Can Fecal Transplants Really Regrow Hair? By Bernard Arocha, MD on March 07, 2019

Thousands of people in Houston, Dallas and Austin have a condition known as alopecia universals (AU), which is characterized by the complete loss of hair on the scalp and body. It can be debilitating for these boys, girls, men and women, as hair can be a symbol of health and beauty, and is closely connected with our confidence. Anyone who has AU or has a loved one who has AU will be interested in published reports about the unexpected observations of researchers testing new treatments for a completely different ailment.

The treatment is fecal microbiota transplantation (FMT) and it was being used to treat recurrent clostridium difficile (C diff) infections. C diff has nothing to do with hair – it is focused on the gut. However, researches noted that two of the C diff patients also had AU, and they observed remarkable hair regrowth following the FMT.

Causes Unknown, Treatments Limited

Even with all the major advances in scientific understanding of hair growth and hair loss, the medical and research community still has not been able to pinpoint what causes AU. The most widely accepted hypothesis is that AU is an advanced form of alopecia aerate (AA), which is believed to be an autoimmune condition in which a person's own immune system attacks the hair follicles.

Why this response is triggered in some people appears to be a combination of genetics and environmental factors. Scientists have identified certain immune-related genes that make a person more susceptible to AA, and about 20 percent of those affected have a family member with alopecia. but only if activated by factors such as a viral infection, trauma, hormonal changes or stress.

Among autoimmune disorders, AA is relatively common. Approximately 4.5 million people in the U.S. have the condition. Two out of three people diagnosed with AA are younger than 30 years old. AU is considerably less common, affecting about one out of 4,000 people. That means about 1,700 people in the Houston metropolitan area have AU.

While hair regrowth sometimes occurs on its own, there is currently no cure for AU. Treatments generally revolve around contact immunotherapy and corticosteroids.

So you can imagine everyone’s surprise when two patients who were experiencing both AU and C diff had the same very positive response to FMT. It was first reported in the American College of Gastroenterology Case Reports Journal in a study titled, “Hair Growth in Two Alopecia Patients after Fecal Microbiota Transplant.”

FMT: What Is It?

It’s likely this is the first you’ve heard of FMT. It is a procedure that was first performed on adults in 2013 – and the pioneering work has been centered in Houston. Here’s a link to a video from the Mayor Clinic on FMT https://www.youtube.com/watch?v=Awn3haOpfcI&t=2s and a story on FMT that aired on FOX 26 Houston: https://www.youtube.com/watch?time_continue=74&v=AMTqzUtm_5o. Basically, the procedure transplants bacteria from the stool of a healthy donor into the bowel of a recipient patient.

The idea that such a procedure could result in hair regrowth just shows how complex the human body is – especially with the immune system is involved. We believe that AU and AA are autoimmune conditions in which a person's own immune system attacks the hair follicles. Could the trillions of microorganisms that are constantly working to help us digest foods, produce vitamins and fend off threats play a role in alopecia? The researchers, led by Dr. Colleen Kelly, MD, FACG believe it is worth exploring:

“Gut microbiota may have immunomodulatory effects in autoimmune conditions such as alopecia areata, and further study may elucidate disease mechanisms and lead to alternative treatment options for these patients for whom treatment options are currently limited.”

Dr. Kelly and her team present two cases to support their hypothesis. The first involved a 38-year-old man who was diagnosed a decade ago with AU. He also was determined to have C diff. After FMT, not only did his C diff clear up, but he reported new hair growth on his head, face, and arms. Three years later, he continued to have patchy hair growth on his arms, scalp and face. The second case was a 20-year-old man diagnosed with AU two years prior to an FMT procedure for C diff. After FMT, the patient improved two grades from stage S4b alopecia (95–99 percent hair loss) to at least stage S2 (25–49 percent hair loss).

While these findings are interesting, they are not relevant to the vast majority of people who experience hair loss. That said, Dr. Kelly’s work certainly shines the light on the importance of overall health to maintaining a healthy head of hair. If you experience sudden hair loss, it could be the body alerting you that something could be wrong, and it is worth looking into.

If you are experiencing hair loss of any kind, including AA or AU, we encourage you to contact Arocha Hair Restoration to arrange a consultation. 

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Arocha Hair Restoration

Since 2002, Bernardino A. Arocha, M.D. has been transforming lives through the power of hair restoration. With an artistic approach and a variety of procedures available, Arocha Hair Restoration has a track record of providing stunning results. Dr. Arocha is affiliated with prominent organizations with memberships that include:

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