Category Archives: Wounding

Skin Regeneration, Wound Healing and Hair Growth

The most “natural” way of regrowing lost hair is via wounding or intentional injury. Hence the massive popularity of at-home microneedling and dermarolling for hair growth.

However, no-one truly understands the biology of wound healing spurred new hair follicle growth. We have been waiting for 15 years for Follica to come through.

I am updating this post because an important new study on wound healing and hair follicle mesenchymal stem cells was published in June 2021. The researchers behind this paper concluded the following:

“During wound healing, dermal papilla (DP) and dermal sheath (DS) cells move towards the wound, but do not directly participate in follicle neogenesis.”

They further elaborate that follicle neogenesis during wound healing is a genuine de-novo process. The new follicle formation does not rely on any preexisting components from preexisting follicles.

October 24, 2020

Wound Healing and Hair Follicle Growth

Two recent papers published important new findings in regards to wound healing and skin regeneration.

Wound healing via skin regeneration is often accompanied by hair follicle regeneration. Or even by brand new hair follicle neogenesis (e.g., Follica). Note that this hair growth after wounding phenomenon was even being researched in the 1950s and 1960s.

Thousands of hair loss sufferers around the world are trying out at-home microneedling and dermarolling. Many of them have seen significant success, although one has to be careful with this type of scalp self-injury. On our hair loss chat, the most interesting recent discussion is around wounding depth levels.

Human embryonic and neonatal skin has the potential to regenerate after wounding. This includes fully functioning hair follicles. However, adult skin no longer has such regenerative capabilities. Researchers have been trying for years to find ways to coax salamander-like regenerative powers in humans. If not for whole limbs, at least for hair growing skin to cover baldness for our sake.

New Studies on Skin Regeneration and Wound Healing

1) In September 2020, a team that included Dr. Jeff Biernaskie published a study on the regenerative potential of dermal fibroblasts during wound healing. They identified a specific population of progenitor cells that reside within the dermis and which aid in wound healing.

Skin Regeneration Regulators
Skin Regeneration Regulators. Source: Bernaskie Lab GitHub.

The research is shared on GitHub. Also see Biernaskie Lab. According to the findings, Runx1, retinoic acid, and Hic1 control mesenchymal regenerative capabilities.

According to this summary, Dr. Biernaskie (whose work I have covered in the past) said that they have shown the following:

“You can alter the wound environment with drugs, or modify the genetics of these progenitor cells directly. Both are sufficient to change their behavior during wound healing. And that can have really quite impressive effects on healing that includes regeneration of new hair follicles, glands and fat within the wounded skin.” 

“It suggests that the adult wound-responsive cells do in fact harbor a latent regenerative capacity, it just simply needs to be unmasked.”

2) Also in September 2020, a new study from the University of Washington identified Wnt transcription factor Lymphoid enhancer-binding factor 1 (LEF1) as the key factor in adult skin regeneration.

LEF1 gene expression in fibroblasts has the potential in adult skin to repair itself like the skin of a newborn baby. This skin  can also grow new hair follicles.

Interview with lead author Dr. Ryan Driskell.

“We identified a genetic factor that allows adult skin to repair itself like the skin of a newborn baby.”

Hair, Skin and Wounds all Interconnected

While researching for this post, I could not believe the number of diverse past posts that I have written on this blog that have focused on skin regeneration, wound healing and hair formation.

Regenerating hair follicle after wounding.
Wound induced single hair follicle neogenesis in a bald old man.

Renowned hair loss researchers such as Dr. George Cotsarelis, Dr. Luis Garza, Dr. Elaine Fuchs and Dr. Mayumi Ito have all also conducted frequent research on skin regeneration. I have discussed their work in past posts if you search for their names.

My gut feeling is that whenever there is a fully effective cure for hair loss, there is a strong likelihood that there will also be a cure for quality skin regeneration.

Skinregeneration.org

The authors of the second study that I linked to earlier have started a new site called skinregeneration.org. The site’s mission is to provide a platform for scientists to easily query large datasets that focus on skin wounding and scarring repair.

For further information, see the Driskell Laboratory site at Washington State University.

Skin Gun and Spray-On Skin

It seems like the technology to repair skin has improved significantly during the past decade. There is an especially unmet need when it comes to treating skin that has been burnt badly.

One of the technologies that I used to very curious about is the skin gun that was widely hyped in 2011. I have not heard much about this in recent years. RenovaCare acquired the technology in 2013. The company’s skin gun and spray-on stem cells for wound healing are trademarked under the names SkinGun™ and CellMist™.

At-Home Microneedling for Hair Loss

Microneedling (also known as collagen induction therapy) entails wounding and skin disruption to induce hair regeneration. In my prior posts on Follica, people often made informative comments about at-home microneedling and dermarolling for hair growth.

Update: January 21, 2021

New Microneedling and Hair Loss Studies

— In February 2021, a study from Korea found that a newly developed home-use microneedle device enhanced the penetration of 5% Minoxidil. Patient self-assessment scores showed the highest satisfaction in the Minoxidil + Microneedling combination treated group. However, the excess hair count in this cohort after 6 months treatment (twice per week) was not statistically significant.

— In December 2020, an interesting letter summarized a pilot study on using Follica’s proprietary microwounding device to treat female pattern hair loss (FPHL). The results were very positive, and I covered them in detail here.

— A September 2020 study from Iran concluded that microneedling at a depth of 0.6 mm was more effective than at a  depth of 1.2 mm. This is quite surprising, since most doctors and hair loss sufferers tend to recommend the higher number. For example, in the below video from 2020, the doctors suggest derma-rolling or micro-needling at a depth of 1-1.5 mm.

— A June 2020 study from China found Microneedling and Minoxidil combination treatment to be superior to either one by itself. The underlying mechanism involves activation of the Wnt/β-catenin signaling pathway.

December 25, 2019

My original post on using dermarolling in combination with Minoxidil was published all the way back in 2013. More evidence on the benefits of microneedling for hair loss reversal came in 2017, courtesy of Dr. Rachita Dhurat.

At-Home Microneedling for Hair Growth

Intentional scalp injury and wounding has been known to induce follicular neogensis via stimulating the dermis’ natural wound healing process. Over the years, there has been a lot of online discussion about DIY at-home microneedling and dermarolling to treat androgenetic alopecia.

I was planning to write a post on this subject in the past, but kept delaying it till today. For one, there are numerous hair loss forum and Reddit threads on this subject running into 100s of pages. Moreover, when it comes to microneedling for facial skin rejuvenation related applications, there is even more information available online. Including numerous reviews and before and after photos.

According to a summary of  papers on microneedling, the procedure can help numerous dermatological conditions. These include skin rejuvenation (via increases in collagen and elastin); reduction of acne scarring, wrinkles, fine lines, stretch marks and surgical scars; improvement in undesired skin color changes such as melasma; and enlarged pore reduction. Note that in 2016, a Japanese research team found age-related hair loss to be caused by reduced collagen.

An increasingly common use entails using microneedling or skin puncturing for better transdermal drug delivery. In the hair loss world, many doctors and surgeons are using microneedling in tandem with application of hair growth serums, Minoxidil, PRP and Exosomes.

Needle Depth, Device Choice and Safety

Among the key questions when trying out at-home microneedling on the head:

  1.  What is the appropriate depth of needles for microneedling on the scalp for hair growth? For thinner facial skin uses, fine needles of 0.25 mm and 0.5 mm depth seem to be preferred. For thicker scalp skin, many people recommend 1.5 mm to puncture the skin and epidermis sufficiently. Reader “PinotQ” mentioned a possible treatment regimen of 1.5 mm once a week, and 0.5 mm daily for maintenance. A September 2020 study from Iran found a depth of 0.6 mm to be more effective than a depth of 1.5 mm.
  2. What device is the best? There are hundreds of dermarollers and dermapens on sale online. A large number of those seem to have great reviews. It seems like most people prefer dermarollers to dermapens when it comes to the scalp, although the lower price of the former could be a factor. While the dermaroller needles enter the skin at an angle, dermapen needles enter vertically. Each device and delivery method has advantages and disadvantages.
  3. Safety precautions, including: making sure that the needles are sterilized and clean to prevent infection; not using too much force when rolling the device to avoid damaging the dermis; aftercare and cleaning up correctly in case of bleeding or other skin injury.
  4. How often to use the dermaroller or other micro needling device? Can one get away with just once a week treatment? Note that some people may easily bleed or have overly sensitive scalps, making microneedling impractical or even dangerous. For those with seborrheic dermatitis or psoriasis of the scalp, it is best to consult a dermatologist before starting treatment.

Dermarollers and Dermapens

Microneedling Dermaroller Device
A Dermaroller for Microneedling.

Note: Dermarollers are very cheap on Amazon. However, sizes range from needle depths of 0.25 mm to 0.5 mm to 1.5 mm. The rolling drum size can also vary significantly. You will need to read the comments to this post before deciding on the best product (s) for scalp hair growth purposes.

Dermapen Microneedling Pen for Hair Growth
Dr. Pen Dermapen.

Many people also use handheld motor powered dermapens (more expensive) for microneedling. These are also known as micropens. An alternative product that some people praise is called the dermastamp (or derma stamp).

For more information, see this article on dermaroller versus dermapen. These two devices are also sometimes termed as microneedling roller v/s microneedling pen.

User Reviews on Microneedling at Home

Ultimately, the point of this post is to benefit from crowdsourced reader comments about this subject matter all in one place. I might even start microneedling myself in 2020 if I get more motivated after reading about people’s experiences.

Follica’s recent statement seems to indicate that many kinds of wounding and skin injury can regenerate hair. Follica’s tried and tested in-office version and device will likely be the most effective. But for the time being, at-home use will have to suffice.

If you find any links to microneedling before and after hair growth photos, please post them in the comments.