SUMMARY: Today the only “cure” for permanent hair loss due to androgenetic alopecia (male/female pattern baldness) is hair restoration surgery. However, recent research into how our bodies use vitamin D has put powerful non-surgical treatments for permanent hair loss potentially just over the horizon. Specifically, researchers have discovered a vitamin D binding mechanism that triggers hair growth in dormant (“sleeping”) hair follicles (see: A Vitamin D Cure For Baldness Part I). If researchers can develop treatments to manipulate this binding mechanism, we will have an effective cure for male (and female) pattern baldness. But what about hair loss due to permanently damaged hair follicles?
By John Frank, M.D. | IAHRS, ABHRS, ISHRS, AHLA, XM Radio: ‘The Bald Truth’, NYC, June 26, 2013
Dead or Permanently Damaged Hair Follicles? There May Be A Vitamin D Cure For That
Researchers have recently uncovered a vitamin D binding mechanism that triggers hair growth in otherwise permanently dormant hair follicles. Doctors call this type of baldness androgenetic alopecia.
Another cause of permanent hair loss, while not as common as alopecia, is dead or permanently damaged hair follicles. Even if we had a way to shift hair follicles out of a permanent dormant phase, it would do little good to reverse balding in this case.
A Vitamin D Cure for Dead or Permanently Damaged Hair Follicles
Many conditions can permanently damage or kill hair follicles, such as chemotherapy, the autoimmune diseases scleroderma1 & discoid lupus and scarring alopecia2.
However, the hair follicle itself may hold the means to give birth to new hair follicles, and, incredibly, vitamin D may be the direct trigger for creating those follicles.
Dr. Elaine Fuchs3, professor of cell biology and development at New York City’s Rockefeller University, has discovered that a structure on the hair follicle, just below the surface of the skin, is a large receptacle for the skin’s stem cells. These stem cells move down to the root of the hair follicle to repair it and spur new hair growth. However, a dead hair follicle has no stem cells to repair itself. Once a hair follicle has died, that’s it, it cannot be replaced or repaired — or so scientists thought.
In early 2000, researchers at New York University, and the University of Pennsylvania, School of Medicine4 found that some of those same stem cells migrate UP to the skin surface to become skin cells. Because those stem cells are “pluripotent,” i.e., they can become either hair cells or skin cells. Dr. Tung-Tien Sun & Dr. Robert M. Lavker, senior authors of the study, say that given how close hair follicles are to each other, these upward and surface migrating stem cells could easily replace a nearby dead follicle.
However, this doesn’t happen naturally, or at least not enough, to offset significant hair loss due to permanently damaged follicles. The problem again is finding the correct trigger, i.e., how do we tell certain stem cells, in certain locations, to become new hair follicles rather than new skin cells?
Building New Healthy Hair Follicles
When it comes to shifting hair follicles out of a permanent telogen (“sleep”) phase, vitamin D doesn’t play a direct role – it’s the way the body binds vitamin D to the vitamin D receptor that does the trick and may lead to a cure for androgenetic alopecia (see: A Vitamin D Cure For Baldness Part I). In the case of permanently damaged or dead hair follicles, however, vitamin D could turn out to be a direct trigger for creating new replacement hair follicles.
Researchers in Japan have discovered that an existing superman version of vitamin D, called VD3, triggers these surface migrating stem cells (called dermal papilla cells) into becoming new hair follicles. As usual in early stage research, researchers have so far only shown this neo-genesis in rats, but this is a critical first step towards the goal of a cell-based therapy for hair regeneration.
Additionally, by treating hair loss patient’s dermal papilla cells with VD3, we could create a “hair follicle farm” for that patient, i.e., an almost unlimited number of custom designed hair follicles for that patient. This would help lower the cost of hair transplantation and could open surgical hair transplant to patients who are now unqualified because of insufficient donor hair follicles.
The study appeared in the journal Stem Cells Translational Medicine5.
References
1. Scleroderma. National Institute of Health Library of Medicine.
2. Scarring Alopecia. Medscape, Basil M Hantash, MD, PhD; Chief Editor.
3. Elaine Fuchs, Ph.D., facility page, Rockefeller University.
4.Taylor G, Lehrer MS, Jensen PJ, Sun TT, & Lavker RM (2000). Involvement of follicular stem cells in forming not only the follicle but also the epidermis. Cell, 102 (4), 451-61 PMID: 10966107
5.Aoi N, Inoue K, Chikanishi T, Fujiki R, Yamamoto H, Kato H, Eto H, Doi K, Itami S, Kato S, & Yoshimura K (2012). 1α,25-dihydroxyvitamin D3 modulates the hair-inductive capacity of dermal papilla cells: therapeutic potential for hair regeneration. Stem cells translational medicine, 1 (8), 615-26 PMID: 23197867
