The Future of Hair Loss Treatments Will Involve a Lot More Robots

blue and white illustration of a futuristic looking person with locs blowing in the windNiege Borges

This story is a part of The Truth About Hair Loss, an exploration into why we lose our hair, the emotional and monetary costs that come along with the experience, and what the future of treatment (and acceptance) could look like.

Even before the pandemic hit, the hair restoration industry was booming (it's projected to reach over $12 billion in 2026). Add in the stress-included hair loss that we’ve seen during the COVID-19 pandemic, and suddenly all eyes are on the scalp.

It may be surprising that, in a market set to see significant growth in the next few years, we're arguably lacking in great solutions to the problem — particularly for women, who aren't always candidates for all the treatments currently available to men. In fact, of the two FDA-approved drugs on the hair rejuvenation market, minoxidil and finasteride (aka Rogaine and Propecia, respectively), only Rogaine is also approved for women. But with advances in technology and other innovations on the horizon, that all may change in the next few years.

Why is treating hair loss so hard? 

First, hair loss is notoriously persistent. Beyond that, it comes down in large part to the fact that it may happen for a variety of reasons (among them: thyroid and metabolism troubles and possibly air pollution) that may require different solutions. Temporary hair loss, caused by events like chemotherapy, stress, or post-pregnancy, may clear up on its own once circumstances change. But other types require intervention to see improvement: For example, the autoimmune disorder alopecia areata may be treated with immunotherapy or with injected and topical corticosteroids. For your average case of male or female pattern baldness (androgenic alopecia), there are a few options that have varying degrees of results and costs associated with them, and with some come the chance of unsexy side effects (see: finasteride's erectile dysfunction). And while researchers continue to study the underlying causes of hair loss, there hasn’t been a drug approved to combat it since 1997.

For people assigned female at birth, finding the right solution — or solutions — can be especially hard. "In general, male hair loss is mainly caused by the hormone DHT (dihydrotestosterone) which causes hair to progressively thin (miniaturize) over each successive growth cycle," says Christine M. Shaver, a board-certified dermatologist at Bernstein Medical Center for Hair Restoration in New York. "Thus, the main treatment for male hair loss is through simply blocking the formation of DHT." While DHT is also a factor for women, Shaver says that in this group overall "hair loss is more complex [so it] can prove quite difficult to treat." Simply blocking the hormone often isn't enough — plus, the main way of doing it, finasteride, hasn't been approved for women. Not that it doesn't work — studies show it can — but there are enough potential safety concerns for women who are pregnant (or may become pregnant), breast-feeding, or have a family history of breast cancer that the FDA considers it a no-go.

Then there's the fact that women aren't often great candidates for scalp hair transplants. Shaver explains that the way that hair loss typically occurs in women is to blame, as it's commonly diffused all over the scalp rather than concentrated in one bald patch. "This poses an issue with hair transplant because the donor hair in hair transplant at the back and sides of the scalp must be stable and not thinning," she says. If it isn’t, it will continue to thin once implanted.

The Current Hair Loss Treatment Landscape

Before we get into what's on the horizon, here's a quick rundown of the major options available now: First, there is surgical hair transplant, which may or may not be done with robotic assistance, and, again, isn't always an option for women. Another in-office offering is platelet-rich plasma (PRP) scalp injections, in which platelets are separated out from a patient's own blood, and then injected back into the scalp, which offers moderate results in some people.

Looking beyond minoxidil (which has been proven to be somewhat beneficial for both men and women), topically you have serums and the like, which mostly get not-so-great reviews from the experts we spoke with, though there are some exceptions. For instance, Samuel M. Lam, MD, facial plastic and hair restoration surgeon in Plano, TX, and the administrative chair of the multimedia committee for the American Academy of Facial Plastic and Reconstructive Surgery — reported success with redensyl, a topical he's found so effective, he formulated his own serum for brows and lashes with it called Folliflo.

In addition to finasteride in the oral category, you have supplements, some of which, like Nutrafol, get namechecked by from experts as beneficial for some. However, Shaver points out, "There is little scientific support behind the ability of vitamins and supplements to promote hair growth unless the patient has a nutritional deficiency that needs to be corrected."

​​Another option is low-level laser (aka cold laser) therapy devices, caps, or wands, which "aim to stimulate the hair follicle and cause hair growth," says Shaver. In theory, they may provide some help, but "practically speaking, they often do not provide much improvement when patients try these devices." Furthermore, many of the devices on the market don't have the correct wavelength or strength to get results, adds Lam.

And a note about hair pieces: There have been many advances in toupees and lace-front hairpieces and wigs that make hiding hair loss easier — and pretty much undetectable. But none of the hairstylists we spoke with offered them up as a long-term solution for someone dealing with permanent hair loss. When it comes to hair, people really want it to be home-grown. 

The Rise of the Clones (and Robots)

Looking to the future, bioengineered hair — or hair cloning, as it's more commonly referred to — was by far the top innovation named by the experts we spoke with as the one to watch. And it's been a long-time coming. Says Yael Halaas, a board-certified facial plastic surgeon, "Every 10 years I tell my patients we are closer to cloning and growing hair in a laboratory. And every 10 years we are getting closer." Sara Wasserbauer, a board-certified hair restoration surgeon of California Hair Surgeons with locations in San Jose, San Francisco, Walnut Creek, and Napa, explains the cloning can happen two ways, either by replicating hairs in a lab or by cloning the cells that make the hair. Cloning is the hair rejuvenation industry's big hope because, Lam explains, "Once we have unlimited donor supply, we can easily rebuild a [patient's hair]." And that includes anyone with overall hair thinning, rather than a single bald patch.

As of now, "we have studies that show hair regeneration from stem cells in mice, but so far no clinical studies to support efficacy in humans," says board-certified plastic and hair surgeon Gary Linkov of City Facial Plastics in New York City. But a team of scientists in Japan, led by Takashi Tsuji, is currently awaiting the start of a clinical trial to test cultured hair follicles in humans, so all eyes will be on the results.

Linkov, who currently prefers to do hair implantation by hand or via motorized equipment, predicts that when we have cloning, we'll also have better robots to help with the transplants. He says, "I envision a time when the surgeon can harvest a few hairs from a person, send it to a company for expansion into thousands of grafts and then plug those grafts into a machine that would perform the transplant."

Exosome Hair Therapy

The second-most name-checked therapy on the horizon is the use of exosomes, which use the same mRNA technology seen in the Pfizer and Moderna COVID-19 vaccines. Explains Wasserbauer, "Exosomes contain mRNA, which is the same type of 'messenger RNA' that COVID-19 vaccines are using to tell cells what to do to recognize the virus. Messenger RNA can tell a cell to do many different things like grow, shrink, or produce a certain protein." Halaas (who co-authored a paper reviewing its therapeutic potential) calls it "by far the most exciting treatment in recent years."

Exosomes are administered via injection, so it's a low-pain option, and patients will likely require maintenance injections once or twice a year. But many are hopeful it could be a good solution. Wasserbauer says, "Everyone in the hair medicine community is anxious to see results of the scientific trials."

New (and Potentially Better) Topicals

There are two innovations getting buzz on the cusp of finishing clinical trials overseas. First, there's a drug called FOL-005 that's being developed for men by the biotech company Follicum. It features osteopontin, a protein in hair which may stimulate or inhibit hair growth, depending on the derivative (Follicum claims to have isolated a stimulating one). It has been studied in injections and is now being looked at in topical form. Linkov calls it "promising for now, but time will tell its safety and effectiveness in humans as their clinical trials proceed."

Another topical with growing buzz, thanks to its ability in trials to antagonize DHT without serious adverse effects, is Breezula, an anti-androgen made by the pharmaceutical company Cassiopea. Explains Halaas, "Because it works on DHT locally, we are hoping we will see good results without the side effects of Propecia." So far its trials have been done on men but the company is currently studying its use for women.

Better Low-Level Light Therapy

While this therapy is currently not considered a go-to treatment — in fact, Shaver predicted a slow turn away from laser therapy, calling it "underwhelming" for most patients — some of the experts we spoke with see the potential for big advances in this area.

The thinking here is that as devices (used both at-home and in-offices) get better and deliver the type of light that provides results, the before/afters will become more dramatic. Wasserbauer’s take: "Low-level light therapy has been dosed improperly for decades." The idea that the optimal number of photons of the right wavelength, direction, strength, as well as the correct time on the head will be found — and can be delivered at home — is exciting because "it's drug-free and boosts the efficacy of other hair loss treatments, even exosomes presumably," she says. 

The Bottom Line

Cloning, robots, mRNA technology, and suped-up laser caps — they all show promise. In reality, whatever technologies may come, patients will likely mix and match them to find their perfect regime. That means hair rejuvenation may end up looking like something out of a sci-fi movie. Can't say we didn't see that coming.

Why Millennials Can’t Stop Watching Teen Rom-Coms






Source: Netflix

Today’s millennials range in age from 25 to 40, meaning the youngest of us are settled into our adult lives and the oldest of us have been settled for a bit. But no matter how far removed we are from our teenage years, we all have one thing in common: We can’t stop watching teen rom-coms.

We happily spend Friday nights on the couch when new seasons of our favorite shows are released, like quarantine-favorite Never Have I Ever. Netflix’s top 10 has been dominated by the Twilight series since the movies returned to the streaming service in July. And we can’t help but get excited when the latest YA book adaptation is announced. So what is it about these shows and films that keep us pressing play?

There’s the romance, of course, but if all we wanted was romance, we’d be just as happy watching romances starring people of any age. There’s something different about teen rom-coms—and it’s about being a teenager. Let’s break it down:

 

Teens Are More Excited By Love Than They Are Jaded by Tinder

There’s a reason why most of the leads of teen rom-coms have never been in a relationship before, or if they have been, all of their previous relationships weren’t serious—but this one is the real deal. And that’s because there’s nothing quite like your first love: when the mere act of having romantic feelings for someone is novel, when holding hands sends butterflies through your stomach, or when your foot pops up during that long-awaited first kiss, like in that unforgettable scene in The Princess Diaries.

Everything about your first love is amplified by that very word: first. So as we argue over what to make for dinner for the 536th day in a row or go on yet another date that leaves us with nothing but disappointment, we love returning to those feelings of our first love.

 

Anne Hathaway Princess Diaries GIFfrom Anne Hathaway GIFs

 

 

Mistakes? Teens Can Make Them

What reaction did you have when our favorite Indian-American heroine of Never Have I Ever made the decision to date not one but two boys at the same time? Some of you likely cringed. But if you reacted the way I did, you were jealous. Here was a girl who genuinely liked two boys and didn’t know which one she wanted to be with. If I was in this situation, could I date both of them? No, I’m married!

Teens are able to act with fewer consequences than adults. We can watch Devi date both Ben and Paxton knowing that there will definitely be some bumps on the road but that the car won’t careen off a cliff. Will dating two people work out? Probably not. But will it end in divorce? Not possible.

 

Romance Is Great, But It Sure Isn’t Everything

It’s required that the star of a teen rom-com is looking for love, but she is always also looking for so much more than that. In To All the Boys I’ve Loved Before, Lara Jean Song-Covey needs to learn what family looks like after her older sister, Margot, leaves for college. In the old favorite She’s the Man, Viola Johnson must hide the fact that she’s posing as her twin brother in order to play her favorite sport. The Kissing Booth kicks off when Elle Evans needs to raise money for a school fundraiser.

Each of these characters wants—or at least wouldn’t mind—a romantic partner, but what they are really after is figuring out their place in the world. As friends and jobs come in and out of our lives, we millennials are realizing that we are very much still figuring life out, too.

 

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Doubt? Teens Don’t Know Her

Like millennials, teens can take time to make decisions. But unlike millennials, once teens make decisions, they live with them. After Lara Jean signs a contract with Peter K., we get a swoon-worthy scene of Peter swinging Lara Jean around with his hand in her back pocket, handing her a note, and whispering in her ear. Lara Jean is only pretending to date Peter, but she still goes all in.

It’s extremely comforting to watch this because I doubt myself before, during, and after every decision I make, from which loungewear I throw on in the morning to what I said in that meeting last week to where I moved to three years ago.

 

Let’s Face It: Teen Leads Are Hot

No offense to my husband, but he is balding at 30, and the male leads of teen rom-coms, well, aren’t. I’m sure I wasn’t the only one getting major Taylor-Lautner-in-New-Moon vibes every time Darren Barnet—who also happens to be 30—was shirtless as Paxton Hall-Yoshida in Never Have I Ever. There is no reason to feel guilty for swooning over John B. from Outer Banks because he’s played by 28-year-old Chase Stokes. In fact, the actors in adult rom-coms are much further away from the age of the average millennial than that (looking at you, 71-year-old Richard Gere). But if you do prefer an older man, let me remind you that teens have parents, and John B.’s girlfriend’s dad, played by 55-year-old Charles Eston, still has a nice head of hair.

 

Hair Flip Chase Stokes GIFfrom Hair Flip GIFs

 

 

Final Thoughts

Millennials may be past the times of dancing around our rooms after a first date. But that doesn’t mean we can’t return to those feelings of butterflies in our stomachs by turning on the latest teen rom-com. Chances are, you’ve already seen To All the Boys I’ve Loved Before multiple times (I know I have), so here are five lesser-known teen rom-coms to fall just as hard for:

  • The Half of It: This heartwarming Netflix original movie stars Leah Lewis as Ellie, a smart teen who agrees to write a love letter for a jock at her school. Unexpectedly, Ellie ends up falling for his crush.
  • Work It: Yet another Netflix original, Work It stars Sabrina Carpenter and Liza Koshy. In this movie, Carpenter’s character attempts to transform a band of misfits at her high school into dance champions. 
  • Yes, God, Yes: Stranger Things’ Natalia Dyer shines in the leading role of this comedy, in which a Catholic girl finds herself pulled in by unexpected temptations after an AOL chat turns racy. Yes, God, Yes can be found on Netflix.
  • The Perfect Date: If To All The Boys leaves you yearning for more Noah Centineo, look no further than The Perfect Date. In this Netflix original, a high school senior sets up an app offering to be a fake date and is surprised when real feelings emerge.
  • The First Time: Dylan O’Brien stars in this hilarious rom-com about an awkward teen who is hopelessly in love with the hottest girl in school even though she only sees him as a friend. The First Time is available on Amazon Prime Video and STARZ.

 

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Understanding The Texas Abortion Law






Source: Shutterstock

On Sept. 1, the most restrictive abortion law in the United States, took effect in Texas. Senate Bill 8 (SB 8), known as the “fetal heartbeat bill,” makes abortion procedures illegal in the state of Texas after the first detection of fetal cardiac activity, unless there is a medical emergency. SB 8 impacts at least 85 percent of abortions that occur in Texas, basically wiping out abortion access in the state altogether.

The bill underwent a lengthy battle in federal court, where it currently remains. The Supreme Court could have temporarily paused enforcement of the law but decided against that in a published opinion that was released late on Sept. 1. With numerous state laws introducing new abortion restrictions and the Supreme Court set to hear a separate abortion case later this year, abortion rights will continue to be a major topic in the coming months. 

 

Some context: Abortions have been performed in the U.S. for hundreds of years

Abortions have been performed in the United States since colonial times, and until the latter end of the 19th century, it was legal up to the fourth month of pregnancy. In 1821, Connecticut became the first state to pass restrictions on abortions, spurring a sweeping anti-abortion movement by physicians who wanted to shift reproductive health care away from midwives and homeopathic medicine. By 1900, all 45 states at the time had passed abortion laws, and access to safe abortions was significantly limited.

In the 1960s, restrictions on abortion access became a point of contention after 28-year-old Geraldine Santoro was found dead in a Connecticut motel room after trying to terminate a pregnancy on her own. Because of limiting state laws, unsafe abortions were prevalent, and feminists in the second-wave feminism movement saw access to abortions and contraceptives as key civil rights and health care issues.

 

Roe v. Wade made abortion access a legal right

As advocacy for abortion access intensified, the United States Supreme Court took a bold stance in 1973 by making abortion legal in the entire country. In Roe v. Wade, the Court held that the right to choose is a privacy right protected under the 14th amendment of the U.S. Constitution. The decision provides a breakdown of abortion access depending on the stage of pregnancy. In the first trimester, abortion access is unrestricted. In the second trimester, states can regulate the point at which abortion occurs, but abortions cannot be denied to patients. In the third trimester, the Court determined that states may restrict abortion access once the fetus reaches viability, which is when a fetus can survive outside of the uterus .

Because of Roe v. Wade, abortion access is a legal right and can only be restricted by states after pregnancy has gone beyond the second trimester—that is, unless you live in Texas.

 

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SB 8 is more than a pro-life vs. pro-choice issue

Governor Greg Abbott and the Texas state legislature passed SB 8 in May 2021, sending shockwaves through the women’s rights community. Limitations on abortion access aren’t uncommon in the U.S.—43 states restrict abortion access after a certain point in the pregnancy unless the pregnant person’s life is in danger, compared to seven states that allow abortion access at any point in the pregnancy. The point of contention wasn’t that an abortion bill was passed; abortion access advocates took particular issue with the provisions of SB 8.

 

It focuses on when a heartbeat is detected

An ongoing debate between pro-life and pro-choice advocates is gestational development of an embryo. Recently introduced abortion laws, including SB 8, prohibit abortions after six weeks of pregnancy—when it is believed that a fetal heartbeat can be detected. Medical professionals in gynecology and obstetrics have refuted this claim. Dr. Ted Anderson, president of the American College of Obstetricians and Gynecologists, said that “pregnancy and fetal development are a continuum.” At six weeks’ gestation, the heart is completely unformed. Tissues that eventually form the heart are present, and those tissues can pulse. However, pulsating activity detected by an ultrasound that early into pregnancy is not considered a heartbeat by women’s health professionals. 

While the bill’s proponents focus on heartbeat detection, those opposing SB 8 also argue that the six-week ban removes patients’ abilities to make informed medical decisions. Pregnancy isn’t usually detectable until four weeks after a missed period. Many childbearing people don’t even know that they’re pregnant at six weeks, eliminating the possibility of abortion before there’s awareness of pregnancy.

 

It allows people who do get abortions to be sued 

Aside from the conflicting viewpoints on heartbeat detection, another significant issue is the bill’s allowance for private citizens to sue people who receive abortions, people who help others receive abortions, and abortion service providers. If someone takes an Uber ride to an abortion appointment in Texas, SB 8 allows anyone with knowledge about that person’s abortion—whether they personally know each other or not—to sue the person receiving the abortion, the doctor who performs the abortion, as well as the Uber driver. If the person suing wins the case, they could be awarded up to $10,000 plus attorneys’ fees. The only exception is that a person who impregnates someone else through incest, rape, or sexual assault cannot sue if the pregnant person receives an abortion. However, the abortion would still be considered illegal, and others in the state of Texas could sue the patient.

Many critics see the private right of action as an unprecedented “vigilante” system. The text of the bill doesn’t necessarily outlaw abortion clincs or providers outright, but it creates an enforcement structure that essentially blocks abortion access with the threat of private, costly consequences. Abortion providers in Texas claimed to be bombarded with patients trying to receive services in the days leading up to Sept. 1, and many clinics’ websites indicate that they will be closed after Sept. 1. 

Some Planned Parenthood locations in Texas will remain open, as the organization provides various services outside of abortions, but the outlook for those locations is grim.

 

It restricts access to safe abortions

A pregnant person in Texas can only receive an abortion if a medical provider says that there is a medical emergency that necessitates the procedure. The bill doesn’t include a definition or examples of what constitutes a medical emergency, leaving that determination to the discretion of individual medical providers in Texas. This means that people electing to have abortions for non-medical emergencies will have to travel to other states in order to receive abortions by medical professionals. For people with the funds and access to do this, SB 8 is an inconvenient obstacle but not a complete barrier. Conversely, people who cannot afford to leave the state, those who live in rural areas, or those whose cases aren’t deemed emergent will not have the option at all. 

This restriction opens the door for grave health consequences, as people tend to resort to their own pregnancy termination methods, like Geraldine Santoro did. In addition to risk of death, self-induced pregnancy termination can lead to hemorrhaging, severe infection, damage to internal organs, and perforation of the uterus that could require emergency hysterectomy. Historically and statistically, people of color experience these negative consequences most. 

The Guttmacher Institute, the leading research organization on reproductive health, found a link between restrictive abortion laws and increased instances of unsafe abortions. Between 2014 and 2017, the Institute reported increasing rates of hospital facilities treating patients who tried ending pregnancies on their own. Restricting access to safe abortions does not decrease instances of abortions. Rather, it forces pregnant people to seek expensive, potentially life-threatening alternatives.

 

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What else does SB 8 do?

With the passing of SB 8, childbearing people in the state of Texas cannot receive an abortion once an ultrasound detects cardiac activity, unless there is a medical emergency. Although SB 8 only applies to residents of Texas, the bill could have the effect of restricting abortion access across the country. The Supreme Court’s decision in Roe v. Wade—abortion before fetal viability is legal in the U.S.—is common law. Put simply, common law is law that’s determined by court opinion and ruled on by a judicial body. This is separate from statutory law, which is law that is presented as a bill, then voted on and passed by legislators (think “I’m Just a Bill” from School House Rock).

The law-making structure in the U.S. allows greater enforcement of statutory law over common law. Here, SB 8 (statutory law) nullifies the enforcement of Roe v. Wade (common law) in Texas, setting the stage for other states to soon follow suit. Many state abortion laws are already poised to change this year, but SB 8 could be the push other states need to further limit abortion access. Typically, once a bill successfully passes in one state, it clears the path for other state legislatures to take a similar course. 

 

What about abortion access outside of Texas?

Roe v. Wade is still the law of the land, except if you live in Texas, and is generally used as the framework for state-specific abortion laws. You can check current abortion access in your state using this Planned Parenthood tool.

At the national level, the Supreme Court still has a say in whether or not abortion access will continue being legal across the United States. When the Court returns from summer recess, it will hear Dobbs v. Jackson Women’s Health Organization, a case challenging a Mississippi law that outlaws abortion after 15 weeks’ pregnancy and directly calls for the overturn of Roe v. Wade. A decision on that case is expected in early 2022. With five conservative and four liberal justices ruling and pro-life ideology being traditionally conservative, abortion access is expected to take major hits. If the Court rules to end or severely limit Roe v. Wade, 10 states have “trigger laws” in place that would automatically make abortion illegal in those states.

 

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What happens next?

SB 8 is being argued in federal court under Whole Woman’s Health v. Jackson. The Supreme Court’s refusal to block enforcement of the law earlier this week suggests that the justices will take a conservative stance on abortion access. Local organizations like Avow Texas and national organizations like the American Civil Liberties Union (ACLU) have taken up the issue and continue to fight for legislative and social changes. 

Rep. Judy Chu (D-Calif.) and Sen. Richard Blumenthal (D-CT) introduced federal legislation, the Women’s Health Protection Act, that would make Roe statutory law. Remember, statutory law takes precedence over common law. House Speaker Nancy Pelosi announced that the U.S. House of Representatives will vote on the act when they return to session later this month. If it passes the House, the act will move to the Senate for vote. If it is passed in the Senate, it will go to President Biden’s desk for official signature and enactment.

It is expected that Republicans in the Senate will delay the vote in order to prevent the Women’s Health Protection Act from passing, so there is still a long road ahead. In the meantime, individuals can donate to Avow Texas, the ACLU, and Planned Parenthood to assist these organizations with research, medical care, and advocacy funding.

 

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