Update on Male Pattern Hair Loss

November 2014 | Volume 13 | Issue 11 | Features | 1308 | Copyright © November 2014


Leopoldo Duailibe Nogueira Santos MD and Jerry Shapiro MD FRCPC

Department of Dermatology and Skin Science
University of British Columbia, Vancouver, Canada
The Ronald O. Perelman Department of Dermatology
New York University Langone Medical Center, New York, NY

and better penetration of a topical drug such as minoxidil. Although these are promising techniques we still need more data proving that they work.

Follicular Cells Implantation (FCI)

FCI is a cell therapy intended to treat hair loss. Two types of follicular cells have been used: dermal papilla and dermal sheath cells (DPC/DSC). These cells possess an inductive property that if they are cultured and implanted into skin allows them to induce formation/rejuvenation of follicles.18,19
The procedure consists of: a punch biopsy from the androgen- insensitive area of the scalp (occipital), cells (DPC/DSC) dissection, and replication in a culture medium and injection of replicated cells to bald sites. Finally, the implanted cells would migrate to damaged/dormant follicles and help rejuvenate them or induce keratinocytes to form new follicles.18,19
Replicel® has been working with implanting autologous cultured dermal sheath cells (DSC) in pattern hair loss patients in order to regenerate hairs. A phase 1/IIa trial has been carried and has proven that this is a safe procedure. Phase I/ IIa trial consisted of a one-time procedure in the beginning of the study and follow-up of 24 months. If there was ≥5% increase in hair density, it was called responder site. Responder-treated sites were more significant than controltreated sites (63% vs 37%). 70% of the responder-treated sites had 11.8% average increase hair density. Phase IIb trial will involve 160 subjects and will be important to optimize treatment regimen (dose and frequency).20

Disclosure

Jerry Shapiro is a consultant for Merck, J&J, Applyed Biology, and Pierre Fabre, and is co-founder and stockholder of Replicel Life Sciences. Leopoldo Duailibe Nogueira Santos has no conflicts to declare.

References

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  2. Olsen EA, Dunlap FE, Funicella T, Koperski JA, Swinehart JM, Tschen EH, et al. A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol. 2002 Sep;47(3):377–85.
  3. Blume-Peytavi U, Hillmann K, Dietz E, Canfield D, Bartels NG. A randomized, single- blind trial of 5% minoxidil foam once daily versus 2% minoxidil solution twice daily in the treatment of androgenetic alopecia in women. J Amer Dermatol. Elsevier Inc; 2011 Nov 12;65(6):1126–1134.e2.
  4. Roberts J, Desai N, McCoy J, Goren A. Sulfotransferase activity in plucked hair follicles predicts response to topical minoxidil in the treatment of female androgenetic alopecia. Dermatol Ther. 2014 Jul;27(4):252–4.
  5. Price VH, Menefee E, Sanchez M, Kaufman KD. Changes in hair weight in men with androgenetic alopecia after treatment with finasteride (1 mg daily): Three- and 4-year results. J Am Acad Dermatol. 2006 Jul;55(1):71–4.
  6. Olsen EA, Hordinsky M, Whiting D, Stough D, Hobbs S, Ellis ML, et al. The importance of dual 5α-reductase inhibition in the treatment of male pattern hair loss: Results of a randomized placebo-controlled study of dutasteride versus finasteride. J Am Acad Dermatol. 2006 Dec;55(6):1014–23.
  7. Jung JY, Yeon JH, Choi JW, Kwon SH, Kim BJ, Youn SW, et al. Effect of dutasteride 0.5 mg/d in men with androgenetic alopecia recalcitrant to finasteride. Int J Dermatol. 2014 Jun 5;:n/a–n/a.
  8. Finasteride Male Pattern Hair Loss Study Group. Long-term (5-year) multinational experience with finasteride 1 mg in the treatment of men with androgenetic alopecia. Eur J Dermatol. 2002 Jan;12(1):38–49.
  9. Gupta AK, Charrette A. The efficacy and safety of 5a-reductase inhibitors in androgenetic alopecia: a network meta-analysis and benefit–risk assessment of finasteride and dutasteride. J Dermatol Treatment. Informa Healthcare USA on behalf of Informa UK Ltd; 2013;25(2):1–6.
  10. ONDA M, IGAWA HH, INOUE K, TANINO R. Novel Technique of Follicular Unit Extraction Hair Transplantation with a Powered Punching Device. Dermatol Surg. 2008 Oct 14;34(12):1683–8.
  11. Rose P. The Latest Innovations in Hair Transplantation. Facial Plast Surg. 2011 Jul 26;27(04):366–77.
  12. Avci P, Gupta GK, Clark J, Wikonkal N, Hamblin MR. Low-level laser (light) therapy (LLLT) for treatment of hair loss. Lasers Surg Med. 2014 Feb;46(2):144–51.
  13. Leavitt M, Charles G, Heyman E, Michaels D. HairMax LaserComb laser phototherapy device in the treatment of male androgenetic alopecia: A randomized, double-blind, sham device-controlled, multicentre trial. Clin Drug Investig. 2009;29(5):283–92.
  14. Gupta AK, Daigle D. The use of low-level light therapy in the treatment of androgenetic alopecia and female pattern hair loss. J Dermatol Treatment. Informa Healthcare USA on behalf of Informa UK Ltd; 2014;25(2):162-3.
  15. Jimenez JJ, Wikramanayake TC, Bergfeld W, Hordinsky M, Hickman JG, Hamblin MR, et al. Efficacy and Safety of a Low-level Laser Device in the Treatment of Male and Female Pattern Hair Loss: A Multicenter, Randomized, Sham Device-controlled, Double-blind Study. Am J Clin Dermatol. 2014 Jan 29;15(2):115–27.
  16. Kim H, Choi JW, Kim JY, Shin JW, Lee S-J, Huh CH. Low-Level Light Therapy for Androgenetic Alopecia: A 24-Week, Randomized, Double-Blind, Sham Device–Controlled Multicenter Trial. Dermatol Surg. 2013 Aug;39(8):1177–83.
  17. Lanzafame RJ, Blanche RR, Bodian AB, Chiacchierini RP, Fernandez-Obregon A, Kazmirek ER. The growth of human scalp hair mediated by visible red light laser and LED sources in males. Lasers Surg Med. 2013 Oct;45(8):487–95.
  18. Teumer J, Cooley J. Follicular cell implantation: an emerging cell therapy for hair loss. Thieme Medical Publishers; 2005;19(2):193.
  19. McElwee KJ, Kissling S, Wenzel E, Huth A, Hoffmann R. Cultured peribulbar dermal sheath cells can induce hair follicle development and contribute to the dermal sheath and dermal papilla. J Invest Dermatol. 2003 Dec;121(6):1267–75.
  20. McElwee K, Panich D, Hall D, Hoffmann R. Towards a cell-based treatment for androgenetic alopecia in men and women: 12-month interim safety results of a phase 1/2a clinical trial using autologous dermal sheath cup cell injections. J Invest Dermatol. 2013(133),1401.P062.

AUTHOR CORRESPONDENCE

Jerry Shapiro MD FRCPC……................ Jerry.Shapiro@vch.ca
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