Basic Hair Science

Understanding Hair Science is Essential in Treating Hair Loss

Different hair loss types (e.g., androgenetic alopecia, scarring alopecia, telogen effluvium) affect different parts of this structure.

Understanding the hair cycle, hair function, and anatomy is essential when receiving treatment for hair loss. It ensures that therapies are accurately targeted, respect the natural roles of hair, and support healthy regrowth without causing unintended damage. Without this knowledge, treatments may be ineffective or even harmful, leading to poor outcomes.

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Applications of Hair Science

Basic hair science includes histology, anatomy, function, biochemistry, and the hair cycle. We will try to explain all these in a comprehensive way.

The bulge in the middle of the hair follicle contains stem cells. It is the most important part in follicle growth and regeneration. During hair transplant this segment of the graft must be well preserved. In FUE, when too small a punch is used, the extracted follicle may deprived of bulge tissue. In “Hair Cloning”, the dermal sheath of the follicle is cultured in medium.

The multiplied tissue is then injected into the skin to induce new hair formation. The stem cells in the bulge is multi-purposes. Hair follicle transplant had shown to return skin color in a skin disease called “vitiligo”. The average healthy hair fiber diameter is 0.08mm or over. Below 0.04mm the hair fibers are too thin to achieve visual coverage of the scalp

Many treatments are being developed to stimulate the stem cells: new hair follicles can be formed; even white hairs can turn black. 5 α reductase converts testosterone into DHT. This enzyme is located in the Sebaceous Glands.

Dr Inaba (Japan) believes that over consumption of animal fat swells the sebaceous gland, increases the amount 5 α reductase and DHT, leading to earlier onset of androgenetic hair loss.

Basic Hair Science

Laser is able to stimulate and preserve hair follicles in patients with androgenetic alopecia and other hair loss disorders. Laser has been used over the past few years in a number of laser devices (combs, caps, hairdryer-like) for treatment of genetic or acquired hair loss. The Laser energy addresses hair loss at the hair follicle cellular level, rejuvenating miniaturizing hair follicles in seven major ways:

  • Photo-Biomodulation and a stimulation effect
  • Initiates protein synthesis
  • Mobilizes calcium ions within the hair follicle
  • Mobilizes cellular stimulation within the dermal papilla
  • Enhancement of ATP production in the cells
  • Significant improvement of blood microcirculation
  • Allows greater nutrient acquisition by follicular site

Hair transplants can initially traumatize the scalp and can result in a temporary hair loss during the first 4 months (this is known as shock loss). Some patients may experience swelling in the transplanted area. The transplanted donor follicles can also experience difficulty adapting to their new environment. Clinical studies have demonstrated the following beneficial effects of laser when use in conjunction with hair transplant.
•  minimizes hair shedding (shock loss)
•  strengthen hair follicles after surgery with a much higher probability of survival
•  reduce swelling, redness and inflammation post-surgery

Advantage 1 : Effect of Laser in Cell Energy Supply

Laser hair therapy stimulates the mitochondria in cells to increase the production of adenosine triphosphate (ATP). ATP is the form of energy used by hair cells to grow imto follicles. Abundant energy supply is critical when dealing with weakened and traumatized hair follicles.

Advantage 2 : Increase Success Rate after Hair Transplant

Laser hair therapy devices have been used by thousands of hair transplant centers all over the world (such as Bosley and HairClub). However handheld contraptions made with cheap Light Emitting Diodes (LEDs) are worthless when it comes to energizing the base of hair follicles. Technologically advanced device with the FDA-cleared is now available in our center for use after hair transplant. A 20 minutes of treatment is able to revive the mitochondria of hair cells. This can result in stronger hair follicles with a higher probability of surviving the operation. These extra amounts of “survivor” hair grafts will eventually grow into healthy, terminal hairs.

Since the first experiments in the 1960s with laser treatment for impaired wound healing, there has been much research-both lab-based and clinically-into the use of lasers for medical treatment. Later Nils Finsen pioneered the use of UV therapy for which he won the Nobel prize in 1904 [2]). The use of lasers and LEDs as light sources was the next step in the technological development of light therapy, which is now applied to many thousands of people worldwide each day.

The Lasers and LEDs are applied directly to the respective areas (e.g., wounds, sites of injuries) or to various points on the body (acupuncture points, muscle-trigger points). Controlled clinical trials have shown efficacy in treating stroke, stimulating wound healing, orthopedic conditions and relief of chronic inflammation. Preclinical studies have shown effectiveness in spinal cord injuries, peripheral nerve regeneration, heart attacks, degenerative brain diseases and traumatic brain injury.

  • Sports-medicine – reduce swelling and hematoma, relieve pain, treat acute soft-tissue injuries
  • Rehabilitation – improve mobility
  • Dentistry – treat inflamed oral tissues and heal diverse ulcerations
  • Dermatology – treat edema, non-healing ulcers, burns, and dermatitis
  • Rheumatology – relieve pain and treat chronic inflammations and autoimmune diseases
  • Veterinary Medicine – especially in racehorse-training centers
  • Other specialists and general practitioners

Hair Cycle – The 5 Phases

Human hairs do not grow all the time, but in phases or returning cycles. Different hairs would have different cycle. During a human life, the growth cycle of a scalp hair will repeat itself on average 20 times from birth on. Scalp hair cycle consists of 5 phases:

Laser Therapy, also referred to as Low Level Laser Therapy (LLLT), cold laser therapy, photobiomodulation, biostimulation, and phototherapy, has been shown in thousands of peer-reviewed publications to increase cellular survival, proliferation and function. The laser light after absorbed by mitochondria in the cell produces the following actions

  • Photo-Biomodulation and a stimulation effect
  • Initiates protein synthesis
  • Mobilizes calcium ions
  • Enhancement of ATP production
  • Significant improvement of blood microcirculation
  • Allows greater nutrient acquisition
  • Increases cellular respiration
  • Induces activation of transcription factors via reactive oxygen species.


The question is no longer whether light has biological effects but rather how energy from therapeutic lasers and LEDs works at the cellular and organism levels and what the optimal light parameters are for different uses of these light sources.

One important point that has been demonstrated by multiple studies in cell culture, animal models and in clinical studies is the concept of a biphasic dose response with the total delivered light energy density (fluence).

The reason why the technique is termed Low-level is that there exists an optimal dose of light for any particular application, and dose lower than this optimum value, or more significantly, larger than the optimum value will have a diminished therapeutic outcome, or for high doses of light a negative outcome may result.

The methods for delivering the therapeutic light are diverse. The field is characterized by a variety of methodologies and uses of various light sources (lasers, LEDs) with different parameters (wavelength, output power, continuous-wave or pulsed operation modes, pulse parameters, polarization state etc). In 2002 MicroLight Corp received 510K FDA clearance for the ML 830-nm diode laser for treatment of carpal tunnel syndrome.

There were several controlled trials reporting significant improvement in pain and some improvement in objective outcome measures. Since then several light sources have been approved as equivalent to an infra-red heating lamp for treating a wide-range of musculoskeletal disorders with no supporting clinical studies.

The methods for delivering the therapeutic light are diverse. The field is characterized by a variety of methodologies and uses of various light sources (lasers, LEDs) with different parameters (wavelength, output power, continuous-wave or pulsed operation modes, pulse parameters, polarization state etc). In 2002 MicroLight Corp received 510K FDA clearance for the ML 830-nm diode laser for treatment of carpal tunnel syndrome.

There were several controlled trials reporting significant improvement in pain and some improvement in objective outcome measures. Since then several light sources have been approved as equivalent to an infra-red heating lamp for treating a wide-range of musculoskeletal disorders with no supporting clinical studies.

The methods for delivering the therapeutic light are diverse. The field is characterized by a variety of methodologies and uses of various light sources (lasers, LEDs) with different parameters (wavelength, output power, continuous-wave or pulsed operation modes, pulse parameters, polarization state etc). In 2002 MicroLight Corp received 510K FDA clearance for the ML 830-nm diode laser for treatment of carpal tunnel syndrome.

There were several controlled trials reporting significant improvement in pain and some improvement in objective outcome measures. Since then several light sources have been approved as equivalent to an infra-red heating lamp for treating a wide-range of musculoskeletal disorders with no supporting clinical studies.

Hair Follicle Anatomy

3 Distinct Structures

  • Hair Shaft
  • Hair Root or Dermal Papilla
  • Surrounding Tissue

3 Layers of Hair Shaft :

  • Cuticle – a tightly formed structure overlapping scales. A healthy cuticle is a protective layer, and controls the water content of the fiber. Much of the shine that makes healthy hair so attractive is due to the cuticle
  • Cortex – makes up most of the hair shaft, and gives hair its special qualities such as elasticity and curl. Packed with strands of keratin and pigments
  • Medulla – a central hollow core found in terminal hair

Hair Shaft Components

Component
Content %
Remarks
Keratin80%-90%•    Formed from dead protein
•    Contains 20 kinds of amino acids•    Provide strength for the shaft
Water10%-30%Provide shaft elasticity
Lipid ( Fat )10% 
Trace ElementsVery small QuantityZinc, Mercury, Cobalt, Iron, Selenium …
MelaninAccounts for hair color

Hair root, alsp known as Dermal Papilla, is a tunnel-like segment of the epidermis that extends down into the dermis. It can be divided into 2 compartments :

1. Vertical Compartments

Upper Follicle( Infundibulum and Isthmus )
  • This part is permanent
Middle Follicle ( the Bulge )
  • The storage area for hair follicle stem cells that are able to regenerate the hair follicles.
  • This part is also permanent
Lower follicle ( the bulb or suprabulbar )
  • This forms the dermal papilla which looks like a healthy “pear” shape.
  • This part degenerates and regenerates with each hair follicle cycle.
  • Here the cells are divided 23 to 72 hours to regenerate the hair follicle.
  • This rate of proliferation is the fastest in the body.

2. Horizontal Compartments

Outmost connective tissue ( dermal sheath )
  • Enveloping the hair follicle, this consists of 2 layers : an outer layer called the connective tissue sheath
  • An inner layer called the hyaline membrane.
Outer root sheath ( ORS )

Protect and form the growing hair shaft. Also service as source of energy for protein synthesis during hair growth. Cells found in ORS are :

  • Merkel’s cell
  • Langerhan cells
  • Amelanotic melanocytes
Inner root sheath ( IS )

Consists of 3 layers :

  • Henle’s layer
  • Huxley’s layer
  • Inner root sheath cuticle

The tissue surrounding the hair root is known as Adventitous Tissue. It is consisted of several components:

1. Arrector Pil

A muscle attaches the bulge to the skin. When this muscle contracts, it causes the hair to stand up which also causes the sebaceous gland to secrete oil. This muscle must be cut in FUE to extract the follicle.

2. Melanocytes

Contain melanosomes and synthesize melanins which account for the pigmentation of hair and skin.

3. Sebaceous Glands

Opens into the isthmus. This gland secretes sebum, a semi-fluid secretion consisting chiefly of fat, keratin, and cellular material. The sebum lubricates shaft and carries away debris generated in the follicle.

4. Fatty Tissue

Scientists have discovered that stem cells are plentiful in the fat tissue, the so called Adiposed Stem Cells (ASC). ASC has been used in cardiovascular and cosmetic surgery to generate new tissues.

A study by Beehner (2010) compared the survival of chubby grafts and skinny grafts. The differences in survival is proportional to the amount of retained surrounding tissues. Stem cells are retained in chubby grafts but trimmed away in the skinny grafts.  
% growth after 19 months
Skinny Graft
Chubby Graft
2-hair follicular units 69.3 % 88.0 %
1-hair follicular Units 48 % 98 %

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