Fecal Transplant Prompts Hair Growth in Alopecia Areata Patients

Oct 19, 2017

A new article describes two patients who experienced hair regrowth of their alopecia universalis after fecal transplants.

Some of the most common, recurrent questions that arise from the NAAF community pertain to the connection of our gut health with immunomodulation in alopecia areata. At the last patient conference in Miami, a few of us fervently discussed the topic of alopecia areata and fecal transplants. And as always, the NAAF community was onto something! A new article describes two patients who experienced hair regrowth of their alopecia universalis after fecal transplants.

So, what is a fecal transplant? How did this even come to existence?  Our intestines contain up to 2,000 different kinds of bacteria, co-existing in a balance which appears to be key to protecting our body from infection and inflammation. When some patients are hospitalized or treated with antibiotics, an imbalance of the normal bacteria in the gut can lead to overgrowth of a bacteria Clostridium difficile. The C. Difficile (“c. diff”) infection can be a very disturbing condition, characterized with abdominal pain, diarrhea and high white blood cell counts. It is highly contagious and usually well treated with antibiotics.  However in some cases, it can stop responding to medications and become resistant, persistent and even life-threatening. This difficulty has led to innovative solutions, such as incorporating fecal microbiome from healthy individuals into the gut of ill ones. That is how “poop- transplant”, or proper name fecal microbiota transplantation (FMT) has saved the day, and lives, for many C. difficile ill patients.

The exciting information for the role of FMT in alopecia universalis comes from two young patients treated for such resistant C. Difficile infections. The first case was a 39-year-old man with a 10-year history of alopecia universalis. He had suffered with recurrent gut C. Difficile infection and was finally treated with FMT with successful resolution of his abdominal symptoms.  Interestingly, at his 8 week FMT follow up, he had regrown patchy hair on scalp, face and arms, which persisted even 3 years later. The second case was a 20-year-old man with the same infection in a setting of Crohn's disease and alopecia universalis. After FMT, his scalp hair loss improved from stage S4b alopecia (95–99% hair loss) to stage S2 (25–49% hair loss), and also noted hair growth on other body parts.

We can all agree: this is very exciting news! FMT is emerging as a treatment option for several inflammatory conditions, and luckily alopecia areata appears to be one of them. Before we all run to the doctors and ask for some, clinical studies with FMT are necessary to properly evaluate safety, efficacy and durability.

For more information please refer to the following article:

Rebello D, Wang E, Yen E et al. Hair Growth in Two Alopecia Patients after Fecal Microbiota Transplant. ACG Case Rep J. 2017; 4: e107. Published online 2017 Sep 13. doi: 10.14309/crj.2017.107

Author: Dr. Natasha Atanaskova Mesinkovska, Chief Scientific Officer

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