In this article I will offer a brief explanation of how stem cell therapy can work for hair growth. The idea of this treatment is to use stem cells, which are cells that can transform themselves into other specialized cell types, such as the components of hair types of cells and inject or transplant them into your scalp to help promote hair growth. This is NOT a hair transplant procedure. It is a stem cell procedure.
In a May 2019 study in the medical journal Cells (1), researchers discussed the use of stem cells to improve hair regrowth, including reversing hair loss by regeneration of hair follicles.
The learning points of this research are:
- Stem cell therapy is a new approach to treating hair loss as opposed to surgery or transplant.
- Methods using donated stem cells are being tested in cell treatment hair loss clinical trials.
- Intra-surgical cell treatments that incorporate autologous cell-based treatments (such as bone marrow) with a one-step approach (cell harvesting, minimal manipulation, and immediate injection) into a single technique “offer tremendous potential” to patients with hair loss.
In our office we offer bone marrow derived stem cells and PRP therapy alone for hair loss. This article will not necessarily compare one treatment to another. This discussion is best offered in the examination room when we have had the opportunity to access the hair loss of the patient. What this article will focus on is the common aspects of these three hair loss treatments and how they can promote hair growth.
A brief explanation of the three treatments.
- Stem cell treatment for hair loss: Bone marrow stem cells are taken from your bone marrow drawn from the iliac crest of the pelvis in a simple procedure. The bone marrow contains stem cells and the healing growth factors found in PRP therapy.
- PRP treatments involve collecting a small amount of your blood and spinning it in a centrifuge to separate the platelets from the red cells. The collected platelets are then injected into an area of thinning hair. This stimulates hair regeneration in many people. The treatment is aptly named Platelet Rich Plasma therapy as it is blood plasma that is rich is platelets.
Alopecia areata treatment using stem cell treatment
A May 2021 case report study on three patients with Alopecia hair loss and treated with stem cells was reported in the World journal of clinical cases.(2)
The three cases presented in this study were:
- Case 1: A 55-year-old woman suffered from Alopecia areata in two areas of the scalp. She had 15 stem cell treatments over a six month timeframe.
- The Alopecia areata gradually improved 3 months after the first round of stem cell treatments. The Alopecia areata did not recur with subsequent stem cell therapies.
- Case 2: A 30-year-old woman, with history of local steroid hormone injections, suffered from Alopecia areata in one area on the scalp. She was given two stem cell injection treatments of Minimally manipulated umbilical cord derived-mesenchymal stem cells over one month. The Alopecia areata immediately improved after the first round. The Alopecia areat did not recur.
- Case 3: A 20-year-old woman, who was diagnosed with alopecia universalis at the age of 12, was given 14 rounds of minimally manipulated derived-mesenchymal stem cells over 12 months. Her hair began to grow about three months after the first round. The alopecia universalis did not recur after her stem cell therapies.
An explanation of Minimally manipulated umbilical cord derived-mesenchymal stem cells
“Minimally manipulated umbilical cord derived-mesenchymal stem cells (used in this study) are isolated from the umbilical cord, immediately frozen, and stored at -197 °C without any other manipulations including cell culture. Minimally manipulated-mesenchymal stem cells have better proliferation and differentiation capacities than cultured mesenchymal stem cells. Therefore, their therapeutic effect is expected to be better. It is generally known that mesenchymal stem cells are safe in vivo and do not form tumors.”
The doctor’s conclusion: “The therapeutic effect of Minimally manipulated umbilical cord derived-mesenchymal stem cells on Alopecia areata and related diseases is very high as shown in the patients presented here. Recurrence of Alopecia areata and alopecia universalis and side effects did not occur during the treatment and follow-up duration of at least one year. Based on these results, we expect that Minimally manipulated umbilical cord derived-mesenchymal stem cell transplantation will be a safe and efficient alternative for the treatment of Alopecia areata, alopecia totalis, and alopecia universalis. However, it is necessary to conduct clinical trials with a greater number of patients.”
Wharton’s jelly-derived mesenchymal stem cells
A study from 2021 in the Advances in clinical and experimental medicine (3) describes the use of Wharton’s jelly-derived mesenchymal stem cells.
- The study involved four Alopecia areata patients who underwent experimental therapy with a suspension of Wharton’s jelly-derived mesenchymal stem cells.
- Hair regrowth was observed in all patients by an average of 67% at the sites where the Wharton’s jelly-derived mesenchymal stem cells was administered.
- In all cases, (the study’s doctors) observed greater dynamics of hair regrowth in the first 3 months after the treatment, with an average increase of 52.2%, compared to the following 3 months, with an average of 32%.
- “The results of the applied intradermal injections of an allogeneic Wharton’s jelly-derived mesenchymal stem cells suspension were positive with hair growth observed in all participants and the therapy was found to be safe, with no side effects.”
Hair loss treatment: Getting the stem cells in your hair follicles and “bulge” to start growing hair again.
In August of 2018 researchers writing in the journal Stem cells international (4) discussed the role of stem cells in treating Alopecia by way of hair follicle regeneration and neoregeneration.
Here are their learning points:
- Hair follicles have a niche for mature stem cells—hair follicular stem cells (HFSCs)—a so-called “bulge” in the attachment region of arrector pili muscles, (the small muscles attached to hair follicles). (Note: There are stem cells in your hair. They are just not active hair stem cells– this can lead to hair loss – see below).
- Hair follicular stem cells can take part in the regeneration of epidermal cells and the structure of hair follicles and sebaceous glands (these glands secrete the hair oil that healthy hairs need.)
- The researchers explain that: Stem cells of the “bulge” can remain in their niche where they self-regenerate, but they can also move down to the hair matrix region, where they become progenitor cells which then form an internal hair follicle and the hair stem.
- In other words, the stem cells can become the building block of new hair when active and may reverse hair loss.
- There is a second type of stem cells within the hair follicle. The dermal papilla cells (DPCs) DPCs play an important role in induction and regulation of hair growth and the formation of new hair follicles. Signals from DPCs activate stem cells in the “bulge” to start hair growth.
The researchers point out that most of these stem cells live in a “dormant state,” and that their activation is essential for hair growth.
Stem cell Hair loss treatments: Activating these stem cell hair follicles
In numerous articles on this website I discuss how stem cells and growth factors introduced into damaged joints activate the native stem cells in that joint to restart the healing process. This is no different when it comes to hair loss. We know that there are many stem cells in the hair follicle, so the problem is not the number of stem cells, BUT, a problem of getting these dormant cells active again and growing hair.
In the research we started this article with from May 2019, a listing of the common growth factors of stem cell hair loss treatment and PRP therapy for hair loss is given: Here is a description of these growth factors and what they do. This is how we can get the stem cells in the hair and the stem cells introduced in the treatment active – by the introduction of growth factors and “communicator” cells in the treatment.
- Hepatocyte growth factor (HGF) and HGF activator enhance the proliferation of hair follicle epithelial cells. (The stem cells send signals for hair to grow).
- Epidermal growth factor improves the activity and growth of follicle outer-root sheath cells
- Basic fibroblast growth factor b-FGF improves the advancement of hair follicles
- Vascular endothelial growth factor (VEGF) improves peri-follicular angiogenesis (new blood vessels to get new blood and more growth factors to the site prior to and to get ready to support new hair growth).
- Transforming growth factor beta TGF-β stimulates the signaling pathways that manage the HC (Hair growth cycle). TGF-β gives structure to the hair growth cycle. It orders the new blood vessels to “barren” areas. It creates the communication network between the native and new stem cells and growth factors so “everyone is working in unison.” It orders the stem cells to get to areas where growth can occur.
- Insulin-like growth factor 1 (IGF-1) improves the migration, survival, and proliferation of hair follicle cells. It does so with the help of Insulin-like growth factor-binding protein-1 to -6 which manages the IGF-1 effect and its connection with extracellular matrix proteins (collagens) at the hair follicle level.
There are many other growth factors involved, the list above are some of the primary ones. As you can see from this list the introduction of these growth factors whether from the bone marrow stem cells or from the PRP treatment alone, stimulates native stem cells and native growth factors to “reboot,” the hair growth mechanism.
In a January 2022 supportive study published in the journal Cell stem cell researches (6) wrote of hair shaft survival by preventing hair follicle stem cell (HFSC) loss : “In aging, androgenic alopecia, and genetic hypotrichosis (hair growth) disorders, hair shaft miniaturization (it gets smaller) is often associated with hair follicle stem cell (HFSC) loss. However, the mechanism causing this stem cell depletion in vivo (in the body) remains elusive.”
In this study the researchers show that hair shaft loss or a reduction in diameter shrinks the physical size, which results in mechanical compression of hair follicle stem cells and their apoptotic (death) loss.
Persistent hair shaft miniaturization during aging and genetic hair growth disorders causes long-term hair follicle stem cell loss. Our results identify an unconventional role of the inert hair shaft structure as a functional niche component governing hair follicle stem cell survival.
In an accompanying editorial, (7) this article’s findings were summarized as “The number of hair follicle stem cells decreases during aging and in hair-loss disorders, such as alopecia. In this (article, the researchers) discover that the hair shaft serves as a physical niche component for the preservation of hair follicle stem cells.”
This is a demonstration of hair injections. This is a PRP hair treatment. It can be considered an alternative to hair transplant surgery.
Looking further at Stem Cell-Based Treatments for Hair Loss Conditions
A 2020 paper from the University of Miami, Miller School of Medicine (5), gives us a good summary of the current research: “Novel discoveries revolving around stem-cell based therapies provide encouraging steps towards developing more effective and successful hair loss treatments. Although these initial steps towards such discoveries are hopeful, there is still a limited amount of clinical data to fully support stem-cell based therapies. . . While results are certainly hopeful, larger and more robust double blind controlled clinical trials are needed to further assess the exact mechanisms, therapeutic potential and safety of stem-cell based approaches to hair loss management.”
Stem cell therapy is not a hair transplant. It is the injection of stem cells derived from bone marrow into the scalp. It is considered a hair loss alternative treatment to other remedies and procedures including hair transplant.
Do you have questions? Ask Dr. Darrow
A leading provider of stem cell therapy, platelet rich plasma and prolotherapy
11645 WILSHIRE BOULEVARD SUITE 120, LOS ANGELES, CA 90025
PHONE: (800) 300-9300 or 310-231-7000
Stem cell and PRP injections for musculoskeletal conditions are not FDA approved. We do not treat disease. We do not offer IV treatments. There are no guarantees that this treatment will help you. Prior to our treatment, seek advice from your medical physician. Neither Dr. Darrow, nor any associate, offer medical advice from this transmission. This information is offered for educational purposes only. The transmission of this information does not create a physician-patient relationship between you and Dr. Darrow or any associate. We do not guarantee the accuracy, completeness, usefulness or adequacy of any resource, information, product, or process available from this transmission. We cannot be responsible for the receipt of your email since spam filters and servers often block their receipt. If you have a medical issue, please call our office. If you have a medical emergency, please call 911.
1 Gentile P, Garcovich S. Advances in regenerative stem cell therapy in androgenic alopecia and hair loss: Wnt pathway, growth-factor, and mesenchymal stem cell signaling impact analysis on cell growth and hair follicle development. Cells. 2019 May;8(5):466.
2 Ahn H, Lee SY, Jung WJ, Lee KH. Alopecia treatment using minimally manipulated human umbilical cord-derived mesenchymal stem cells: Three case reports and review of literature. World Journal of Clinical Cases. 2021 May 26;9(15):3741-51.
3 Czarnecka A, Odziomek A, Murzyn M, Dubis J, Bagłaj-Oleszczuk M, Hyncewicz-Gwóźdź A. Wharton’s jelly-derived mesenchymal stem cells in the treatment of four patients with alopecia areata. Advances in Clinical and Experimental Medicine. 2021;30(2):211-8.
4 Owczarczyk-Saczonek A, Krajewska-Włodarczyk M, Kruszewska A, Banasiak Ł, Placek W, Maksymowicz W, Wojtkiewicz J. Therapeutic potential of stem cells in follicle regeneration. Stem cells international. 2018 Oct;2018.
5 Egger A, Tomic-Canic M, Tosti A. Advances in Stem Cell-Based Therapy for Hair Loss. CellR4–repair, replacement, regeneration, & reprogramming. 2020;8.
6 Xie Y, Chen D, Jiang K, Song L, Qian N, Du Y, Yang Y, Wang F, Chen T. Hair shaft miniaturization causes stem cell depletion through mechanosensory signals mediated by a Piezo1-calcium-TNF-α axis. Cell Stem Cell. 2022 Jan 6;29(1):70-85.
7 Hinnant T, Lechler T. Hair follicle stem cells feel the pressure. Cell Stem Cell. 2022 Jan 6;29(1):1-2. doi: 10.1016/j.stem.2021.12.001. PMID: 34995491.