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Stem cells have the ability to self-renew and differentiate into other cell types, which forms the foundation for their use in regenerative medicine and cosmetic dermatology. Adipose-derived stem cells have proven particularly attractive in aesthetics given their relative ease of collection and abundance. Stem cells have been employed for the treatment of androgenetic alopecia and skin rejuvenation with promising results, while its incorporation into cosmeceuticals is still in its infancy. Despite promising preclinical data and small clinical studies, additional randomized, controlled trials and standardization of treatment are needed in order to truly understand the place of stem cells in the aesthetics arena. We review the current literature and discuss current controversies and debates.

The prevalence of hair loss, its psychological consequences, and historically subpar treatments present a unique challenge to the physician. The current Food and Drug Administration–approved treatments for hair loss are plagued by ineffectiveness, noncompliance, and adverse effects. Recent advances in our understanding of hair physiology have fueled the development of more efficacious, minimally invasive, and safer treatment options for hair restoration including plasma-rich protein and stem cell therapy. Platelet-rich plasma, the autologous preparation of concentrated platelets in plasma, when injected into the scalp of patients with both androgenetic alopecia (AGA) and alopecia areata (AA), has been shown to increase hair count and density. The clinical findings have been supported by histologic evaluation of the scalp skin. These findings have been recapitulated in numerous randomized controlled trials. Stem cell therapy, although newer in its application in hair restoration, has also been effective for treating both AGA and AA. The isolation techniques for stem cells are varied, but regardless have shown promising results in early prospective and retrospective studies.

Alopecia areata (AA) is a common cause of non-cicatricial hair loss with a sudden, unpredictable, and recurrent course that is associated with significant psychosocial burden. Current treatment options, such as topical and intralesional corticosteroids, systemic immunosuppression, topical immunotherapy, and Janus Kinase Inhibitors (JAK inhibitors), have been employed with varying success. Recently, platelet-rich plasma (PRP) and stem cells (SCs) have been introduced as minimally invasive, safe treatment options for hair loss, including AA. The literature to date suggests that PRP is comparable to intralesional corticosteroids and topical minoxidil in patchy alopecia areata with trends toward an earlier, more robust, and more sustained response. The in vitro and animal studies regarding the use of stem cells in AA are promising, but more clinical studies are required to understand its full potential as a treatment option for AA.

This study evaluates the effect of negative pressure wound therapy with antiseptic instillation (NPWTi) in the clearance of infection and biofilm formation in an in vivo model of infected spinal implants compared to traditional treatment modalities.Five pigs underwent titanium rod implantation of their spinous processes followed by injection of 1 x 106 CFUs/100μL of methicillin-resistant Staphylococcus aureus through the fascia at each site. At 1 week postoperatively, an experimental arm of 3 pigs received NPWTi, and a control arm of 2 pigs received wet-to-dry dressings. The persistence of local infection in the experimental group was compared to the control group using tissue cultures. Biofilm development on spinal implants was evaluated using scanning electron microscopy.Mean bacterial count showed a statistical difference between the experimental and the control groups (P.05). Scanning electron microscopy revealed the presence of uniform biofilm formation across the surface of control group instrumentation, whereas the experimental group showed interrupted areas between biofilm formations.The authors concluded that NPWTi is associated with decreased bacterial load and biofilm formation compared to wet-to-dry dressings in an in vivo porcine model of infected spinal instrumentation.