Caring About Baldness

The superficial aspects of regenerative medicine and attempts to revert portions of the aging process attract far more attention than the meaningful aspects. People seem much more interested in evading baldness and making skin look good than in restoring youthful function to the inner organs whose failure will kill them. You can live with baldness, and not with a age-damaged heart, but you wouldn't know that if going just by the level of discussion devoted to these topics. This is far from the only area of life in which observed priorities fail to match up to the best course for personal self-interest, of course.

The ultimate victory, when it comes to the long-fought battle against baldness, would be to find a way to trick the body into creating brand-new hair follicles. Researchers first raised the possibility in the 1950s, when they observed new hair follicles forming during wound healing in rabbits and mice, but the work was later discredited. Then, in 2007, George Cotsarelis, a dermatologist at the University of Pennsylvania's Perelman School of Medicine, spotted hairs growing in the middle of small cuts they'd made in the skin of adult mice. "We figured out they were de novo hair follicles formed in a process that looked a lot like embryogenesis," says Cotsarelis.

It turns out that the wound-healing process causes skin cells to dedifferentiate, providing a limited time window during which those cells can be persuaded to form new hair follicles. Even more intriguingly, the researchers also found that inhibiting Wnt signaling during this window reduced follicle neogenesis, while overexpressing Wnt molecules in the skin increased the number of new follicles. In 2006, Cotsarelis, Zohar, Steinberg, Olle, and several other scientists cofounded a company called Follica to develop new combination therapies to induce follicle neogenesis. Although Follica has released few details on their proprietary procedure, the general idea is clear: their patented minimally invasive "skin perturbation" device removes the top layers of skin, causing the underlying skin cells to revert to a stem-like state, after which a molecule is applied topically to direct the formation of new hair follicles.

Indeed, Follica has already done preclinical and clinical trials, says Olle, "all of which confirm that we can consistently create new hair follicles in mice and in humans. As far as I know, no other approach has been able to achieve that." News of the progress has attracted strong interest from the public, with comments piling up below online articles about Follica and serving as de facto message boards for the science-savvy bald community to exchange expressions of hope and skepticism - and to speculate about when the "cure" might hit the market. Earlier this year, Cotsarelis's group sparked another comment frenzy by demonstrating that a protein called fibroblast growth factor 9 (Fgf9), which is secreted by gamma delta (γδ) T cells in the dermis, plays a key role in the formation of new follicles during wound healing in adult mice.



The reason, I think, it's that people tend to discount the future. By the time death is imminent, it's too late to do anything about it. There's little to gain from supporting research to cure aging in thirty years if you only have three. Also, death from aging
targets the old and infirm, who don't have the energy to wage war on aging.

Baldness foolishly attacks the relatively young and healthy, who have both the energy to fight and decades left in which to benefit from a cure.

Posted by: Brandon Berg at September 6th, 2013 7:54 AM

You can SEE baldness, but you can't see your heart. It's not just about wanting to look good, it's about normal people being able to easily notice and measure some kinds of aging damage and not being able to notice or measure other kinds (until they kill you).
If baldness makes people study embryogenesis, cell signalling, wound healing, stem cells, and cell differentiation then it may be useful for other aging repair too.
And a cure for an easily visible form of aging would certainly help with raising awareness for the cause of anti-aging research.

But I agree with you about the far greater importance of repairing heart aging.

Posted by: Carl at September 6th, 2013 8:50 AM

I believe strongly that if we wish to create awareness of the possibilities of coming rejuvenation technologies, there is no better way to make the broader public grasp that than through the "superficial" and cosmetic areas such as hair and skin.

Yes, you can survive without hair or nice skin. But Carl above states if well: People believe what they see. We are visual creatures. If you suddenly saw a bald man you knew sporting a head of hair and were shown it to be actual hair, you'd be curious. We'd have the full attention of tens of millions.

THEN you say to that amazed public: We can do something similar to your heart, liver and heart. If you help us we can do it sooner. Etc.

Brilliant academics and researchers working on more life threatening projects are often angry about this sort of research, often with comments about human vanity. That's fine. But understand you are in defiance of human nature whereas you could be in synch with this great force and use it to greater advantage.

The first biotech to deliver some kind of functioning and impressive solution for the silly problem of hair loss or skin wrinkling will not only make a lot of money for that company, they will also get enormous media attention and a rapt audience of billions around the globe. And this audience will be curious to understand rejuvenation beyond just hair or skin.

Many speak about the need for awareness, including the people at SENS and beyond. Those who solve this much more vain, petty and superficial problem will actually be the greatest harbingers of the biotech revolution we shall see and this I believe will open up the money spigots faster than appeals to cure Alzheimer's, though that goal is vastly more important. It's a contrarian approach but I think these unimportant areas of research will hasten other research more than any other appeal to the larger public. As the Talking Heads sang-

We are vain and we are blind.

Just my three cents.


Posted by: Jersey Jones at September 6th, 2013 12:21 PM

I agree with Jersey Jones's comment. Another advantage of working on skin rejuvenation is that the skin is very accessible and the problem of "targeting" therapies to the appropriate tissue is rendered mostly trivial.

Furthermore, on a sociological note, I think the cries of "vanity" are a bit naïve or even superficial themselves. Ample evidence and common sense are in agreement that these aspects of aging affect how others will treat you, and in a social species like ours, how is that not important to any meaningful concept of quality of life?

Posted by: José at September 6th, 2013 1:08 PM

Quite agree with both JJ and Jose's comments. Curing baldness may not be up there with the prevention of death, but it is a sight that causes great depression for millions of men (and women) when they see it in the bathroom mirror and also often impacts on their relationships and public life. If we are talking quality of life, then the reality is that physical appearance matters, and it is naïve to cry "vanity" or believe otherwise.

Posted by: Ian at September 8th, 2013 9:37 PM

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