News on Follica

It’s pretty interesting news. It looks like their Lithium Gluconate 8% Phase 2 Clinical Trials in Germany in 2010 must have failed. I do wonder if they proceed, which compound they will use.

http://puretechhealth.com/careers.php?gh_jid=189236
http://puretechhealth.com/careers.php?gh_jid=189240

[quote][postedby]Originally Posted by Aran Linvail[/postedby]
It’s pretty interesting news. It looks like their Lithium Gluconate 8% Phase 2 Clinical Trials in Germany in 2010 must have failed. I do wonder if they proceed, which compound they will use.[/quote]

I thought it was well-known that their trials in Germany with Lithium had failed.

Honestly, I think Follica is flogging a “technology” that is both immature and obsolete at the same time.

When Dr. Cotsarelis wrote his paper about wounding tissue promoting hair growth, he immediately set out to “monetize” the idea before it was fleshed out and developed into a working technology. He sold the idea to Follica, then Follica patented it. But what did they really patent? All they patented was the concept of wounding tissue PLUS adding some “unknown”, as yet untested compound – Lithium, Zinc, plus a long, long list of other candidates – none of which were conclusively proven to work with wounding to reliably produce hair.

The only problem now is that the research has moved beyond this. Now researchers are able to grow induce pluripotent stem cells (iPSCs), enhance DP cell trichogenicity via genetics and culturing techniques, and isolate key growth factors secreted by hair follicle stem cells and progenitor cells.

With all of the above advances (which are admittedly still being worked on), who needs wounding tissue now? Remember, the only advantage of wounding is that it releases certain growth factors which work with HF stem cells and DP cells to activate the follicle. Well, if all those things can be done independently now, why is wounding still needed?

The other problem with wounding tissue is that, although it may have short-term effects of releasing growth factors, the LONG TERM effects of wounding are harmful to hair follicles. For wounding to be a real cure, it has to be done repetitively on the scalp (one session of wounding will not cure you for life). But the more you wound the scalp tissue, the more you will disrupt and damage existing follicles and create scar tissue.

I think Follica is “stuck” with a bad idea, and now they feel they have to make good on it, because so many investors have given them money. So they’re kind of desperate, looking for that “magic compound” that, together with wounding, will make them rich and famous.

But, it’s been what – over 10 YEARS – yes, Follica has been around flogging this same idea for over ten years (it was founded in 2005) – and they still haven’t found it and begun serious clinical trials yet???

As for the “2018” announcement in the PureTech prospectus – if Follica had indeed discovered its magic compound, which, together with wounding, will grow lots of hair, THEY WOULD HAVE PUBLICLY ANNOUNCED THIS BY NOW.

I think that date is just kind of a stalling tactic to keep investors at bay. What they really mean is that they have not yet found this compound, and they’re using “2018” as a “soft date” by which they HOPE to have found it.

The job announcement for VP of clinical development is just Follica casting its fishing pole into the water to see if some genius will show up to discover their magic compound and save the day.

Derms & guys with MPB have known for years that a single instance of needling or dermabrasion can sometimes produce a few new hairs. New thick dark terminal hairs on shiny bald skin, and they last.

Please explain how this fits with your assertion that skin wounding must be chronic to do us any real good.

Follica may never amount to anything. Wounding-based regrowth may never be used if we find another hair regrowth method first.

But wounding-based regrowth is still a real phenomenon. Follica was smart to pursue it. It has a real chance of working for us if we understood it better.

Wounding has to be chronic because the perturbation of the skin just triggers temporary physiological changes which are associated with tissue healing – release of growth factors, eosinophils, platelets, etc. These peak not too many days after the wounding incident and then gradually dissipate back down to baseline.

But for a hair follicle to remain viable and cycling, and to resist re-miniaturization from DHT, it must have these growth factors present continuously. Otherwise the same miniaturization process that happened before will take hold again.

The same principle applies with any drug therapy, by the way, like anti-androgens, minoxidil, etc. Triggering growth factor release via wounding is really no different, physiologically, from drug therapy. Both produce transient results and if withdrawn, the effect goes back to zero.

Where is the link or article?

[quote]Wounding has to be chronic because the perturbation of the skin just triggers temporary physiological changes which are associated with tissue healing – release of growth factors, eosinophils, platelets, etc. These peak not too many days after the wounding incident and then gradually dissipate back down to baseline.

But for a hair follicle to remain viable and cycling, and to resist re-miniaturization from DHT, it must have these growth factors present continuously. Otherwise the same miniaturization process that happened before will take hold again.

The same principle applies with any drug therapy, by the way, like anti-androgens, minoxidil, etc. Triggering growth factor release via wounding is really no different, physiologically, from drug therapy. Both produce transient results and if withdrawn, the effect goes back to zero. [/quote]

So you’re saying the derms & guys who observe this phenomenon are ALL either mistaken or lying?

I have a handful of full-strength terminal hairs in the middle of the shiny bald skin of my temples. They were created most of a decade ago after dermabrading the area. I have done essenatially zilch to maintain them besides get some Nizoral on them during hair washing. I have even been plucking some of them to try and kill them again because they are slightly odd. (Are these hairs “lifetime permanent?” I dunno. But they are worth at least a decade & multiple hair cycles after a single wounding incident. And that’s for accidental creation and zero maintenance efforts from then on. That already blows every other commercial MPB treatment out of the water.)

I am not alone in this at all. Look at the reports of scattered new terminals from guys who needle. Look at the occasional anecdotal stories of unusual regrowth after serious scalp wounds. Look at the Gefitnib cancer patients who grew thick dark patches of hair on areas that look like probable sunburn sites. Etc.

This phenomenon is real. It may never do us any practical good in the foreseeable future. But it’s real. With how far off everything else is looking for commercial HM these days, we would be wretchedly stupid to brush this off as imaginary just because we don’t understand it.

I have little faith in Cotsarelis’s work restoring my hair in the next 20 years. I have absolutely no trust in his honesty. But he has been barking up the right tree for the most part. If the goal was commercially treating MPB rather than pure research then he definitely picked the smart thing to pursue a decade ago. It hasn’t panned out yet, but neither has anything else. And most of the decent discoveries about hair during that time have Cots’s fingerprints on them.

Are you on any medication, e.g. dutasteride, finasteride, minoxidil? Those would tend to preserve any regrown hairs.

[link] http://bit.ly/1OrL1WE[/link]

I’ve been on small amounts of Fin and topical RU at various times in the past. But nothing for most/all of the time these scattered hairs have been surviving on my head. Just Nizoral shampoo for at least 6-7 years now. If these new hairs are succumbing to MPB then it’s not happening very quickly.

I might have been on Fin at the time I did the dermabrasion that helped create the hairs. I’m not sure off the top of my head. If I was, then the dosage would have been something tiny like 0.25mg EOD.

Fin is not very dose-dependent so you have to get the dosage down pretty small before it’s much less potent than the normal 1mg. (Hence they can prescribe 1mg for baldness and 5mg for prostate issues.) But the dose I was taking was small enough to feel far less potent than the standard 1mg/day.

Cal, then my best assessment of why those hairs are still there is that your serum testosterone level is lower now than when you originally lost those hairs.

People don’t realize it but serum testosterone levels have a LOT to do with the rate of hair loss, and whether and for how long hair loss progresses at all after a certain age. After age 30, serum testosterone decreases on average 1% per year in men.

Most likely, you lost the majority of hairs on your scalp (i.e., the ones you did lose) when your serum testosterone level was highest, and since then it’s decreased. Even a modest decrease can push some people below the threshold necessary for further hair loss. A fraction above that level, and you’ll continue to lose hair. A fraction below that level, and your hair loss stabilizes and you lose no more hair.

Remember, the serum testosterone level DIRECTLY influences how much DHT can be created by the alpha-reductase enzyme. The more testosterone you have in your blood, all other things being equal, the more T will be converted into DHT. It is inborn cellular DHT-sensitivity, genetically programmed, that results in the MPB phenotype.

Probably what happened with you is that you dermabraded your scalp and it was just enough to promote some “new” hair growth (actually not de novo, but revived miniaturized follicles). Meanwhile, your serum testosterone levels were dipping just below the threshold needed to cause terminal hairs to miniaturize, so those hairs you grew back were able to remain.

But the fact is, dermabrasion and tissue wounding are not, and never will be, a magic bullet to cure hair loss. If you want a complete explanation from me, the next time I have about 2 free hours, I’ll write it up or try to explain here. Trust me. The very short answer is that “there are too many variables at play.”

Wounding CAN promote some hair growth, but its effects are extremely anecdotal and case-specific, and it is NOT a sure thing. In fact it does the EXACT SAME THINGS as many other treatments which are under study right now and don’t involve wounding at all (Histogen’s HSC and others like that are just one example of a much more varied array of examples.)

So the question then becomes, why even use wounding at all? And when you look at the downsides – tissue damage, follicle damage, etc. when done chronically – combined with the fact that you actually have to do it chronically for it to be part of anything you could rationally call a “cure” or “reliable treatment” – not to mention that tissue wounding alone is evidently far too weak of a stimulus to reliably regenerate terminal hair – all these things and more add up to the fact that it is effectively a dead-end “technology”.

Given that, when you assess the whole thing, wounding offers no “value added” to anything that’s already on the table or in advanced stages of research right now. I feel confident that Follica – even if they come out with something – and they probably will, just for business purposes, to satisfy investors who have sunk millions into their work – will never offer anything beyond what other companies will be able to do much better.

The anecdotal hair growth appearances from dermabrasion stuff is normally quoted as “de novo follicle formation”. Are the derms all wrong?

I would guess that most dermabrasion in clinical settings is not being done on men and not being done on MPB’d skin areas at all.

Besides, did one of the Gefitnib regrowth patients just “revive” a bunch of scalp hairs all over the tip of her nose?

I saw the original photo years ago and that is what it was. It was not some wispy thin little scattered vellus peach fuzz. It was thick dark terminal hairs. They were densely packed like an aggressive HT doc would do it. There was absolutely no chance of that being anything normal. If those hairs had previously existed at any time in the patient’s life then she sure as hell would have remembered it.

Most likely it can have two effects, one de novo growth on hairless skin, and another effect of reviving miniaturized follicles on scalp skin that had succumbed to non-scarring alopecia. I think it’s safe to say that most of the effect it has on people who dermabrade their scalps is in reviving miniaturized follicles.

The question is, are people going to agree to have regular dermabrasion just to get the very marginal benefit of reviving a few hairs?

If dermabrading is found to work much better in conjunction with some as yet unknown “magic” chemical, then to keep up the effect, you’d still have to get regular dermabrasion. Any effects of dermabrasion would be self-limited and transient. And that’s not even considering the long-term deleterious effect it would have on the tissues. Just because something can grow hair in the short term, doesn’t mean it also can’t be harming the follicles in the long term.

I see absolutely no reason why the de novo effect would not be occurring on skin with existing hairs. And given how difficult it has always been to revive androgen-damaged hairs in any serious way, I find the de novo idea much easier to believe.

Why?

It might very well be true. But there is no more reason to assume it than to assume the de novo effect isn’t there.

Follica found it pretty easy to use skin wounding to provoke “proto follicle structures” and they didn’t say the existing condition/history of the skin had any bearing on it.

And let me throw in something else here: The Gefitnib patient who grew a patch of new hair on his long-balded head, got new hair without visble graying. The rest of his existing hair was decidedly salt-n-pepper looking. It doesn’t necessarily prove anything but it’s interesting IMO.

I am not now, and never have been, arguing that dermabrasion alone is a viable MPB treatment. The principle appears to work but the cost/benefit ratio isn’t even in the ballpark.

The combination of wounding + pharamceutical assistance could be a game-changer. That has always been my primary argument. One of the most respected hair researchers in the industry has spent the last decade getting investor money & making discoveries on the same original premise.

I do complain that we’ve seen a lot of HM trials involving wounding (“skin perturbation” or “scalp stimulation” etc) and they brush that off as if it has no relevance to their successes. I think that’s deceptive and I think they know it.

Your conjecture says this is the case. Many years of anecdotal evidence suggests that it’s not.

On this I agree. Superficial wounding is not the ideal way to provoke regrowth. I only support it because it has a far better track record than anything else.

Lots of respected MPB treatments slow down the MPB process or reverse it very slightly for a few years. Skin wounding can produce fully thick pre-MPB-looking hairs. The hairs can last for years without even androgen-blocking maintenance. If we could harness the wounding effect in a usable way, it would be far more practical & effective than any other MPB treatment we have even attempted to do, let alone succeeded at doing.

What if I told you that many of the treatments currently under development – like Histogen’s HSC, and like virtually all the treatments using stem cells – are harnessing the very same “wounding effect”, but without wounding?

And that’s part of my point. The only thing wounding does is prompt the release of certain growth factors. But usually it does this in quantities too minute to trigger hair growth. So, as a treatment to grow hair, the results are highly unreliable.

HSC is nothing but a combination of the very same growth factors triggered by wounding – but it delivers them in a much more reliable way. When HSC is injected, you know exactly how much of these things are being put into the skin.

Activated stem cells are also associated with the release of the growth factors necessary for follicular activity and hair growth.

Please understand what I’m saying here. You’re focusing on wounding like it’s some kind of unique, mysterious solution to regrowing hair, as if it can produce effects that are possible no other way.

I’m saying that the underlying results of wounding are not mysterious at all – they are all known, and now we’re at the point where we can get the effects of wounding without actually doing the wounding – in fact, much more reliably.

Let’s have a contest.

You go get whatever growth factors you like. Inject them all over 1 square inch of your balding/receding hairline.

I will dermabrade 1 square inch of my hairline.

This will be a one-time treatment. No repeat treatments, no oral Finasteride, no topical Minox, nothing.

In 5 years, we will meet up, with before/after pics, and compare who has regained more/thicker terminal hairs on that square inch.

I don’t give a s**t how well the subject appears to have been explained by existing research. They are still not producing the same end result with growth factors as nature does from wounding. Nature’s end results are better than researchers’ end results. Therefore the topic is not adequately understood by researchers.

I’m interested in a practical, long-term solution, without drawbacks like having to regularly traumatize the skin.

Your proposition is a straw man, because it’s a one-time application. I’m not interested in comparing results of one-time applications of anything, because there’s too much of a chance of the results being skewed by paradoxical and anecdotal responses.

At this point, I’m interested in treatments that actually would form the basis of something like a viable cure, and which actually have a realistic chance of getting to market.

[quote]I’m interested in a practical, long-term solution, without drawbacks like having to regularly traumatize the skin.

Your proposition is a straw man, because it’s a one-time application. I’m not interested in comparing results of one-time applications of anything, because there’s too much of a chance of the results being skewed by paradoxical and anecdotal responses. [/quote]

I keep talking about potential gains from one-time wounding. You keep responding as if I’m advocating repeated woundings. Who is straw-manning here?

My point is valid and you know it. I’m sorry if the implications of this conflict with your preferred idea of what wounding is capable of.

Neither of us knows of anything practical and near the market. Not me, and not you either. I’m just pointing out that the wounding avenue has more practicality & supporting evidence than it gets credit for.