IHA Summer 2020

CORPORATE

MARKETING A New Day Superhairpieces Looks Foward Pg. 4

What We Learned C&D Manager reflects on Covid 19 Pg. 32

MEDICAL

REGULATORY No FDA Approved Exosomes

Beyond Cloning The pioneers behind HairClone Pg. 8

Pg.32

International Hair Authority The Profesional Publication of Hair Replacement & Restoration

Volume 24 No 84

TM

Summer 2020

Men Are in Denial Nioxin Hair Loss Study A poll of 2,000 men aged 25-50 conducted by Nioxin in the UK found that over half of the men who took part were in denial for two and a half years before finally accepting that their hair was thinning. Most men believed that having hair loss would make them look older (62%) or less attractive (60%). The research also revealed that 49% of those aged between 35 and 50 had never talked to anyone about their hair loss. Nearly one third of thinning men are attempting to disguise it by changing their hair style, while 33% hide their receding hairline by wearing a hat.

Big Bucks

Hair Restoration Market Estimated to Reach $12,119.4 million by 2026 According to a report published by Allied Market Research titled, “Hair Restoration Services Market by Service Type, Gender, and Service Provider: Global Opportunity Analysis and Industry Forecast, 2019 – 2026,” the global hair restoration services market size was valued at $8,452.5 million in 2018, and is projected to reach $12,119.4 million by 2026, growing at a CAGR of 4.6% from 2019 to 2026. In 2017, North America accounted for nearly 35.19% share of the hair restoration services market.

‘Fix My Hair’

Oops! New reality show will fix DIY disasters A new TV series “Fix My Hair” is in the pipeline. It will feature and fix “hair disasters” that resulted from women attempting to style their hair at home during the Covid lockdown. A company known for casting “Let’s Make A Deal,” “The Price Is Right,” and “Family Feud is inviting applications from women in California who are open to sharing their bad hair stories and having their hair revitalized by a celebrity stylist. Prior reality show experience is not required.

Bald Not Sexy Even for Celebrities

A survey of 1,000 men carried out for The Harley Street Skin Clinic reported that only two percent of respondents approved of Prince William’s bald head compared with twenty-seven percent for Bruce Willis, twenty-eight per cent for chef Gordon Ramsay and thirty-five percent for actor Vin Diesel. At only two percent, the heir to the throne was voted the least attractive bald celebrity. Unsurprisingly, the survey noted that eighty per cent of men aged 25-65 years said they would rather be overweight than lose their hair.

New Hairloss Study

microRNA awakens dormant hair cells

Researchers at N. Carolina State University believe they have found an effective way to promote hair regeneration.

Contrary to what most people think, hair follicles do not always die when hair is lost. The research team was able to demonstrate that dormant hair cells can be revitalized using specially cultured DP cells. In the study, shaved mice were injected with 3D DP cells that had been cultured in a spheroid environment that replicated the microenvironment inside a hair follicle. After 15 days, the DP treated mice regained 90 percent of their hair coverage. In comparison, mice treated with Minoxidil got only 35 percent of their hair back.

2 Hair Authority Spring 2020

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Editorial How Others are Coping - In this

issue, executives from two major companies leave their corporate offices to share their responses to the pandemic and the ways they are reaching out to customers caught in the crossfire between staying safe and saving their business. Church & Dwight and Superhairpieces are just two of the many companies that are finding innovative ways to support hair-care professionals and, through their efforts, the hair loss industry. We look forward to sharing more personal insights like this in our next issue and invite you to call or write us with your own stories.

Consumers want research - In 2009, we interviewed Andy Goren, CEO of HairDX, a forward-looking company that had developed a technology that provided a genetic analysis of a man’s or woman’s likelihood of developing Androgenetic Alopecia, the most common type of hair loss.

Nioxin Research Laboratories was the first to market this test to consumers through multiple vehicles including professional salons and beauty stores.

The simple HairDX test quickly spread to Europe and other important markets and was offered by international networks like Svensons. However, momentum slowed when clients realized the diagnosis did nothing to reverse or stop hair loss and there were no follow-up medical solutions. This perception was encouraged by clinics and studios that used HairDX testing as a seductive lead generator, but then offered traditional hair loss remedies.

Genetic research continued to advance in labs and on university campi, but it did not profoundly impact hair loss again until recently. Cell multiplication came and went and PRP showed promise. The House of Daniel Alain partnered with Daniel Alain Life Sciences, a biotech company to explore cures for hair loss, hair thinning, and hair shedding in women.

The company pointed out that topical minoxidil is available over the counter (OTC) and as such is widely used for the treatment of hair loss; however, following 4-6 months of daily or twice daily application, a significant number of patients do not respond to the drug. Since hair loss is progressive and is often a manifestation of an underlying condition other than pattern hair loss, identifying patients that are unlikely to respond to topical minoxidil is of great importance. That’s why the company developed “The Minoxidil Response Test” to aid a physician in assessing if a patient is likely not to respond to topical minoxidil treatment for pattern hair loss.

Hair Authority Spring 2020 3

Fast forward to 2020 - The Covid 19 epidemic has heightened awareness of health research in all its forms. Your editor was reminded of this when he received the following offer from the University Club in San Diego.

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world, knowing we’re healthy and doing everything we can to protect our health is of critical importance to ourselves, our families, our businesses and our communities. Introducing 100+, a proprietary program from Health Nucleus that uses Before After the most advanced health technologies available to help to preempt disease. 100+ provides annual exams that include genomic sequencing, whole body imaging, blood chemistry analysis, advanced screening, precision health reports and much more. Your Health Nucleus physicians, experts in interpreting large data sets, continuously track your health to aid in maximizing your vitality, performance and longevity.”

Hair cloning is center stage again - One example of the

focus on wellness and forward planning will be found in this issue in a fascinating interview with Paul Kemp, PHD, Chief Executive Officer of HairClone, and Dr Bessam Farjo MB, CHB, BAO, LRCP & SI. Medical Director. HairClone® is collaborating with leading scientists to develop systems that expand follicle cells in culture, firstly in order to rebuild miniaturizing follicles and also to produce hair rudiments that could be used to generate new hair follicles. HairClone® has also launched the World’s First Licensed Follicle Banking Service which allows clients to store a small number of hair follicles for future cell isolation and expansion.

Taking Care of Self - “The customer comes first” is a good

maxim in normal times, but nothing today is normal. As they say when you fly, “Please put on your own oxygen mask before helping those around you.” What works in the air also makes sense on the ground. A recent relaxation report stated that 49% of Americans aren’t getting the sleep they need and 78% don’t set aside enough time to relax. And that was before Covid 19. Please take care of yourself. A solid work ethic is healthy, but must be balanced with the proper amount of rest and relaxation.

Stay well, be happy,

4 Hair Authority Spring 2020

Superhairpieces Looks Ahead We’re All in This Together

The hair replacement industry is having one of its toughest years since we started Superhairpieces in 2007. We have reached out to stakeholders in our industry from factories to hair salons and our consensus is that COVID-19 is the most severe and threatening situation we’ve all faced.

Hair replacement services are one of the most impacted industries by CEO, George Lee COVID-19. The market’s recovery is still not stable, even though the virus appears to be slowing in some countries. In my opinion, the road to recovery will be long and challenging both for our industry and for the world.

However, I’m optimistic that Superhairpieces and other resilient companies will make it through this crisis with lessons learned that will help us to be better prepared for the future.

COVID-19 has affected our servicing segment and our supply chain, but we are more fortunate than most other suppliers. Many major

hairpiece distributors are facing worse inventory shortages, delivery delays and lower production capacity.

Clients are stressed out by this situation and business owners we’ve talked to are becoming desperate for supplies and need production to return to normal levels as soon as possible.

Sticking to Our Valuesw

Superhairpieces’ central principle has always been to deliver the highest quality at an unbeatable price. We identify heavily with Jeff Bezos’ belief: “There are two kinds of companies, those that work to try to charge more, and those that work to charge less.” We will be the second of these. We’re trying our best to maintain our prices despite the supply chain uncertainty and cost hikes. We remain committed to keeping our prices at the same level they enjoyed before the pandemic struck to help ensure the profitability and viability of our partners and customers.

As an example of our commitment to low prices, the price for our model M101 was kept the same from 2007 to 2017.

In 2017, we were forced to raise its price due to constant cost increases, but we raised it by only 8% - and we’ve kept that unchanged until now. When we are obliged to raise our prices, we justify the change by explaining that it is due to increased costs in our supply chain or by investments that will make our products or fulfilment model more efficient.

We never raise prices for no reason.

Supporting Our Customers

A key operational philosophy of Superhairpieces has always

Hair Authority Spring 2020 5 been to keep ample stock on hand to provide fast fulfilment across a wide variety of models. This philosophy served us well during the COVID-19 pandemic when we were still able to ship products when our customers needed them despite supply chain disruptions. Not only did our stock on hand create a buffer that minimized clients service disruptions, it also protected customers against third party price increases.

Pivoting for the Consumer

In response to the lockdown period, we prepared Home Care Kits and began to offer online base cut, Haircut Service Demonstrations and other online tools to help customers maintain their hairpieces at home.

We have seen our online Cutting Service package become very popular in the consumer marketplace.

Our video consultants are also giving us positive feedback about their online consultations. Expectedly, it’s our younger customers who appear to be the most receptive. However, all clients tell us they feel comfortable with the online experience and appreciate the convenience, while the consultants say they can be more productive by screen-sharing to demonstrate and compare products, play videos and forward useful links.

As millennials begin to experience hair loss, we have entered a chapter in hair replacement with new lifestyles and new expectations. The breakout of COVID-19 has simply accelerated this evolution.

Stay Calm - We’ll Help

Our customer support philosophy has always been to pick up phone calls within 60 seconds so as to not waste our customer’s time. We’re still committed to that and we try to make sure we always have enough agents available to make sure phone calls are picked up in a timely manner.

Superhairpieces will always follow up a client’s email or online chat and respond to all tickets within 24 hours.

The cost of manufacturing, especially the labour cost, has surged since the spread of COVID-19. Workforce reductions and government limits on traveling are the prime reasons for this. Despite this, our commitment to keeping prices low is holding strong. After reviewing the situation, our management team voted to keep prices the way they were before the pandemic. We believe helping our customers through this crisis is our mission, even if it means taking a hit ourselves.

We have also seen anxious hair replacement business owners stocking up on hairpieces because they anticipate future hairpiece shortages or price increases. These irregular orders

get amplified when transmitted to the factories and make the manufacturing labour market worse.

At Superhairpieces we will keep processing custom made orders and offer alternate stock item replacements solutions for faster delivery or emergencies

A Message from CEO, George Li

I would like to delivery this message to all hair technicians and business owners: Please explain the situation to your clients regarding hairpiece availability.

We hope they will understand that we too are being affected and we’re trying hard to provide all the support we can.

Ask your clients to try to either extend the usage of their hairpiece or send it to us to repair.

Avoid ordering custom-made hairpieces whenever possible.

Be ready to switch to a stock hairpiece.

Be flexible in your hairpiece selection as we may not always have every model available.

“Now is the time when a great famine has just begun, and grains will be grown next year, please save food for the winter” A Message from Manager, Marcello Masseran

I always admired Jack Welch, former chairman and CEO of General Electric for his quote “Change before you have to”.

This is very relevant today, as our industry is experiencing an array of changes that are forcing us to adapt.

I have been in contact with so many of you and I have noted your concern about inventory levels. Please be aware that to maintain a safe environment, our factory in China is now working at 25% capacity. This may affect delivery times (10 to 12 Weeks) on your custom orders. We are working hard to adapt to this challenge, but please consider contacting us to discuss replacing your custom order with a stock piece as we may be able to fulfil it more quickly.

It’s always a pleasure to discuss our different products and guide you to the best solutions. I would love to hear your feedback as we work and learn together. I am confident that we will all prevail during this pandemic.

A Team Effort

Thanks to our amazing shipping team, we were able to keep Cont’d Pg 6

6 Hair Authority Spring 2020 the warehouse and shipping department open and operational in both our Fort Lauderdale and Toronto warehouses.

Thanks to our kind and warm-hearted customer support team, we were able to maintain all customer support tasks either at the office or from home.

Thanks to our manufacturer team, production never stopped. Despite the challenges and working understaffed, we were still able to take and process orders and deliver custom made hairpieces one by one for our customers.

Meet the Players

Marcello, Sales Manager - Marcello has been the sales manager and hiring manager of Superhairpieces for almost 6 years. He spends his time communicating with hair professionals and hair business owners. With his deep research and insight investigation, he builds up a nationwide network of hair professionals for us. Marcello also is a liaison between our customer service team and Superhairpieces CEO. He provides video training for customer service support and tries to find the best qualified people for our team.

Lizzy, Customer Support Supervisor - Service for our clients is one of her most enjoyable tasks. Lizzy is in her 5th year working at Superhairpieces. She gained experience in understanding client’s business needs with her warm and kind heart. She also works closely with our product team and is always on top of the production schedules. She keeps alert on all stock, custom made orders, and receiving plans. She is always ready to give clients the answers they need. If you are expecting quick, sharp, and straightforward answers, Lizzy is always ready for you.

Liyue, Customer Support Specialist - Liyue is one of the sweetest and most knowledgeable senior customer support specialists.

Due to the COVID-19, she can only work from her home in Toronto in order to connect with clients from all over the world.

Liyue is in her 4th year working at Superhairpieces and she loves solving problems for our clients. For any tickets assigned to her, she always follows up and makes sure it’s solved correctly.

Jessica, Customer Support Specialist - Jessica is new to our team with only 2 years of work experience at Superhairpieces. Jessica works very hard and always tries her best to seek the best possible solutions for clients. Due to the COVID-19, she works at her Fort Lauderdale home to support our clients.

Lissette, Custom Order Specialist - Lissette has been working in our custom order department for over 6 years. Fluent in English, French, and Spanish, she reaches out to clients to ensure all order details are in place. With many years of experience, she completely understands hairpieces very well. It’s been almost 2 years since she has been working at her home in Toronto.

IHA

Hair Authority Spring 2020 7

Make a Wish

Can Dandelions Help Reduce Hair Loss?

Contrary to popular belief, dandelions are not just garden weeds, says Britain’s Express newspaper. They may hold some key health benefits and helping with hair loss may be one of them.

The polysaccharides found in dandelions also possess anti-inflammatory and anti-oxidative properties which help play a role in lowering levels of inflammation.

How could dandelion roots help with hair loss?

Dandelions help to reduce the production of pro inflammatory cytokines, which are compounds usually involved in the body’s inflammation.

Dandelion root is a rich source of vitamin A, C and E as well as B-complex vitamins.

Dandelion also contains choline, iron, magnesium, phosphorus, potassium, biotin, and calcium.

“There are many different causes of hair loss,” says Dr Deborah Scott, assistant professor of dermatology at Harvard Medical School. “Some are associated with inflammation in the body.”

All of these ingredients play a significant role in making one’s hair healthy, stronger and help stimulate hair growth.

This is why dandelion root may help with hair loss due to its inflammation fighting capabilities.

IHA

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8 Hair Authority Spring 2020

Hair Cloning Is Coming You Can Bank on It

HairClone is a unique International partnership of Scientists, Hair Transplant Surgeons and Patients created to develop treatments for hair loss.

The most common type of hair loss in men and women (androgenetic alopecia) is caused by the affected hair follicles losing their natural regenerative abilities, causing them to miniaturize, producing the appearance of thinning hair.

HairClone is developing a treatment to replace these lost cells. A few of a patient’s non-affected follicles will be harvested in a simple out-patient procedure. Potent cells will be isolated from these follicles, multiplied in the laboratory, and micro-injected into the affected part of the scalp with the intention of rejuvenating the hair shafts, making them thicker and longer.

To learn more about this 2nd generation cell multiplication project, The Hair Authority met with HairClone’s CEO, Dr. Paul Kemp and Medical Director, Dr. Bessam Farjo.

Chris Webb, Editor, NHA

Paul Kemp, PhD

Authority: Dr Farjo, we have known each other for over 15 years, and we’ve seen many technologies come and go. One of these was cell multiplication, but now it’s back. What has changed?

Dr. Farjo: Two things. Our increased understanding about hair loss and the fact that we now have more practical expectations. As you point out, we have been down this road before under another venture which was called Intercytex.

The idea of culturing hair cells, multiplying them in the lab and injecting them to make new hair has been the goal of scientists for a long time. Ever since people succeeded in growing cells in a lab, researchers have tried and failed to produce cosmetically significant new hair growth. We tried here in the UK, and other people tried in the in the USA, but without success.

Bessam Farjo,MB, CHB, BAO, LRCP & SI

However, as I mentioned, a number of things have changed since then. Technology has evolved, notably the ability to ”interrogate” and determine all the proteins that they are making and examine how this changes when the cells are cloned. We can use this to better develop the culture systems as we’ve learned that these cells have what you might call a “program” attached to them, and you need to maintain that ‘programming’ for them to produce the correct signals for hair rejuvenation. Previous technologies did not protect that “programming” and prevent it from dissipating, so the cells forgot what they were supposed to do and what they were supposed to produce.

The other thing is that is fundamentally different is what we are trying to achieve. At the beginning, everybody felt very heroic and thought, “We’ll produce these cells, put them

Hair Authority Spring 2020 9 in a bald head and voila new mature hair will grow!” But over the decades, science has shown that new hair growth is much more complicated than that. It’s multifactorial and there’s a lot we still don’t know. However, there has been a lot more research and as a result, hair growth out of culture has become more predictable. One key discovery is that we’ve learned we can rejuvenate thicken existing miniaturizing hair.

In the past, we noticed that some areas of thinning hair had thickened up, but that didn’t seem very exciting because everybody wanted to grow new hair from nothing. However, attitudes have changed and today there’s a lot more emphasis on preservation rather than waiting for everything to fall apart and then trying to recreate it. As a result, there’s a growing market for thickening existing hair and preventing hair from getting to that advanced thinning stage in the first place.

medicine in Boston with a company called Organogenesis.

We were trying to build skin, but it quickly became obvious that this would be really expensive since we first had to build tissue in a dish and then there were limitations as to what we could do with it. So, when I returned to the UK and set up Intercytex, we took a different approach. This time, we tried to build the tissues actually in the patient rather than in a dish and then transplanting it.

This was about the time that Colin Jahoda was publishing his work on using dermal papilla cells and generating hair follicles, a process he called, “follicular neogenesis.” When we looked at what he was doing with follicles, hair appeared to be a more promising target than skin. It seemed simple; implant or inject cells into the skin and a new hair formed.

So, we thought, Bingo, we could create these new hairs, just by using cell suspensions! So, that’s how we started our hair work at Intercytex and how I got to know Dr. Farjo. We moved quickly and embarked on our first clinical trials. The goal was to demonstrate that we could create brand new hair follicles.

Authority: You assembled a powerful research team with impressive credentials. How did you all come together?

So, to summarize, the two principles that have changed are firstly the technology that makes these cells grow better quality hair, and secondly, the fact that we’ are now aiming to prevent hair loss rather than reverse end-stage baldness.

We believe rejuvenating existing hair is a more attainable goal than creating hair from scratch. Also, this repair of existing hairs will maintain their natural distribution and direction of growth.

Authority: It has always been hard to define our business. Is it “hair rejuvenation,” “hair restoration,” “hair replacement,” or “hair preservation?” At the Hair Authority we use the term, “Hair Management” which covers all bases. And while we are talking terminology, hair consultants we’re always instructed not to talk about “hair cloning” and use medical language like “follicular neogenesis” instead. However, your new company is actually called “HairClone.” What has changed?

Paul Kemp: To understand how this came about we really need to wind back the clock. I started in regenerative

Paul Kemp: We set up Intercytex, as a classic startup biotechnology company. The typical game plan is you raise a lot of money from venture capital, then float on the stock market. Then you raise another ton of money, and you get products to the clinic. And then Big Pharma buys you. That’s generally the process and Intercytex raised just short of 60 million pounds sterling. But the problem with doing that is you’re then on this treadmill or escalator and you can’t stop. It’s not your escalator; you’re driven by the investors’ timelines and you have to keep generating more income. I spent most of my time raising money when what we really needed to do was focus on the goal of multiplying and implanting hair cells. Someone once used a great analogy.

He said, “You just have to run at the brick wall. And the faster you run at the brick wall, the greater the likelihood you might burst through it or just splat against the wall.” That’s the problem; you only get one shot at it. We didn’t create new hairs, although there were some fine hairs that weren’t cosmetically useful. We were making progress, but it wasn’t enough. You can’t go back to the venture capitalists and say, “Can we have another 50 million please” and try again.

Authority: If you were pitching a venture capitalist today and you had one minute to him excited, how would you summarize your new goals?

Paul Kemp: Rebuilding miniaturizing hairs.

Authority: If the new HairClone program goes according Cont’d Pg 11

10 Hair Authority Spring 2020

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Hair Authority Spring 2020 11 to plan, who could participate? Is there an age limit, gender limit or hair loss qualification?

Dr. Farjo: From all that we know now and all we’ve gained from the Intercytex and Aderans Research Institute days… and from things that Replicel and Shiseido have done… the prime targets are people with Norwood two/three, maybe four. Men and women are both fine, but with early stages of hair loss. What everyone seems to have shown is that miniaturizing hairs can be rebuilt, but only to a certain point. Hairs can go beyond a point of no return and get too small to be rebuilt. So, for someone who is category six or seven, you may be able to repair and rebuild some of their hair at the margins, but those hairs in the central area have probably miniaturized too far. You need to catch them early on just before the point where it becomes impossible to rejuvenate them.

RepliCel is a good example of a company that is exploring multiple technologies and medical targets. They’re doing tendons as well as hair. We wanted to just work on hair, and you might say we nailed our colors to the mast with our company name. HairClone is an accurate description of our work, which is cloning hair cells. Another reason to call ourselves HairClone was so we stayed focused on to rebuild miniaturizing follicles and couldn’t go off and work on some other area and dilute our efforts in hair.

We’re targeting early stage hair loss. Women are great examples because they tend to thin rather than go bald. They have plenty of hair that you could work with. Men can be more challenging.

In most of the experiments people have done in the past, they showed somebody with a with a bald patch in the center and a zone around that bald patch where was is some vague thinning. They injected the bald patch with cells and found that nothing happened in the bald patch - but in the surrounding area, things started to look better. Nobody paid attention to that surrounding area however, because it wasn’t the original target. They missed the important fact that you can apparently rebuild existing hair in the thinning area, even if you could not repopulate a bald spot. So, our goal is to catch those people who have that thinning zone. If they already have a bald patch, they may be candidates for a hair transplant, but if we can catch them before they develop a bald patch then there’s hair that we could bring back to life.

Authority: Could you envisage a time where people have an annual “hair physical?” Your doctor checks your vital signs, examines your scalp and tells you to bank some hair cells because your hair is vibrant today, but it would be prudent to plan for the future.

Dr. Farjo: Makes sense. People are already scheduling regular dental checkups and watching their cholesterol, so it’s logical to expect them to ask what else needs to be protected?

Authority: Are you considering expanding into other areas of personal care?

Paul Kemp: One of the things that attracts venture capitalists is biotech companies with a strong product pipeline; a whole series of products in development.

Authority: There is an Italian company that is promoting the implantation of synthetic fibers into the scalp. This has been banned in many countries. Have there been advances in artificial hair fibers that now make this a safe procedure?

Dr. Farjo: Synthetic materials like this have been around for a long time. Although people claim they’ve improved their technology and their fibers don’t cause as much inflammation, it’s still an unproven field. I think there’s an Israeli company that about two years ago was claiming that their material was completely inert and didn’t cause any reaction, but the point remains that it’s a still a foreign body and if you have the option, it’s always better to restore living hair. I don’t want to dismiss artificial hair completely, but we don’t practice this because of the risk of infections and tissue necrosis.

“We believe rejuvenating existing hair is a more attainable goal than creating hair from scratch. Also, this repair of existing hairs will maintain their natural distribution and direction of growth.”

Authority: Returning to hair cloning, can a patient “double dip?” In other words, can she have one initial implant of her cloned hair cells, and then and have a second or third Cont’d Pg 12

12 Hair Authority Spring 2020 procedure later if she still has reserves in the bank

That’s the end of the matter as far as the patient is concerned, but when the treatment becomes available, we will withdraw somewhere between five and ten follicles that we will use to dissect out the basic cells, the progenitor cells, which then get grown into a culture. A few weeks later, the new cells will be ready. The patient gets called back and it’s a little bit like a PRP session. You anaesthetize the area at the top and you give individual injections of the cells that are ready and held in solution. It may take half an hour or so to inject these cells.

Authority: How long can you preserve these hair follicles?

Dr. Farjo: Yes, that’s exactly the plan. When we bank follicles, we don’t cryo-preserve them all in one tube. We keep them in multiple tubes so we can thaw them out one tube at a time, isolate the cells we need from those few follicles, clone them and use them for one specific treatment.

Paul Kemp: The idea is that we can support the patient over time as his or her hair loss progresses. Patients may have hair follicles that have miniaturized beyond the point of recovery, but there will also be follicles that are destined to miniaturize but haven’t done so yet. Those follicles haven’t started miniaturizing yet, and we obviously can’t treat them today, but we can be ready when they do. So, the idea is to be ready to help patients as this wave of miniaturization progresses.

Dr. Farjo: We use a specialized tissue freezer that chills the tissue at a very slow speed to preserve the viability of the tissue and stop ice from forming in the in the follicles themselves. Once it’s frozen, it’s cryo-preserved and goes into long term storage in a tissue bank. The one we’re using is in Sheffield in Yorkshire, UK. We don’t yet have long term data with follicles, but we know many different types of tissue can be safely preserved for at least 20 years.

We anticipate that people may need treatments once every hair cycle. So, if the adult hair cycle is a couple of years, we anticipate that initially, they might need a new treatment] every two years. However, this is not something they have to do forever. After two or three sessions, some patients may not need any more treatments, so compared to other rejuvenation therapies, it could result in a permanent solution.

Authority: A few practical questions: When a patient comes in for a consultation, how do you determine if they qualify?

What is involved in the actual procedure? Does it hurt? How long does it take? Where do those cells go? What happens next?

Dr. Farjo: Since the end of 2019, when we first received a license to bank cells, I’ve been offering hair banking as an option to my patients. I present it in the same way that I discuss the benefits of finasteride, Minoxidil, PRP, lasers and hair transplants. I explain that banking their cells for the future could become a way to rejuvenate their hair when new technology becomes available. If they say, “Okay, I want it done,” I’ll explain that it involves a minor procedure that’s like half a regular hair transplant. I will just need to remove 100 hair follicles by FFP and that’s it. To treat 100 hair follicles, I need about 40 to 50 grafts. It’s all done under local anesthetic. We remove the grafts, insert them into special tubes and place them in a tissue freezer. We can do this without shaving the patient’s head and it’s all over and done with in under half an hour.

Paul Kemp: The thing that has changed from the early Intercytex days to these HairClone days is an incredible increase in our basic understanding of hair follicle biology.

This gives us abilities that we couldn’t dream of in the Intercytex days. Now we can now look at the complete genetic profile of an individual cell in a single hair. It’s called *transcriptomics. Every cell in the body has the same genetic Cont’d Pg 16

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16 Hair Authority Spring 2020 practice) protocol, just as though we were going to do an actual clinical trial. We are doing this in collaboration with Newcastle University using an “Innovate UK” government grant, but Covid-19 came along which has delayed things.

We’re continuing to work on the GMP system which requires a lot of paperwork, a lot of quality control and so on. Once we’ve completed this, the regulations in the UK will allow Dr Farjo’s clinic to prescribe those cells and implant them back into the patient. And then exciting part begins as look and see if we’re right about converting those frontal hairs and rebuilding them.

Authority: Why is the research being conducted in the UK? profile, but there are certain genes that get turned on and turned off in different cells. The transcriptome is the gene that is turned on. We now know that hairs from this region come from a different developmental origin compared to other hairs. When the fetus is developing and your face is forming, these dermal papilla cells retain a positional memory. That’s why you can transplant them. They remember their transcriptomic profile when you transplant them. So, we plan to take the dermal papilla cells from this region knowing from transcriptomic studies that they will maintain that memory, even in culture. We will then expand them in culture and inject them into the affected region. To make things better, we also know from academic labs that dermal papilla cells can home in on the hair follicle, so you don’t need to actually inject them back into the follicle itself.

They’ll hopefully move through the dermis into the dermal papilla region, migrate into the roots of the thinning hairs and repopulate them with cells that came from the donor area.

So, what you’re doing now is taking the controlling dermal papilla cells from the occipital region and having them populate hair follicles in the frontal region. What we haven’t shown yet, but hope to demonstrate, is that you will not only be able to rebuild these hairs, you can also change the character of frontal hairs and turn them into occipital hairs.

If we’re right on this, then then that will be a permanent switch and they won’t continue to miniaturize.

Authority: You said, “if we’re right.” Where does the research stand at the moment?

Paul Kemp: We’re on a fast track. We’ve decided to work with humans rather than start with animal studies because apart from the ethics of animal work, they can be an expensive distraction and so many studies have shown that animal hairs behave differently to human hairs. We know we can expand these human cells in culture but what we can’t do yet from a regulatory point of view, is inject them back into someone’s head. In order to do that, we have to manufacture the cells following a GMP (good manufacturing

“Today there’s a lot more emphasis on preservation rather than waiting for everything to fall apart and then trying to recreate it.”

Dr. Farjo: Primarily because of the regulations. In order to conduct a clinical trial, you have to get permission from the regulatory body, which is the FDA in America. In the UK, it’s the MHRA (Medicines and Healthcare products Regulatory Agency). The first stage is called a CTA or “Clinical Trial Application” where you are required to define three things; “What is the product I’m going to use?”, “What type of patient am I going to treat?” and finally, “What am I going to do to those patients?” Those three things together become the CTA, and you’re then stuck with that protocol. You just have to hope that you are right, that you picked the right patients, product and procedure.

It’s not easy, I know from experience. I’ve probably done 30 trials with cell therapies and it’s always an educated guess.

That’s where the UK provision give you some flexibility.

There is a provision in the UK regulations called “Specials.”

As long as you accurately define what you’re going to use, and you manufacture it to the same quality that you would use in a clinical trial in a facility like that in Newcastle which is licensed by the MHRA to produce cell based “Specials”, then the other two criteria are left up to the clinician who is working in the special medical interest of the patient. The clinician can pick who they feel is the most appropriate patient population and they can apply the GMP manufactured product in the manner they judge best using their professional skills.

Technically, this is not a “clinical trial,” but does allow us to try different iterations. Once we have an iteration that works, we can use that information to go head and design a classic clinical trial and run that study in the UK, US or

Hair Authority Spring 2020 17 Canada simultaneously to satisfy all the relevant authorities.

The only catch with our initial UK study is since it is not a clinical trial, you cannot go to market. it’s just between the doctor and his patients. You cannot promote any product or procedure or allow other doctors to do it. For that you need a marketing license, and for that you need the clinical trial.

Authority: Can other professionals participate in your frontend research?

Paul Kemp: This is part of a different business plan and funding structure. Let’s assume we now have this procedure and it works. We can take a hundred hair follicles, bank them, grow them as the patient needs them and put them back. It’s a personalized treatment with the same cells going back into the same patient. Our top concern now is quality control and safety. We want our new procedure of hair cloning to have the highest level of security. We need to be sure that the clinician who’s taking the hair follicles out and putting them back is doing it appropriately. We don’t just want to create some cells that we ship off and not know what people will do with them. So, we plan to take the ethical quality hair transplant surgeons and work with them to develop this system together. In return, we’re giving them regional exclusivity.

Authority: Could you take follicles from one individual and neutralize them so they would be accepted by a different recipient?

Dr. Farjo: Obviously, one of the things people say is , “Well, you haven’t got the treatment yet. Why should I bank my hairs now? I’ll wait till you come up with something that works.”

That’s a common question in my consultations and there are several answers. One thing we didn’t mention earlier is that hair goes through other changes in addition to genetic alopecia. It goes through an aging process, just like every other cell in the body. We’ve proven in university studies that hair from a man in his 50’s or 60’s is different from hair from somebody in their 20’s and 30’s. The way the way they respond to stem cell proliferation and culturing is very different. The younger hair cells are more vital and resilient.

In fact, when we’re working with researchers, they always ask us to send them young patients’ hair because it will maintain its characteristics after cryo-preserving and if you use those hairs in years to come, you can expect to get the same qualities of the younger hair.

We tell patients that rather than waiting until you’ve lost your hair and then try to revitalize it with old, fatigued hair, it’s better to bank your quality hair today. Stopping the aging clock is the first reason to bank as soon as possible.

The second takes us back to our business plan. All the funds we raise from banking are put back into research. Follicle banking allows us to generate funds without resorting to outside investors - and we like the fact that our patients become part of the process too.

Paul Kemp: I don’t think so. Possibly a long time in the future. We don’t yet understand the immunology of using cells genetically. For example, we know alopecia areata is an autoimmune problem so we wouldn’t want to be in a scenario where we’re stimulating something like that? On a practical level, in order to do that, you would have to do a huge amount of viral safety testing. And in order to make that cost effective, you’d have to create huge banks of cells which would require a large amount of starting material.

Authority: With earlier hair multiplication studies there was a problem with “angularity,” the angle at which hair emerged from the scalp. It was hard to create a satisfactory cosmetic solution. Is that still an issue?

Dr. Farjo: No, because we’re rebuilding, or revitalizing the patient’s existing hair follicles. We’re simply enhancing an existing structure.

Authority: With a regular hair replacement or hair system, you get more hair immediately. With a hair transplant, you will see results in a few months. But you are asking patients to invest in something that is not yet available. What is their response?

“Transcriptome” - A transcriptome is the full range of messenger RNA, or mRNA, molecules expressed by an organism.

The term “transcriptome” can also be used to describe the array of mRNA transcripts produced in a particular cell or tissue type. In contrast with the genome, which is characterized by its stability, the transcriptome actively changes. In fact, an organism’s transcriptome varies depending on many factors, including stage of development and environmental conditions.

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“It’s then down to the formulator to ensure that a premium lavender oil is selected. We see a lot of oil adulteration on the market; oils incorporating fragrances rather than pure lavender oil. To achieve the antibacterial or antiviral performance that is so important, formulators must seek out authentic, premium lavender oils that are fully accredited and have clear, demonstrable supply chain provenance.”

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22 Hair Authority Spring 2020

FIGHT the FIGHT! In an effort to warn unsuspecting consumers about the growing problem of fraudulent, illicit clinics performing hair restoration surgery, the International Society of Hair Restoration Surgery (ISHRS) is launching a multi-pronged public awareness campaign to educate potential patients with tips and tools to find qualified hair restoration physicians.

In the United States and Canada, these illicit clinics operate in a more subtle way, most commonly using a “turn-key” approach. In this instance, a plastic surgeon, dermatologist, or other physician purchases a commercially marketable device that can help perform one step of the hair transplant procedure.

“Beware Blackmarket” Campaign Fight The FIGHT, which stands for Fight the Fraudulent, Illicit & Global Hair Transplants, was started by the ISHRS to address the alarming problem of unlicensed non-physicians performing hair restoration surgery around the world.

Patients are lured to these illicit clinics by misleading advertising claims promising low prices and guaranteed results, often with disastrous results and significant health risks with little to no recourse for correction. Specific problems ISHRS members report encountering in these patients include scarring, unnatural hairlines, poor hair growth, wrong hair direction, depleted donor area and infections.

For example, in Turkey, Iran and several countries throughout Europe, unscrupulous clinics are luring patients from around the world to travel to these countries for hair restoration procedures.

However, the vast majority of patients are having their procedures performed by technicians who do not have medical licenses or surgical training.

Instead of performing the procedure themselves, these physicians hire technicians by the day to perform most, if not the entire, procedure — including surgery planning and surgery execution (e.g., graft removal, hairline design, and making scalp incisions to place the grafts)*. Patients are being led to believe either a doctor will be performing the procedure or assured by a doctor that the technicians are “experts and as good as any doctor in performing hair transplants”.

“With the proliferation of illicit hair restoration clinics in recent years, ISHRS members have seen firsthand the suffering of patients who have experienced botched hair restoration surgeries at the hands of unscrupulous clinic operators who have absolutely no business performing this highly specialized surgery,” said Ricardo Mejia, MD, FISHRS, chair of the ISHRS Committee on Issues Pertaining to the Unlicensed Practice of Medicine, and Fellow, American Academy of Dermatology. “Our goal with the Fight The FIGHT campaign is to not only warn consumers about this dangerous practice, but to educate them on how to recognize deceptive marketing techniques and how to find qualified physicians trained in the art and science of hair restoration surgery.”

The cornerstone of the ISHRS’s Fight The FIGHT public awareness campaign is a newly launched microsite — https:// fightthefight.ishrs.org/ — featuring tips on identifying fraudulent clinics, FAQs on illicit surgery, patient case studies, and suggested questions potential patients should ask prior to undergoing hair restoration surgery, among other resources.

In addition, patients may find physicians who pledge to always perform hair transplant surgery themselves, Scarf and not del-

Hair Authority Spring 2020 23

THE INTERNATIONAL TM HAIR AUTHORITY The Hair Authority’s mission is to provide hairmanagement professionals from all disciplines with accurate information that will help them provide superior service to their clients and patients. It is a full-color tabloid, published quarterly and distributed worldwide.

EDITOR IN CHIEF Christopher Webb

“Beware Blackmarket” Campaign egate surgery to technicians. They will be recognized on the Fight The FIGHT website in the “Doctors Pledge” section.

To help ensure patients have the information needed to make informed decisions about who performs their hair restoration surgery, the ISHRS urges potential patients to ask the following questions, as well as questions regarding costs, risks, and short- and long-term benefits and planning: Who will evaluate my hair loss and recommend a course of treatment? What is their education, training, licensure, and experience in treating hair loss?

Who will be involved in performing my surgery, what role will they play, and what is their education, training, licensure, and experience performing hair restoration surgery?

Will anyone not licensed by the state (or country) be making incisions or harvesting grafts during my surgery? If so, please identify this person, explain his or her specific role and why this person is legally permitted to perform it.

Is everyone involved in my surgery covered by malpractice insurance?

“Hair restoration is more popular than ever, which is due in large part to the advances and refinements in surgical techniques made by our physician members,” said Arthur Tykocinski, MD, FISHRS, ISHRS President. “The Fight The FIGHT campaign is another way that ISHRS is at the forefront of our industry, educating and protecting patients with high standards and shining a spotlight on this glaring problem that has the potential to do irreparable harm to patients affected by hair loss.”

About the ISHRS: The International Society of Hair Restoration Surgery (ISHRS) is a global non-profit medical association and the leading authority on hair loss treatment and restoration with more than 1,200 members throughout 70 countries worldwide. Above all, the ISHRS is dedicated to achieving excellence in patient outcomes by promoting the highest standards of medical practice, medical ethics, and research in the medical hair restoration industry.

IHA

cwebb@hairauthority.com

CREATIVE DIRECTOR Dylan Case dcase@hairauthority.com

CONTRIBUTING EDITOR Larry Oskin info@hairauthority.com

LEGAL NOTICE

The views expressed in The International Hair Authority are those of the individual author or contributor and not those of The International Hair Authority, its editors or staff. The Authority’s contents reflect the opinions of the authors and are not analyzed, peer-reviewed or otherwise investigated before publication. All authors and contributors are asked to disclose any interests they have of a commercial nature.

The International Hair Authority makes no attempt to validate the sufficiency of such disclosures and makes no warranty, guarantee or other representation, expressed or implied with respect to the accuracy or sufficiency of any information provided. The publication of an advertisement does not constitute on the part of the International Hair Authority a guarantee or endorsement of the quality or value of the representations or claims made by the advertiser. The International Hair Authority accepts no responsibility for unsolicited materials.

All articles and letters become the property of the International Hair Authority and may be edited for clarity, presentations and space. By allowing your articles, interviews and personal commentary to be used in The International Hair Authority, you are giving the publication permission to use these materials in its pages, websites and other information materials.

Advertisers are required to sign a formal advertising agreement indicating that they are not violating any trademarks or other intellectual properties. Full details are outlined in The International Hair Authority Media Kit.

COPYRIGHT

The material published in The International Hair Authority is copyrighted and may not be utilized in any form without the written consent of the editor.

THE INTERNATIONAL HAIR AUTHORITY 39252 Winchester Road #107-383 Murrieta, CA 92563 Email: info@hairauthority.com Tel: 626-709-6397

24 Hair Authority Spring 2020

Reopening Survey Results Staff Safety Number One Concern for Salon Owners For the past few months, salons around the world closed their doors in order to help contain the COVID-19 pandemic. We are now starting to see hair, barber, beauty and spa businesses in various countries opening back up and getting busy again as restrictions are lifted across USA and Europe.

Phorest Salon Software recently surveyed salon owners to see what aspects of reopening are getting them concerned and how they plan to handle the reopening.

Staff Safety Is the Main Concern They found that the number one concern of salon owners about reopening is their staff’s safety (35%). Another significant area of concern for 30% of salon owners was the potential gap between the revenue their salon generates versus the overheads they have to pay.

Salon owners are least concerned about the communication with clients (6%), indicating that they have been using tools to stay connected to their customers even during the lockdown.

When asked how confident salon owners in general feel about reopening their salon safely, the surveyed rated their confidence on average as 7.3 out of 10.

What Do Salon Owners Plan To Do When Reopening?

Besides government guidelines and social distancing rules salon owners need to consider when reopening, they also need to decide how their ‘new normal’ and the new day-to-day operations within their salon will look like.

• The majority (68%) of the surveyed salon owners plan to open their doors for customers for 5 or 6 days.

• 41% of the survey respondents plan to lengthen their opening hours to cope with the demand, at

least temporarily.

• Most of the salon owners plan to have 0 to 2 (34%) or 3 to 4 (36%) staff working in the salon at the same time, depending on the salon size.

• 47% of the surveyed salon owners plan on offering restricted services and treatments when reopening their doors.

Looking at how salon owners plan to schedule the first weeks of appointments, the surveyed agreed that they’ll first reach out to customers that were booked in, then contact loyal regular clients, followed by customers on the waiting list.

Walk-ins and spontaneous bookings will not be accepted by most once salons reopen. The majority of the surveyed salon owners will only accept phone and email bookings, at least for the first few weeks. Full survey results, including graphs, are available at the Phorest blog.

The Phorest Reopening Toolkit Phorest launched a ‘Back in Business’ toolkit which has everything every salon needs for a safe and successful reopening, including email and SMS templates, wellbeing practice guides for the new normal as well as data and advice from those who have been there before. Phorest clients can also now use brand new appointment control features, client filtering options, COVID-specific messaging and Online Booking banners.

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Hair Authority Spring 2020 25

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28 Hair Authority Spring 2020

Trichology Section Presidents Message In previous posts I have written about the plethora of people who call themselves trichologists without having any trichology-specific education or certification. In this post I will be discussing organizations who teach and certify trichologists.

David Kingsley, PhD. President World Trichology Society

In the past few years in the USA many new trichology organizations have sprouted up with an alphabet soup of names and acronyms. These organizations are often overseen by self-certified trichologists (a conflict of interest?), trichologists certified by other organizations whose memberships have lapsed (more about this later), inexperienced trichologists, and individuals with no trichological background whatsoever.

In my opinion, this just makes our whole industry fraught with poorly trained ‘certified’ trichologists and open to even more ridicule by prospective clients and the medical community.

Everyone wants to make money. The whole idea of being a trichologist is to make a big splash in this niche market, help people with hair loss and make a living. So why not make money being a teacher of trichology? A fair argument, but a specious one.

Being a trichological organization is more than just certifying students. It is also about the level of education from the course (note: if the teacher hasn’t the university-level educational background how is he/she able to teach to a necessary standard?), the completeness of the course, the ability to offer post-graduate continuing education courses, being able to support its members, dealing with client complaints and, most importantly, being recognized by other organizations in the trichological and medical fields.

Is the trichology organization you are certified through respected by its peers? Will your organization’s certified trichologists be accepted by certified trichologists of other trichological organizations?

In respect to the World Trichology Society (WTS), the answer is yes and yes. Amongst many accreditations and recognitions, the WTS is recognized by the medical hair authorities of the World Congress of Hair Research and the American Hair Research Society. It is recognized by other trichological authorities, such as the International Trichology Congress and the Hair University; and it is recognized by other hair authorities, such as the International Hair Journal, Hair Plus and the American Hair Loss Council. The WTS has been asked by the World Congress of Hair Research to be a co-chair at probably the most prestigious medical hair conference in the world (Melbourne, Australia 2021); and you often see members of the WTS doing presentations at most other trichology organization’s conferences.

Being a certified trichologist comes with expectations. One is that the trichologist continually educates him/herself as treatments and trichological knowledge change frequently. This is accomplished by reading articles (medical and para-medical) and attending trichological and/or medical conferences. This education should be overseen by the certification body. A graduate may be doing this without renewing his/her membership, but how does the certification body know? When you achieve your State cosmetology license you have to keep renewing it to stay licensed, why not the same with trichology? To keep their licenses, physician’s need to complete hours of monitored continuing education, so why not trichologists?

To this end, the World Trichology Society has introduced a Continuing Trichology Education (CTE)™ program to make sure its trichology certified members are sufficiently educated. If its certified trichologists do not renew their membership each year or not reach the required CTE™ credits, the WTS will ‘deactivate’ their certification until membership can be re-established. The WTS also has many introductory and Advanced courses for its members and students to help with their education. This includes a weekly WTS-Live! seminar on its private Facebook page.

Every week the World Trichology Society (WTS) receives emails and calls from students and graduates of other trichological organizations who want more education. In my opinion, the need to authenticate the certification the graduate received from another organization by taking a WTS course is pretty damning for that organization. Therefore, before making a choice of which trichology organization you choose to become certified through, please make sure they provide you with the tools to also help you keep at the forefront of your profession.

Hair Authority Spring 2020 29

Yvonne Kingsley Memorial Prize In remembrance of Mrs. Yvonne Kingsley, the World Trichology Society’s Co-Founder, Chief Financial Officer and Company Secretary, the World Trichology Society is proud to announce the introduction of the Yvonne Kingsley Memorial Prize for the student who attains the highest standard during each WTS certified trichologist clinical training course.

Yvonne was very proud of all the students who were able to become Certified Trichologists through the World Trichology Society. She always believed it took a special person to have the drive, determination and self-discipline to complete the WTS certification course while also juggling their families and careers.

This award comes with an award certificate and a $250 USD prize.

The student will be judged on: 1) his/her interaction during the clinical training period, 2) his/her understanding of the material from the academic part of the course, 3) his/her knowledge in completing assignments, 4) his/her mark in the written part of the final exam, an 5) his/her ability in the viva voce (oral) part of the final exam.

Head Lice - Facts and Fallacies

By Tony Pearce RN Consulting Trichologist, National Trichology Services

There are many myths and rumors associated with contracting and treating head lice. To help dispel some of these seemingly perennial misconceptions I have been asked to provide this information sheet ‘Pediculosis Capitis’ is the medical term for head lice. Head lice are tiny mites that live in human hair. Head lice spend their lifecycle on the human scalp and survive by sucking the host’s blood - in much the same way as a mosquito.

The female louse lays about 6-9 small white eggs (called nits) per night when the host is still. The nits are cemented to the hair shaft close to the scalp; the temperature of the scalp being ideal for their maturing and hatching.

The nits hatch in about 6-7 days, with the new lice reaching maturity in about 10 days. Adult lice live for about 20-30 days.

Head lice multiply quickly and are not only a distressing annoyance but in some countries can also carry serious diseases like typhus and trench fever.

Telltale Signs Persistent, intense itching of the back of the head or neck.

(The intense itching is a result of an allergic reaction to the

lice’s saliva). Tiny white specks firmly attached near the base of individual hair. These are the ‘nits’ or eggs.

Seeing the mites themselves.

How does head lice spread?

• Direct. Close contact or by shared combs, brushes or caps.

• Can also travel from one head to another on a towel, pillow or seat/chair headrest. Borrowing ribbons, scarves or other head coverings.

• Because head lice prefer an undisturbed environment, they are more commonly seen in people with longer hair and/or who don’t wash/brush their hair regularly.

Some common myths • Head lice do not only go to clean hair.

• Head lice cannot fly but can jump from person to person.

• They do not live in pillows or mattresses and come out at night!

Treatment • Consult a qualified health professional such as your family doctor.

• Modern commercial preparations will usually eradi-

Cont’d Pg 30

30 Hair Authority Spring 2020 cate infestations in a one-step shampooing treatment. Again, consult your doctor or pharmacist.

• Following treatment remove dead mites and nits with a tine-toothed (preferably metal) ‘nit comb’ Robi-combs are reported to be quite effective in trapping mites and nits.

• Head lice are very contagious, and it is advisable that all family members be treated promptly and at the same time • Thoroughly wash, dry-clean or dispose of any items that came in contact with the infested scalp These items would include brushes, combs, hairclips, caps, ribbons and hairdressing or household linen.

Some Important Points!

• The white shells that can easily be seen is the louse’s natural diversionary camouflage. These shells are empty and harmless.

• The living eggs are laid close to the scalp as the hair grows outward to reveal previously undetected eggs.

• Treatment failure may then be assumed as the hair grows outward to reveal previously undetected eggs.

• If an effective louse/ovicide treatment has been used, no mobile stages of lice will be detected, and re-treatment is not necessary.

-------------------------------------------------------------------------------Tony Pearce is regional director of the Asia/Pacific chapter of The World Trichology Society.

A personal note from Tony - I am regarded by my peers, media and consumers as an authority in female, children’s and autoimmune hair and scalp problems (I also consult males for hair & scalp concerns). I am passionate about what I do, and how (I feel) I make a positive difference to my Client’s health and hair concerns. I have ZERO tolerance for the charlatan poseurs that see my field (hair loss treatment) as an easy way to make quick money, and prey on consumer anxieties. I enjoy researching my areas of expertise, and always seek to assess methodology out of the orthodox ‘norm’ (“things aren’t always as they appear” is my Mentor’s mantra to me).

‘Your life is the Universe’s gift to you ... what you do with your life is your gift back to the Universe.’ I am most thankful for all I have ai159407610733_PhytoTress World Trichology Ad 7.06.20.pdf 1 7/6/2020 6:55:09 PM received!

IHA

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Dermatology Advisor reports, “Scalp pruritus, dysesthesia, and hair loss are more prevalent in Black patients compared with their White counterparts,” investigators found in a survey that gathered data from 648 respondents. The findings were published online in the Journal of the American Academy of Dermatology.

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Hairy Skin from Stem Cells

Researchers created hair-growing skin from human stem cells

By Erin Bryant, National Institutes of Health

Koehler had used in earlier work to create sound-sensing cells in the inner ear. The researchers applied a combination of growth factors and small molecules to coax the stem cells into skin tissue.

After 4-5 months, the stem cells had grown into a small, cyst-like “organoid” that replicated the micro-anatomy of skin. This “skin in a dish” had both the top and bottom layers of skin (epidermis and dermis), fat, nerves, and was able to sprout hair. Hair buds, which produce hair, formed after about 70 days, similar to the timing during embryonic development. The organoids also produced specialized cell types like Merkel cells, which are responsive to touch.

Hair-bearing human skin 49 days after being grafted to a mouse. Koehler lab, Nature

Skin is the body’s largest organ and plays a vital role in health. It helps regulate body temperature, retain body fluid, and defend against the outside world. It also allows the sensation of touch and pain.

Skin is a complex structure made up of multiple layers. It contains fat, nerves, glands, and hair follicles. Scientists have been able to grow human skin outside the body for over 40 years. However, skin grown in cultures lacked embedded structures, like hair follicles and sweat glands, found in real skin.

A team of researchers led by Dr. Karl Koehler of Boston Children’s Hospital aimed to create complex, hair-bearing skin in the lab using human pluripotent stem cells, which are present early in embryonic development and have the potential to transform into any cell type in the body.

The study was funded in part by NIH’s National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institute on Deafness and other Communication Disorders (NIDCD), and National Institute of Child Health and Human Development (NICHD). Findings were published in Nature on June 3, 2020.

The scientists had successfully generated hair-bearing skin from mouse stem cells in the past. To transform human stem cells, they started by revisiting a culture method that

The team analyzed the organoid and determined that it was similar to the facial skin of a fetus in the second trimester.

The researchers next grafted the hair-bearing skin onto the backs of nude mice. Within a month, the mice grew small, pigmented hairs at the site of the graft. The transplanted skin had many features unique to adult human skin, including sebaceous glands which secrete lubricating oil for the skin and hair.

Being able to create hair-bearing skin in the lab may help advance research into skin development and diseases.

It could have implications for treating baldness as well, although many challenges remain.

“We now have a technique that could generate nearly unlimited hair follicles for transplantation,” Koehler says.

“But immune rejection is a major hurdle, and generating follicles tailored to an individual will be incredibly costly and take a year or more.”

References: Hair-bearing human skin generated entirely from pluripotent stem cells. Lee J, Rabbani CC, Gao H, Steinhart MR, Woodruff BM, Pflum ZE, Kim A, Heller S, Liu Y, Shipchandler TZ, Koehler KR. Nature.

2020 Jun 3. doi: 10.1038/s41586-020-2352-3. PMID: 32494013.

Funding: NIH’s National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institute on Deafness and other Communication Disorders (NIDCD), National Institute of Child Health and Human Development (NICHD), and National Center for Research Resources (NCRR); Ralph W. and Grace M. Showalter Trust; Indiana Clinical and Translational Sciences Institute; Indiana Center for Biomedical Innovation.

IHA

32 Hair Authority Spring 2020

Responding to Covid 19 What we did... what we learned... and where we go from here Church & Dwight - Viviscal and Toppik

The Covid 19 pandemic has affected everyone differently. It has been a time for reflection and for reassessing priorities on both a personal and corporate level. Church & Dwight is a company committed to customer support and welfare, so it was only logical that the Hair Authority would turn to them to learn how they had responded. We are pleased to be able to share this thoughtful and caring response from Stacey Ramstedt, VP of Specialty Hair Care.

What have you learned as a result of the COVID-19 crisis, both personally and professionally?

I have learned that we are resilient. I have learned that we are stronger when we band together and support one another.

I have learned to never take anything for granted, be in the present and treasure the ‘everyday’ moments.

I continue to see that we are beautiful, inside and out. We have evolved as people and so too we will need to evolve how we serve up beauty to our clients. Beauty brings hope, confidence and optimism. It is and will continue to be an important part of our lives.

We want to give stylists and their clients the freedom to let their true beauty shine.

“The shutdown of non-essential businesses, rise of at-home beauty, and pending recession is going to put the professional beauty business to the test.”

What will you/your organization do differently going forward?

We will do two things differently going forward. First, we will reach, educate and engage the stylist community and their clients from an omni-channel perspective. Our audience has been exposed to and is more accepting of virtual

training and webinars, ecommerce and social communication now more than ever before. We are pleased to have connected as many salons as possible to ecommerce support to help them get up and running properly. This isn’t even what we do... but saw the need to help wherever possible. We are also proud to have donated 10% of Viviscal sales to the Professional Beauty Associations’ relief fund to support stylists.

Second, we will connect our innovation to emerging beauty trends. Trends that we are seeing include a move from health and wellness to self-care and wholeness, natural low maintenance looks, clean beauty where less ingredients is ‘more’, a move from skin care to skin health, and beauty as a form of escapism/hope.

How will the professional beauty business be different going forward?

The shutdown of non-essential businesses, rise of at-home beauty, and pending recession is going to put the professional beauty business to the test. For those to survive (and thrive) in the current market conditions, they will need to find new ways to create value as some of the old ways may have been replaced and clients will want ‘more’ for their money.

Our audience will want to think of offering new products and services that cannot be replicated easily, remind clients about why their offering is spe-

Hair Authority Spring 2020 33

“EVERYTHING I have read indicates that this industry will recover in full. What we don’t know is timing and what it will look like in the future.” cial and unique, consider strong loyalty programs and digital add-ons.

I believe service and meaningful experiences will be key differentiators in the professional beauty space. This also includes how salons and stylists work. I fully expect that this will look very different in the year to come and we may see many getting creative and bringing the salon experience into the home.

What will be key to the industry’s recovery?

EVERYTHING I have read indicates that this industry will recover in full. What we don’t know is timing and what it will look like in the future.

The key to the industry’s recovery will be speed, flexibility and creativity. How quickly are we going to change our ways of doing business and pivot from the way it has always been done? How are we going to creatively solve for the changes

in the market and better meet our clients’ needs?

Opportunity is omnipresent. We will have to behave differently to leverage it, and the first one to do so will have the first mover’s advantage.

Stacey Ramstedt is the Vice President of the Specialty Hair Care division at Church and Dwight, Inc., Co. Stacey has 18+ years of brand management and consumer marketing experience in personal care and beauty industries. Most recently, she built market-leading beauty brands for Paris Presents by lead marketing and innovation efforts to establish a compelling brand strategy and activate across all consumer touchpoints. She accomplished this by leveraging her understanding of consumer needs, finding new ways to connect digitally to build brand awareness and loyalty, and tapping into her earlier experience working at consumer goods companies, Kimberly-Clark and Sara Lee. IHA

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No FDA-Approved Exosome Products “Public Safety Notification on Exosome Products” (Source: The Food and Drug Administration)

The Food and Drug Administration (FDA) is informing the public, especially patients, health care practitioners, and clinics, of multiple recent reports of serious adverse events experienced by patients in Nebraska who were treated with unapproved products marketed as containing exosomes. These reports were brought to the agency’s attention by the Centers for Disease Control and Prevention, among others, and the agencies worked with the Nebraska Department of Health and Human Services. FDA is carefully assessing this situation along with our federal and state partners.

There are currently no FDA-approved exosome products. Certain clinics across the country, including some that manufacture or market violative “stem cell” products, are now also offering exosome products to patients.

They deceive patients with unsubstantiated claims about the potential for these products to prevent, treat or cure various diseases or conditions. They may claim that they these products do not fall under the regulatory provisions for drugs and biological products – that is simply untrue.

As a general matter, exosomes used to treat diseases and conditions in humans are regulated as drugs and biological products under the Public Health Service Act and the Federal Food Drug and Cosmetic Act and are subject to premarket review and approval requirements.

The clinics currently offering these products outside of FDA’s review process are taking advantage of patients and flouting federal statutes and FDA regulations. This ultimately puts at risk the very patients that these clinics claim to want to help, by either delaying treatment with legitimate and scientifically sound treatment options, or worse, posing harm to patients, as evidenced by these recent reports of adverse events.

Health care professionals and consumers should report any adverse events related to exosome products or any other unapproved product to the FDA’s MedWatch Adverse Event Reporting program. To file a report, use the MedWatch Online Voluntary Reporting Form. The completed form can be submitted online or via fax to 1-800-FDA0178. FDA monitors these reports and takes appropriate action necessary to ensure the safety of medical products in the marketplace.

Patients considering treatment with exosome products in the United States should: • Ask if the FDA has reviewed the treatment. You also can ask the clinical investigator to give you the FDA-issued Investigational New Drug Applica-

tion (IND) number and the chance to review the FDA communication acknowledging the IND. Ask for this information before getting treatment and follow up with your personal health care provider to confirm this information.

• Request the facts and ask questions if you don’t understand. To participate in a clinical trial that requires an IND application, you must sign a consent form that explains the experimental procedure.

The consent form also identifies the Institutional Review Board (IRB) that assures the protection of the rights and welfare of human subjects. Make sure you understand the entire process and known risks before you sign. You also can ask the study sponsor for the clinical investigator’s brochure, which includes a short description of the product and information about its safety and effectiveness.

Patients considering treatment using an exosome product in another country should: • Learn about regulations that cover products in that country.

• Know that FDA does not have oversight of treatments done in other countries. FDA typically has little information about foreign establishments or their products.

• Be cautious. If you’re considering an exosome product in a country that may not require regulatory review of clinical studies, it may be hard to know if the experimental treatment is reasonably safe.

FDA remains committed to protecting patients. Our work to ensure compliance with the law does not take away from our firm commitment to advance an efficient path for the safe and effective development of novel regenerative medicine therapies and to help foster beneficial new innovations. We’ll continue to work closely with investigators and firms legitimately working in this field and will do so in the most effective manner possible, while meeting the FDA’s standards for safety and efficacy. We look forward to working with those who share our goal of bringing safe and effective products to market to benefit individuals in need.

IHA

Hair Authority Spring 2020 35

Software Company Launches Salon Re-Opening Kit Life in salons as we know it is changing and it is key to adapt to these changes in order to get back in business, successfully.

Phorest Salon Software has been working hard to ensure salons can adapt with ease, whilst continuing to generate revenue and watch their business grow. The team at Phorest has created a Reopening Resource Bank to support salon owners & managers.

Resources include blogs, podcasts, email and SMS templates, the Post Lockdown Revenue Calculator and a Reopening Action Plan worksheet, to name a few.

In addition to this, Phorest has put together a ‘Getting Back In Business’ playbook which is comprehensive guide to helping salon professionals during the reopening phase. The playbook covers everything from managing your operations to assessing and working with your financial situation and can be downloaded via the Reopening Resource Bank.

The Resource Bank is reviewed and updated weekly with up to date and relevant information and tools. Salon owners who download the resource bank will receive a weekly email, highlighting any new resources to help ensure a smooth reopening.

About Phorest: Phorest is a cloud-based salon management system that offers a suite of software solutions from scheduling to payments, online gift card sales and the most premium integrated marketing suite on the market.

IHA

36 Hair Authority Spring 2020

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