posted by Nilofer P. Farjo, MBChB, FISHRS on October 20, 2014
New findings from research help explain why hair loss happens (ie. specific gene/hormone carried by individual).
Research by Rodney Sinclair’s lab in Melbourne studied patients with androgenetic alopecia (AGA) vs normal subjects. His findings showed that the arrector pili muscle degenerated and was replaced by fat tissue in all subjects. This was not the case in patients who did not have AGA. In previous work, the research team showed that stem and progenitor cells are located at the insertion of the arrector pili muscle with the hair follicle. So depletion of these cells might be related to the degeneration of the muscle and this may be why AGA is resistant to treatment.
Also, researchers at the Institute of Human Genetics at the University of Bonn, Germany showed that there was no association between female pattern hair loss and the genetic variants found to be associated with androgenetic alopecia. These results support the theory that there is a different underlying mechanism for female pattern hair loss vs male pattern hair loss.
New drugs are currently being tested that are safe for men & women, however no drug is free of side affects.
Dutasteride, which inhibits both type I and type II 5-alpha-reductase, was approved in 2009 to treat androgenetic alopecia in Korean men aged 18-41. A safety and tolerability study was performed on 712 patients to assess side effects when treated with 0.5mg/day. The study ran from 2009 to 2013 and found the following side effects: decreased libido 1.3%, dyspepsia 1.1%, impotence 1.0%, fatigue 0.7%, sexual function abnormality 0.6%, ejaculate disorder 0.1% and gynecomastia 0.3%.
This side effect profile is very similar to that found for finasteride which supports the safety of use of this drug in AGA.
Hair growth stimulant Tafluprost (F2alpha analogue), may lead to clinical applications in the future in treating androgenetic alopecia . Tafluprost which is licensed in Japan to treat glaucoma has been studied in mice and found to promote hair growth. Another F2alpha analogue, bimatoprost, has previously been reported as promoting hair growth.
Additionally, there have been a number of newly developed surgical punches for FUE techniques that may make removal of grafts by this method easier and cause less transection. Some newer punches for example have the bevel on the outside rather than the inside and others have a serrated edge rather than a continuous sharp or dull edge. For the robotic machine there is now a smaller size punch so that extraction sites are smaller (0.9mm vs 1.0mm).