In medicine, we use the term fibrosis to describe the histological deposition of fibrin, collagen, and other connective tissue proteins.
Usually, this process takes place after the affected area gets injured or damaged. For instance, when you cut yourself, the scarring that occurs weeks after is the result of fibrosis.
In the case of scalp fibrosis, it’s widely believed that there’s a relationship between increased fibrosis activity in the dermal layer of the scalp and male pattern hair loss (MPHL).
What causes scalp fibrosis?
Fibrosis is caused by increased production of fibrotic tissue, such as collagen, fibrin, and elastin. These proteins are produced by inflammatory cells (e.g. mast cells, macrophages).
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In a 2008 study, researchers tried to connect scalp fibrosis to MPHL. 15 participants took part in this study. 10 of them had MPHL.
Researchers performed scalp biopsies on all 15 participants and analyzed the tissue to see how much collagen and elastin were deposited. Collagen bundles were significantly increased in balding vertexes than in non-balding occiput scalp skin.
Additionally, the number of mast cells (MCs) was two times higher in patients with MPHL than healthy subjects.
The researchers concluded “these findings suggest that accumulated MCs might be responsible for increased elastic fiber synthesis in MPHL, and indicate that future investigations are warranted.”
Does DHT cause scalp fibrosis?
The most common causes of scalp fibrosis trauma to the skin, radiation, scleroderma, and DHT. DHT causes fibrosis by the overactivation of mast cells.
How does scalp fibrosis cause hair loss?
Perifollicular fibrosis and the inflammation seen in androgenic alopecia may alter the normal cycle of the hair follicle, which leads to poor hair growth and baldness. Additionally, the scar tissue that deposits around the dermal papilla may destroy them and induce early apoptosis (cell death) of follicular cells.
For a long time, scientists were uncertain about the relationship between perifollicular fibrosis and hair loss. Is it an associative or a causative relationship?
However, by studying the fibrosis seen in scleroderma (an autoimmune disease), researchers identified the role of perifollicular fibrosis to be an exacerbating factor to AA.
How can you prevent scalp fibrosis
In one study dedicated to perifollicular fibrosis, scientists studied the role of fibrosis in androgenetic alopecia. At the end of the study, they concluded:
Perifollicular ﬁbrosis induced by androgen can be suggested as one of the underlying pathogenetic mechanisms, resulting in hair follicle miniaturization in AA.
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In simple English, perifollicular fibrosis is a cause of hair low; however, it is only a mechanism involved in androgenetic alopecia, and since we do not have curative treatment for AA yet, we cannot stop the fibrosis.
It’s not all bad news, though. By identifying fibrosis as one contributing factor to hair loss, scientists may counter that effect using pharmacological drugs.
One of the suggested drugs that may slow down this process is Aminexil by L’Oréal; however, it is not approved by the FDA yet.
How can you reverse scalp fibrosis?
Fibrosis is scarring of the tissue at a micro-level. In order to reverse fibrosis you need to heal the scars. However, scars can’t be healed, but what you can do is replace the scar tissue with new, healthy tissue. This is actually a very common practice performed by many people using a device called a Dermaroller or a Dermastamp. These devices use tiny needles to gently remove tiny parts of the skin tissue by punching tiny holes in the skin. When the skin heals the tiny holes, it generates new tissue which is not scarred.
There are hundreds, if not thousands of examples online of people who have used Dermarollers to replace scar tissue with healthy new tissue — effectively removing scars. It makes a lot of sense that hair loss is caused by androgen hormones and auto-immune disorders, but in the end, what causes the hair follicles to become irreversibly damaged is fibrosis. So a tool that heals scars is actually an incredibly logical tool for treating hair loss.
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Can adenosine reverse scalp fibrosis?
I’ve seen some research that indicated the chemical adenosine can reverse perifollicular fibrosis! I’m not sure as yet exactly how it does this so I’ll look into and see what I can find.