When it comes to hair loss, you’ve probably heard it all before. This product or that treatment claims to give near-instant results or bring your hair back to its former glory; invariably, this isn’t the case, and results don’t last.
Despite 80 per cent of men suffering from male pattern hair loss, until recently, we knew remarkably little about how to slow, halt and reverse its seemingly inevitable onset.
But now scientists think they might finally understand what’s going on up there and, more importantly, what they can do about it.
The secret? It might involve cryogenically freezing and cloning – yes cloning – your hair. Sci-fi fans feel free to cheer.
What causes male pattern baldness?
Here's the thing: balding people aren't actually losing their hair – it's just shrinking.
“Balding is caused by hair miniaturising,” says Paul Kemp, CEO at HairClone, a company seeking to develop next-gen balding treatments. “They're not really lost. They just get smaller and smaller, so that they're not really visible.”
The reason our hairs can shrink away is because of a specialised type of skin cell called dermal papillae that surround the base of hair follicles. These cells are vital in determining hair formation, growth, texture and thickness.
When balding occurs, the number of these cells around each follicle, which should be around 1,000, begins to fall.
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In what feels like a cruel coincidence, the specialised cells are killed off by none other than dihydrotestosterone, the active form of the hormone testosterone that causes men to develop during puberty.
Typically, the dermal papilla cells on the top of the head, as opposed to those on the side, are most susceptible to premature death – think mediaeval monk hair-do – which could stem from an interesting genetic quirk that originates in the very earliest stages of development in the womb.
Recent research published in the journal Experimental Dermatology described how cells differentiate into different layers a matter of weeks into an embryo’s development, each layer assuming specific future roles. Most organs in the body then develop from just one of these so-called ‘lineages’.
Skin cells on the head, however, appear to come from different lineages, meaning their developmental paths would be very different.
“The dermal cells that are lost and those that are not lost come from totally different populations of cells,” explains Kemp. “Essentially, where you’ll lose hair is like a ticking clock that was set from the moment your body developed.”
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Why cloning your hair might be the cure to balding
Now that we know losing dermal papilla cells is responsible for balding, the race is on to find effective ways to replace them. Hair cloning, also known as hair multiplication, is an early front-runner in that race with companies like HairClone – unsurprisingly given the name – backing it.
Hair cloning isn’t available in the UK or US just yet, and will likely cost thousands of dollars when it hits the market in the next few years.
“It's obviously going to cost more in the early days and then as we can scale up and have cost savings, then the price will go down,” Kemp says. “We're imagining it will be about the same as a kind of high-level hair transplant.”
Unlike a hair transplant, however, hair cloning can be carried out before any significant balding has occurred. The promise is that no one will be able to tell that you’ve had any treatment whatsoever.
The process works like this:
1. Harvesting and banking follicles:
Healthy, non-miniaturising hair follicles are extracted from areas on the scalp that are still growing hair and cryogenically frozen for use at a later date.
Unfortunately for those, ahem, slightly older readers, the younger these cells are, the better. The future of cloning likely relies on banking hair early and countering balding as it occurs, rather than reversing the process in the later stages.
2. Multiplying cells:
This is the ‘cloning’ part. The extracted follicles are taken to a lab, where the dermal papilla cells are isolated and multiplied.
“We can multiply them over a thousand times, so you can get over a million cells from one follicle,” Dr Jennifer Dillon, head of research at HairClone, tells BBC Science Focus.
3. Reimplantation:
After this, the multiplied dermal papilla cells are injected back into the balding areas of the scalp, ready to restore your luscious locks to their prime.
Although this final step is awaiting regulatory approval, Dillon says that the early clinical data is looking promising.
“We've developed a special clinically relevant technology to be able to take those follicles, expand the dermal papillae, multiply them out and get a large quantity of them. And we've got a manufacturing facility who have been trained; we've got paperwork in place; we just need to validate that process,” she says.
In the meantime, it is now possible to bank your hair follicles all over the world, although it will cost you a few thousand dollars to do so.
What else is on offer?
Cloning might be the treatment generating a lot of buzz at the moment, but it’s certainly not the only one.
In November, a study published in the Journal of Cosmetic Dermatology suggested that fat cells taken from the belly could be used to regenerate hair. While the procedure’s name might not be as cool as hair cloning, autologous fat grafting (AFG) looks promising and would negate the need for the cryogenic freezing of follicles when young.
AFG falls into the category of stem cell therapies, which utilise versatile cells capable of transforming into various cell types as needed for regeneration.
Instead of freezing healthy hair cells, stem cells can be harvested from a patient’s body at any time and genetically activated to develop into the required hair cells. Think of these cells like clay that can be moulded into any shape needed.
Once developed, the stem cells could be injected into the scalp in the same way as in the hair cloning procedure.
Another hopeful treatment in the pipeline seeks to harness microRNA – tiny molecules that act like cellular dimmer switches, fine-tuning gene expression by interacting with messenger RNA – to stimulate hair growth.
A microRNA treatment has the potential to be much less invasive than cloning or AFG, since, in theory, it could be delivered as a topical solution directly onto the skin.
When will these treatments be available?
Just like hair cloning, several stem cell and microRNA treatments are in the process of gaining clinical approval, which means they could be available within the next few years.
But while hope of a cure for balding continues to grow, Dr Claire Higgins, a tissue regeneration researcher at Imperial College London, urges some caution. “Unfortunately, things that have shown promise in the lab have not demonstrated much efficacy in clinical studies, and so the timeframes for a treatment keep changing,” she says.
Higgins thinks that the key to finding an effective treatment lab lies in identifying a specific target that makes some dermal papilla cells susceptible to balding but others not. “We know how the hair follicle physically changes leading to balding ... but it’s unclear what drives this change in the first place.”
If we find out what’s driving the change, she says, “then the treatments can be better designed and hopefully more effective in clinical studies.”
Perhaps unsurprisingly, Kemp struck a slightly more optimistic tone, concluding that balding treatments will be revolutionised within a generation.
“I'm imagining it somewhat analogous to dentistry,” he says, “in that, in previous generations, you would wait to lose your teeth and then get dentures, which is kind of like a hair transplant.
“Whereas now, dentistry is progressive. You have fillings, bridges, crowns and all sorts of things to maintain your dental appearance throughout your life.
“In the future, people will maintain the same degree of hair throughout life too. You won’t know whether that was just the luck of nature or whether it was due to treatment.”
About our experts
Dr Paul Kemp is the co-founder and CEO of HairClone. Before his time at HairClone, he was the lead inventor on patents for the first multi-cell therapy to be approved by the FDA, which has now been used to treat two million people worldwide. Kemp also co-edits the Journal of Regenerative Medicine and is co-director of doctoral training in Regenerative Medicine at the University of Manchester.
Dr Claire Higgins is a lecturer in the reader in tissue engineering and regenerative medicine, and principal investigator in her own research group in the Department of Bioengineering at Imperial College London. Her research group focuses on skin and hair follicles, wound repair and regeneration.
Dr Jennifer Dillon is the head of research at HairClone, focusing on optimising and delivering the company's cell therapy for hair loss. Prior to joining HairClone, she worked in the field of stem cell and cancer research for 13 years.
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