Botox Injections for Hair Growth

For several years, I have thought about writing a post on Botox and hair growth. A few sources have in the past suggested that the Botulinum toxin (which is what Botox is made from) can grow hair.

Botox Hair Growth Before After
Botox hair growth before and 12 months after. Source: BioMed Research International, Vol. 2020.

Update: A new study from China published in August 2020 concluded that Botulinum toxin type A (BTA) was safe and effective at growing hair. Some of their before and 12 months after Botox photos of hair growth are impressive. 30 sites on each patient’s site were injected with 100 U of BTA. The patients received further BTA injections every three months for a total of four sessions.

Update: New study from South Korea published in April 2020 concludes that intradermal injection of botulinum toxin could be a possible treatment option for androgenetic alopecia. It is likely working by inhibiting TGF-β1 secretion from hair follicles.

Botox is a multifaceted magic-like poison with numerous potential approved uses as of 2019. It is no longer solely a product to reduce wrinkles.

Even if you are extremely skeptical, do remember that there is some scientific evidence that surprising procedures such as mechanotherapy and scalp exercises can benefit hair growth; as can dermarolling and microneedling; as can the ill advised ligature of arteries.

Botulinum Toxin for Hair Loss

Botulinum Toxin (Nabota Brand)
Botulinum Toxin Nabota.

However, both research and evidence to date on this subject of Botox and hair growth have been scant. Yesterday, reader “Alek” posted an interesting new article from South Korea regarding the testing of botulinum toxin Nabota brand for hair loss on male patients with androgenetic alopecia. This brand is manufactured by Daewoong Pharmaceutical.

The Phase II-b trial will entail 180 units of the toxin delivered via 6 injections to the scalp once per month. It will be led by Dr. Park Byung-cheol, a professor of dermatology at Dangook University Hospital. Note that the less costly Nabota only hit the US market in 2019, and is facing a lawsuit from Botox manufacturer Allergan.

Botox vs Botulinum vs Botulism

It should be noted that the capitalized BOTOX® is a brand name (or trade name) for Botulinum toxin. The latter is a neurotoxic protein produced by the bacterium Clostridium Botulinum. “BOTOX®” is a trademark of Allergen (Ireland). Botulism is a serious, albeit rare, paralytic food poison illness caused by the Botulinum toxin.

Botox is classified as Botulinum Toxin Type A (BTX-A), the most popular variety. Botulinum Type B (BTX-B) received FDA approval for treatment of cervical dystonia in the US in December 2000. The main Botox Type B product sold in the US is Myobloc (known as NeuroBloc in the EU). The scientific name for Myobloc is rimabotulinumtoxinB.

Botox and Hair Growth

In 2010, an interesting study from Canada found Botox injection to the scalp to be successful in growing new hair in 40 test patients. The authors postulated an interesting theory as to why BTX-A succeeded so well in growing hair. The Botox injections induce scalp muscle paralysis, which in turn:

“Enhances blood flow to the scalp by reducing the tension on the scalp skin. Because the conversion to dihydrotestosterone (DHT) is enhanced in a low-oxygen environment, oxygenated blood reduces this conversion and increases conversion to estradiol.”

In 2017, an article in Vogue magazine had an encouraging quote from dermatologist Dr. Dendy Engelman:

“Preliminary studies for Botox in the scalp are showing that 50 percent of patients are growing new hair.”

Botox for Hair Growth
Botox injections: before and after hair growth.

Also in 2017, a study from India found that 8 of 10 male patients with androgenetic alopecia who were treated with Botox injections ended up with good to excellent results. The before and after image on the right is of one of the excellent responders to the Botox treatment.

Other Brands of BTX-A

Besides Allergen, other companies also product their version of Botulinum.

  • Companies in Western Europe produce the well known brands Dysport and Xeomin.
  • In South Korea, BTX-A is produced under the names Botulax, Innotox, Meditoxin (Neuronox) and Nabota.
  • In Russia, Botulinum toxin is sold as Relatox.
  • China also produces various strains of BTX-A.

Botox is technically known as onabotulinumtoxinA; Dysport is known as abobotulinumtoxinA; and Xeomin is known as incobotulinumtoxinA.

Electricity and Hair Growth

No matter how many years I research hair loss, virtually every month still brings a major surprise. The latest eyebrow-raising story concerns electricity stimulating hair growth, and comes to us from UW Madison.

Baseball Cap to Zap your Scalp and Stop Hair Loss

Electricity Stimulation for Hair Growth
Electric Stimulation to Grow Hair. Source: ACS Nano, Wang et al.

Yesterday, an article in Futurism discussed a new baseball cap invention that mildly electrocutes your scalp and leads to hair growth. Moreover, the cap is powered by small head movements from whoever is wearing it. i.e., no battery or electricity needed. Of course I initially laughed off this whole concept. However, upon further examination, there is some logic to this story.

The scientist who made this invention is Dr. Xudong Wang from the University of Wisconsin-Madison. He leads the nanoscience and nanotechnology group at this university. His lab has done an especially large amount of work in the bioelectronic and energy harvesting sectors. This particular invention makes use of something called the triboelectric effect.

In this particular cap, small nanogenerators passively gather energy from day-to-day body movements. These nanogenerators then transmit low-frequency pulses of electricity to the scalp skin. This electric stimulation and electrostatic field causes dormant (or telogen) hair follicles to wake up.

Note that there are already battery powered devices such as electric combs for hair loss on the market.

Dr. Wang is a world leading expert in the design of energy-harvesting devices. Among the inventions that his lab is most famous for include electric bandages that stimulate wound healing; and a weight loss implant that uses electricity to trick the brain into thinking that the stomach is full.

Note that this work was only proven in mice, and supposedly in one human (Dr. Wang’s father). The cap will not regrow hair in completely bald men, but it may regrow recently lost hair as in the case of Mr. Wang’s lucky father.

This work was published in ACS Nano. It was also covered in New Scientist magazine and Science Daily, all fairly reputable magazines as far as I can tell. Dr. Wang’s team aims to conduct human clinical trials in the near future.

Prior Work on Electricity and Hair Growth

Moreover, all the way back in 1990, Canadian scientists discovered that they can help restore thinning hair by stimulating the scalps of balding men with a pulsed electrical field. The lead research was a Dr. Stuart Maddin. Their theory on how this works was that:

The turning on and off of the electrical stimulus at the electrodes causes the alternate polarising and depolarising of the (root and follicle) cell. This opens electrically sensitive calcium channels in the cell membrane, allowing calcium and other positively charged ions to enter the cell where they will stimulate the production of DNA and, from there, protein (and hair) synthesis.

Interestingly, reader “bw” found the following page on an electrical scalp stimulator for hair follicle regrowth. The article cites Dr. Maddin’s work.

This phenomenon is known as electrotrichogenesis (ETG).