Toupee for everyone or how hair clinics plan the 'extinction' of alopecia

First it is a hair on the brush, a drop in the capillary ocean.

Nothing to worry about.

Then a small skein grows in the sink drain, but that's normal, one thinks.

Soon the tangle of hair becomes a plug in the bathtub, and then the worry does start;

because the hair no longer does it ... You cut the ponytail, you buy a razor and you shave to zero, that the obvious thing is not noticed.

From there, the path to

is all downhill.

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Or not.

Because at this point there is a way to go back in the story of how baldness debuted - which is usually a variant of the previous story, at least since brushes, sinks, bathtubs and electric razors have existed.

Hair transplantation has changed the rules of the game: lost hair is not recovered, but it

that, in cases of common baldness, will not fall out again.

And it doesn't look bad: the usual old "doll hair" is rare, mainly because the technique that used to be used in the seventies, which is known as

And that transplants whole locks, it has been surpassed by others in which it works hair by hair.

The result is infinitely more natural (although it is advisable not to trust yourself and choose well who to entrust the rebirth of your thick toupee).

However, a significant limitation remains.

The problem is that trichologists find enough hair for a good hair transplant to solve scarring alopecia - it is not the best known application, but it is one of the most traditional: it was already used in World War II Japan to cover scars caused by burns, and it is also an option to cover those from surgery.

There is usually hair to replace the one that falls from the eyebrows with cancer treatments, as well as to hide the loss caused by the hormonal changes experienced by women from the age of 40, all of them situations that the coordinator points out as common clinical physician of the Insparya Group, Carlos Portinho.

But many times there is not enough material on the entire scalp to fill in the gaps left by androgenic alopecia (common baldness), which affects more or less half of men and is responsible for more than 90% of cases of hair loss.

Portinho hopes to see a radical change.

And it's not the only one.

Get from where there isn't?

Everything is possible

Apart from attracting clients, those in charge of hair clinics like the one in Portinho are exposed to all kinds of concerns, some as curious as having enough left-handed workers - for the treatment to last a few hours, they select hair with four hands and, for reasons Regarding technical equipment and access to the hair, the professionals work in right-left-handed pairs.

Other concerns are very far from the offices, in the research laboratories, and have led them to dissect, literally, the origin of each hair: the microenvironment in which it is born, reproduces and, if things do not go as one wants, go dead.

In this microenvironment, follicular units develop, which are complex biological assemblages from which follicles sprout (this is how hairs are called in scientific jargon).

From a follicular unit, one to four follicles can emerge.

In a transplant, those that generate three or four hairs are selected to cover the areas of greater density and those that only have one are placed at the limit of the scalp, since they allow to better define the line.

In one treatment, up to 4,000 follicular units are transplanted, of which Portinho estimates that between nine and ten thousand hairs come out (he says that more than 90% take hold).

They are many, but not

(for example, grade VII on the Hamilton-Norwood scale for men, the one you remember from your grandfather. For women there is the Ludwig scale, which only counts up to grade III) .

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Why?

Because scientists - and readers well versed in this matter - have known for a long time that, in this type of alopecia (which is typical of men but also occurs in women), the difference between hairs that fall out and those that are left on the scalp is in sensitivity to

.

Follicular units that do not get along with the hormone experience premature aging and eventually die, while those with a normal biochemical relationship move on.

When someone decides to have a hair transplant, they benefit from a rule of nature that resistant follicles are always on the back and sides of the head.

If you extract the follicular units in these areas and the plants in the others, the hair grows again and does not fall out again.

It is immune to testosterone.

And this is where you have to do the numbers.

According to Portinho, there are about 50,000 follicular units in donor areas, and more than 100,000 in the entire head.

In one day, their clinics can relocate up to 4,000 but, no matter how large they have and no matter how many transplants one undergoes, in advanced alopecia

.

Follicular units could be transplanted from other parts of the body such as the beard, armpit and chest, but the hairs from those regions have a different appearance that one does not usually want to see on the head (they say that Indians have similar chest hair the head, which is not so noticeable in them ...).

The doctor has a bolder solution: turn 100 follicular units into 10,000.

In other words, repopulate a wasteland with less than half the material that is now extracted in one treatment (currently it is normal to go through several to get much less).

It is not a miracle.

His plan is to better understand the dermal papilla, one of the parts that make up the follicular units.

In it, the

are generated

responsible for the fact that when a hair cycle ends, which lasts between 2 and 7 years, a new follicle replaces the one that falls out.

If scientists knew how to replicate this biological machinery, obtaining 10,000 units from the cloning of 100 units would not be unreasonable;

if hair cloning were a reality, there would be hair for everyone.

And there they are.

A countdown of a decade (or less)

"Everyone wants to know how to produce hair," says Elsa Logarinho, a scientist at the Institute for Health Research and Innovation at the University of Porto.

She too.

Because "there are many patients who want to undergo a microtransplant but do not have a donor area, they need more follicles," he says.

Her research, promoted with the collaboration of Insparya, seeks to extract these cells under conditions that, in the future, can be replicated: “When we extract them and try to multiply them, we spoil the context and lose their identity.

It is a great challenge to understand how to expand these cells while maintaining their identity ”.

In other words, multiply them and that, when they are grafted onto the scalp, they produce a new and healthy hair.

Logarinho is not alone in this search.

The research that, in the long term, will lead to hair cloning is a race of many, and very powerful, adversaries.

In 2013, for example, a study led by researcher Claire Higgins, then at Columbia University, explained to the scientific community how to reprogram the microenvironment to induce human hair growth from a laboratory culture of the dermal papilla.

All proof that the goal is possible.

But it needs to be done on a large scale, one that can be touched with the comb without making a plug in the bathtub.

It seems that that moment is near, according to the head of the Dermatology Service of the Ramón y Cajal hospital, Sergio Vañó, said a couple of years ago.

In an interview on the occasion of a trichology course taught at the hospital, Vañó stated that hair cloning

.

There are 8 left (in case you want to save).

Don't be overly optimistic;

there are milestones of those that change everything that are always ten years away and never arrive ... Of course, they are decades in which time is not wasted.

In this case, there are other striking proposals when it comes to cloning these stem cells, such as the therapy being tested by Shiseido and RepliCel in 66 men with androgenic alopecia.

The clinical trial is currently in phase 2, and the objective is to clone these immune cells to the influence of testosterone (again, from the back of the head) and then reintroduce them in the areas affected by alopecia.

Hopefully the result will be new hair resistant to the influence of testosterone.

As a side effect, the toupee may also come back into fashion, the thicker the better.