Androgenetic alopecia is the medical term for pattern baldness. Pattern baldness can manifest in several ways such as a receding hairline, a bald spot in the crown of the head, and/or generalized thinning hair. Pattern baldness is the most common form of hair loss. Approximately 4 out of 5 men will experience some degree of androgenetic alopecia by the time they reach age 70. Androgenetic alopecia affects a substantial number of women as well. Pattern baldness is not lethal, but it can create substantial amounts of psychological suffering and greatly diminishes the quality of life for both men and women.
The two first-line treatments for androgenetic alopecia in men are finasteride or minoxidil. Finasteride is an oral medication, while minoxidil is topical, i.e. it is placed on this directly on the scalp. These baldness treatments are modestly effective in a certain percentage of men. Patients may also be treated with dutasteride, light therapy, platelet-rich therapy, or surgery. Minoxidil is the main form of treatment for women with androgenetic alopecia. If minoxidil fails to help regrow hair or stop the balding process, women may alternate treatments including spironolactone, finasteride, cyproterone acetate, or flutamide. As with male pattern baldness, female pattern baldness is somewhat resistant to treatment, leaving most women to cover their baldness with wigs or concealers.
One important observation about androgenetic alopecia is that while the number of hair follicle stem cells remains the same in people who are balding, the number of more actively proliferating progenitor cells drops dramatically. In other words, it is theoretically possible to treat androgenetic alopecia with hair follicle stem cells that contain actively proliferating progenitor cells.
Indeed, researchers recently tested this hypothesis in a group of 11 patients with androgenetic alopecia. The researchers collected a bit of tissue from each patient and then purified the sample to collect hair follicle stem cells with actively proliferating progenitor cells. The doctors then injected those stem cells into balding areas on the patients’ scalps. For comparison, some were treated with a placebo injection, i.e. saltwater.
Patients treated with hair follicle stem cells enjoyed a 29% increase in hair density over the treated area. by contrast. Patients treated with placebo had less than a 1% increase in her density over the same time period. The researchers also noticed that they were substantially more stem cells in and around hair follicles in balding areas.
The authors of this research concluded that isolated cells are capable of improving hair density in patients with androgenetic alopecia. While additional, larger studies are needed to confirm these results, the current study provides strong evidence that bald and balding patients may benefit from autologous stem cell treatment.
Reference: Gentile P. et al. (2017). Stem cells from human hair follicles: first mechanical isolation for immediate autologous clinical use in androgenetic alopecia and hair loss. Stem Cell Investigation. 2017 Jun 27;4:58.
You don’t need a microscope to recognize aging skin. Aging skin has fine lines and wrinkles; it sags because it has lost elasticity; it is discolored and blotchy. But if you did look at aging skin under a microscope, you would notice that it lacks collagen, elastin, and many other helpful proteins. There would be many old cells and a few young ones. Indeed, old skin looks different under a microscope than new skin, and it is these differences at the cellular level that causes the aging we see on people’s faces.
Fortunately, these cellular changes may not be a curse. Stem cell therapy may be able to replace the proteins that are lost during aging and replace old cells with newer, healthier cells. In short, stem cell therapy may be able to can rejuvenate facial skin and reverse the signs of aging.
The team of Korean stem cell researchers recently completed a study in which they collected mesenchymal stem cells from various sources and used them to rejuvenate human skin. The researchers collected stem cells from fat tissue (adipose), bone marrow, and umbilical cord samples. Umbilical cord tissue is tissue that is normally discarded after childbirth as medical waste. In the laboratory, the scientists then cleaned and purified each of these types of mesenchymal stem cells.
In laboratory studies, the researchers found that mesenchymal stem cells produced substantial amounts of skin rejuvenating factors including collagen type I, collagen type IV, fibronectin, and elastin. Interestingly, they found that umbilical cord mesenchymal stem cells produced a 100-fold greater amount of GDF-11 than adipose or bone marrow stem cells. This is important because GDF-11 is a cytokine that stimulates the production of collagen and elastin. GDF-11 also attracts human dermal fibroblasts (i.e. healthy skin cells) that then, in turn, produce their own collagen and elastin. These substances make skin healthy, elastic, vibrant, plump, and full.
Given the remarkable amounts of GDF-11 that umbilical cord-derived stem cells produced, the researchers decided to conduct a clinical trial to test the effect of these cells on aging skin. The scientists created a cream that contained the substances produced by the stem cells, including exosomes and beneficial proteins. The women who volunteered for the study applied the cream to their faces once per day. Within 2 to 4 weeks, the women had increased skin density (i.e. thickness/fullness) and substantially reduced wrinkles, especially around the eyes. Moreover, treatment with the stem cell-derived cream did not cause irritation, stinging, or any other adverse reaction.
This clinical study will need to be repeated in larger numbers of volunteers; however, the results are quite remarkable. Researchers were able to collect stem cells from umbilical cord tissue and prepare a cosmetic that reversed some of the signs of facial aging. Conveniently, this treatment did not require injections but could be applied topically. If future research confirms this work, treatment with a cosmetic/cosmeceutical made from umbilical cord stem cells could be a painless way to achieve facial skin rejuvenation.
Reference: Kim, YJ. (2018). Conditioned media from human umbilical cord blood-derived mesenchymal stem cells stimulate rejuvenation function in human skin. Biochemistry and Biophysics Reports. 2018 Oct 25;16:96-102.
No matter how young we may feel, our aging skin often gives our age away. As we age, we lose important proteins in the skin like collagen and elastin. We also lose a thin layer of fat that lies just below the skin. Without this fat and protein, the skin sags and loses its elasticity (“bounce back”) appearing thin and wrinkly.
One of the main skin rejuvenation techniques is to inject fat into aging skin. In its most basic form, a bit of fat is removed from the patient via liposuction and injected into an area of aging skin. These transplanted fat cells give the skin a plumper appearance and seem to turn back the clock on skin aging. However, mature fat cells do not last forever, and many people need to have repeated skin rejuvenation procedures to maintain the effect.
More recently, however, physicians have realized that they achieve better results when they include stem cells in their fat grafts. The mature fat cells provide a beauty benefit immediately, while stem cells help maintain the effect longer. Some physicians have taken the procedure so far as to only inject stem cells and remove mature fat cells completely. While this approach seems reasonable, is unclear whether the stem cell-only approach is actually superior.
While the benefit of fat grafts that include stem cells is widely known, it is unclear how the process works. By understanding the process, researchers hope to learn what provides the strongest antiaging effect. To help them better understand the skin rejuvenation process of fat-derived stem cells, researchers performed liposuction on several patients and then reinjected fat cells and stem cells into areas of aging skin. Three months later, the researchers took samples of the skin to see what effect the combination of fat cells and stem cells had on the skin structure.
While the specific results are quite complex, researchers found that a fat graft that included adipose-derived stem cells improved the elasticity of the skin by creating what is known as an “oxytalan elastic network.” These fibers helped to smooth out the skin and allowed it to retain more moisture than it did before skin rejuvenation treatment.
Perhaps most importantly for patients, the skin rejuvenation procedure left patients with fuller, younger-looking skin.
The researchers concluded that the most beneficial skin rejuvenation approach is to inject a combination of fat cells and stem cells derived from fatty tissue. The benefits were the same as those obtained by injecting stem cells alone. The researchers argue that the combination approach provides a good clinical benefit with the added benefits of being easier to perform, cheaper, and less prone to complications.
Reference: Charles-de-Sá, L. et al. (2015). Antiaging treatment of the facial skin by fat graft and adipose-derived stem cells. Plastic and Reconstructive Surgery. 2015 Apr;135(4):999-1009.
Alopecia, better known as hair loss, is a cosmetic problem. People do not need hair on their scalp to survive. Nonetheless, people with thinning hair or hair loss often endure considerable distress and suffering. Hair loss can cause low self-esteem, symptoms of depression, and a diminished quality of life. So while hair loss may be a simple cosmetic, strictly speaking, many people with alopecia struggle with an ongoing and serious problem.
Unfortunately, there are few effective treatments for hair loss. The two main medical treatments for hair loss are minoxidil and finasteride. Finasteride is generally only useful for male pattern baldness. Both men and women can use minoxidil, but it, too, is only partially effective. Various surgeries can be used to treat hair loss such as hair transplantation, scalp reduction, and scalp expansion, but patient satisfaction rates for these procedures are fairly low.
Stem cells that have been derived from fat tissue (i.e. adipose) secrete a number of beneficial chemicals called cytokines. These cytokines are important for wound healing and new blood vessel growth (i.e. angiogenesis). Cytokines released by adipose-derived stem cells are also able to stimulate hair follicles and induce the growth of hair. Based on these successes in the laboratory, dermatologists in Japan have used the substances secreted by adipose-derived stem cells to help people with hair loss.
Drs. Fukuoka, Narita, and Suga published a report detailing their successes in treating hair loss with proteins extracted from adipose-derived stem cells. A single hair loss treatment involves making a number of very small injections into the scalp. Each patient usually needs 6 to 8 treatment sessions, given once per month.
The doctors have performed this stem cell-based hair loss treatment on more than 1,000 patients and they have not encountered a single allergic reaction or infection. Indeed, no serious complications have occurred in their patients.
Not only is this stem cell-based hair loss treatment safe, but it is also apparently effective, as well. Patients have new growth of thin hair after two or three treatments, but this is minor and can usually only be detected by the doctors. After the fourth or fifth treatment, however, patients often notice new hair growth. By the sixth treatment, most patients can easily see new hair growth.
To confirm the effectiveness of their treatment, the doctors performed a half-side comparison test. In this test, they injected the stem cell-based hair loss treatment on one side of the scalp and injected saline on the other. The side of the scalp that received the stem cell extract had significantly more hair growth than the saline-treated side. This is strong evidence that the treatment is effective.
Reference: Fukuoka H. et al. (2017). Hair Regeneration Therapy: Application of Adipose-Derived Stem Cells. 2017;12(7):531-534.
have observed that the pH inside of certain stem cells affects their ability to
proliferate and differentiate. These cells include mesenchymal stem cells and
pluripotent stem cells, all of which have important applications in
regenerative medicine. It is therefore important that pH be optimized to ensure
that these stem cells can proliferate and differentiate so
that they can be as useful as possible when utilized for therapeutic purposes.
A recent review, published in Current Problems in Dermatology, explored the importance of pH to stem cell function as well as the factors that influence pH. According to the authors, a protein known as the sodium hydrogen exchanger regulates intracellular pH and impacts both the proliferation and differentiation of different types of stem cells. When pH is changed, either within the cell or outside the cell – where the cell is exposed to the change in pH – stem cell functions includingmaintenance, self-renewal, and pluripotency are altered.
The effect of pH in stem cells is highly relevant for skin conditions and therefore for the practice of dermatology. According to the reviewers, research on how the sodium hydrogen exchanger and pH levels affect skin stem cells (also known as epidermal stem cells) and their behavior could enable the discovery of new interventions to improve the use of stem cells in skin therapies. This research would be particularly relevant for skin conditions like melanoma, psoriasis, and wound healing because the movement and proliferation of stem cells are keyissues in these conditions.
A. & Ghadially, R. (2018). Influence of pH on skin stem cells and their
differentiation. Current Problems in
Dermatology, 54, 71-78.
Although all living organisms experience aging, scientists have relatively little understanding of why aging occurs. The leading theories on aging suggest that living creatures sustain damage to their DNA through exposure to ultraviolet light, toxins, or even the day-to-day stresses of using oxygen for our cellular metabolism. Whatever the cause, this DNA damage causes cells to 1) repair themselves, 2) die, or 3) enter a middle state called senescence where they remain alive, but simply stop participating in active living. If cells successfully repair themselves, they don’t perceptibly age. If cells enter senescence or die, the body shows signs of aging.
The bottom line: If we can help cells repair themselves, and replace dying and senescent cells, we can slow or even reverse aging. All of this may be possible through the careful use of stem cells.
As we age, stem cells lose the ability to renew themselves, to become other cells (differentiate) and to replace aged cells. Older stem cells secrete less and less of the substances that help the cells around them stay young and healthy. Not only do our regular cells age, but so do our stem cells. This is perhaps the strongest point for using stem cells to reverse the visible signs of aging.
Adipose-derived stem cells are one of the most promising sources of stem cells for anti-aging and regenerative medicine. They are easy to harvest by liposuction to remove stem cells along with fat cells. In addition, adipose-derived stem cells have the potential to become all cell types in the skin; namely fat cells, skin cells, muscle cells, and fibroblasts, and others. Even if the stem cells do not become other cells, they strongly secrete cytokines and other substances that help renew and replenish the cells around them.
While additional research is required, adipose-derived mesenchymal stem cells are currently being tested in clinical trials to treat a number of age-related conditions. Indeed, clinicians are currently using the stem cells to perform a number of aesthetic procedures such as breast or buttock augmentation, hand rejuvenation, as facial dermal fillers, and to promote and restore hair growth. As we learn more about how to use the power of stem cells in aesthetic procedures, we will be able to better address the visible signs of aging in the face and body.