Is "maintaining" Even A Relevant Concept Anymore

[hairblues]

II found this also that is interesting

Arrector Pili Muscle and Androgenetic Alopecia
Hair exists as follicular units consisting of 3-5 terminal hairs per follicular unit nourished by a single arborizing arrector pili muscle (APM), which attaches circumferentially around the primary follicle with variable attachment to other follicles (91,97). A study by Yazdabadi et al demonstrated that in MAA and female pattern hair loss, where follicle miniaturization is either irreversible or only partially reversible, there was a consistent loss of attachment of the APM to vellus hair follicles (Figure 6). This was in contrast to potentially reversible alopecia areata, in which the APM maintained contact with the miniaturized secondary vellus follicles (Figure 7). The study suggests that the persisting contact between the APM and follicular unit predicts reversibility of miniaturization (106).

A recent proposition for the pathogenesis and mechanism of androgenetic alopecia suggests that in the early stages of MAA, the arrector pili muscle remains attached to the primary follicle, yet loses attachment to a number of the regressing secondary follicles in some follicular units (81). As further miniaturization and detachment occurs, patients may first notice a change in their hair density and complain of thinning. Once the arrector pili muscle has detached from all secondary follicles and primary follicles have undergone miniaturization and detachment, hair loss is likely irreversible (81). This proposed mechanism establishes the importance of early treatment to halt balding prior to the loss of primary hair follicles.

 

[Gone]

It's not silly if you're still in the process of learning about it. Almost every person arguing how simple it is, "of course, follicles eventually die," has to subsequently go take the time to research it or amend their own beliefs through others' input.

 

[hairblues]

It's not silly if you're still in the process of learning about it.

Very true--but it comes up a lot from people who are NOT just learning about it.

 

[Swoop]

@Gone

The quote is recent from Dr. Cotsarelis: http://www.nature.com/nbt/journal/v34/n2/full/nbt0216-120.html?message-global=remove

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.

I have no clue. Would probably differ across individuals. I only know about this study which puts the timeframe at ~30 months (well at least that fibrotic changes can already occur) http://www.ehrs.org/conferenceabstracts/2001tokyo/researchabstracts/130-Konstantinova.htm

 

[hairblues]

@Swoop Do you know if Histogen is theoretically aiming to repair the damage done to the follicle?

I just have a hard time imagining a damaged follicle can be repaired by anything coming out in next few years.
Maybe Sammond because they repaired a broken back of a rat on the video--at least it seems that is what they are aiming for to repair scar tissue.

 

[That Guy]

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.

I'm honestly not sure what point you're trying to make. This is something that can be observed under a microscope; there is no question that wounding can create new follicles. I'd suggest reading Cotsarelis' research.

 

[Gone]

I wish there was a scientifically accurate diagram showing exactly what the arrector pili/stem cells/shaft/follicular structure looked like in the early, middle, and late stages of androgenic alopecia. And furthermore there should be methods to teach people with the condition what stage their hair follicles are in by examination or biopsy. This is the heart of the "how do you know if a follicle dies" thread, because viable treatment is going to be based on the degree to which your follicles have been damaged, if the APM is still intact, sh*t like that. People shouldn't have to just guess.

If follica's treatment is not an activation of microscopic hairs, then this serves the need of those with dying follicles very well. But without classification on the different stages of baldness, people won't know if they need follica or not, or if samumed would help them better, etc. Since the structure of the follicle does change over time I can't believe it's been so long and yet any info on late Androgenetic Alopecia is basically "yeah your hair is fucked, now go research it yourself and put together your own hypothetical model."

 

[coolio]

If the APM was necessary for decent hair growth then hair transplantation would not work.

The hair transplant process cuts the APM. It remains a lost connection after the grafts have healed.


Having said that, I do not rule out the possibility that the APM has some relevance for preserving/restoring hair.

 

[abcdefg]

We already have maintenance with propecia and dutasteride. More powerful AAs for prostate issues might be applicable to male pattern baldness in the future. For all the talk and hype about all the future things I still have the most faith in the tried and true anti androgen approach.
We need to replicated androgen insensitivity syndrome either through receptors, AAs, or both. Some experimental prostate drugs destroying receptors might work well for male pattern baldness although they might be kind of dangerous for cosmetic use
Maintance options are very limited as we know, and curing male pattern baldness should come after preventing it. Prevention is more important and arguably a cure by itself

 

[Swoop]

If the APM was necessary for decent hair growth then hair transplantation would not work.

The hair transplant process cuts the APM. It remains a lost connection after the grafts have healed.


Having said that, I do not rule out the possibility that the APM has some relevance for preserving/restoring hair.

Well it's cut but the connection probably doesn't remain lost. It just regenerates itself lol.

"The APM is considered one of the most important appendageal structures in hair transplant studies. Sato et al. studied single follicular unit transplants in androgenic alopecia (Androgenetic Alopecia) patients. They demonstrated that restoration of the APM and adjacent nervous system induces the regeneration of the neurofollicular and neuromuscular junctions in the follicle bulge."




Picture of how the APM is connected

Progressive miniaturization within follicular units. (a and b) Arrector pili muscle (APM) loses attachment to secondary follicles in herald units but remains attached to the primary follicles. (c and d) Miniaturization of secondary follicles and detachment of the APM from these follicles is then extended to the remaining follicular units. (e) Primary follicles in herald units are affected by miniaturization, and eventually muscle attachment is totally lost. (f and g) Baldness occurs when the entire follicular unit is miniaturized. The same pattern of miniaturization and muscle loss continues until all follicular units are affected

 

[Gone]

Yeah I read that study, the apm also gets replaced with fat.

 

[Gone]

One of the more significant things I read about is that the "streamers" as they're called (the stretch of follicle left behind as the hair moves up in catagen) eventually turns to scar tissue in late male pattern baldness. So I think anti-fibrotic substances in addition to anti-inflammatory would be needed for a theoretical full reversal.

http://www.sciencedirect.com/science/article/pii/0738081X88900740

"Senescent baldness and male pattern baldness are clearly different processes. The former is characterized by modest reduction in the size of follicles that are otherwise normal. Inflammatory foci are uncommon. male pattern baldness is a genetically determined inflammatory disorder that should not be construed as premature aging. The eticology of the inflammation is unknown. Follicular miniaturization in male pattern baldness is a consequence of pathologic fibrosis of the connective tissue sheathe. The central pathology relates to abnormalities of the perifollicular connective tissue sheathe, evident as inflammed streamers subtending involuted follicles. These streamers show fibroplasia and hypertrophy, along with proliferation of capillaries and a mixed infiltrate of lymphocytes, histoocytes, and mast cells. Chronic inflammation of the streamers prevents anagen follicles from being fully reconstructed during each new cycle. After many years, this can lead to scarring and preclude regeneration. Even in advanced male pattern baldness, most follicles were not fully scarred, offering the theoretical possibility of regrowth. Fibrotic streamers are increased in proportion to the duration of baldness and chronologic age."