Hair restoration is going through its biggest change in decades, and much of it is happening in the laboratory rather than the operating theatre. Scientists are now growing new hair follicles from cells, an advance that could one day help patients long told nothing more can be done for them: those with extensive hair loss and little donor hair left, women with diffuse thinning, people with scarring or autoimmune conditions, and cancer survivors whose hair never fully returns after chemotherapy.
Dr Kashmal Kalan, Medical Director at Alvi Armani South Africa, sees this as one of the most important developments of his career. “Regenerative technology has the potential to turn candidates who were previously limited into fully treatable patients,” he says. “This is why research matters so profoundly. Without it, we could never give these patients hope.”
The science is complex, though the idea is easy enough to picture. Researchers are developing hair follicle organoids and bio-fabricated follicles: new follicles grown in a laboratory, so a surgeon is no longer restricted to the supply a patient already has. “A hair follicle is a remarkably complex little organ, with many cell types that have to communicate in precise ways,” Dr Kalan explains. “The hard part isn’t growing those cells in a dish. It is creating one that survives in human skin and keeps growing natural hair for years.”
However, he is quick to manage expectations: the progress is coming in stages, with early treatments likely to stretch donor hair further and revive weakening follicles, and fully lab-grown follicles arriving later.
That progress matters because the need for it is growing. More than half of men and a sizeable share of women experience pattern hair loss by the age of 50. In South Africa, a University of Cape Town study found traction alopecia in close to one in three women with afro-textured hair. Patients are also getting younger and more often female: the International Society of Hair Restoration Surgery reports that 95% of first-time transplant patients in 2024 were aged 20 to 35, with female patients up 16.5% since 2021.
A shortage of donor hair has always been the main reason patients are turned away, and South Africa adds a complication. Conventional techniques were developed with straighter hair in mind, and the follicle beneath tightly curled hair curves under the skin, which makes it harder to remove and place. “For years, patients with tightly curled hair were wrongly labelled poor candidates, when the real limitation was the surgeon’s experience or the technology of the day. Hair restoration must work for every hair type, not only the straightforward cases.”
Cancer survivors stand to gain too. It is a group Alvi Armani South Africa knows well, through a longstanding partnership with the Cancer Association of South Africa (CANSA). Many see their hair return after chemotherapy; others are left with thinning that never fully reverses. “For many survivors, getting their hair back means getting part of their identity back. Regenerative medicine may one day repair the environment around the follicle itself. Survivorship is about restoring dignity and quality of life, not only treating the disease.”
The excitement has also brought hype. “Words like ‘stem cells’ and ‘hair cloning’ are used far more freely in advertising than in evidence-based medicine. No clinic anywhere offers proven, unlimited hair cloning today. People need to tell genuine science apart from a sales pitch.”
He believes regenerative treatments could reach mainstream practice within five to ten years and urges anyone worried about hair loss to get a proper diagnosis first. The bigger shift, he believes, is not only scientific.
“The future of this field will be more personalised, more inclusive and more attuned to each patient’s biology,” he concludes. “The clinics that lead it will not just move follicles well. They will understand people well.”
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