Papilla … anagen … telogen

Hair Removal Methods Professional Electrolysis
#1

The “papilla only” idea persists. The “you can only destroy hairs in anagen” persists too. The thing is, when most people write new textbooks, their research is mostly “secondary” research, not “primary.” Consequently, the notions of the old books simply get “copied and pasted” into the new book. So the fables go on and on and on. I think I have a valid argument for your consideration.

Let me focus on the (ancient) idea that the follicle is destroyed when the blood supply (papilla) is destroyed.

I spent all yesterday at the office of Dr. Brad Kurgis who is a hair transplant specialist. He was operating on one of my clients and I sat in … had a good time too. I also have done these myself with Dr. Perkins (Santa Barbara) and I’ve spent a lot of time looking at follicles under a microscope.* Well, so what?

Let me quickly explain the process. A full-depth strip of skin is removed from the back of the patient’s head (all the way below the fat layer to the tough collagen layer “fascia.”). The strip is cut into tiny cubes and then each follicle is carefully dissected out (using a razor blade). The tiny hair grafts look like long-grain white rice … with a hair sticking out one end.

Importantly, the follicle has been totally removed from the blood source. The papilla clots and is rendered useless and any adjacent blood vessels quickly clot and are rendered useless. The hair graft is ONLY the follicle itself: complete with stem cells, however. There is NO blood supply at all! There are no blood vessels anywhere (grain of rice, remember?)

When the hair graft is implanted in the tiny slit, the hair goes into “shock.” All the visible hairs fall out. The hair goes into a protracted resting stage and then the miracle takes place. The stem cells completely rebuild the hair and follicle AND rebuild a totally new papilla.

Dr. Kurgis said that a few weeks ago the power went out during a surgery. They stopped and put the hair grafts in the refrigerator. They continued the surgery the next day. Even after 24 hours of being without a “blood supply” all the grafts took perfectly!

I have been working on, and destroying, telogen hairs for 30 years; I don’t need verification. However, if a completely “cut out” hair graft, with no blood supply, can re-create a perfect hair, what do you suppose is doing this miracle? Clearly, the stem cells in the follicle (particularly the upper follicle/bulge are responsible). There is no other explanation! Is there?

I have a few more examples to share, but this is the “big one” and should be enough evidence that simply “destroying the papilla” is not enough. Those getting superior results with electrolysis have been employing this reality for a long time.

*All drawings of the telogen follicle show the papilla as a tiny “clump” under (and attached to) the follicle. I’m not entirely sure this is valid (remember old drawings just get re-copied in the new books).

I have spent a lot of time examining hair grafts under the microscope. Yes, there is a tiny “clump” under (attached to) the telogen follice, but it looks nothing like a blood vessel (it’s 100% colorless). My GUESS is that this tiny clump is the bulge/stem cells themselves. Remember, at the time most drawings were done, people did not know about the “bulge.” They simply assumed this clump was some sort of “resting papilla.” I don’t think so! I think this whole subject needs to be investigated in a new light.

#2

FASCINATING!

#3

Argument #2 (papilla/anagen only?)

Although I talk a bit about it in my book, the Dr. Bouman (The Netherlands) experiment is worthy of note.

Bouman’s fix for “ingrown beard hairs on the neck” was surgical. He would cut a flap of skin and flip it over. With scissors he would cut out the entire lower follicle, thus surgically removing the bulb and papilla. From the fat layer, he would snip all the way up to the dermis, and a bit of dermis too.

I met Bouman sometime in the mid 1980s. He was a buoyant guy with a big smile; I liked him: it was at an ANBOS conference where I was giving a talk. About 10 minutes before my lecture, the ANBOS chairman told me (and John Blokker, my rep in Holland) that my talk would go as follows: On the stage, there would be me and a physician and an electrical engineer. The audience would ask a question, I would answer and then either the doctor or the engineer would say if it was “right or wrong.”

Blokker objected to this set up, but I was happy to have these experts on hand. After a few questions, Bouman got up and made a short statement that made the audience laugh (it was in Dutch, so I hadn’t a clue). Basically he said: “I don’t know the technique Bono’s talking about, but if you are able to treat the entire follicle (not just the bottom part) then you need to do that.”

Later, Bouman told the audience that his experimental surgery was a total failure (also resulting in scars). He reckoned that, indeed, the upper follicle was able to reconstruct the entire lower follicle, including the bulb and papilla!

The point is that Bouman was surgically removing the papilla and bulb and in spite of this, the hair was still able to regrow itself: papilla and all. Once again, the need to destroy the upper follicle (bulge and stem cells) was confirmed to me … WAY BACK in the 1980s!

#4

Michael, do you know if the Dr. Bouman´s work was published?. Let me tell you the reason for my interest.
Halfway through the 80’s, I had a case of severe hirsutism on the face of a woman of 36 years. I do remember this case, for several reasons, but mainly because of what the woman was about to do. She had tried everything, hormone therapy, electrolysis for a year (in the wrong hands) nothing worked. She worked as a nurse in a health center also featuring specialists in all fields. When she had enough confidence in me, told me that one of the doctors spoke of experimental work being carried out somewhere in the world. The description of the technique that she told me is very similar to what you have mentioned. Fortunately, someone (I think a gynecologist friend of hers) took this crazy idea out of her head. There was no guarantee to remove hairs, but a good chance of catching a resistant virus, characteristic of the operating room.

The oddest thing about all this is that I never knew what were the results of that investigation, until I read this thread yesterday. Thanks again for sharing your experiences with us.

#5

Yes Jossie, this was published. Of course FINDING it … well, I’ll bet YOU can do it girl! You amaze me! (In Dutch, of course.)

Dr. Peereboom’s study was also published. OYE!

#6

I always enjoy reading these scientific topics on HairTell. Hair follicles are becoming more fascinating to me. :slight_smile:

#7

I think this is the paper: Surgical depilation for treatment of pseudofolliculitis or local hirsutism of the face.
I have downloaded it if anyone wants a read.

#8

Just a side note: from the time i started to hunt especially after the short broken telogen stubble hairs my efficiency increased noticeably. Even even when my insertions were noticeably below standards.

In that private workshop i enjoyed with Jossie last summer i did a treatment in order show demonstrate her the relative ineffectiveness of auto sensor mode in a pretty radical setting: 0.2 s preset time followed by a multiplex pulse of just 0.1 s total time. Fine hair on my lower leg, size 2 IBP. In such a short time i am not able to obtain a full coverage of an anagen follicle even by movement of the probe, but i am able to do mostly correct insertions whe the hairs are telogen. The overall setting was pretty low, i actually could feel a slight plucking of the anagen hair. The telogens released fine.

To my surprise i noticed a significant reduction of hair growth in that stripe. Which means that i must have covered the region containing the stem cells reasonably well.

(Despite of that - there is nothing beyond thorough insertions which cover at least the full “bulge” - we simply do not know the actuall distribution of our target cells).

Apropos bulge: the picture below shows follicular grafts extracted during a hair transplant surgery using an FUE approach. Especially in the third graft containing a cluster with 4 anagen hairs no dedicated “bulge” structure can be recognized. Correct me if i’m wrong but to me it simply looks as if the hairs go through a matrix of skin tissue (which as we know contains the stem cells). So is the “bulge” we take out with hair a real structure or just an artefact representing (part of) the destroyed tissue?

#9

GREAT photo Beate!

With a “back light” and microscope you can faintly make out the bulge … but yes, it’s “skin color” and nearly impossible to see. Graft #3 sort of shows it (off to the left, just above the sebaceous gland.)

The blade-cutting creates the tiny grafts as you have nicely illustrated so the bulge is difficult to detect (it does not cut around the bulge).

In the two center grafts, you can make-out the sebaceous gland. Again, these look different than in most illustrations: the gland is closely attached to the follicle and the “channel” or duct is much shorter than typically drawn. (My illustrations are wrong too.)

Notice too how REALLY thin the epidermis is and also how it has resisted the cutting (it has a different shape). It’s also REALLY tough. Notice on the second graft how deeply the hairs extend into the fat layer (the yellow shiny stuff).

The other odd thing is the way these smell! I think the odor is from the fat: not exactly “nice” at all. It used to make me sick until I got used to the odor (sort of like raw chicken!).

#10

I will dream about these beautiful hairs tonight and wake up in the morning with these perfect images in my mind. Alas, I wish I could see the nerve bundles that net around the bottom of the follicle. Thanks Beate! These hairs are perfect specimens. Wow.

#11

Would this information then totally change what electrolysis who are beginning their education should be learning ??

#12

For sure, studies proved that bulge and stem cells are responsible for hair growth.
Though, I was thinking about this photo and wondering is there really no cells at all in the (near?) the bulb, which responsible for hair growth (which this photo made us believe).

And I found next scientist experiment.
http://clonemyhair.com/haircloning/haircloning/item90019.html

“Small punch biopsies were taken from his scalp skin and from the hair follicle end bulbs dermal sheath and dermal papillae were isolated. Up to 11 pieces of dermal sheath were combined and implanted into small, shallow wounds on the inner forearm of his wife.”

“Transplanted dermal sheath is believed to induced fibres were distinct and often pigmented. Than, from induced follicles, 200 to 400 dermal papilla cells were removed and PCR-based gender determination was performed. Group claim, that results indicate, that dermal papillae were of mail origin and they contained X and Y chromosomes, while epithelial part of inducted hair follicles were of recipient, female origin and they contained 2 X chromosomes.”

Am I understand right that to eliminate the hair in anagen all lower 2/3 of the follicle should be eliminated since bulb has cells as well?