Is "maintaining" Even A Relevant Concept Anymore

[Grasshüpfer]

Sorry for the sloppy answer, I am quite busy right now.

Then thank you for the anwer even more! Short story on my side: Waited too long, now very thin but barely full coverage. A bit better than @Massive i think. Thinning all over. Now throwing everything at it. Since august on ru and one month on finasteride, E2 starting if the itch is not gone in december.

 

[SmoothSailing]

That was actually pretty funny. No wait, it wasn't.

By the way no, I'm not gay, unfortunately. They're not as picky and shallow as girls, I wouldn't have suffered as much as I had, and I wouldn't be virgin at my age.

Yeah I sometimes wish I was gay haha. Some things would be so much easier. I could just look at this whole courting girls thing with a smirk from the sideline, with a dick in my mouth haha.

Or when I come across a tranny on tinder I've often though, "even this guy dressed in a dress is getting more action than me".

 

[Grasshüpfer]

With ru58441 that was probably the case.

 

[Gone]

Also while follicles generally survive maybe a decade after they turn invisible and sometimes many decades, they eventually become damaged beyond repair.

What source says this? If that's true, then maintaining hair would absolutely be important, I just thought this idea of them eventually getting too damaged was proven false, or at least not proven to be true.

 

[That Guy]

What source says this? If that's true, then maintaining hair would absolutely be important, I just thought this idea of them eventually getting too damaged was proven false, or at least not proven to be true.

Dr. Cotsarelis discovered a number of years ago that the follicles shrink to microscopic sizes and that slick-bald areas have as many stem cells as haired areas.

Some users like to bring this up whenever somebody talks about "dead" follicles, reminding them that hair follicles never really die. In my opinion, it's a cope, though. It gives hope to the idea that one day soon a topical will be able to give you back hair from 30 years ago. Contemporary science would seem to indicate that it is just easier to create brand-new follicles, use multiplied dermal papillae and induce neogenesis via wounding than it is to reactivate the decades-long miniaturized follicles.

For all intents and purposes: they're dead.

 

[hairblues]

Dr. Cotsarelis discovered a number of years ago that the follicles shrink to microscopic sizes and that slick-bald areas have as many stem cells as haired areas.

Some users like to bring this up whenever somebody talks about "dead" follicles, reminding them that hair follicles never really die. In my opinion, it's a cope, though. It gives hope to the idea that one day soon a topical will be able to give you back hair from 30 years ago. Contemporary science would seem to indicate that it is just easier to create brand-new follicles, use multiplied dermal papillae and induce neogensis via wounding than it is to reactive the decades-long miniaturized follicles.

For all intents and purposes: they're dead.

I agree..
I have read in text books that advanced Androgenetic Alopecia in a biopsy can be mistaken for Scarring Alopecia because of scar tissue or fibrosis. Basically it becomes so damaged nothing is going to make it grow hair.
Also Dr Cost himself is working on creating new follicles.
I have no idea 'when' the follicle becomes so damaged. I have a feeling its not for many years...but if someone starts to go bald at 18--i would think by 40 at least some of those follicles are beyond repair.


I was reading a lot of pathology papers when i was misdiagnosed with Areata...I think the pathologist texts are the best place for this kind of information but i found them very hard to read. I mean i did what i had to do for myself but they were a struggle.

 

[That Guy]

Also Dr Cost himself is working on creating new follicles.

Which should tell everyone everything they really need to know.

 

[Swoop]

The day that maintaining isn't a relevant concept anymore would be a day of great celebration for us all. It's still highly relevant come on lol.

 

[Dench57]

Maintenance is all I've ever been after. Some dudes in Belgium have the regrowth sorted.

 

[That Guy]

The day that maintaining isn't a relevant concept anymore would be a day of great celebration for us all. It's still highly relevant come on lol.

Maintaining will always be relevant for anyone reading these forums. Unless you've been Tsuji'd, we can assume.

The people who will experience maintenance being irrelevant have yet to be born.

 

[Gone]

How do we know that Follica's follicles aren't just reawakened microscopic hair that's turned terminal? Say you use follica on an area without noticeable hair, and terminal hairs grow. Most parts of the
body have hair follicles. You might say "this created follicles" but it's also possible that it just activated the microscopic hairs. "Neogenisis" and "new follicles" might just be impressive and marketable terms for saying, those microscopic hairs are growing.

People say "yeah but eventually you lose those stem cells/hairs, they become too damaged to be reawakened." But we don't know this.

Dr. Cotsarelis discovered a number of years ago that the follicles shrink to microscopic sizes and that slick-bald areas have as many stem cells as haired areas.

Some users like to bring this up whenever somebody talks about "dead" follicles, reminding them that hair follicles never really die. In my opinion, it's a cope, though. It gives hope to the idea that one day soon a topical will be able to give you back hair from 30 years ago. Contemporary science would seem to indicate that it is just easier to create brand-new follicles, use multiplied dermal papillae and induce neogenesis via wounding than it is to reactivate the decades-long miniaturized follicles.

For all intents and purposes: they're dead.

It's not a matter of opinion though, but limited information. I think the cope you're describing is sometimes expressed in a different way. This is what i meant by my second post in this thread, some people would still perform treatments even with the cure a couple years down the road, because they don't want to see themselves bald in that time between. Even with encouraging news in the pipeline, they cope with conventional treatments. If follicles can be reawakened by a future treatment, it is not necessary to try to preserve them until then.

I agree..
I have read in text books that advanced Androgenetic Alopecia in a biopsy can be mistaken for Scarring Alopecia because of scar tissue or fibrosis. Basically it becomes so damaged nothing is going to make it grow hair.
Also Dr Cost himself is working on creating new follicles.
I have no idea 'when' the follicle becomes so damaged. I have a feeling its not for many years...but if someone starts to go bald at 18--i would think by 40 at least some of those follicles are beyond repair.


I was reading a lot of pathology papers when i was misdiagnosed with Areata...I think the pathologist texts are the best place for this kind of information but i found them very hard to read. I mean i did what i had to do for myself but they were a struggle.

What makes you think 40 is the age when it happens? If I had to guess, I would guess the same. Because that's the consensus belief, that we have to do everything we can or our hair will die. It makes sense in our minds because that's how we perceive the condition. The thing is, Androgenic Alopecia is not a scarring alopecia, even if it was mistaken for one. If follicles can survive for decades and still produce tiny hairs, I need proof before I say, "yup, they're dead."

The day that maintaining isn't a relevant concept anymore would be a day of great celebration for us all. It's still highly relevant come on lol.

Perhaps, but it's worth discussing and not dismissing.

 

[hairblues]

@Gone

From what i understand Dr Cost is creating a wound and then pushing the wound to creating a new follicle rather than growing skin--thats at least how I have come to understand it. You can research it yourself and see what you find.


The people heavy into biology and science can probably answer this much bette than me..

I think maybe its more years that the follicle is inactive it atrophies or wastes away becomes damaged...I would imagine it can develop scar tissue..This may be why it 'looks' like scarring alopecia in biopsies--because there is scar tissue or tissue waste. If a 70 year old is biopsied and started losing hair in late 30s then thats 30 years of hair loss..I think that is unlikely to ever be healthy follicle..dead or not dead I think its too damaged to grow hair.

I just think once you get into 20-40 years of hair loss (some even say as little as 3 years) those follicles are wasted away...i don't know if they can come back..something would not only have to fight the DHT and increase nutrients flowing to the follicle but it would have to repair the damage done to the tissue and muscle of the follicle..This can be possible in future but may be easier to just create new follicles i have no idea....BUT why wait and find out?

To me maintaining hair even if it's an intermediate hair or a vellus is similar to the phrase 'use it or lose it'. Keep that follicle as active as you can so there is more chance of turning it back to a healthy thicker hair when/if better treatments come a long.

 

[That Guy]

How do we know that Follica's follicles aren't just reawakened microscopic hair that's turned terminal? Say you use follica on an area without noticeable hair, and terminal hairs grow. Most parts of the
body have hair follicles. You might say "this created follicles" but it's also possible that it just activated the microscopic hairs. "Neogenisis" and "new follicles" might just be impressive and marketable terms for saying, those microscopic hairs are growing.

We know this because this phenomena has been observed since the 1960s; maybe earlier. Follica and Cots have also have said as much and described the treatment as "wound neogenesis". Neogenesis meaning new origin.

For example, there was an English dude who fell headfirst into a coal fire and refused medical attention. So, they looked after him as an outpatient. Said guy had Androgenetic Alopecia and when the burn was left to heal on its own, lots of new, thick hair grew in where the burn was. Miniaturized follicles present would have been destroyed.

In controlled lab conditions, this has been observed many times. You create a wound and if you let heal without any intervention, it might become hair or it might become skin, depending on what the stem cells decide to do. Follica's process is based on the idea that certain compounds can influence what they come together to form.

 

[Swoop]

To add to this:

Dr. Higgins: Yeah, with Androgenetic Alopecia you do get to the point of no return where you can’t go back. That’s why it is different from alopecia areata.

Dr. Hoffman: He said that he thinks there is point of no return in androgenetic alopecia. That means that after some time you can’t regrow hair.

Cotsarelis says that in gauging future prospects for alopecia treatment, it’s important to have realistic expectations. “I’d hate to use the word cure, because I don’t think male-pattern baldness can be completely reversed,” he says. “Instead, we’ll develop different treatments, and as with other personalized therapies in medicine, some will work better in various subgroups than others.”


Domyati et al 2009:

Over time, thickening of perifollicular sheath takes place due to increased deposition of collagen, resulting in marked perifollicular fibrosis, and sometimes ends by complete destruction of the affected follicles in advanced cases.

Olsen 2003:

"The end result is the production of smaller, unpigmented vellus hairs instead of larger, pigmented terminal hairs. Although the follicles do progressively get smaller, the overall scalp follicle density appears to be preserved until late in the course of hair loss when follicles are eventually destroyed (for a thorough description, see Olsen, 2003)."

Sinclair 2016:

The proximal APM attachment was observed to be lost or extremely miniaturized in androgenic alopecia. The unique shape, location, and attachment sites of the APM suggest a significant role for this muscle in maintaining follicular integrity. Proximally, the APM encircles the follicular unit and only attaches to the primary hair follicle in the bulge; this attachment is lost in irreversible hair loss.


ETC..

 

[project100]

To add to this:

Dr. Higgins: Yeah, with Androgenetic Alopecia you do get to the point of no return where you can’t go back. That’s why it is different from alopecia areata.

Dr. Hoffman: He said that he thinks there is point of no return in androgenetic alopecia. That means that after some time you can’t regrow hair.

Cotsarelis says that in gauging future prospects for alopecia treatment, it’s important to have realistic expectations. “I’d hate to use the word cure, because I don’t think male-pattern baldness can be completely reversed,” he says. “Instead, we’ll develop different treatments, and as with other personalized therapies in medicine, some will work better in various subgroups than others.”


Domyati et al 2009:

Over time, thickening of perifollicular sheath takes place due to increased deposition of collagen, resulting in marked perifollicular fibrosis, and sometimes ends by complete destruction of the affected follicles in advanced cases.

Olsen 2003:

"The end result is the production of smaller, unpigmented vellus hairs instead of larger, pigmented terminal hairs. Although the follicles do progressively get smaller, the overall scalp follicle density appears to be preserved until late in the course of hair loss when follicles are eventually destroyed (for a thorough description, see Olsen, 2003)."

Sinclair 2016:

The proximal APM attachment was observed to be lost or extremely miniaturized in androgenic alopecia. The unique shape, location, and attachment sites of the APM suggest a significant role for this muscle in maintaining follicular integrity. Proximally, the APM encircles the follicular unit and only attaches to the primary hair follicle in the bulge; this attachment is lost in irreversible hair loss.


ETC..

I really f*****g hope that my little dudes can hold on long enough. They're small and hard to see, but they're still there! I have really aggressive hairloss. I wonder how long it takes for my follicles to die.

 

[Folliman]

Maintenance will stay relevant as long as we are unable to change our genes.

 

[Gone]

That Guy, I know that it's called "neogenesis." But follica isn't using their treatment on the bottom of your feet or someplace hair doesn't usually grow. They're using it on scalp, where there are thousands of hair follicles. There are hairs almost everywhere on your body, and it would take using follica on a completely hairless area to confirm that the follicles are in fact new.

To add to this:

Dr. Higgins: Yeah, with Androgenetic Alopecia you do get to the point of no return where you can’t go back. That’s why it is different from alopecia areata.

Dr. Hoffman: He said that he thinks there is point of no return in androgenetic alopecia. That means that after some time you can’t regrow hair.

Cotsarelis says that in gauging future prospects for alopecia treatment, it’s important to have realistic expectations. “I’d hate to use the word cure, because I don’t think male-pattern baldness can be completely reversed,” he says. “Instead, we’ll develop different treatments, and as with other personalized therapies in medicine, some will work better in various subgroups than others.”


Domyati et al 2009:

Over time, thickening of perifollicular sheath takes place due to increased deposition of collagen, resulting in marked perifollicular fibrosis, and sometimes ends by complete destruction of the affected follicles in advanced cases.

Olsen 2003:

"The end result is the production of smaller, unpigmented vellus hairs instead of larger, pigmented terminal hairs. Although the follicles do progressively get smaller, the overall scalp follicle density appears to be preserved until late in the course of hair loss when follicles are eventually destroyed (for a thorough description, see Olsen, 2003)."

Sinclair 2016:

The proximal APM attachment was observed to be lost or extremely miniaturized in androgenic alopecia. The unique shape, location, and attachment sites of the APM suggest a significant role for this muscle in maintaining follicular integrity. Proximally, the APM encircles the follicular unit and only attaches to the primary hair follicle in the bulge; this attachment is lost in irreversible hair loss.


ETC..

1. Right, of course you can't "go back" right now because the treatments we have are all maintenance treatments. No one is saying
baldness is going to reverse itself on its own.

2. Again, of course you wouldn't be able to regrow hair the way things are now. Think of a better version of Samumed. Their trial was done on late norwoods. Perhaps their relatively low regrowth was due to follicle fibrosis, but hair still grew in places that many people would have thought were "too damaged."

3. When was that quote by Cotsarelis from?

4, 5. Good evidence

6. So there is damage to the follicle's APM. Perhaps it can be reversed with proper manipulation of the bulge stem cells.

 

[hairblues]

That Guy, I know that it's called "neogenesis." But follica isn't using their treatment on the bottom of your feet or someplace hair doesn't usually grow. They're using it on scalp, where there are thousands of hair follicles. There are hairs almost everywhere on your body, and it would take using follica on a completely hairless area to confirm that the follicles are in fact new.

1. Right, of course you can't "go back" right now because the treatments we have are all maintenance treatments. No one is saying
baldness is going to reverse itself on its own.

2. Again, of course you wouldn't be able to regrow hair the way things are now. Think of a better version of Samumed. Their trial was done on late norwoods. Perhaps their relatively low regrowth was due to follicle fibrosis, but hair still grew in places that many people would have thought were "too damaged."

3. When was that quote by Cotsarelis from?

4, 5. Good evidence

6. So there is damage to the follicle's APM. Perhaps it can be reversed with proper manipulation of the bulge stem cells.

You are saying 'perhaps' something can be manipulated.

I think the point is why risk letting follicles get to damaged state when you can treat it for maintenance?

Its like the difference between breaking a leg that the bone can be set and repair because still bone and amputating a leg and saying perhaps they can figure out how to clone the leg or make your body regrow the leg.

I mean that is an extreme example but trying to make a point.

Maintenance EVEN if they find a cure will probably be encouraged by Doctors...The less hair they have to replace/implant/create the better for cost down time etc.

Plus it's a very big 'perhaps' to hang your hat on.

 

[hairblues]

To add to this:

Dr. Higgins: Yeah, with Androgenetic Alopecia you do get to the point of no return where you can’t go back. That’s why it is different from alopecia areata.

Dr. Hoffman: He said that he thinks there is point of no return in androgenetic alopecia. That means that after some time you can’t regrow hair.

Cotsarelis says that in gauging future prospects for alopecia treatment, it’s important to have realistic expectations. “I’d hate to use the word cure, because I don’t think male-pattern baldness can be completely reversed,” he says. “Instead, we’ll develop different treatments, and as with other personalized therapies in medicine, some will work better in various subgroups than others.”


Domyati et al 2009:

Over time, thickening of perifollicular sheath takes place due to increased deposition of collagen, resulting in marked perifollicular fibrosis, and sometimes ends by complete destruction of the affected follicles in advanced cases.

Olsen 2003:

"The end result is the production of smaller, unpigmented vellus hairs instead of larger, pigmented terminal hairs. Although the follicles do progressively get smaller, the overall scalp follicle density appears to be preserved until late in the course of hair loss when follicles are eventually destroyed (for a thorough description, see Olsen, 2003)."

Sinclair 2016:

The proximal APM attachment was observed to be lost or extremely miniaturized in androgenic alopecia. The unique shape, location, and attachment sites of the APM suggest a significant role for this muscle in maintaining follicular integrity. Proximally, the APM encircles the follicular unit and only attaches to the primary hair follicle in the bulge; this attachment is lost in irreversible hair loss.


ETC..

I have only been on here since this Summer and i am surprised how often this debate comes up in various threads.

THIS post should be saved and reposted whenever it comes up again because it honestly just shuts down the debate as silly.

Maintenance is key in fighting hair loss.

 

[FutureSaitama]

To add to this:

Dr. Higgins: Yeah, with Androgenetic Alopecia you do get to the point of no return where you can’t go back. That’s why it is different from alopecia areata.

Dr. Hoffman: He said that he thinks there is point of no return in androgenetic alopecia. That means that after some time you can’t regrow hair.

Cotsarelis says that in gauging future prospects for alopecia treatment, it’s important to have realistic expectations. “I’d hate to use the word cure, because I don’t think male-pattern baldness can be completely reversed,” he says. “Instead, we’ll develop different treatments, and as with other personalized therapies in medicine, some will work better in various subgroups than others.”


Domyati et al 2009:

Over time, thickening of perifollicular sheath takes place due to increased deposition of collagen, resulting in marked perifollicular fibrosis, and sometimes ends by complete destruction of the affected follicles in advanced cases.

Olsen 2003:

"The end result is the production of smaller, unpigmented vellus hairs instead of larger, pigmented terminal hairs. Although the follicles do progressively get smaller, the overall scalp follicle density appears to be preserved until late in the course of hair loss when follicles are eventually destroyed (for a thorough description, see Olsen, 2003)."

Sinclair 2016:

The proximal APM attachment was observed to be lost or extremely miniaturized in androgenic alopecia. The unique shape, location, and attachment sites of the APM suggest a significant role for this muscle in maintaining follicular integrity. Proximally, the APM encircles the follicular unit and only attaches to the primary hair follicle in the bulge; this attachment is lost in irreversible hair loss.


ETC..

I was wondering about this for a long time, but is there any scientific research about the period of time needed for a miniaturized follicle to be considered unrepairable ? Like for example the period of 5 years dr. Brotzu gave us, an average amount of time after the onset of male pattern baldness that follicles become damaged beyond repair.