March Madness 2018 in the Hair Loss World

— I covered Dr. Lu Le in detail in May of last year due to his team’s groundbreaking discovery related to Krox20 and its impact on hair growth and hair pigmentation. In a new video interview Mr. Le says:

“It will not be tomorrow. It is in the realm of possibility. We are working really hard in the lab to make it happen.”

Ed Cooley Hair
Ed Cooley Alopecia Areata

— For those of you in the US, this is the traditional March Madness month of playoffs in college basketball. A great excuse to frequent and support your local pubs. One of the most discussed teams so far this year has been Providence (unfortunately they were eliminated today). As is often the case in sports, Providence coach Ed Cooley is a bigger attention grabber than the team’s players. The most admirable thing abut Mr. Cooley is that despite suffering from alopecia areata (i.e., patchy hair loss) for years, he does not care and never discusses the subject. In the above image from a game earlier in the week, he is wearing a towel because he ripped his pants after a fit of exuberance and decided to cover the tear up rather than waste precious game time going to the changing room. Thankfully, he never covers up his patchy hair loss.

— I am not going to write yet another post on Aclaris Therapeutics as requested by several people. However, it is worth checking out blog reader “Malcolm”‘s useful comments in the last post based on Aclaris’ latest investor conference presentation (which can be listened to via the company’s website and includes attached slides). The company is definitely on schedule to finish Phase 2 trials by mid-2019 as announced a few weeks ago and covered on this blog. Also, Aclaris was granted yet another new patent covering the use of JAK inhibitors to treat hair loss disorders, including androgenetic alopecia (which most of us care about the most). Patent details here.

— On a related note, a new study from Dr. Angela Christiano’s Columbia University lab titled “Hair Growth Is Induced by Blockade of Macrophage-derived Oncostatin M and Downstream Jak-stat5 Signaling in Hair Follicle Stem Cells”. The author’s unusual name (Dr. Wang Cho Ee Etienne) stands out just as much as the paper title.

— In 2016, I wrote a post in relation to umbilical cord Wharton’s jelly-derived mesenchymal stem cells (WJMSCs) and hair regeneration. I had forgotten about the subject till I read a new article (h/t “Paul Pheonix”) about South Korea based Medipost being granted a domestic patent related to “stem cell culture fluids preventing hair loss”. It seems like these stem cells will be derived from umbilical cord blood.

— Apparently Monat sold $200 million worth of hair care products in 2017 through multi-level marketing. However, now the company is faced with mounting class-action lawsuits. Complaints range from an increase in hair loss to major scalp irritation to adverse skin reactions.

Another interesting article on PolarityTE.

The Hair & Nails Symposium started in Poland yesterday. Several well known speakers and presenters from the hair loss cure world such as Dr. Antonella Tosti and Dr. Ulrike Blume-Peytavi.

Will we EVER cure baldness?

Carboxytherapy may be useful for alopecia areata treatment. Maybe also minor improvements in androgenetic alopecia patients when used as an adjuvant therapy. I am skeptical.

— Fractional non-ablative laser-assisted delivery of topical finasteride and various growth factors leads to improvement in male and female pattern hair loss. I did not try to find the entire study and see if results are superior to using plain old oral finasteride 0.5mg per day.

Artificial Hair Implants

Several years ago, I considered writing a post on artificial hair implants (also known as synthetic hair implants or prosthetic hair transplants).

However, upon initial research, I read some major horror stories about adverse reactions to artificial hair implants. In several instances, the reactions happened months after the procedure. This gave me some doubts and I put the subject on the back burner.

I reconsidered writing about this topic several times during the past couple of years, but each time I was dissuaded by the fact that  most people who have had this procedure do not seem to post about their experiences on online hair loss forums. A lot of forum members also seemed to ridicule artificial hair transplants, with no solid counterarguments from people who have undergone the procedure successfully.

For hair transplants involving real hair, you can see thousands of online testimonials and reviews with short- and long-term before and after photos. The same cannot be said for synthetic hair implants. However, one sudden realization on my part (see next section) and two new studies finally pushed me into writing this post.

US Ban on Artificial Hair Implants

Until researching for this subject matter earlier this week, I did not realize that artificial hair implant procedures were banned in the US by the FDA all the way back in 1983. This ban on “prosthetic hair fibers” was reviewed again in 2017 with no changes in the decision. This situation seems to have continued to this day, despite appeals and petitions to the FDA by synthetic hair fiber manufacturers.

This decision to ban artificial hair implants stemmed from numerous consumer complaints in the 1970s and 1980s. It seems like inexperienced clinics at the time were using improper techniques and dangerous materials in a highly unregulated market. This was leading to numerous side effects from the synthetic hair implant material, including:

  • Scalp inflammation.
  • Infections.
  • Allergic reactions and fiber rejection.
  • Scalp scarring.
  • Toxicity.
  • Damage to native original existing hair.
  • Wig-like odd appearance.
  • Other harmful skin reactions.

So now it finally makes sense why we have seen very few online testimonials and stories about artificial hair implants here in the US.

Earlier generation fibres (US spelling = fibers) tended to be made with material such as modacrylic, polyacrylic and polyester, which resulted in many undesirable reactions and side effects. Newer generation fibres are made with polyamide based materials, which are supposedly much safer because of the inert nature of the material. The implantation procedure itself is an outpatient one performed under local anesthesia.

Biofibre® (Italy): Two New Studies

While doing by searches on newer alopecia related studies, I noticed that there were two new ones in the past several months concerning synthetic hair. Interestingly, both studies involved a company name Biofibre (Italy). Moreover, both articles speak favorably about modern day artificial hair implants.

The first of these studies provides a summary of Biofibre and its success in the EU, where it obtained CE approval for use on human scalps in 1996. It also obtained TGE approval in Australia in 1996. The Biofibre product is biocompatible with a person’s existing scalp. It is available for use in both men and women suffering from androgenetic alopecia or other forms of hair loss. It is manufactured by an Italian company named Medicap.

The second of these studies analyzes the results of a recent 5-country multicenter clinical trial on 194 patients who underwent the Automatic Biofibre® Hair Implant System procedure. Almost all of these patients got satisfying results and great psychological satisfaction. About 10 percent of the patients obtained some side effects that were “easily controlled by either topical or systemic treatment in 8 to 10 days”.

Perhaps this second study has some biases that I am unaware of, but the fact that 5 countries were involved in the findings does add a bit more credence to Biofibre. It seems like this company is the most important player in the global synthetic hair transplant market. They have also been covered in other older studies that I did not include here.

Biofibre hair strands are available in 13 different colors and with different lengths (15, 30 or 45 cm). Hair type selections include straight, wavy, curly and afro.

Nido (Japan)

According to most sources that I read online, the only other major competitor to Biofibre seems to be Japan based Nido. The company has close to three decades of presence in the artificial hair sector.

On Nido’s dated site, it states that the International Society of Hair Restoration Surgery (ISHRS) recognized its technology in 2003. However, that statement is a bit surprising, considering that this procedure is banned in the US where the ISHRS is headquartered. Moreover, the artificial hair implantation procedure is a direct competitor to the hair restoration procedure.

Update: In November 2020, the ISHRS contacted me to say that they are formally notifying Nido to remove the above mentioned statement from the company’s website.

Note: I contacted the ISHRS when writing this post, and they pointed me towards their official position on artificial hair implants document. It was first published in 2004.

Artificial Hair Implants Cost

The typical artificial artificial hair implantation session involves attaching around 1,000 fibres to the scalp. Most balding people will require around 2,500 fibres according to Biofibre’s FAQ section.  Each fibre equates to 3 hairs, and there are between 90,000 to 150,000 hairs on the average human head before any balding.

There is little online data about the cost of each fibre in an artificial hair fixing procedure. Some anecdotal reports I read suggest the price to be around 2 Euros per fibre, but I am sure this will vary depending on country and clinic.

Keep in mind that around 10-20 percent of the fibers need to be replaced every year due to irreparable damage. Moreover, even with the latest technology, many patients will have unforeseen scalp reactions that will need to be tackled each time they occur.

Since the fibres are exposed to dirt, heat, moisture, wind and other elements of the environment, the possibility of damage and infection is always present. Your existing original hair will also be growing all the time while the prosthetic fibers maintain the same length.

Thoughts on Synthetic Hair Transplants

A third company that I did not cover in this post is Hairstetics. Perhaps a good unbiased take on this  entire controversial subject is summarized in this article from 2010.

Have you ever had an artificial hair transplant or known someone who has had one? It would be interesting to get some first hand in-person accounts of those who have gone through the implantation procedure. How satisfied are you in the long term?

I would definitely prefer a hair transplant to getting artificial hair implants. However, perhaps the latter really does have its place in the hair replacement world despite the high level of online criticism? A majority of the complaints also seem to arise from people who have never had the procedure themselves.

Biofibre or Nido

On Youtube, you can find a bunch of videos from doctors offering Biofibre and/or Nido synthetic hair implants. For example, the below video was published in 2020 by a doctor from India. He offers both Biofibre and Nido artificial hair transplants at his practice.