24-27 April 2019 : Sitges, Barcelona, Spain

11th World Congress for Hair Research

These highlights were written by Dr Sergio Vañó-Galván during the congress

Highlights #WCHR2019 April 24th 2019

Dr. Ramon Grimalt, Dr. Juan Ferrando, Dr. Francisco Camacho and Dr. Sergio Vañó-Galván inaugurate the 11th World Congress for Hair Research with more than 900 registrations from 70 countries!!

In order to act in the best interest of the patient, the hair surgeon should master both techniques (FUE and strip techniques) and recommend the most suitable method based on individual criteria (Dr. Andreas Finner, hair transplant session)

  • In scarring alopecias the vascular supply is limited, so lesser graft density of 25-30 FU/cm2 is recommended. Inactive stage should be confirmed by dermoscopy or histopathology. (Dr. Ratchathorn Panchaprateep, hair transplant session) 
  • Hair transplant in frontal fibrosing alopecia: a multicenter study of 51 patients showed that the survival of the grafts decreased over time (approx 40% after 5 years of follow-up) despite maintaining the adequate medial therapy (Dr. Sergio Vañó-Galván, hair transplant session).

  • The substantial changes in scars observed after hair transplantation demonstrate the beneficial role of follicles in scar remodelling. (M. Plotczyk, hair transplant session)
  • Alopecia areata: Today, AA research is active in genetics, the microbiome, dietary modulators, the role of atopy and allergens, immune cell types in AA pathogenesis, primary antigenic target(s), mechanisms by which immune cells influence the hair follicles, and of course new treatment development based on these discoveries. (Dr. Kevin McElwee, alopecia areata research session) 
  • Alopecia areata: new evidence suggests that CD8+ T cells are not the only drivers of disease. Instead, subsets of NK and so-called “unconventional” T-cells (iNKT cells, T-cells, classic NK cells, ILC1), all of which can produce large amounts of IFN-γ, may also drive AA pathobiology independent of classical, autoantigen-dependent CD8+ T cell functions. Another important new frontier is the role of regulatory lymphocyte subsets such as Tregs, γδTregs, NKT10, as well as perifollicular mast cells in maintaining the physiological HF immune privilege. (Dr. Amos Gilhar, alopecia areata research session) 
  • Two major trigger factors that can induce the collapse of the hair follicle immune privilege have been identified: interferon- gamma (secreted e.g. by perifollicular NKG2D+ cells like CD8+ T cells, NK cells and gamma/delta T cells) and substance P, most likely secreted by perifollicular sensory nerve fibres under conditions of perceived stress/neurogenic skin inflammation. (Dr. Ralf Paus, alopecia areata research session)
  • “We are now working to identify upstream triggers of alopecia areata, specifically, environmental factors such as the microbiome”. (Dr. Angela Christiano, alopecia areata research session)
  • Alopecia areata: “In our patient population, of the 20 patients treated with oral tofacitinib, 47% experienced regrowth of hair by 12 months. However, the extent of regrowth varied greatly, ranging from only 5% to nearly complete regrowth. (Dr. Wilma Bergfeld, alopecia areata clinical session) *PICTURE 2
  • Alopecia areata: Treatment against specific allergens (allergen desensitization treatment), concomitant with standard corticosteroid treatments, may benefit atopic AA patients in the long term. (Dr. Zixun Zeng, alopecia areata clinical session)
  • Alopecia areata: The combination of tofacitinib and oral minoxidil therapy leads to substantial hair growth in patients with severe AA. (Dr. B. King, alopecia areata clinical session)
  • Neogenesis and tissue engineering: “We have conducted clinical research studies in Japan on autologous cell-based therapy both for 66 male and female patients with Androgenic Alopecia using Dermal sheath cup cells. This type of cell therapy is characterized by acting on existing miniaturized hair follicles with a safe and organized procedure. The study is currently ongoing in two medical institutions and no serious adverse effect has been reported. (Dr. J. Kishimoto, tissue engineering session)

Highlights #WCHR2019 April 25th 2019

  • Central centrifugal cicatricial alopecias: The recent findings of mutations in peptidylargi- nine deiminase 3 (PADI3) an enzyme that post- translationally modifies other proteins essential to hair shaft formation has been associated with CCCA (Dr. Ncoza Dlova, cicatricial alopecias session)
  • In permanent chemotherapy-induced alopecia (pCIA), promoting PPAR-g signaling may provide an effective CIA-management strategy, and advocate the use of PPAR-g modulators, such as NACGED, as possible therapy for preventing permanent hair loss in chemotherapy-treated cancer patients. (Dr. I. Piccini, cicatricial alopecias session)
  • The depletion of macrophages using genetic and pharmacological approaches induces hair growth by removing the source of the IL-6 family cytokine Oncostatin M, opening the possibility of treating human hair disorders characterized by arrested telogen follicles by targeting a cell type outside the hair follicle itself. (Dr. Etienne C. E. Wang, auxiliary cells session)
  • Our results uncover a novel function of arrector pili muscle in bridging the body’s sympathetic modulations to influence hair follicle stem cell activity. (Dr. M. Gonzalez Celeiro, auxiliary cells session)
  • The Alopecia Density and Extent Score (ALODEX) is a new visual aid for assessing hair loss in alopecia areata that can track absolute hair loss and small changes in density that may otherwise go undetected with the SALT score. (Dr. Elise Olsen, alopecia areata clinical session)
  • The expression levels of FGF7, IGF1 and WNT5a in plucked anagen hairs from male patients with androgenic alopecia were reversed by 5AR inhibitors under testosterone stimulation. (Dr. T. Hatanaka, androgenic alopecia research session)
  • Aromatase mRNA levels were significantly lower in women with female pattern hair loss (FPHL) than in controls, suggesting a reduction in estrogen levels and an increase in the androgen/ oestrogen ratio in hair (Dr. Ulrike Blume-Peytavi, FPHL session)
  • Oral 1mg minoxidil was safe and well tolerated in the treatment of FPHL. Its efficacy did not differ from topical 5% minoxidil solution. It can be an option for patients with poor compliance to topical therapy. (Dr. P. Ramos, androgenic alopecia clinical session)
  • Retinoic acid enhances minoxidil response in androgenetic alopecia patients by upregulating follicular sulfotransferase enzymes (Dr. A. Sharma, androgenic alopecia clinical session)
  • WNT10A is as a critical ligand controlling adult epithelial proliferation and suggest downstream β-catenin pathway activation as a possible approach to ameliorate hair growth defects in patients with WNT10A variant isoforms or mutations. (Dr. Sarah E. Millar, stem cells session)
  • PPARg modulators and therapeutic restoration of the bulge immune privilege are particularly promising approaches in future scarring alopecia management. (Dr. Ralf Paus, stem cells session)
  • Trichoscopy definitely improves the quality of care of patients with alopecia and reduce the necessity of taking scalp biopsies. (Dr. Antonella Tosti, trichoscopy session)
  • Trichoscopy may be of major significance in examining treatment efficacy, it has the potential of serving as a prognostic tool for hair regrowth, and it should become a sine qua non tool for clinical trials in hair diseases, and maybe for validation of cosmetic products, which are designed to improve hair regrowth. (Dr. Lidia Rudnicka, trichoscopy session)
  • We designed and validated a trichoscopic activity scale for folliculitis decalvans that can be used in clinical practice and future research. The presence of perifollicular pustules, extens perifollicular erythema, yellow tubular scaling, yellow crusts and yellow interfollicular scales were associated with disease activity. (Dr. David Saceda, trichoscopy session)
  • STX17 plays a role in melanogenesis and that disruption of this pathway may increase immune activation, serving as a catalyst for alopecia areata autoimmune attack on the hair follicle in genetically susceptible individuals. (Dr. S. O Erjavec, hair graying pigmentation session)
  • “After the evaluation of 100 female patients with telogen effluvium, we could observe three specific clinical patterns: half moon, triangle and band.” (Dr. Daniela Guzmán, telogen effluvium session)

Keynote Lecture – Dr. Jerry Shapiro It was a pleasure to listen Dr. Jerry Shapiro talking about his experience about how to successfully run a hair clinic. We can summarize his advice in the three “A” ability, affability and availability. Congratulations Dr. Shapiro!!

Highlights #WCHR2019 APRIL 26th 2019 Pediatric trichology

  • The diagnosis of hair dysplasia requires the correlation between clinical (alopecic pattern), trichoscopic and microscopy investigation of hair shafts. X-ray microanalysis, hair aminoacid chromatography and gene testing can also be used. Topical minoxidil 1-3% can be useful for hair dysplasias. (Dr. Juan Ferrando)
  • Sabinas Syndrome is an AR congenital syndrome characterized by mental retardation, nail dysplasia and brittle hair (decreased cystine content). (Dr. Julio Cesar Salas-Alanis)
  • Recent research has shown that antiJAK treatment could be useful for children affected by alopecia areata. (Dr. Yuval Ramot,) Dermal papilla
  • Wnt signaling pathway is involved in the timing of dermal condensates morphogenesis. (Dr. Michael Rendl)
  • Tissue non-specific alkaline phosphatase plays a critical role in the hair-inductive capacity of human dermal papillae spheres by regulating Wnt/β-catenin signaling. (Dr. Yeung Kwan Sung,)
  • Dermal papilla cells could be reprogramed in adult humans to induce the growth of new hair follicles. (Dr. Nikolaos Pantelireis, Dr. Carlos Clavel, Dr. Claire Higgins)
  • SFRP1 (a Wnt inhibitor) may be used as a treatment of hair disorders in the future. (Dr. Ralf Paus). Mechanical (Physical) therapy for hair diseases
  • Skin patting is a new painless physical therapy for hair disorders. (Dr. Staracce)
  • Main uses of platelet rich plasma (PRP) in trichology is androgenetic alopecia, telogen effluvium and alopecia areata. (Dr. Rubina Alves).
  • Microneedling along with minoxidil treatment seems more effective than only minoxidil for treatment of male androgenetic alopecia (Dr. Rachita Dhurat).
  • Low-level laser therapy (LLLT) seems to be a useful treatment for androgenetic alopecia. Further studies are needed to elucidate best wavelength. (Dr. Joaquin J. Jimenez)
  • Low- level laser therapy, Platelet-Rich Plasma, microneedling, mesotherapy with finasteride or dutasteride and injection of pluripotential cells are various methods to improve hair density after hair transplant but their efficacy and security remain unvalidated. (Dr. Rui Oliveira-Soares). Genotrichosis
  • Congenital hypotrichosis require a systematic approach for a correct diagnosis and clinical and genomic correlation. (Dr. Arti Nanda).
  • Studying keratin diseases help us understand better keratins’ physiology. (Dr. Yuval Ramot).
  • Trichoscopy helps to identify common genotrichoses in order to better select patients susceptible of genetic testing. (Dr. Lidia Rudnicka)
  • Mutation in LSS (lanosterol synthase) is associated to AR hypotrichosis simplex. This finding links cholesterol metabolism and hair disorders. (Dr. Maria-Teresa Romano). Frontal Fibrosing Alopecia
  • Frontal fibrosing alopecia (FFA) is a genetically predisposed immuno-inflammatory disorder in which transcriptomic analysis has shown overrepresentation of transcripts encoding components of innate and adaptive immune response pathways. (Dr. Christos Tziotzios).
  • Three studies have linked FFA with sunscreens use worldwide (UK (Aldoori et al.), Australia (Sinclair et al.) and Spain (Moreno-Arrones et al.). (Dr. Rod Sinclair)
  • FFA is the most frequent cicatricial alopecia. It can present in three patterns (linear, diffuse and pseudo-fringe) but also has unusual presentations. Prognosis is based in age, age of onset, clinical presentation, BMI and education level. (Dr. Sergio VañóGalván).
  • The FFASI and FFASS scales can help graduate FFA severity. (Dr. Adriana Rakowska)
  • New treatments of FFA are retinoids, JAKinhibitors, LLLT and naltrexone.(Dr. Rodrigo Pirmez) Hair follicle aging
  • Hair aging should be approached holistically. (Ralph Trueb).
  • Integral hair lipid (IHL) which cement and connect various layers within hair cuticle and hair cortex is crucial element to keep structural integrity of hair fiber. (Dr. WonSoo Lee).
  • Hemidesmosomes senescence is linked to hair follicle aging. (Dr. Emi K. Nishimura) Psychological aspects of hair disease
  • Anxiety due to hair loss is perceived differently between females and males. (Dr. Michela Starace,)
  • Psychological problems due to hair disorders improve after alopecia treatment. (Dr. Ramon Grimalt,).
  • Trichoscopy and adequate referral of these patients is key to the management of these disorders. (Dr. André Lencastre,) Prostaglandins and hair follicle regulation
  • The outer root sheath of the follicle may play a pivotal role in the regulation of the hair follicle. (Dr. Talveen S. Purba,).
  • Bimatoprost increase hair growth of intermediate hair follicles and could be a potential therapy in the future. (Dr. Miranda BH))
  • John Ebling Lecture (Sexual hormones and hair follicles) (Valerie Randall)
  • John Ebling Lecture (Sexual hormones and hair follicles) (Valerie Randall)