Experience the future of hair today

Hair is a powerful factor in how we're perceived by others and even how we see ourselves. It plays a significant role in the perception of youth and attractiveness. Studies have shown that hair style, color, and quality can significantly affect how old we look and how attractive we're considered [1]. Research suggests that hair is one of the most defining characteristics of our appearance, with the potential to make us look years younger or older [1]. From an evolutionary perspective, lustrous hair has long been associated with youth, health, and fertility [1]. Culturally, hair has been a symbol of beauty and status across societies for centuries [2].

HAIR GENETICS BEYOND MATERNAL INHERITANCE
We have approximately 5 million hair follicles distributed across our bodies, with only about 100,000 located on the scalp [3][4]. Contrary to popular belief, hair characteristics are not solely inherited from one's mother. Human genetic makeup consists of 23 pairs of chromosomes, including the sex-determining X and Y chromosomes [5]. Females typically have two X chromosomes (with one usually inactivated through a process called X-chromosome inactivation), while males have one X and one Y chromosome [6]. Our hair's characteristics, including texture, color, and growth patterns, are determined by about 600 genes [7]. Interestingly, only 11% of these genes are located on the X chromosome [8]. The majority of genes influencing hair traits are found on autosomes (non-sex chromosomes), contributing to the inheritance patterns observed in families [9]. For instance, genes like EDAR and FGFR2 have been associated with hair thickness in Asian populations, while TCHH has been linked to hair texture in individuals of Northern European ancestry [10]. Research has identified several genes on the X chromosome that play a role in male pattern baldness, including the androgen receptor (AR) gene. Telomere length in hair follicle stem cells correlates with hair growth capacity and may be a biomarker for hair follicle aging. The complexity of hair genetics extends beyond sex chromosomes, involving multiple autosomal genes, environmental factors, hence epigenetics, and this is great news as changes in epigenetic patterns are partially reversible!

Epigenetics
Epigenetics refers to heritable changes in gene expression that occur without alterations in the DNA sequence itself [11]. Environmental factors, diet, lifestyle, chronic stress, sleep, circadian rhythms, physical activity, aging and even social interactions can influence gene expression through four main epigenetic mechanisms:

1. DNA methylation: This involves the addition of methyl groups to DNA, typically at CpG sites, which can lead to gene silencing [12].
2. Histone modifications: These include various chemical changes to histone proteins, such as acetylation, methylation, and phosphorylation, which can alter chromatin structure and gene accessibility [13].
3. Chromatin remodeling: This process involves the restructuring of nucleosomes, affecting DNA accessibility and gene expression [14].
4. Non-coding RNAs: These include microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and small interfering RNAs (siRNAs), which can regulate gene expression at both transcriptional and post-transcriptional levels [15].

These epigenetic mechanisms can significantly impact hair biology

• Silencing or activation of hair growth-related genes: Epigenetic modifications can alter the expression of genes crucial for hair follicle cycling, potentially contributing to hair loss or promoting regeneration [16].
• Regulation of hair follicle stem cells: Epigenetic mechanisms play a vital role in maintaining hair follicle stem cell function and identity [17].
• Response to environmental stressors: Factors such as oxidative stress, pollution, and diet can induce epigenetic changes that affect hair growth patterns [18].
• Aging-related hair changes: The accumulation of epigenetic alterations over time may contribute to age-related hair loss and graying [19].

Example of change in epigenetic pattern
Ever wondered why hair starts growing in odd places as we age? It is a good example of epigenetic changes. As we get older, changes in our epigenome can cause regions of our DNA that are normally silent (due to histone modifications) to become readable. In essence, we're becoming more like our ancient ancestors! This is why some people start growing more hair in places like ears and noses as they age. Epigenetic changes can thus silence or activate hair growth-related genes, potentially contributing to hair loss or promoting regeneration. Thus, the future of our hair health is literally (at least partially) in our hands today!. 

Lifestyle changes and hair regrowth
Lifestyle modifications have demonstrated impacts on hair regrowth, particularly in early stages of hair loss and for prevention.
1. Nutrition: A balanced diet rich in proteins, vitamins (especially biotin, vitamins A, C, and D), and minerals (iron, zinc) has been associated with improved hair growth [20]. Supplementation with these nutrients has shown benefits in treating telogen effluvium and other hair loss conditions [21].
2. Stress Management: Chronic stress can lead to telomere shortening and premature hair follicle aging. Stress reduction techniques like meditation and yoga have been linked to increased telomerase activity, potentially benefiting hair growth.
3. Exercise: Regular physical activity improves blood circulation to the scalp, potentially enhancing nutrient delivery to hair follicles. A study found that moderate exercise was associated with increased expression of hair growth-related genes.
4. Sleep: Adequate sleep is crucial for maintaining healthy hair growth cycles. Sleep deprivation has been linked to increased oxidative stress and inflammation, which can negatively impact hair follicles.

Studies have shown promising results in targeting epigenetic mechanisms for hair loss treatment

• Histone Deacetylase (HDAC) inhibitors have shown potential in promoting hair growth in preclinical models [22].
• miRNAs have been identified as regulators of hair follicle cycling and potential therapeutic targets [23].
• lncRNAs have been implicated in hair follicle development and cycling [24].
• DNA Methyltransferase (DNMT) Inhibitors: 5-azacytidine, a DNMT inhibitor, has been shown to promote hair follicle neogenesis in wound healing models by modulating Wnt signaling [25]. This suggests potential applications in treating hair loss disorders.
• Epigenetic Modulation of Wnt Signaling: Enhancing Wnt signaling through epigenetic mechanisms has emerged as a promising approach. For example, inhibition of SFRP1, an epigenetically regulated Wnt inhibitor, has been shown to promote hair growth in preclinical models [26].

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In office therapies
1. Low-Level Laser Therapy (LLLT): LLLT works by decreasing nitric oxide enzyme activity, leading to a beneficial "micro-stress" in mitochondria. This hormetic effect increases energy production, allowing stem cells to stay young and rejuvenate. Clinical studies have demonstrated improved hair density and thickness with LLLT in androgenetic alopecia patients.
2. Platelet-Rich Plasma (PRP) and exosomes: These regenerative therapies deliver growth factors and signaling molecules to hair follicles, potentially reversing miniaturization and promoting the anagen phase. PRP has shown promising results in multiple clinical trials for androgenetic alopecia.
3. HydraFacial Keravive scalp treatment: A 3-step process involving cleansing, exfoliating, and nourishing the scalp to improve hair follicle health.
4. Hair Transplantation: Includes techniques like Follicular Unit Extraction (FUE) and strip harvesting to transplant hair from donor areas to balding areas.
5. Scalp micropigmentation: A cosmetic tattooing procedure that creates the appearance of a fuller head of hair.
6. Corticosteroid Injections: Used primarily for treating alopecia areata by injecting steroids directly into affected areas of the scalp.
7. Microneedling: Uses small needles to create micro-injuries in the scalp, potentially stimulating hair growth when combined with topical treatments.
8. Scalp Reduction: A surgical procedure that removes bald areas of the scalp and stretches hair-bearing skin.
9. Mesotherapy: Involves injecting vitamins, minerals, and other nutrients directly into the scalp to nourish hair follicles.

BALD AINT BAD (for men)

• Perceived dominance and strength. A study from the University of Pennsylvania found that bald men were rated as more dominant, taller, and stronger than men with full heads of hair [27].
• Attractiveness and confidence. Bald men are often perceived as more attractive and confident [28][29].
• Intelligence and success. Men with receding hairlines were 17% more likely to be considered successful and 13% more likely to be viewed as intelligent compared to men with full heads of hair [30].
• Leadership potential. The perception of dominance in bald men could increase their potential for leadership roles [27].
• Masculinity. Baldness is often associated with higher levels of masculinity, which can be beneficial in various social contexts [31].
• Age and maturity. Bald men are often perceived as more mature and experienced, which can be advantageous in professional settings [32].
• Cultural shift. There's been a cultural shift in recent years, with baldness becoming more accepted and even celebrated, as evidenced by the popularity of bald celebrities and public figures [33].

Always consult a qualified healthcare professional or dermatologist to determine what the most suitable approach is for your particular skin or hair condition.

Take care!
Anne-Marie

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WATCH VIDEO ABOUT EPIGENETICS

The picture I used for this post is from my lovely daughter, who is blessed with fabulous hair.

References

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2. The AutoEthnographer. (n.d.). Is Beauty Truly in the Eye of the Beholder? Hair and Societal Standards. ​
3. Buffoli B, et al. The human hair: from anatomy to physiology. International Journal of Dermatology. 2014;53(3):331-341.
4. Martel JL, et al. Anatomy, Hair Follicle. In StatPearls. StatPearls Publishing; 2022.
5. Genetics Home Reference. What are the different ways in which a genetic condition can be inherited? 2020.
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7. Heilmann-Heimbach S, et al. Hunting the genes in male-pattern alopecia: how important are they, how close are we and what will they tell us? Experimental Dermatology. 2016;25(4):251-257.
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9. Medland SE, et al. Common variants in the trichohyalin gene are associated with straight hair in Europeans. American Journal of Human Genetics. 2009;85(5):750-755.
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16. Botchkareva NV. The molecular revolution in cutaneous biology: chromosomal territories, higher-order chromatin remodeling, and the control of gene expression in the epidermis and hair follicle. J Invest Dermatol. 2017;137(5):e93-e99.
17. Lien WH, et al. In vivo transcriptional governance of hair follicle stem cells by canonical Wnt regulators. Nat Cell Biol. 2014;16(2):179-90.
18. Trueb RM. Oxidative stress in ageing of hair. Int J Trichology. 2009;1(1):6-14.
19. Panhard S, Lozano I, Loussouarn G. Greying of the human hair: a worldwide survey, revisiting the '50' rule of thumb. Br J Dermatol. 2012;167(4):865-73.
20. Guo, E. L., & Katta, R. (2017). Dermatology Practical & Conceptual, 7(1), 1-10.
21. Almohanna, H. M., et al. (2019). Dermatology and Therapy, 9(1), 51-70.
22. Lee WS, et al. Valproic acid induces hair regeneration in murine model and activates alkaline phosphatase activity in human dermal papilla cells. PLoS One. 2012;7(4):e34152.
23. Andl T, et al. The miRNA-processing enzyme dicer is essential for the morphogenesis and maintenance of hair follicles. Curr Biol. 2006;16(10):1041-9.
24. Wan DC, Wang KC. Long noncoding RNA: significance and potential in skin biology. Cold Spring Harb Perspect Med. 2014;4(5):a015404.
25. Yang, C. C., et al. (2015). Journal of Investigative Dermatology, 135(9), 2289-2298.
26. Rishikaysh, P., et al. (2014). International Journal of Molecular Sciences, 15(1), 1647-1670.
27. Mannes, A. E. (2013). Shorn scalps and perceptions of male dominance. Social Psychological and Personality Science, 4(2), 198-205.
28. Muscarella, F., & Cunningham, M. R. (1996). The evolutionary significance and social perception of male pattern baldness and facial hair. Ethology and Sociobiology, 17(2), 99-117.
29. Henss, R. (2001). Social perceptions of male pattern baldness: A review. Dermatology and Psychosomatics, 2(2), 63-71.
30. Innerbody Research. (2021). Perception of Chrome Domes in the US. Retrieved from https://www.innerbody.com/perception-of-chrome-domes-in-the-us 
31. Kranz, D. (2011). Young men's coping with androgenetic alopecia: Acceptance counts when hair gets thinner. Body Image, 8(4), 343-348.
32. Cash, T. F. (1999). The psychosocial consequences of androgenetic alopecia: A review of the research literature. British Journal of Dermatology, 141(3), 398-405. 
33. Ricciardelli, R. (2011). Masculinity, consumerism, and appearance: A look at men's hair. Canadian Review of Sociology, 48(2), 181-201.

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