank”. These cells can then be retrieved when needed, grown and multiplied in the laboratory, and injected into areas of hair loss to induce new follicle formation. 

Dermal papilla cells are reduced in certain hairs and conditions leading to hair thinning and loss. HairClone is therefore researching the utility and ability to create a virtually limitless source of implantable hair follicles. Clinical trials are still years away, but in the meantime, they are planning to offer a cell expansion service starting in 2022, where a patient’s hair cells can be multiplied and transplanted as an unlicensed procedure prior to clinical trials. (36)

TissUse and J. Hewitt’s Smart Hair Transplant System

In 2019, TissUse , a German biotechnology company, granted distribution and development rights to Japanese biopharmaceutical firm J. Hewitt for their Smart Hair Transplant (SHT) system. This agreement allows J. Hewitt to develop hair regeneration therapies, leveraging this technology and the expertise of TissUse. (37)

The Smart Hair Transplant system functions similarly to RepliCel’s RCH-01 and to Epibiotech’s system. It works by obtaining about 30 hairs from the back of the scalp to retrieve dermal papilla cells. These cells are then cultured to form about 10,000 “neo-papillae”, which can be injected back into the patient’s scalp. Clinical trials were delayed due to the Covid-19 pandemic, but are now scheduled to begin in 2022. (37,38)

The Riken Institute’s HSFCs for Cyclical Hair Regeneration

In February 2021, Dr. Takashi Tsuji of the Riken Institute released a paper in Nature Scientific Reports titled “ Expansion and characterization of epithelial stem cells with potential for cyclical hair regeneration” . In this paper, Tsuji developed a new culturing method using hair follicle-resident epithelial stem cells (HFSCs). Using this unique culturing technique, these stem cells can grow into functioning hair follicles capable of following the hair growth cycle just like a natural hair follicle! (39) 

The Riken Institute hopes that these cells will be the ideal type to harvest, grow, and reimplant in people suffering from hair loss. They ultimately intend to clone these cells and implant them, creating cycling hair follicles. Phase 1 trials are expected to begin in 2022. (40)

Stemson Therapeutics’ Folliculogenic Cells

Human beings possess induced pluripotent stem cells (iPSCs), which are stem cells that have the unique ability to replicate and differentiate into almost any type of tissue. Stemson Therapeutics , headquartered in San Diego, California, is attempting to utilize these cells to produce “folliculogenic cells”, or cells that are responsible for the formation and growth of hair follicles. 

This company has created a method to obtain regular cells from a patient, generate pluripotent stem cells from them, and differentiate these stem cells into folliculogenic cells. They have also created a cellular scaffold to support these growing hair follicles. The next step in their research is to implement their system in clinical trials, which are expected to begin by 2024. (41,45)

Seeking a Cure for Baldness

Baldness is an issue that has many causes and can stem from many conditions. As such, a “cure” for baldness does not exist, and research into curing baldness is still in its infancy. 

One realm of potential promise is in the area of gene editing. CRISPR-Cas9 (clustered regularly interspaced short palindromic sequences), is a technology that is used to edit genes within organisms! 

CRISPR has been utilized for basic scientific research, treatment of diseases, and the development of biotechnology. Its utility for treating hair loss has yet to be fully explored. In treating androgenic alopecia, for example, it could be used to decrease responsiveness to DHT, increase the expression of pro-growth proteins such as collagen, biotin, vascular endothelial growth factor (VEGF), among many other possibilities! 

CRISPR is typically delivered into cells via viruses. But recently, a team of researchers developed a novel microbubble-nanoliposomal CRISPR delivery system that is activated by ultrasound! To test their new system, they implemented it on a mouse model for androgenic alopecia. These mice had their backs removed of hair and were given testosterone to mimic this form of hair loss. 

The mice received a CRISPR-Cas9 molecule designed to “snip” (or deactivate) the SRD5A2 gene. This gene is responsible for coding an enzyme that converts testosterone to DHT. Once activated, they found that SRD5A2 production decreased by 70 percent, and up to 90 percent of hair regrowth was achieved! (42,46) CRISPR-Cas9 technology is a breakthrough, and it may just hold the cure for baldness !

Although it’s not exactly a cure, advances in stem cell research could also soon make baldness a thing of the past. A study published in 2020 successfully demonstrated the ability to grow functional skin “organoids”, complete with hair follicles, from pluripotent stem cells in mice! (43) Pluripotent stem cells can duplicate but have not yet specialized. They therefore have the potential to develop into any cell of an adult body. 

The researchers from this study used specialized growing methods to coax these cells into developing layers of skin equivalent to those found in a second-trimester human fetus, which includes nerves, specialized touch-sensitive cells, and hair follicles. What’s more, they then grafted these organoids onto nude mice. The organoids formed into planar, hair-bearing skin! (43) 

The ability to grow complete skin means the ability to also grow functional hair follicles. And if hair follicles can be created from cells found anywhere on the body, people could grow a virtually unlimited supply. In theory, they could always have full heads of hair. 

Of course, implementing this in people would probably require going into a clinic for a small procedure every few years. Implanting new cells will always require minor surgery, whereas CRISPR gene editing can be done without any surgical interventions. Nonetheless, it means baldness could eventually become a problem of the past and easily treatable at any point in life!

What We’ve Recently Learned About Hair Loss

The last few years have seen an incredible expansion of hair loss treatment options, with major advancements in cutting-edge hair science research. The future looks bright and hair loss may soon be a thing of the past.

What We Learned in 2020 About Hair Loss

In 2020, well-known hair loss treatments were redesigned and tested in interesting ways, such as dutasteride microinjections and low-dose oral minoxidil. Interesting combinations, like oral minoxidil with spironolactone and topical finasteride with minoxidil, were also used to combat androgenic alopecia. 

2020 also saw successful clinical trials for dermal sheath cup cells and for Follica’s microneedling-type device. An ultrasound-activated CRISPR delivery system with the potential to combat androgenic alopecia was developed as well! 

What We Learned in 2021 About Hair Loss

2021 saw a great deal of boundary-pushing in the field of hair loss and ways to treat it. This year, we saw how boosting the SULT1A1 enzyme greatly improves minoxidil’s efficacy as a hair growth treatment. The combination of minoxidil and spironolactone was again tested, but this time in adolescent girls, showing continued success. A study reviewing the utility of oral minoxidil was published, showcasing it as an ongoing, effective, and well-tolerated treatment option. 

In 2021, we also saw the expansion of several research streams and experimental treatments such as topical hemp oil, androgen receptor blockers, androgen receptor degraders, topical small molecule therapy, cell enzyme boosters, and more! Stem cell treatments made significant strides this year, with The Riken Institute and Stemson Therapeutics preparing for clinical trials. Autologous cell transplant therapies created by HairClone, TissUse, Epibiotech, and RepliCel have also been expanded and trials continue to progress. 

The possibilities in treating hair loss continue to grow due to the continued research and development of exciting new therapies. As the year draws to a close, we will keep a close eye on Biosplice’s Wnt agonist treatment. They completed their phase 3 trials and are expected to release their results by the end of 2021. 

• Phillips, J. H., Smith, S. L., & Storer, J. S. (1986). Hair loss. Postgraduate Medicine , 79 (5), 207–215.
• Zins, G. R. (1988). The history of the development of minoxidil. Clinics in Dermatology , 6 (4), 132–147. 
• Zhou, Z., Song, S., Gao, Z., Wu, J., Ma, J., & Cui, Y. (2019). The efficacy and safety of dutasteride compared with finasteride in treating men with androgenetic alopecia: a systematic review and meta-analysis. Clinical Interventions in Aging , Volume 14 , 399–406. 
•     Avci, P., Gupta, G. K., Clark, J., Wikonkal, N., & Hamblin, M. R. (2013). Low-level laser (light) therapy (LLLT) for treatment of hair loss. Lasers in Surgery and Medicine , 46 (2), 144–151.
• Li, Z. J., Choi, H. I., Choi, D. K., Sohn, K. C., Im, M., Seo, Y. J., Lee, Y. H., Lee, J. H., & Lee, Y. (2012). Autologous Platelet-Rich Plasma: A Potential Therapeutic Tool for Promoting Hair Growth. Dermatologic Surgery , 38 (7), 1040–1046.
• Fertig, R., Gamret, A., Cervantes, J., & Tosti, A. (2017). Microneedling for the treatment of hair loss? Journal of the European Academy of Dermatology and Venereology , 32 (4), 564–569.
• Rose, P. (2015). Hair restoration surgery: challenges and solutions. Clinical, Cosmetic and Investigational Dermatology , 361.
• Vañó-Galván, S., & Camacho, F. (2017). New Treatments for Hair Loss. Actas Dermo-Sifiliográficas (English Edition) , 108 (3), 221–228.
• Epstein, G. K., & Epstein, J. S. (2018). The Evolving Role for Autologous Adipose Tissue (Fat) in Treating Hair Loss. International Society of Hair Restoration Surgery , 28 (2), 54–56.
• Dhurat, R., Daruwalla, S., Pai, S., Kovacevic, M., McCoy, J., Shapiro, J., Sinclair, R., Vano‐Galvan, S., & Goren, A. (2021). SULT1A1 (Minoxidil Sulfotransferase) enzyme booster significantly improves response to topical minoxidil for hair regrowth. Journal of Cosmetic Dermatology . Published.
• Ramos, P. M., Sinclair, R. D., Kasprzak, M., & Miot, H. A. (2020). Minoxidil 1 mg oral versus minoxidil 5% topical solution for the treatment of female-pattern hair loss: A randomized clinical trial. Journal of the American Academy of Dermatology , 82 (1), 252–253 .
• Busanello, E. B., & Turcatel, E. (2018). Androgenic alopecia and dutasteride in hair mesotherapy: A short review. Our Dermatology Online , 9 (1), 75–79.
• Saceda-Corralo, D., Rodrigues-Barata, A., Vano-Galvan, S., & Jaen-Olasolo, P. (2017). Mesotherapy with dutasteride in the treatment of androgenetic alopecia. International Journal of Trichology , 9 (3), 143.
• Reguero-del Cura, L., Durán-Vian, C., & de Quintana-Sancho, A. (2020). RF-Mesotherapy With Dutasteride: A Future Alternative Treatment for Androgenetic Alopecia. Actas Dermo-Sifiliográficas (English Edition) , 111 (5), 419–420.
• Mazzarella, G., Loconsole, G., Cammisa, G., Mastrolonardo, G., & Vena, G. (1997). Topical finasteride in the treatment of androgenic alopecia. Preliminary evaluations after a 16-month therapy course. Journal of Dermatological Treatment , 8 (3), 189–192.
• Suchonwanit, P., Iamsumang, W., & Rojhirunsakool, S. (2018). Efficacy of Topical Combination of 0.25% Finasteride and 3% Minoxidil Versus 3% Minoxidil Solution in Female Pattern Hair Loss: A Randomized, Double-Blind, Controlled Study. American Journal of Clinical Dermatology , 20 (1), 147–153.
• Rafi, A. W., & Katz, R. M. (2011). Pilot Study of 15 Patients Receiving a New Treatment Regimen for Androgenic Alopecia: The Effects of Atopy on AGA. ISRN Dermatology , 2011 , 1–11.
• Abdel‐Raouf, H., Aly, U. F., Medhat, W., Ahmed, S. S., & Abdel‐Aziz, R. T. A. (2020). A novel topical combination of minoxidil and spironolactone for androgenetic alopecia: Clinical, histopathological, and physicochemical study. Dermatologic Therapy , 34 (1).
• Olamiju, B., & Craiglow, B. G. (2021). Combination oral minoxidil and spironolactone for the treatment of androgenetic alopecia in adolescent girls. Journal of the American Academy of Dermatology , 84 (6), 1689–1691.
• Biosplice . (2021). 2011–2021.
• RepliCel . (n.d.). RepliCel.
• SHISEIDO | Skincare, Makeup & Suncare . (n.d.). Shiseido.
• Follica . (n.d.). Follica Bio.
• Home Page . (2020, August 27). Cassiopea.
• Kintor Pharmaceutical Limited . (n.d.). Kintor.
• ENERGENESIS BIOMEDICAL CO., LTD – Core Technology . (2021). Energenesis Biomedical Ltd.
• TechnoDerma Announces Achievement of FIH with TDM-105795 in Topical Formulation – TechnoDerma Medicines Inc. (2021). TechnoDerma Medicines Inc. 
• Medical Life Care Planners – Medical Cost Projections and Life Care Plans . (2021). Medical Life Care Planners.
• Lim, X., & Nusse, R. (2012). Wnt Signaling in Skin Development, Homeostasis, and Disease. Cold Spring Harbor Perspectives in Biology , 5 (2), a008029.
• Slator, W. (2021, March 31). What Is SM04554 and Does it Help with Hair Loss? (2021 Update) . Hairguard.
• Tsuboi, R., Niiyama, S., Irisawa, R., Harada, K., Nakazawa, Y., & Kishimoto, J. (2020). Autologous cell–based therapy for male and female pattern hair loss using dermal sheath cup cells: A randomized placebo-controlled double-blinded dose-finding clinical study. Journal of the American Academy of Dermatology , 83 (1), 109–116. 
• Business Wire . (2019). Businesswire.
• A. (2019, September 18). Announces Very Positive Phase II Twelve Months Results for Breezula® (Clascoterone) in Treating Androgenetic Alopecia [Press release]. 
• Smith, G., & Satino, J. (2021). Hair Regrowth with Cannabidiol (CBD)-rich Hemp Extract – A Case Series. Cannabis , 4 (1), 53–59.
• Epibiotech . (2021). Epibiotech.
• Home . (2019, August 4). HairClone.
• TissUse GmbH & TissUse GmbH. (2019, April 8). TissUse grants first Smart Hair Transplant (SHT) License in Japan . PresseBox. 
• A. (2021, April 19). TissUse Smart Hair Transplants in Japan . Hair Loss Cure 2020. 
• Takeo, M., Asakawa, K., Toyoshima, K. E., Ogawa, M., Tong, J., Irié, T., Yanagisawa, M., Sato, A., & Tsuji, T. (2021). Expansion and characterization of epithelial stem cells with potential for cyclical hair regeneration. Scientific Reports , 11 (1). 
• RIKEN . (2021). Riken Institute.
• Stemson Therapeutics . (2021). Stemson Therapeutics.
• Ryu, J. Y., Won, E. J., Lee, H. A. R., Kim, J. H., Hui, E., Kim, H. P., & Yoon, T. J. (2020). Ultrasound-activated particles as CRISPR/Cas9 delivery system for androgenic alopecia therapy. Biomaterials , 232 , 119736. 
• Lee, J., Rabbani, C. C., Gao, H., Steinhart, M. R., Woodruff, B. M., Pflum, Z. E., Kim, A., Heller, S., Liu, Y., Shipchandler, T. Z., & Koehler, K. R. (2020). Hair-bearing human skin generated entirely from pluripotent stem cells. Nature , 582 (7812), 399–404.
• Deshmukh, V., Pedraza, M., Barroga, C., Seykora, J., & Yazici, Y. (2017). 712 A small molecule modulator of the wnt pathway (SM04554) as a potential topical treatment for androgenetic alopecia (AGA). Journal of Investigative Dermatology , 137 (5), S122.
• Stemson Therapeutics Featured In Atlantic Article – Follicle Thought . (2019, July 26). FollicleThought.
• FollicleThought. (2020, November). Ultrasound-Activated Particles as CRISPR/Cas9 Delivery System for Androgenic Alopecia Therapy .

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