International Society of Hair Restoration Surgery at the Forefront of Hair Restoration Education, Research
Geneva, IL – December 2, 2015. For more than 20 years, the International Society of Hair Restoration Surgery (ISHRS) Scientific Research, Grants & Awards Committee has been recognizing and awarding grants to clinical investigators dedicated to research in hair loss and hair restoration. While hair restoration surgery and proven medical therapies are an effective combination in treating people with thinning hair and limiting future hair loss, researchers—like those funded by the ISHRS—are making great strides in identifying potential new therapies that could one day help more people struggling with hair loss.
The following four research projects were partially funded by grants provided by the ISHRS and examples of the type of investigations being conducted in the field of hair restoration.
Cold Laser Therapy: Any Effect on Hair Loss?
Sara Wasserbauer, MD, a hair restoration surgeon and ISHRS member based in Walnut Creek, Calif., conducted a study entitled “The Effect of Cold Laser Therapy on Hair Mass as Measured by Cross Sectional Diameter”.
It is well known that lasers of a certain wavelength can and do stimulate hair growth. However, Dr. Wasserbauer acknowledges that hair restoration experts do not fully know exactly how much more hair the average patient can expect. Her research aimed at accurately measuring the amount of increased hair mass using cross-sectional diameter—a technique which takes into account not only the number of hairs growing, but also the thickness of those hairs—which Dr. Wasserbauer explains is much more precise than photos alone.
“Having studied several hundred patients with cross-sectional diameter over the years, I find it is an extremely useful tool to quantify results for both medical and surgical treatments,” said Dr. Wasserbauer. “Ultimately, both the number and thickness of growing hairs are the factors which directly correlate with the perception of increased volume of hair and, therefore, with patient satisfaction.”
Study Uses Pigmented Hair Follicles to Treat Vitiligo
Narendra Patwardhan, MD, a hair restoration surgeon and ISHRS member based in India, conducted a study entitled “Study of Repigmentation in Localized Stable Vitiligo Patches with Leucotrichia by Follicular Unit Transplant”.
Vitiligo, a condition in which the skin loses pigment and color in patches, is a major social problem in the Indian community despite educational efforts. While a stable patch of vitiligo is treated with various modalities such as punch, blister grafting and non-cultured melanocyte suspension, vitiligo patches with white hair (a condition known as leucotrichia) fail to respond to these treatments.
Patients who are not good candidates for hair restoration surgery could experience complications, which makes it extremely important for young patients to understand their options. After an initial consultation, Dr. Perez-Meza often advises young patients to return for a second or third evaluation or seek a second or third opinion about their hair loss and possible treatments.
“In our study, we plucked the white hair and grafted with a hair follicle from the scalp area with a pigmented root,” said Dr. Patwardhan. “Our success rate for repigmentation in a dozen patients using this procedure was 80 percent, and the patient satisfaction rate was approximately 85 percent. This trial needs to be repeated in many more patients, if possible.”
Dr. Patwardhan added that around 10-15 grafts are used for a vitiligo patch measuring one square inch.
Growth Factors Investigated for Early Stage Hair Loss
Marie Andrée Schambach Morel, MD, a hair restoration surgeon and ISHRS member based in Guatemala, conducted a study entitled “The Efficacy of Autologous Platelet Rich Plasma on Non-Transplanted Miniaturized Hair in Different Norwood Scale Grades of Androgenetic Alopecia”.
Certain hair loss diseases are related to poor or short term growing phase, and platelets have very important growth factors inside them that are already known to stimulate that growing phase. The specific aim of Dr. Schambach’s study is to evaluate what type of patient with male pattern baldness is the proper candidate to offer Platelet Rich Plasma (PRP) as a treatment— or at least offer the patient a certainty in percent of recovery.
Early findings of 12 patients with different grades of Norwood scale male pattern baldness treated with three monthly PRP treatments showed promise. Specifically, patients with Norwood scale II-V have reported a perceptible decrease of hair shedding, but Dr. Schambach noted that differences in hair diameter cannot be reported yet and are pending on the final evaluation at six months. She also noted that patients with more advanced hair loss (Norwood scale VI or VII) experienced no changes with PRP therapy after three months.
“In my experience and very personal opinion, these growth factors can help during the early stages of hair loss to postpone the need for hair restoration surgery or reduce the amount of hair follicles needed in that same surgery,” explained Dr. Schambach. “Further investigations will definitely be needed, comparing PRP to existing medications or the combination of these therapies.”
PRP Pilot Study Yields Inconclusive Results
Carlos J. Puig, DO, a hair restoration surgeon and chair of the ISHRS Scientific Research, Grants & Awards Committee based in Houston, Texas, conducted a study entitled “Pilot Study Autoglogel Platelet Rich Plasma Injections on Hair Growth in Patients with Female Pattern Hair Loss”.
In this pilot study, 28 patients with female pattern hair loss, biopsy proven or in addition to a physical exam with miniaturization of hairs, and two other family members with the same pattern were separated into the study group (15 patients) or placebo group (13 patients). After one treatment and at six-month observation, the results of the study concluded that there was no statistical significance between the placebo group and the study group.
Dr. Puig noted both groups had individuals that improved by as much as 24 percent, but they were unable to demonstrate that PRP was the cause of the changes.
“Hair restoration therapies are some of the most difficult to study in all of medicine,” said Dr. Puig. “The ISHRS believes that the specialty needs to focus on developing protocols that provide solid, evidence-based, practice recommendations for hair restoration. To that end, ISHRS has expanded its budget for scientific study grants to its members and allied hair research scientists.”
In addition, many research protocols are now being facilitated by the ISHRS FUE Research Committee, with results of these recommendations to be made available in the coming years. Follicular unit extraction (FUE) is now a popular method for obtaining donor hair for hair transplantation thanks to improvements in instrument technology and technique. Traditionally, FUE is a technique that requires more skill on the part of the physician hair restoration specialist than the technique of strip harvesting, which involves the removal of a strip of scalp tissue bearing hundreds of follicular units.
“With the popularity of FUE donor harvesting, research is needed to determine the optimal techniques and instrumentation, the preferred method of handling the grafts to optimize graft survival, and the impact of FUE on the donor area. The committee is dedicated to designing and implementing studies that will result in the best patient outcomes,” said James A. Harris, MD, chair of the ISHRS FUE Research Committee.
To help patients understand the causes and available treatments for hair loss, the ISHRS has produced a series of videos available on its website (www.ishrs.org) entitled “Why do women lose their hair?” and “Why do guys lose their hair?”
About the ISHRS
The International Society of Hair Restoration Surgery (ISHRS) is a global non-profit medical association and a leading authority on hair loss treatment and restoration with more than 1,200 members throughout 70 countries worldwide. Above all, the ISHRS is dedicated to achieving excellence in patient outcomes by promoting the highest standards of medical practice, medical ethics, and research in the medical hair restoration industry. The ISHRS also provides continuing medical education to physicians specializing in hair transplant surgery and is committed to delivering the latest information on medical and surgical treatments to consumers suffering from hair loss, and most commonly from androgenetic alopecia—male pattern baldness and female pattern hair loss. It was founded in 1993 as the first international society to promote continuing quality improvement and education for professionals in the field of hair restoration surgery. For more information and to locate a physician, visit www.ishrs.org.
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