The role of autologous micrografts injection from the scalp tissue in the treatment of COVID-19 associated hair loss (telogen effluvium): Clinical and trichoscopic evaluation
Why can you suffer with hair loss following COVID-19 injection?
Hair loss following COVID-19 infection is becoming more increasingly understood. The body responds to SARS-CoV-2 infection by creating a pro-inflammatory state, which leads to tissue damage. Proinflammatory cytokines are released, which is understood to provoke stress related hair loss - telogen effluvium (TE) via the systemic inflammatory response in the hair follicles.
Hair follicles are known to contain a well-characterised niche for adult stem cells which can generate the inter-follicular hair follicle structures. The recent Aug 2022 study looked to investigate an effective therapeutic modality for the treatment of TE and TE caused by COVID- 19 by autologous micrografts injection from the scalp tissue, and then to provide analysis of the hair regrowth clinically and trichoscopy to assess the gain for the patients from this treatment modality.
TE is a disturbance in the hair cycle characterised by excessive telogen hair loss. It has many triggering factors as stress, malnutrition, surgery, pregnancy, hormonal/thyroid dysfunction, and others leading to excessive hair loss and diffuse thinning. Furthermore, it can be acute or chronic. COVID-19 became one of the stressors that the patients suffered which contributed towards TE related hair loss.
To date, stress related hair loss (TE) has been increasingly difficult to treat. This recent study discusses the evaluation of the management of TE caused by COVID-19 by hair follicle stem cells (HFSCs) micrografts injection from scalp tissues for the improvement in hair density after 3 months of treatment and at the 6 months follow-up.
The results of this study identified significant improvements in hair thickness, density, and tensile strength with the use of HFSC (hair follicle stem cell) injection in the scalp for the treatment of different types of alopecia. Fat tissue and scalp tissue could be sources of adult stem cells and progenitor cells. The fat tissue contains a great number of mesenchymal stem cells and could be collected using a minimally aggressive procedure, with minimal downtime. Adipose-derived mesenchymal stem cells and stromal vascular fraction cells are vital for the activity of the stem cells in the scalp, through the release of several growth. The vascular endothelial growth factor stimulates hair growth while the platelet derived-growth factor prompts the anagen stage, and insulin-like growth factor-1 controls the hair growth cycle. In addition, it is likely that the anti-inflammatory and immuno-modulatory properties of platelet-rich plasma and progenitor stem cells, as in the HFSC, may favor hair regrowth.
It had previously been identified that our hair follicles contain a stem cell population that can give rise to various types of cells used to provide optimal function. Their information demonstrates that Oct4-positive cells, belonging to the family of pluripotent cells of the developing embryo, are available in the human epidermis, and the majority of them are situated in the hair follicles. These cells show very promising developmental activity in varying conditions, making them good viable candidates for both cell engineering as well as cell replacement therapies.
Scalp tissue was selected as the source of (HFSCs) micrograft as the scalp is very rich in hair follicles, and it is easily accessible. The stem cells in the bulge of this follicle- rich site are critical ensuring a good therapeutic response. Simple biopsies were taken from the area behind the ear as it is a hidden site where no scar tissue can develop, with the use of a very small 2.5 mm punch. This tissue was then processed to develop autologous micrografts which has very promising results in the treatment of hair loss.
At the clinical level in the current study, HFSC was used to treat patients with TE and those patients identified very good results in hair regrowth and a positive response to treatment. Furthermore, included patients did not complain of any side effects or pain during the procedures.
The results identified that HFSC is a safe and effective therapeutic method in the treatment of TE due to the significant improvement of hair density and thickness with minimal side effects.
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