Stem Cells, Laser Treatments, Other Alternative Therapies Effective for Alopecia

Stem cells, low-level laser therapy (LLLT), and natural oils may be effective alternatives for managing alopecia, new findings suggest, with diverse mechanisms of action and generally favorable safety profiles.1

These data resulted from a comprehensive review of alternative options to treat hair loss outside of the more widely-accepted use of minoxidil. The review was authored by William Abou Shahla, MD—from the Department of Dermatology at the American University of Beirut Medical Center in Lebanon—along with a team of investigators.

Shahla and colleagues noted that stem cells, especially those derived from adipose tissue and patients’ hair follicles, had been previously cited as having potential for patients with alopecia.2 Additionally, alternative options such as induced pluripotent stem cells (iPSCs) had also previosuly show promise in addressing cell shortages for patients’ hair regrowth.3

“This paper explores these emerging solutions, shedding light on their clinical applications, safety profiles, and potential to transform the management of hair loss,” Shahla and coauthors wrote.1 “By reviewing recent studies and therapies, we aim to provide insights into the future of alternative hair restoration solutions.”

Trial Design Details

The investigative team carried out a broad review of available clinical trials, systematic reviews, and preclinical animal studies. The team sought to examine the safety, mechanisms of action, and clinical outcomes of a variety of alternative, nonsurgical treatment strategies for alopecia.

Shahla and coauthors began their research using a literature search in the Embase and PubMed databases. They targeted publications released in the period between January 2010 - March 2024, using search terms that would combine variations of “alopecia,” “nonmedical treatment,” "hair loss," “stem cells,” “low-level laser therapy,” “hair regrowth,” and "natural oils."

The investigators only included English-language articles from peer-reviewed journals in their final review. The review included clinical trials, systematic reviews, and preclinical investigations of device-based interventions and biologic options, as well as relevant case reports.

Findings on Alternative Hair Loss Therapies

Shahla and colleagues' review highlighted a variety of findings, including data showing that stem cell–based treatment use—and particularly treatments employing adipose-derived stem cells, induced pluripotent stem cells, and hair follicle stem cells—was linked to measurable improvements in patients' hair density and hair shaft thickness levels.1 Such impacts were largely attributed to mechanisms such as paracrine signaling as well as angiogenesis.

Low-level laser therapy was also shown by the investigators to lead to potential benefits, largely by activating the Wnt/β-catenin signaling pathway and enhancing circulation on patients' scalps. However, Shahla et al highlighted the variation of consistency of outcomes across the different studies. The findings, they noted, were often impacted by patient characteristics and device parameters. The data highlighted also suggested that reported side effects were generally minimal, with most trial participants expressing moderate satisfaction with results.

In their evaluation of research into natural oils, Shahla and coauthors highlighted data on rosemary oil and pumpkin seed oil. These alternative, oil-based therapies demonstrated the capacity to stimulate hair regrowth among those with alopecia through anti-inflammatory pathways and via hormonal modulation.

Overall, the investigators' review highlighted the growing body of evidence for alternative, nonsurgical interventions—including biologic options and device-based therapies—in managing multiple forms of alopecia. Collectively, such modalities have demonstrated either hair-loss preventative properties, hair growth–promoting effects, or both. The highlighted therapies also maintained acceptable safety profiles.

Among the therapy options evaluated in this review, adipose-derived stem cell–conditioned extract (ADSC-CE) were shown by Shahla et al to currently holds the most robust clinical and preclinical support of both efficacy and tolerability. Conversely, the investigators noted that approaches such as plant-derived extracellular vesicles (PDEVs) and induced pluripotent stem cells (iPSCs) continue to be experimental. Although early results seem promising, additional validation using rigorously-designed human clinical trials may be necessary before these options can be integrated into routine practice.

“Additional clinical trials are needed to further improve and understand these innovative therapies to advise and recommend them,” the investigators concluded.1 “And it is worth investigating further in their potential properties on different types of alopecia, whether scarring and non-scarring alopecia, classify their drug interactions and explore the underlying unknown mode of action for some these modalities.”

References

1. Shahla WA, Daou R, et al. Alternative Therapies for Hair Loss: Stem Cells, Oils, and Laser Treatment. Dermatological Reviews, 6: e70050. https://doi.org/10.1002/der2.70050.

2. JH Lee and S Choi. “Deciphering the Molecular Mechanisms of Stem Cell Dynamics in Hair Follicle Regeneration,” Experimental & Molecular Medicine 56, no. 1 (2024): 110–117.

3. C Vatanashevanopakorn and T Sartyoungkul. “iPSC-Based Approach for Human Hair Follicle Regeneration,” Frontiers in Cell and Developmental Biology 11 (2023): 1149050.