Receding hairline

A receding hairline is often the most recognizable sign of hair loss. It affects millions of people worldwide. As such it’s been the focus of numerous studies and treatment options. From topical treatments to a stem cell approach or the Janus kinase (JAK) inhibitors there seem to be a number of solutions that have been scientifically proven to help in some cases with a receding hairline.

What causes a receding hairline?

The most common cause of a receding hairline is androgenetic alopecia also known as male pattern baldness. It is a general consensus in the academic community that most androgenetic alopecia cases come from a genetic predisposition which is caused by a by-product of testosterone which is called dihydrotestosterone or DHT a type 2 5α-reductase. DHT attaches itself to hair follicles and causes them to become thinner over time, until some stop growing altogether.

Best treatnments for a receding hairline

Stem Cell Therapy

the treatment could induce hair growth or even help reverse hair loss, including receding hairlines

One of the most promising approaches to treating a receding hairline comes from stem cell therapy. While not yet available as an FDA approved treatment, three recent studies suggest a very promising solution for recovering hair lost to alopecia. Kandiba and Kobielak (2014) looked at stem cells in hair follicles and concluded that they are controlled by two signalling pathways called BMP and Wnt. The interaction between the pathways dictates when hair grows, stops growing and falls out. Kandiba et al. (2012) mainly focused on the role of Wnt pathways in hair growth. By increasing levels of Wnt signalling, the study suggests, the treatment could induce hair growth or even help reverse hair loss, including receding hairlines.

In a similar study, Kandiba et al. (2014) looked into the BMP pathway, clarifying its function by better understanding and describing proteins like Smad1 and Smad5 which transmit instructions to hair follicle stem cells.

While further research is required to develop a course of treatment, stem cell therapy can prove an efficient way to deal with all forms of hair loss and, indirectly, with a receding hairline.

JAK Inhibitors

Tofacitinib JAK inhibitor for hair loss

Another potential treatment that could have a significant impact on receding hairlines and hair loss is Janus Kinase (JAK) inhibitors. The treatment works by blocking certain enzymes in hair follicles that lay in a resting state. By blocking said enzymes, hair growth can be restored on any part of the scalp, not just on the vertex as other topical treatments have achieved. This makes this course of treatment one of the most promising in terms of halting a receding hairline and restoring hair growth.

A Christiano et al. (2015) study published in the Journal of Science Advances showed that the drugs that inhibit Janus kinase enzymes can also help with rapid growth of hair when applied directly on the scalp. Currently, the FDA has approved 2 JAK inhibitors, ruxolitinib, which is used as a treatment for blood diseases and tofacitinib, which is used to treat rheumatoid arthritis.

There is still more research needed to find the exact effect JAK inhibitors have on hair follicles and to determine the exact formula for scalp usage, however, early testing suggests that it may be one of the most effective solutions in terms of dealing with a receding hairline.

Platelet-Rich Plasma (PRP)

Before and after hair regrowth from PRP therapy

research showed that hair count increased from an average of 71 hair follicles to 93 hair follicles with an average mean gain of 22.09 follicles per square centimetre

Platelet-Rich Plasma therapy is a relatively new treatment for hair loss, but is becoming increasingly available in clinics around the world. The science behind the treatment is based on the clotting capabilities of platelet rich plasma, which is basically a high concentration of platelets found in the blood. The platelets release a series of bioactive proteins with significant regenerative capabilities. These proteins have been proven to help with the regrowth of hair in the areas they are injected in.

A study conducted by Gentile, et al. (2015) showed a 31 percent increase in the follicle density of participants over a period of 2 months. The research also concluded that of the 20 participants none had experienced any significant side effects.

PRP Therapy on scalp

Another study conducted by Khatu, et al. (2014) showed that after just four PRP injections a significant reduction in hair loss was observed. The same research showed that hair count increased from an average of 71 hair follicles to 93 hair follicles with an average mean gain of 22.09 follicles per square centimetre. The study concluded that PRP injections prove a feasible, effective and cost effective treatment for androgenetic alopecia.

PRP’s potential for combating a receding hairline has also been proven when it comes to alopecia areata. In a study conducted by Taieb, et al. (2016), PRP injections were compared to the FDA approved topical solution minoxidil 5%, one of the most often prescribed non-invasive solutions for alopecia. The study’s 90 participants were split into three groups, two being administered minoxidil 5% and PRP injections while a third was administered placebo treatment.

High strength topical minoxidil

The study suggested that while both PRP injections and minoxidil 5% showed significantly better results than the placebo group, PRP injections produced an earlier response for hair regrowth, a reduction in short vellus hair as well as a reduction in dystrophic hair. The research concluded that PRP injections proved to be a more effective treatment for alopecia areata. The topical nature of PRP injections also suggests that if Alopecia Areata would affect the frontal scalp, PRP injections would be an efficient treatment course.

Conclusions

A receding hairline is one of the most visible symptoms of hair loss, however, there are solutions that can help stop its advance and even promote hair regrowth. A huge amount of research is also being done on how to treat a receding hairline and hair loss as a whole, and whether through Stem Cell Therapy or via JAK inhibitors, future treatments seem to hold the key to combating one of the most visible signs of baldness.

References and further reading

  1. Eve Kandyba, Krzysztof Kobielak – Wnt7b Is an Important Intrinsic Regulator of Hair Follicle Stem Cell Homeostasis and Hair Follicle Cycling, 2014 – Stem Cells Journal – http://onlinelibrary.wiley.com/doi/10.1002/stem.1599/abstract;jsessionid=05B151BAC91A5CCCF4965BDD93960DFA.f04t03
  2. Eve Kandybaa, Yvonne Leunga, Yi-Bu Chenb, Randall Widelitzc, Cheng-Ming Chuongc, and
    Krzysztof Kobielaka – Competitive balance of intrabulge BMP/Wnt signaling reveals a robust gene network ruling stem cell homeostasis and cyclic activation, 2012 – Proceedings of the National Academy of Sciences – http://www.pnas.org/content/110/4/1351
  3. Eve Kandyba, Virginia M. Hazen, Agnieszka Kobielak, Samantha J. Butler, Krzysztof Kobielak – Smad1 and 5 but Not Smad8 Establish Stem Cell Quiescence Which Is Critical to Transform the Premature Hair Follicle During Morphogenesis Toward the Postnatal State, 2014 – Stem Cells Journal – http://onlinelibrary.wiley.com/doi/10.1002/stem.1548/abstract
  4. Sivan Harel, Claire A. Higgins,J ane E. Cerise, Zhenpeng Dai, James C. Chen, Raphael Clynes, Angela M. Christiano – Pharmacologic inhibition of JAK-STAT signalling promotes hair growth, 2015 – Journal Science Advances – http://advances.sciencemag.org/content/advances/1/9/e1500973.full.pdf
  5. Pietro Gentile, Simone Garcovich, Alessandra Bielli, Maria Giovanna Scioli, Augusto Orlandi and Valerio Cervellia – The Effect of Platelet-Rich Plasma in Hair Regrowth: A Randomized Placebo-Controlled Trial, 2015 – Stem Cells Translational Medicine – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4622412/
  6. Swapna S Khatu, Yuvraj E More, Neeta R Gokhale, Dipali C Chavhan, and Nitin Bendsure – Platelet-Rich Plasma in Androgenic Alopecia: Myth or an Effective Tool, 2014 – Journal of Cutaneous and Aesthetic Surgery – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4134641/
  7. El Taieb, Ibrahim, Nada, Seif Al-Din – Platelets rich plasma versus minoxidil 5% in treatment of alopecia areata: A trichoscopic evaluation, 2016 – Wiley Online Library – https://www.ncbi.nlm.nih.gov/pubmed/27791311
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