No matter how old you are, there’s no age that’ll prepare you for thinning hair. Unfortunately, dealing with sparse-looking strands or bald patches can take a major toll on your self-confidence, but luckily there’s an upside. Thanks to technological advancements, there are a variety of non-surgical treatments available to combat hair loss. Among the most interesting procedures is stem cell therapy—but what exactly is it? We talked with Beverly Hills, CA hair restoration specialist Dr. Craig Ziering of Ziering Medical about the causes of loss, the different treatments available and how stem cell therapy is changing the way we think about thinning hair.

NewBeauty: What are the main causes of hair loss?
Dr. Ziering: The most common causes of hair loss in men and women are genetic or androgenetic hair loss (usually male or female-pattern hair loss). Diseases like anemia, lupus, thyroid disorders and alopecia areata are additional causes, but a common (and yet often underrated one) is traction alopecia, which is a result of wearing tight braids or hairstyles which pull out the hair and destroy it.

NewBeauty: If you’re experiencing hair loss, what is the consultation process like in order to draw up the proper treatment plan?
Dr. Ziering: The first things that you have to do when you see a patient with hair loss is look at their health history and perform a scalp exam. Once we determine the cause, I explain the various treatment options that are available based on their degree of hair loss, how much hair they have left, and what their goals are. We educate our patients on their options as early as possible—especially if they have a family history of hair loss.

NewBeauty: Once the trigger is determined, what are the different treatment options available?
Dr. Ziering : If a patient comes in just because they have a family history of loss and they want to be preventative and proactive, the mildest course of treatment is a supplement like Vivascal Professional or Nutrafol. These are designed specifically to make sure the body has the nutrients it needs for proper hair growth. Other nonsurgical options are topical treatments in the form of Minoxidil. Finasteride—which was only in oral form for men in the past—can now be applied topically as well.

In addition, there is low-level laser therapy, which is just as beneficial. Many times, combining these therapies is extremely effective—for example, combining prescriptions with laser therapy can often give the best outcome.

NewBeauty: Can you tell me about the more advanced methods of treatments like stem cell therapy?
Dr. Ziering: In the past, patients might jump straight to a hair transplant, but recently there’s an intervening step called regenerative hair restoration. It started with PRP where you draw blood from the patient, centrifuge it to concentrate the platelets and inject it back into the scalp. The negative aspect of PRP is that it can cause inflammation which is not good for the hair, so we now use growth factors and exosome therapy because it combats any unwanted inflammation. 

To give you a little background, our cells communicate through complex languages of chemical signals, genetic codes, hormones and proteins which transmit important information about the cellular environment and influence individual cell formation and behavior. In many areas of medicine, regenerative treatments that focus on these connections are becoming prominent. With hair, they’re going to be a game changer, and exosome therapy helps improve this communication.

NewBeauty: What exactly are exosomes?
Dr. Ziering: Exosomes are stem cell-derived microvesicles—there’s no nucleus, there’s no DNA, they’re about 1/1000 the size of a cell and they’re involved in direct-cell signaling. Therefore, there’s a huge array of growth factors that can stimulate and modulate many processes within the healing cascade. Exosomes target tissue and promote wound healing by activating the patient’s own regenerative cell response. Instead of moving stem cells to the head directly, you’re moving new, fresh signaling factors and growth factors, which enables angiogenic growth (the new blood vessel formation which is important to feed the cells). Plus, exosomes provide regenerative signals and properties.

NewBeauty: Where do you get exosomes?
Dr. Ziering: The exosomes we use come from bone marrow, but you can get them from multiple sources like the amniotic fluid, the placenta and blood cells.

NewBeauty: When a patient comes in, what is the process of using exosomes?
Dr. Ziering: Used in conjunction with other therapies or as a standalone therapy, exosomes reverse the hair thinning that’s taking place. We inject the patient’s scalp with a very tiny needle, similar to Botox, anywhere hair is thinning or absent. There’s no anesthesia needed, as it is a minor pinch. In order to stimulate growth, we use a laser or microneedling to activate the injection. What we have found is that when we use it in conjunction with the hair transplant surgery, it speeds recovery. Additionally, the growth seems to start significantly earlier than normal.

NewBeauty: Once you do an exosome treatment, are the results permanent?
Dr. Ziering: To be honest, we don’t know for sure, but it wakes up those stem cells and allows them to function better. After the patient’s first round of injections, we re-evaluate their progress after six months and potentially repeat the process at twelve months. Another treatment we use in conjunction with this is the “Amnio Z” shot, which is rich in growth factors that’s derived from amniotic fluid. While Amnio Z and exosomes act in similar ways, I find Amnio Z works better for patients with thinning hair while exosomes are better for people who don’t have hair at all in certain areas. I have a fair amount of patients who get an Amnio Z shot every quarter, because they feel like it creates a significant difference and strengthens their hair so much.

NewBeauty: Are there any side effects to using these types of treatments?
Dr. Ziering: There have not been any side effects that we have seen with this. However, it is important that you know the company where you’re getting your stem cells from because that sterilization process is extremely important. 

NewBeauty: Do you see this technology exploding over the next few years?
Dr. Ziering: Yes, I do. Beyond being used on patients with male or female pattern baldness, it can aid those who have scarring alopecia with inflammation and it can be used in patients with alopecia areata, so it has a lot of multiple uses. We’re just scratching the surface with this cutting-edge treatment.

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