Category Archives: Fat Cells

Thinner and Tighter Scalps in Balding Men

Update: A study from January 2020 concluded that androgenetic alopecia is associated with increased scalp hardness.

Over the years, I have read a number of articles and studies that discussed how balding men’s scalps are tighter and thinner than scalps of non-balding men. In tandem with fibrosis, this leads to permanent hair loss once the male hormones have started the damage.

Scalp Fat Loss and Fibrosis in Hair Loss Sufferers

Even in 1954, there were already theories that perhaps fat loss on the scalp was to blame for hair loss. Maybe dihydrotestosterone (DHT) spurred androgenetic alopcia affected some people more than others? Depending on how susceptible individual scalps were to losing fat layers and fat cells. Even further back, in 1942, Dr. Frederick Hoelzel postulated a baldness and calcification of the ivory dome theory.

Another old study from 1972 concluded that in advanced stages of baldness, all skin layers of the scalp other than the galea exhibit significant thinning. Fibrosis, calcification and increased scalp tension are all part and parcel of male pattern hair loss.

Kerastem, ADSC, AAPE and SVF

I have covered the issue of fat cells and hair growth numerous times on this blog in the past. Kerastem is perhaps the most important company in relation to this area of hair loss treatment. Stromal vascular fraction (SVF) enhanced adipose transplantation is the more technical name of this method of trying to regrow hair.

Also make sure to read my posts on adipose derived stem cells (ADSC) and hair growth; and the related AAPE for hair growth. Sooner or later, I think that these technologies will become better and more reliable. They will probably never regrow hair on completely bald regions of the scalp. However, anything that can permanently maintain and strengthen existing hair is a huge success.

Could Botox Stop Further Scalp Thinning and Fibrosis?

After I wrote my last post on Botox and hair growth, I received an interesting email from a surgeon named “Gabriel P”. I am pasting it verbatim below, and hope to hear back from him in the next few months.

“I wanted to share with you my story as a surgeon with hair loss maybe it could help our community.

Ok Hear me out.

Preface: Been losing hair for a number of years 10+. I am now 32 years old. I even went through a few hair transplants utilizing body hair and beard hair. I’m a surgeon myself so I tried everything I could in terms of medical literature defined what could help me with my hair loss. I didn’t want to try Propecia because of side effects and I like my sex life. So here’s what I’ve tried that has only marginally helped.

  • Metanx (prescription grade vitamin b12/ b6).
  • Nizoral (helps scalp inflammation in the very short term).
  • Hair transplant (my donor hair in the new transplanted areas also starts to thin so i transitioned to beard and body hair to some success).
  • Scalp massage using a cheap Wahl body massager (helps break down fibrosis in the scalp and promote blood flow).

That is about it. I’ve had this theory for a while now. With scalp hair loss and decreased blood flow.In a type lower extremity surgery I do, we bring blood flow to the legs utilizing an angio. The leg skin then goes from thin and shiny and no hair growth, to more malleable and better quality thicker skin.

If you look at patients with peripheral vascular disease, their skin on the legs will be very thin shiny and there will be almost no hair growth in the foot and ankle area.

The same goes for the balding scalp; most bald men in the Galea Aponeurosis area have thin and shiny skin and you can almost see the demarcation. people who aren’t bald don’t have this phenomenon on their scalps.

I thought to myself- “Why is it that my scalp itching started when my skin started getting shiny, thin and super tight- and why is it that when my blood pressure goes up my hair feels better? Or why my scalp itch goes away after a good nights rest when I’m in supine position, only to return during the day?”

The frontalis, temporal and occipital muscles all pull at the scalp and galea from different directions. We’ve had DHT pumping in our blood since puberty but my hair loss didn’t start then so whats the deal? I believe that as this skin gets tighter fibrosis occurs and the hair starts to miniaturize because the DHT or whatever it might be is not able to be washed out. This is only one factor, but I think its a key factor to fighting hair loss.

Back to botox: Botulinum toxin prevents muscle contraction for a very long time. To my knowledge there is only one study that studied the effectiveness of botox on the scalp- here it is:

Relatively small study, with good results. Apparently women have been using botox to keep their hair straight, but what I wanted to do was inject in the areas of the muscle tendon attachments to see if I can restore blood flow to the area as a result of loosening the scalp and the galea apopneurosis.

So I did. I have a plastic surgeon who I work with who I punted this idea to and we injected my scalp with botox loosely following the protocol in the paper. I wont go into the details, but its been a week so far and my scalp itch is COMPLETELY GONE. I cannot emphasize how this is NOT placebo and something definitely changed.

Whether it will last I will keep you updated. So far my scalp itch is gone and shedding has gone down a bit, but no regrowth bc its too soon for that. My hair feels significantly less limp as well. Botox lasts around 3 months so this should feel good for about the same time. I doubt I will get regrowth, but if I can keep what I have, its a win.”

Stromal Vascular Fraction Enhanced Adipose Transplant

I have covered the link between fat cells and hair cells a number of times on this blog in the past. In this post, I discuss Stromal Vascular Fraction (SVF) enhanced adipose transplantation for hair growth.

The regenerative action of SVF is largely attributed to its paracrine effect on neighboring cells via the secretion of various growth factors and cytokines. This includes adipose tissue-derived stromal cells (ASCs).

Update: December 16, 2022 — A new study concludes that autologous stromal vascular fraction injection treatment of androgenic alopecia is effective.

Update: August 2021 — A South Korea study covered nine AGA patients who received one single transplantation of autologous SVF via injection. The results showed increased hair density and “keratin scores” after 6 months.

Update: December 2020 — A Turkish study on 20 patients concluded that SVF is an effective and safe treatment for AGA patients. The average patient saw an almost 25% increase in both hair count and hair thickness. Interestingly, the researchers also included dermapen wounding alongside the SVF treatment in order to boost regaional blood supply. Make sure to read my post on microneedling for hair growth.

Fat Cells and Scalp Hair Growth

  • In 2014, I discussed a newly published paper by Dr. Fiona Watt and various others that found a positive correlation between hair growth, adipocytes (fat cells) and epidermal Wnt/β-catenin signaling. One of their findings (albeit on a small sample size) was that “regions of hair loss were correlated with reduced adipocyte layer thickness in the samples we examined“.
  • Thereafter, in March 2015, I wrote about Dr. Valerie Horsley’s work related to fat cells and scalp hair.
  • In April 2015, I wrote a post on adipose-derived stem cells (ADSCs) and hair growth.
  • Also in April 2015, I wrote about Advanced Adipose-Derived Stem Cell Protein Extract (AAPE) and hair growth.
  • In July 2015, I wrote a post on an upcoming company named Kerastem that was working on using autologous fat graft enriched with adipose-derived regenerative cells (ADRCs) in the treatment of early male pattern hair loss. Kerastem has become much more renowned since then, and has been conducting clinical trials under the acronym STYLE. These trials are supposed to be complete in September 2017, and the renowned Dr. Ken Washenik is actively involved. I have discussed Kerastem in several other post since 2015.
  • In my February 2017 brief items of interest post, I discussed the STRAAND clinical trials that will be completed in June 2018. These trials focus to on something called stromal vascular fraction (SVF), which is a type of adipose tissue, and platelet-rich plasma (PRP).

There are some significant differences between some of the above subject matters, but in the end, they all involve adipose tissue and hair growth.

A number of doctors around the world are now offering procedures where they inject adipose tissue into your scalp, often with the addition of growth factors and various stem cells. In most cases, these procedures are insufficiently tested and largely unproven.

I am skeptical about the potential of these treatments beyond making existing hair stronger and perhaps reversing very recent follicle miniaturization (in an absolute best case scenario). However, I remain open minded based on the assorted wide range of work from around the world related to fat cells and hair growth that is outlined in the earlier listed bullet point past posts of mine.

Stromal Vascular Fraction (SVF) Enhanced Adipose Transplantation

As several commentators have pointed out, this week fat cells and hair were in the news yet again. This time, the excitement was limited to UK newspapers due to some work in which locally based Dr. Edward Ball was involved (note that the actual study is here and the principal author is Dr. David Perez-Meza).

Update: It seems like this whole study is related to Kerastem’s Celution System technology (and Puregraft’s fat purification technology). See Kerastem CEO update here. Strange that both the UK newspaper stories (see bottom of this post) that covered this development do not even mention Kerastem.

Before and after image below from the Maitland Clinic per the two UK newspaper links further below:

Stromal Vascular Fraction (SVF) Adipose Hair Growth
Stromal Vascular Fraction (SVF) enhanced adipose fat cell transplantation for hair growth.

Basically, they conducted a small study in which they removed fat from six people’s stomachs, added stem cells to the fat, and then moved the resulting concoction to the same people’s scalps. They supposedly got great results. The procedure is described as “Stromal Vascular Fraction (SVF) Enhanced Adipose Transplantation”. Dr. Craig Ziering was also involved, and I have covered him on this blog several times in the past. I can’t think of many superficial things that I would love more in life then less stomach fat and more scalp hair:

Express article on moving fat cells from stomach to scalp.

The Sun article on moving fat cells from beer belly to scalp.

Note that there was another small-scale nine patient study done on SVF enhanced adipose transplantation in 2016 with a favorable conclusion. Two of the authors in that one were Dr. Ken Washenik and Dr. Eric Daniels (the latter also co-authored this latest study).