Does the recipient site influence the hair growth characteristics in hair transplantation?

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Dermatol Surg 2002 Sep;28(9):795-8; discussion 798-9

Does the recipient site influence the hair growth characteristics in hair transplantation?

BACKGROUND: Recently hair transplantation has been widely applied not only to correct androgenetic alopecia, but also to correct hair loss on other parts of the body such as the eyebrows and pubic area. It is believed that the transplanted hairs will maintain their integrity and characteristics after transplantation to new nonscalp sites. OBJECTIVE: To evaluate whether the transplanted hairs maintain their hair growth characteristics after transplantation to a new anatomic site other than the scalp. METHODS: Three study designs were used. Study I: Hair transplantation from the author's occipital scalp to his lower leg was performed and clinical evaluations were made at both 6 months and at 3 years after the transplantation. Study II: After finding changes in hair growth characteristics, transplanted hairs were harvested from the leg and retransplanted to the left side of the nape of the neck (group A). As a control study, occipital hairs were transplanted to the opposite side (group B). Observations were made at 6 months after the operation. Study III: An observational study was done in 12 patients with androgenetic alopecia about 1 year after transplantation of occipital hair to frontal scalp. At each step, survival rates were documented and the rate of growth and the diameter of the shafts were measured for both recipient and donor sites. RESULTS: Study I: Surviving hairs on the lower leg showed a lower growth rate (8.2 +/- 0.9 mm/month), but the same diameter (0.086 +/- 0.018 mm) compared with occipital hairs (16.0 +/- 1.1 mm/month, 0.088 +/- 0.016 mm). The survival rate 3 years after transplantation was 60.2%. Study II: There was no significant difference in the growth rate, shaft diameter, and survival rate between retransplanted hairs (group A) and controls (group B). Groups A and B showed a lower growth rate, but the same diameter, compared with occipital hairs. Study III: There was no significant difference in the growth rate and shaft diameter between the transplanted hairs on the frontal scalp and the occipital hairs. CONCLUSION: These results strongly suggest that the recipient site affects some characteristics of transplanted hairs, such as their growth and survival rates.

Clin Exp Dermatol 2002 Jul;27(5):389-5

Telogen effluvium.

The term telogen effluvium, first coined by Kligman in 1961, refers to the loss of club (telogen) hair in disease states of the follicle. Kligman's hypothesis was that whatever the cause of hair loss, the follicle tends to behave in a similar way, namely the premature termination of anagen. "The follicle is precipitated into catagen and transforms into a resting stage that mimics telogen." Ipso facto the observation of telogen hair loss does not infer a cause. To establish the cause of the hair loss, one requires a history to identify known triggers, biochemical investigations to exclude endocrine, nutritional or autoimmune aetiologies and in many cases histology to identify the earliest stages of androgenetic alopecia. The duration of the hair loss at presentation helps predict those patients in whom further investigation will have the greatest yield. "It is unfortunate that baldness has been approached with an eye toward "regrowing" or "restoring hair", and thus with a tendency toward commercialism. Locked within the metamorphosing hair follicles in the balding scalp are all the secrets of growth and differentation. Searching for these secrets should transcend the eagerness to "regrow" hair on a bald scalp, an achievement which is of no great consequence. When we know these answers, we shall have the key, not to hair growth alone, but to all growth, which is, after all, the basis of all biological phenomena." William Montagna, 1959.

J Dermatol Sci. 2003 Apr;31(2):91-8.

The extract of Thujae occidentalis semen inhibited 5alpha-reductase and androchronogenetic alopecia of B6CBAF1/j hybrid mouse.

BACKGROUND: The conversion of testosterone to dihydrotestosterone; 5alpha-androstan-17beta-ol-3-one by 5alpha-reductase plays a crucial role in hair baldness and prostatomegaly. Recent approach showed specific inhibitors for 5alpha-reductase type 2 such as finasteride promoted hair growth in male pattern alopecia. OBJECTIVE: In order to search for effective medicinal plant extracts applied topically for androgenetic alopecia, we screened natural plant extracts having inhibitory activities of 5alpha-reductase type 2 and demonstrated its biological function in androgen-related animal models. METHODS: We evaluated the inhibition activities of numerous plant extracts by contact cell based metabolic method using a stable HEK 293 cell line expressing human 5alpha-reductase (type 2). To elucidate the biological activity in vivo, the Thujae occidentalis semen (TOS) extract was topically applied to fuzzy rat and androchronogenetic alopecia (AGA) mouse, respectively. The secreted sebum and the size of sebaceous glands of fuzzy rat were measured after 6 weeks. Also, after the topical treatment with TOS extract and androgen receptor antagonist (cyproterone acetate) simultaneously with subcutaneous injection of testosterone (1 mg/mice/day), hair loss patterns of female B6CBAF1/j hybrid mouse were observed. RESULTS: TOS extract showed higher inhibition activity of 5alpha-reductase type 2(IC(50) value=2.6 microg/ml) than that of gamma-linolenic acid, but lower than that of finasteride. When applied to fuzzy rat, the amount of sebum and sebaceous gland size decreased remarkably. In AGA model, alopecia degrees of two groups, treated with TOS extract (P<0.015) or cyproterone acetate (P<0.01), were lower than that of vehicle (propylene glycol:ethanol=7:3) and there was no difference between above two groups. CONCLUSION: We have demonstrated the inhibitory activity of TOS extract for 5alpha-reductase type 2 and its biological action in two animal models, suggesting that TOS extract would be used as an effective agent for male pattern baldness by modifying androgen conversion.

J Liposome Res. 2002 Feb-May;12(1-2):143-8.

Follicular liposomal delivery systems.

Traditionally, the prime pathway for the topical delivery of active agents across the skin was thought to be through intercellular routes and transcellular routes of the stratum corneum. However, alternative means such as via appenageal transport, i.e., follicular transport, is gaining more acceptances in the scientific community. Targeting specific sites of the hair follicle may represent a feasible therapeutic approach to skin diseases such as hair loss. It is therefore an object of this research to develop novel liposomal formulations for enabling the topical delivery of difficult-to-absorb agents for localized action, specifically to the hair follicles and sebaceous glands. We examined small and large molecules. The small molecule chosen was minoxidil, a known hair growth stimulator. The large molecular weight molecule was plasmid DNA encoded with interleukin-1 receptor antagonist protein (IL-1ra).

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