Science and research in hair surgery

Symbolic image of hair transplant

Medical research brings advances in modern hair surgery. © Africa Studio (#145026653) / Adobe Stock

Hair loss is a subject surrounded by many myths. For those affected, the loss of hair on the head in particular is anything but trivial and can entail a variety of psychological and physical stresses. In many cases, the reasons for hair loss are not easy to determine. Medical research and scientific findings are essential in order to be able to diagnose individual causes and recommend the right therapy to those affected. Research and science have become an indispensable basis for modern hair surgery to sustainably treat hair loss.

Hair loss from a medical perspective

Everyone loses hair. This fact is initially medically harmless. Every human body hair has a limited lifespan. If this is exceeded, it fails. At the same time, new hair grows back and completes the natural cycle of hair growth and hair loss. If a person regularly loses more than 100 hairs a day, medicine speaks of hair loss. If there is an imbalance between hair loss and hair growth, this is usually due to irreversibly damaged hair roots, which make it impossible for lost hair to grow back.

The causes of hair loss can be varied. The so-called hereditary hair loss, which is known in medical terms as “androgenetic alopecia”, is particularly common. This affects around 70 percent of men and around 40 percent of women. A genetically caused hormonal imbalance has long been the focus of medical research. In this context, particular attention is paid to the hormone dihydrotestosterone (DHT), the biologically most active form of the male sex hormone testosterone. DHT is formed from testosterone by the enzyme 5-alpha-reductase. In hereditary hair loss, hair roots are hypersensitive to DHT. If the genetic disposition is appropriate, the hormone causes the hair roots to become smaller and the growth phase to be shortened, which leads to hair loss.

The second most common form is so-called “alopecia areata”, circular hair loss. This affects around 1 to 2% of the population. In medicine, alopecia areata is considered a multifactorial disease. This means that scientists consider not only genetic factors, but also environmental influences as the cause of hair loss. How the Institute for Human Genetics at the University of Heidelberg informed, the research assumes “a genetically complex inheritance with a large number of disease-contributing genes. The disease risk for first-degree relatives of an affected person is around 7% for siblings, just under 8% for parents and just under 6% for children. The risk for second-degree relatives corresponds to that of the general population and is around 1-2%.” In contrast to androgenetic alopecia, men and women are equally affected by patchy hair loss.

In addition to hereditary and patchy hair loss, there is a wide range of different causes that produce different forms of hair loss and may require various therapeutic approaches.

Therapeutic approaches and treatment methods for hair loss

The media focus in particular on cosmetic aspects of hair loss. For those affected, however, it is often a serious medical problem that can have psychological and physical effects.

However, treatment options were limited for a long time. Until a few years ago, there were only a few recognized therapeutic approaches that focused primarily on hereditary hair loss in men. For women with alopecia problems, medical research has long lagged behind the needs of those affected and only a few medications or surgical treatment approaches have reached the market.

The spectrum of treatment options ranges from regenerative treatments with a minimally invasive approach to modern hair surgery. Extensive clinical studies and new research approaches have ensured that both approaches have developed significantly, particularly in the last ten years. Today, the medical data on alopecia in its various forms allows for scientifically sound findings that take treatment options for those affected to a new level.

Modern research makes an important contribution to a better understanding of the medical causes of hair loss and thus to the development of promising treatment methods. Here, research facilities and institutions work closely with specialized doctors to develop new therapeutic approaches based on scientifically based findings and to be able to offer those affected with a wide variety of alopecia problems the appropriate treatment options.

Important impulses from German research

On the German side, Reza P. Azar has made a name for himself in scientific research. The expert in medically based hair transplants and head of the Center for Modern Hair Transplantation in Berlin researches and shapes the market with innovative therapeutic approaches that are based on the evaluation of medical studies and sound scientific findings. In addition to numerous other scientific publications, his specialist book “Minimal Invasive Hair Transplantation” has had a lasting impact on both modern research and the market for hair surgery and hair transplantation. In addition to his specialist practice for alopecia in Berlin, Azar has been participating in medical research in his field for almost 20 years and has developed into a pioneer in modern hair surgery with innovative therapeutic approaches.

A treatment method from the field of regenerative approaches that the doctor has used to shape the work in his field is PRP therapy (Platelet Rich Plasma). The therapeutic approach has been used in the center for modern hair transplantation in Berlin since 2009. Regenerative hair treatment is suitable for women and men with thin, fine, thin hair, acute or gradual hair loss due to hereditary alopecia, autoimmune diseases such as frontal fibrosing alopecia and alopecia areata, thyroid diseases or as a preventative medical measure. It is a minimally invasive treatment to activate the body's own self-healing powers using injections. The body's own blood is injected, which has been specially prepared to separate growth-promoting blood components. The blood prepared in this way contains increased nutrients and growth factors that stimulate the fibroblasts to produce the body's own elastane, collagen and hyaluronic acid. PRP therapy can stimulate cell regeneration of the hair roots and counteract the processes that promote hair loss.

New research results from the USA

In August 2022, a research team from the USA went public with results that could provide new impetus for the treatment of alopecia. Biologists Katherine Dinh and Qixuan Wang from the University of California reported in the “Biophysical Journal” that their research shows that the protein TGF-beta controls the growth of hair follicles. The hair follicles are responsible for protecting the hair root and anchoring it in the skin. “TGF-beta has two opposing functions. It helps hair follicle cells to produce new life, and later it helps control apoptosis, the process of cell death,” explains Qixuan Wan in a publication on the part of the university. According to the researchers, the concentration of the protein in the hair follicles is said to have a significant influence on the healthy growth of hair. In particular, too high a concentration is said to damage the hair roots and result in significant hair loss.

The two biologists from the University of California are also of the opinion that damaged hair follicles can be reactivated with appropriate therapy. Medical research discovered a few years ago that hair follicles contain stem cells. According to Wang when explaining her research results, the cells' own stem cell reservoir is generally not attacked, even if they destroy themselves due to disturbed metabolic processes. The detailed analysis of a healthy TGF-beta level could not only provide a new therapeutic approach to hair loss, but also provide new impetus for basic stem cell research in medicine.

New hair transplant technology could transform hair surgery

A new development in the field of hair transplantation has recently attracted media attention. Under the name “IG-Hair Transplantation” (Instant Growth), the Center for Modern Hair Transplantation in Berlin developed and presented a procedure in 2022 that differs from previously used therapeutic approaches in hair surgery. A key difference in the new method for those affected is that a large proportion of the transplanted hair immediately begins to grow actively after the surgical procedure and does not fall out again within a few weeks, as is the case with all transplant techniques used to date. The IG hair transplant concept, based on medical research results, shows immediate growth in 70 to 100 percent of the hair inserted. Outdated transplant approaches only had a success rate of 5 to 10 percent. This means that German research has achieved a success in the field of hair surgery, which could have a lasting impact on therapeutic approaches around the world.

The new findings that intensive medical research in the field of alopecia has gained in recent years give cause for hope for those affected. The better medicine understands the causes of hair loss, the more targeted and successful treatments can be recommended. The development of new therapeutic approaches is progressing and makes it possible to view and treat the different forms of alopecia individually. When choosing specialist advice and treatment, it is important for those affected to find out in advance what level of scientific research a practice is working on and whether they have the opportunity to be treated using the latest approaches.

August 29, 2023

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