In the last few years, many advances have confused one and all in the treatment of hair loss. It is about impossible for a patient to know what is an effective therapy and what is mere hogwash. A couple of concepts, difficult to understand, along with a story to convince people how it acts on the cause and not just the symptoms convince the consumer lightly.
When it first made an entrance decades ago in hair loss, stem cell therapy did not have sound scientific evidence to back it up, and thus it was not very successful and lost its standing in the first-line treatment of hair loss.
As more research and more studies started pouring in, new and more targeted stem cell therapies came to light, showing more promise than their predecessors. This article will talk about the concept of stem cell therapy for hair loss and some up-and-coming therapy options.
What are stem cells?
Stem cells are, what one could call, parent cells. They have the ability to self-renew, and they can evolve into other types of cells. Hair has its own stem cells in a pocket in the hair follicle, which divide and differentiate and are integral to hair regeneration.
The goal of stem cell therapy is to introduce new all-rounder stem cells in the “pocket”, which can transform into hair stem cells. The source of the all-rounder stem cells could be:
Treatment with stem cells is a part of the regenerative medicine field. Regenerative medicines are innovative ways to repair or regenerate the defective cells or tissues in the body by acting on the very basic step of cell division.
How can stem cells be used for hair loss treatments?
Stem cells and how they interact with each other play an essential role in how the hair looks and behaves in each phase of the hair cycle. The activation of stem cells helps transition the hair follicle from a miniaturized version in the telogen phase to a sturdy and robust state in the anagen phase.
A lot about how this happens on a molecular basis is largely unknown. A few pathways have been identified, and they are the primary targets of stem cell therapy in hair loss.
Although stem cell therapy has been going around for decades, an accurate understanding of this treatment method and its application in hair loss is relatively new.
One of the most studied sources of stem cells in hair loss is fat tissue. Researchers have found uncanny similarities between hair follicle stem cells’ activation and fat cell production from the stem cells, making fat-derived stem cells one of the ideal sources for alopecia treatments.
Fat stem cell-conditioned medium, which is produced when fat-derived stem cells are cultured, is rich in growth factors and has also been utilized to treat hair loss. The conditioned medium could either be injected, applied with a microneedling technique, or injected superficially using a mesotherapy gun in multiple sessions.
Almost all the studies reported a positive outcome in the hair growth in pattern hair loss. Particularly in the female pattern hair loss, the growth observed is superior to 2% minoxidil.
The stem cells can even be isolated from hair follicles and the surrounding tissues from the scalp’s unaffected portion. A small biopsy from the scalp and subsequent centrifugation of the tissue gives the cells, which, in a study with 11 patients who had pattern hair loss, when injected back on the scalp resulted in an increase in hair density (see fig. 1) compared to non-treated patients.
Stem cells derived from bone marrow are as efficacious (and safe) as hair follicle-derived stem cells. In a study, a single treatment session in 20 patients with alopecia areata and 20 with pattern hair loss showed similar improvement in both bone marrow-derived and hair follicle-derived stem cells after six months.
Interestingly, a combination of PRP therapy (platelet-rich plasma rich in growth factors) and the fundamentals of regenerative medicine along with stem cells, have also shown some promise. In a study, PRP was combined with fat-derived stem cells and was injected into a single area on the scalp of 10 patients with male pattern hair loss. A significant increase in the hair density was observed in the treated area compared to the non-treated area in 6 and 12 weeks.
Regenera activa for hair loss
Regenera activa is a popular stem cell hair loss therapy discussed in the media and on social networks. It is a type of follicular stem cell therapy against androgenetic alopecia.
How is it performed?
In this method, three 2.5 mm samples of hair follicles are taken from the back of the scalp. The follicles on the scalp’s back are unaffected by the hormones, thus offering a perfect donor area with robust hair follicles. Every sample contains multiple hair follicles and the tissue surrounding it.
These tissue samples are then placed into the ‘Regenera’ machine for around 5 mins. In this step, the tissue is disintegrated and centrifuged, and the stem cells are extracted. These stem cells are then injected superficially into the scalp (the affected area) using a thin needle with a microinjection technique.
This procedure is a little uncomfortable and has minimal downtime. Donor areas heal in a week or two. Results are promised within six months.
How much does it cost?
Depending on where you are getting it done, it could cost you anywhere upwards of 2000 dollars for a session.
Does Regenera activa work?
Maybe. There are small studies that speak in favor of this method of stem cell extraction with this method, and show some degree of success with it. But is it better than the other therapies on offer for androgenetic alopecia? I strongly doubt that.
It is also unclear what the treatment regimen is and how many sessions in which intervals are needed, and at some point in time, the treatment costs may exceed the cost of a good old reliable hair transplantation.
If you weigh the scientific evidence this procedure has behind it against the asking cost, it will not look too alluring. The results are, at best, variable. It may work for some, but there is no guarantee that you will have thicker, denser hair after making your wallet lighter by thousands of dollars.
Limitations of stem cell therapy
Even with all the promising studies, stem cell therapy is still far from being the first-line therapy for hair loss because of the following limitations:
Stem cells as a topical therapy?
While most studies involve injecting the stem cells superficially in the scalp, a recent study also showed a positive effect of topical application of stem cells.
In a randomized double-blinded study, fat-derived stem cells were applied twice a day topically. At weeks 8 and 16, hair growth and hair diameter both showed a significant improvement from the baseline in the treatment group. There were no consequential side effects.
While attractive, this method’s real-life application remains questionable because of the elaborate process required to obtain the product. Since androgenetic alopecia is a chronic hair loss condition, the process, and the cost involved, will become deterring in the long term.
Stem cell therapy, the research behind it, and its use in real life are all in their nascent stage. It involves a complicated theory with practical limitations. Much research needs to go into it before it comes into the big league of minoxidil, finasteride, or even PRP for hair loss.
Although promising, the results are still in minimal studies, and no comparison studies to quantify its outcome. If it is altogether worth spending so much money on this therapy, I have my reservations there.
Much further research is needed to establish its efficacy compared to the existing treatment options, standardization of treatment regimen, and even to come up with a cost-effective preparation and administration.