Is Fibrosis really a factor?

[goata007]

I've been looking into fibrosis and couldn't find much except for this:

http://www.androgeneticalopecia.com/hair-loss-biology/hair-loss-histology-men-women.shtml

"In the vast majority of cases, there is no genuine reduction in the number of follicles, and follicular fibrosis is only seen in about 10% of cases. . However, fibrosis is seen in a small number of normal scalp biopsies as well."

"That this inflammation or fibrosis may have prognostic value for re-growth in pattern hair loss is shown by the results of a case study which documented that only 55 percent of those with vs. 77 percent of those without either fibrosis or inflammation demonstrated a response to topical minoxidil therapy."

So basically fibrosis is present only in small number of balding scalps, and if it is present then it does affect the response to hair growth treatments.

What's the indicator of fibrosis?...i'm certain it's not shiny scalp because i've seen people with shaved head (not balding) with shiny scalps, and people with alopecia totalis with shiny scalps. Also, there is a bald guy (pic below) who took an EGF inhibitor (kind of drug used by Follica), and he regrow significant hair on the top of his head and if you look closely at the picture the scalp where he regrew hair is shiny, the bald areas are sort of dead/matte.

http://www.hairsite.com/hair-loss/img/uploaded/129_image1.jpg

I'm 26/NW6 with a shiny scalp..I'm pretty sure shiness is a sign of healthy scalp because I also see vellus hair all over my NW1 area. Still, I'm thinking about getting a scalp biopsy, has anyone had a scalp biopsy? any thoughts of fibrosis?

 

[bornthisway]

Fibroris:
viewtopic.php?f=32&t=45230&start=0&st=0&sk=t&sd=a&hilit=fibrosis

More threads related to fibrosis can be found by using search.

 

[goata007]

Fibroris:
viewtopic.php?f=32&t=45230&start=0&st=0&sk=t&sd=a&hilit=fibrosis

More threads related to fibrosis can be found by using search.

I have searched about fibroris - infact that is the first line of my post. The reason I started a new thread was because the general concensus seems to be that shiny scalp means fibrosis and low possibility of regrowth. However, I have a shiny scalp and loads of veluss hair, plus I've also seen shiny scalped non-balding guys. I just wanted to see what others think about it.

 

[blueshard]

I don't know about fibrosis. But I do know that inflammation is related to it and that getting inflammation under control is a huge key to stopping hair loss.

 

[Orin]

It could indicate that the theory of why needling works, ie, "breaking up fibrosis" is perhaps not as likely, as the effect (which has been documented) of wounding the scalp generally activates hair to get out from a resting phase, is.

So in regard to judging needling merely on the merits of it being able to regrow (awaken) hair, it is probably inferior something that doesn't go as deep and covers a larger area, like any kind of dermabrasion.

This is all assuming that the fibrosis itself is not a big deal .

 

[harold]

I've been looking into fibrosis and couldn't find much except for this:

http://www.androgeneticalopecia.com/hair-loss-biology/hair-loss-histology-men-women.shtml

"In the vast majority of cases, there is no genuine reduction in the number of follicles, and follicular fibrosis is only seen in about 10% of cases. . However, fibrosis is seen in a small number of normal scalp biopsies as well."

"That this inflammation or fibrosis may have prognostic value for re-growth in pattern hair loss is shown by the results of a case study which documented that only 55 percent of those with vs. 77 percent of those without either fibrosis or inflammation demonstrated a response to topical minoxidil therapy."

So basically fibrosis is present only in small number of balding scalps, and if it is present then it does affect the response to hair growth treatments.

Jury is still out on fibrosis. It might not ever come back either since it doesnt seem to have been picked up by many investigators. Perhaps when the Cotsarelis study on PGD2 is published that will have a little more. At any rate fibrosis was supposed to be the endpoint of balding and people kind of jumped on that as a posssible explanation as to why the broad category of antiandrogenic drugs do not seem to be effective in regrowing hair but are effective in stopping further loss. There was a paper a while ago that laid out this theory.
I'm a little fuzzy on this stuff at least right now but basically each follicle has a sheath of skin that the hair follicle grows out of and I believe the dermal papilla grows down into when it is going from catagen to anagen. In slick bald scalp there was just empty hair follicle sheaths and they appeared to be thickened, collagenous, fibrotic tracts according to a few researchers. The fibrosis was due to either sustained inflammation or tgf-beta secretion. This led to the idea that the reason hairs miniaturised was because as this fibrotic tissue was laid down the new hair follicles could not descend as far or grow as large. More or less. Personally I suspect its a theory that was more plausible when we didnt know as much as we do about molecular stuff like BMP and wnt that can directly control the size of hair follicles.

What's the indicator of fibrosis?...i'm certain it's not shiny scalp because i've seen people with shaved head (not balding) with shiny scalps, and people with alopecia totalis with shiny scalps. Also, there is a bald guy (pic below) who took an EGF inhibitor (kind of drug used by Follica), and he regrow significant hair on the top of his head and if you look closely at the picture the scalp where he regrew hair is shiny, the bald areas are sort of dead/matte.

http://www.hairsite.com/hair-loss/img/uploaded/129_image1.jpg

I'm 26/NW6 with a shiny scalp..I'm pretty sure shiness is a sign of healthy scalp because I also see vellus hair all over my NW1 area. Still, I'm thinking about getting a scalp biopsy, has anyone had a scalp biopsy? any thoughts of fibrosis?

A shiny scalp is more indicative of active/overactive sebaceous glands and sebum secretion than anything else much like a greasy face is a shiny face.

 

[michael barry]

kevin mcelwee, a hair researcher in the hm field and owner of keratin.com, thought that healthy hairs could secrete enzymes to eat through collagen rather easily.

when you think about it, it does kind of make sense as transplanted single hairs from the back of the head dont have any problem when transplanted to shiny bald scalp.....................they grow just fine.



if you think about it further, if baldness has an autoimmune component, the body is just trying to "seal off" the offending organ with collagen seemingly......that doesnt' mean that the extra collagen is what shut it down, even though the crosslinked collagen fibers in the dermal sheath would seem to be problematic.

 

[goata007]

now that you mentioned it michael, I just remembered a study I glanced over (see below) which talked about how skin fights microbes, infections etc through antimicrobial polypeptides (AMP) which is produced through the activation of EGFR.

This, in a way, puts some crediblity to that demodex theory that oily scalp (which most of the baldmen have) gives rise to overpopulation of demodex, which causes increase in inflammation and increase in AMP production by activation of EGFR, thus probably causing excessive skin cells to build up over the follicles resulting in thinner hair. In a way, the body is protecting itself by shielding the follicles, but for us it's having a negative effect of losing hair. Maybe that is why bald men's skin is so shiny, because it's jam-packed with skin cells to block hair follicles?

Here's the link:
http://www.sciencedaily.com/releases/20 ... 130748.htm

 

[michael barry]

very interesting.........................I'd always just assumed it was enlarged sebaceous glands and excessive collagen up there doing the trick...

I work with a fairly young bald guy, maybe 35, who has a head so damned shiny, I mean HARD SHINY, that you can just about comb your hair in the reflextion off of it. I mean it is glossy-shiny. He friggin GLEAMS in the light.



I suppose the extra skin would be photoprotective, and a dude with no hair would indeed probably need that......oh well....



To be honest though, Nioxin came out with a product that inhibited demodex mites from being able to breed up there, but it didn't help hair loss much. That was in about 2000-2001 or so. It was a "new product of interest" on the forums at the time, but it apparently didn't pan out. Just about everyone on earth has those mites as we all have sebum......they actually help eat the stuff-----its really hard to say, but Im glad I bathe everyday (lol).

 

[harold]

now that you mentioned it michael, I just remembered a study I glanced over (see below) which talked about how skin fights microbes, infections etc through antimicrobial polypeptides (AMP) which is produced through the activation of EGFR.

This, in a way, puts some crediblity to that demodex theory that oily scalp (which most of the baldmen have) gives rise to overpopulation of demodex, which causes increase in inflammation and increase in AMP production by activation of EGFR, thus probably causing excessive skin cells to build up over the follicles resulting in thinner hair. In a way, the body is protecting itself by shielding the follicles, but for us it's having a negative effect of losing hair. Maybe that is why bald men's skin is so shiny, because it's jam-packed with skin cells to block hair follicles?

Here's the link:
http://www.sciencedaily.com/releases/20 ... 130748.htm

I havent read the link but that is interesting about the link between EGFR and microbes. Though I think its probably the yeast associated with dandruff (I would mangle the name m. furfur?) that are more important than demodex. It might explain the (slight) efficacy of different anti-dandruff shampoos in reducing hair loss. Although EGF seems to have no role in hair growth after hair follicle formation.

Again I would emphasise that bald mens heads often shine because they secrete more sebum. Having more skin cells shouldnt make a difference. Its like a bodybuilder rubbing oil into their muscles so they catch the light.
hh

 

[goata007]

Previously I mentioned how EGFR is activated in the presence of microbes, infection etc. Here is more info about hair-growth/loss & EGF

1. EGF & Hair Growth in mouse

"Injections of 1 or 4 micrograms EGF/g body weight for 14 consecutive days from birth resulted in the development of curved overhairs (monotrichs), caused a retardation in rate of growth in length of hair and a reduction in hair diameter and length of follicle bulb. Growth rate partially recovered after cessation of EGF treatment"

[http://joe.endocrinology-journals.org/cgi/content/abstract/88/2/293]



2. minoxidil vs EGF

"Calcium may also be involved in the process of hair regrowth. In the presence of calcium, epidermal growth factor (EGF) inhibits hair growth. The entry of calcium into a hair cell is opposed by potassium channel openers, such as minoxidil; therefore, EGF-induced inhibition of hair will be opposed by the action of minoxidil, and hair will grow more proficiently. Biopsy specimens have not demonstrated evidence of new follicle formation with the use of minoxidil"

[DeVillez RL. The Therapeutic Use of Topical Minoxidil. Dermatol Clin 1990;8:367—74.]


3. Dr. Loren Pickart is a world-renowned researcher of copper peptide skin and hair treatment. On his website, Skin Biology, I found the following information.

“Skin remodeling starts with the hair follicles. The body's signal for remodeling first activates the systems that break down damaged proteins and remove damaged skin lesions. Various proteins … start breaking down scars and damaged tissue. Then the signals enlarge the hair follicles in the skin area to be rebuilt. New skin cells arise from the hair follicle and migrate into the surrounding skin area. "......."But although skin remodeling improves hair follicle health, it does not create new follicles or grow hair in (genetically)hairless areas"

This is also consistent with Fuchs' video that I posted, according to which stem cells from the buldge in the hair follicle actually repair epidermis. So a minitaurized hair follicle should imply bad scalp health.

 

[harold]

3. Dr. Loren Pickart is a world-renowned researcher of copper peptide skin and hair treatment. On his website, Skin Biology, I found the following information.

“Skin remodeling starts with the hair follicles. The body's signal for remodeling first activates the systems that break down damaged proteins and remove damaged skin lesions. Various proteins … start breaking down scars and damaged tissue. Then the signals enlarge the hair follicles in the skin area to be rebuilt. New skin cells arise from the hair follicle and migrate into the surrounding skin area. "......."But although skin remodeling improves hair follicle health, it does not create new follicles or grow hair in (genetically)hairless areas"

This is also consistent with Fuchs' video that I posted, according to which stem cells from the buldge in the hair follicle actually repair epidermis. So a minitaurized hair follicle should imply bad scalp health.

I thought I had commented on this before - maybe you posted it in the follica thread as well and I did but forgot - that thing moves fast
Anyway good stuff but the above is something that really caught my eye. There is actually quite a lot of info on this stuff out there and its obviously very relevant to the Follica thing.
hh