I originally wrote this post about Absci and its AI-developed ABS-201 that targets the prolactin receptor in April 2025 (see the bottom section). New updates are regularly added on top. Update: June 22, 2026 Joe Tillman (the Hair Transplant MentorTM) is interviewing Absci CEO Sean McClain today and the video will be released on Wednesday. If any reader has a question he/she would like to ask, please post it in the comments by 2pm PST today! The recorded interview will be available on Joe’s YouTube channel on Wednesday (I assume in the “Videos” tab of the channel). A recent article about Absci on seekingalpha is also worth a read. Update: January 22, 2026 Absci is publishing numerous new videos on its YouTube channel. All of them are very encouraging so far. Also check out the company’s detailed presentation on ABS-201 from the end of 2025. Absci ABS-201 and its hair growth compared to Minoxidil. Absci (US) is an artificial intelligence (AI) drug and biologic creation company that is developing novel treatments via the use generative AI. One of the key products that they are focusing on is a prolactin receptor (PRLR) targeting injection based hair growth treatment called ABS-201. Phase 1 clinical trials for this product began in Australia at Sinclair Dermatology in December 2025. Note that Hope Medicine (China)’s Phase 1 clinical trials for its prolactin receptor blocking HMI-115 injections also occurred at Sinclair Dermatology in 2022. Hope Medicine later completed Phase 2 trials in China in 2025. The top half of this post is all new updates. Update: December 11, 2025 ABS-201 Regenerates Hair Stem Cells and Promotes Key Growth Modulators Absci today unveiled new preclinical data for ABS-201. The data was generated using translational human ex vivo scalp models. It demonstrated that ABS-201 stimulates hair growth by regenerating the stem cell niche as well as by promoting additional key growth modulators. The studies were led by Dr. Ralf Paus, who says: “Our study provides the first evidence that antagonizing prolactin signaling with ABS-201 could open a radically new chapter in future AGA management.” Among the key findings: ABS-201 significantly inhibits the PRLR signaling pathway. ABS-201 prolongs the anagen phase by blocking catagen, and promoting hair matrix keratinocyte proliferation. In addition, it increases the production of the hair growth-stimulatory growth factors IGF1 and FGF7. ABS-201 protects and expands the hair follicle progenitor cell pool. It inhibits prolactin-induced apoptosis of K15+ stem cells , and increases their proliferation and capacity to generate CD34+ progeny. This is crucial, since the depletion of progenitor cells is a key hallmark of androgenetic alopecia. It facilitates the reconversion of vellus hairs to terminal hairs. Also of interest, long-time hair loss sufferer and former US soccer superstar Landon Donovan has teamed up with Absci. Way out of leftfield. Update: December 4, 2025 Absci just announced that the first volunteers have been dosed in their Phase 1/2a HEADLINE study evaluating ABS-201. Absci will host a virtual KOL seminar on Thursday December 11 to discuss further details about this drug and its clinical trials. Also check out this great detailed interview of Absci founder and CEO Sean McClain with ARK Invest’s legendary Cathie Wood. Update: October 20, 2025 Absci to Begin Phase 1 Clinical Trials for ABS-201 in December 2025 In a new article about Absci’s ABS-201 hair growth injections that target the prolactin receptor, it is mentioned that Phase 1 clinical trials will begin in Australia in December 2025. The renowned Dr. Rodney Sinclair will oversee the trials at his Sinclair Dermatology clinic. Interestingly, Hope Medicine’s Phase 1 clinical trials for its prolactin receptor blocking HMI-115 injections also occurred in Australia at Sinclair Dermatology in 2022. Of note, the Absci research team believes that ABS-201 could also cure premature greying by re-pigmenting the hair. This is based on their pre-clincial work on macaques, in which the animals’ hair reverted back from grey to black. Key quote regarding Absci’s use of AI to develop this product: “Using AI to develop the needle itself (in this case, the perfect antibody sequence) researchers were able to discover key antibody binding regions that could precisely target the prolactin receptor, thus ceasing hair loss. Using computer simulations, Absci was able to optimize certain drug qualities, including increased potency and decreased likelihood of negative immune response.” Update: July 2025 The CEO of Absci posted the below Tweet recently. The before and after macaque monkey image in there seems identical to the image from Hope Medicine’s HMI-115 and its effect on macaques. Strange. The same image can also be seen in their 2024 R&D document. Both HMI-115 and Absci’s ABS-201 target the prolactin receptor to regrow hair. Hope Medicine has already completed Phase 2 clinical trials, while Absci is yet to commence any human trials. ABSCI ABS-201 Hair Growth Prolactin. April 6, 2025 Absci is a data-first artificial intelligence drug and biologic creation company that is unlocking novel treatments through the use generative AI. Most interestingly, one of the key products that they are focusing on is a hair growth treatment called ABS-201 that targets the prolactin receptor. I first heard about the company in January 2025 when Absci received a $20 million investment from chip manufacturer Advanced Micro Devices (AMD). Unlike virtually all new entrants in the hair loss world, Absci has a great website. However, it should be noted that the company originally started operations way back in 2011, under the auspices of founder and CEO Sean McClain. In March 2025, Absci presented on the subject of AI in dermatology at the Dermatology Innovation Forum. On a related note, in 2022, I wrote a post on AI and machine learning for hair loss drug discovery. Absci Presentation on ABS-201 Considering that Absci’s pipeline page shows that ABS-201 is yet to even enter Phase 1 clinical trials, I was reluctant to write this post. However a new video presentation (embedded below) that the company uploaded in February 2025 changed my mind. It is titled “Absci R&D Day 2024”. The portion devoted

June 09, 2026 I enjoyed speaking to our dermatology residents at the University of British Columbia about important trichoscopic signs of hair loss last week. We review 20 of the most common signs! This article was written by Dr. Jeff Donovan, a Canadian and US board certified dermatologist specializing exclusively in hair loss. Source link

Over the past four years, the landscape of alopecia areata has changed dramatically. What was once a condition with limited and often unpredictable treatment options has entered an era of evidence-based targeted therapies. Baricitinib helped pave the way for additional approvals, while also accelerating research into the biology of autoimmune hair loss. Perhaps most importantly, baricitinib changed expectations. Patients, physicians, researchers, and regulators began to view significant hair regrowth not as an exception, but as a realistic treatment goal for many individuals with severe disease. Four years later, we continue to learn about long-term outcomes, durability of response, and how best to personalize treatment. But June 13, 2022 will always be remembered by me as the day alopecia areata treatment entered a new era. Here’s to the patients who participated in the clinical trials, the researchers who advanced the science, and the many individuals with alopecia areata who continue to inspire progress every day! Source link

We need to forget about formal terminology for a few moments- and just observe, observe, observe. One of the mistakes many practitioners make is trying to match every trichoscopic image to a known list of “trichoscopic signs.” Although this cataloguing is important, true trichoscopic skill starts somewhere much simpler: State what you see! The terminology comes later. The difficult part of trichoscopy (and in fact, all of hair loss diagnosis) is developing the power of simple observation. The detective Sherlock Holmes once said “You see, but you do not observe.” Indeed, many people look at things without truly processing what they are seeing. When I perform trichoscopy, I don’t begin with trying to find terms that fit with textbook terms. I begin with observing:• shapes• loops• colors• symmetry Only afterwards do I attach terminology – and then seek to link what I observe with disease pathogenesis and ultimately a diagnosis. As an example, consider this image. I ask practitioners…. What do you see? In nearly all situations, I hear some wonderful answers about vascular patterns and bleeding. After listening to a few answers, I let the audience know that to my eye, it looks like “a fairy holding a bucket.” That may sound silly — but it’s actually incredibly useful. By describing the image in a simple term, I am forcing myself to state what I see not what I think matches some textbook definition of vascular patterns. Yes, these are likely thin loops (vascular structures) related to seborrheic dermatitis…but I allow my brain to reach that conclusion only later. To me, trichoscopy is more than memorization. It is a wonderful form of biologic storytelling. We tell the best stories when we observe – rather than state what we think we are supposed to be seeing≠≠≠ Source link

Although they are a classic sign of alopecia areata, it is important to understand both their strengths and limitations. Yellow dots are generally quite sensitive for diagnosing alopecia areata, meaning they are commonly present and often help point us toward the diagnosis. However, they are not very specific. Yellow dots may also be seen in other disorders including androgenetic alopecia, telogen effluvium, discoid lupus, dissecting cellulitis, and several additional scalp disorders. One fascinating aspect of yellow dots is their relationship to age. They are seen much more commonly in adults than in children. This likely relates to sebaceous gland development. Before puberty, sebaceous glands are not fully mature and produce far less sebum. Since yellow dots partly reflect accumulation of sebaceous material within follicles, they are less prominent in children. Yellow dots may also provide clues regarding disease severity. Patients with more extensive alopecia areata often demonstrate larger numbers of yellow dots across affected scalp regions. For those learning trichoscopy, yellow dots are an important structure to recognize. However, true expertise comes not simply from identifying “yellow dots,” but from understanding why they form, when they appear, and what else belongs in the differential diagnosis. Source link

While the apple’s dent was simply a harmless imperfection, steroid-induced skin atrophy can create a similar appearance in the skin—a visible depression or “dent” caused by thinning of the skin and underlying tissues. Patients sometimes describe these areas as looking like a “divot,” “crater,” or “sunken spot.” In reality, the process is more complex than an apple dent, but the image serves as a useful visual reminder of what can happen when corticosteroids affect collagen production and local fat tissue. Just as the apple has lost some of its normal contour, steroid-induced atrophy results in localized loss of tissue volume. The skin may appear depressed, shiny, wrinkled, lighter in color, or accompanied by small visible blood vessels. Fortunately, unlike many dents in apples, most cases of steroid-induced skin atrophy gradually improve with time. Understanding why these dents occur—and how to prevent them—is an important part of safely using intralesional corticosteroid therapy in dermatology. In my opinion, the secret to reducing the risk of atrophy is for hair specialists and dermatologists to use 2.5 mg per mL triamcinolone as their baseline NOT 5 mg/mL and to limit injection to every 6-12 weeks (not every 2-4 weeks) Source link

The field of hair loss is dynamic! What is amazing to me is how patterns keep repeating! New diseases are recognized. New treatments emerge. New side effects are discovered. New technologies reshape how we practice. If history is any guide, the next few decades will bring a lot of change. So, what can we expect? First, I suspect science will be communicated differently. Open-access publishing has transformed access to research. Social media, podcasts and online education have changed how clinicians learn. We may see entirely new models of publication, peer review, and scientific discussion. Artificial intelligence will almost certainly play a larger role in how research is reviewed & shared. Second, we will certainly see more approved treatments. The approval of JAK inhibitors for alopecia areata marked a major milestone. Additional approvals for AA are 100 % guaranteed, and it’s conceivable that conditions such as frontal fibrosing alopecia, LPP, chemotherapy-induced alopecia, or even certain forms of telogen effluvium could someday become targets for regulatory approval. Third, some therapies we currently use may be withdrawn from the market. Every era of medicine witnesses the withdrawal of certain drugs as new safety information emerges. Fourth, many currently approved drugs will likely undergo new label changes. We have seen important label revisions over the years for medications such as finasteride & even topical minoxidil. As larger numbers of patients use newer therapies over longer periods of time, additional warnings, precautions, & recommendations are likely to emerge. It would be shortsighted to assume that today’s labels are the final version! Fifth, new hair disorders will almost certainly be identified. As trichoscopy, pathology, genetics, and molecular biology continue to advance, clinicians will recognize patterns that were previously overlooked. Some conditions we currently group together may prove to be distinct diseases. Finally, new causes of hair loss will be discovered. New medications, new infections, new environmental exposures, and perhaps even new technologies will likely introduce triggers that we do not yet recognize today Source link

It was a great privilege to work with wonderful colleagues on a systematic review and meta-analysis assessing the efficacy upadacitinib for treating alopecia areata (AA). The study was led by Dr Ghassan Barnawi and Raquel Lazarowitz from McGill University. We analyzed 33 studies involving 136 patients and found significant improvements in hair growth across a wide range of patient groups.The average “baseline” SALT score was 77, reflecting severe hair loss. After treatment, patients experienced an average SALT score reduction of 68.5 points over approximately 24 weeks. Even patients with severe AA (baseline SALT >50) showed remarkable improvement, with SALT scores decreasing by nearly 80 points.One of the most encouraging findings was the consistency of response. Adults and children responded similarly, and patients who had previously failed another JAK inhibitor achieved results comparable to JAK-naïve patients. In addition, higher doses did not appear to provide substantially greater benefit than lower doses. Response rates were impressive: 94% achieved SALT50 and 89% reached a SALT score of 20 or less. Side effects occurred in about one-third of patients, but were generally mild and did not lead to treatment discontinuation. While larger long-term studies are still needed, these findings suggest that upadacitinib may become an important addition to the growing list of effective treatments for alopecia areata. Congratulations to all our group! The article is available to all online with open access publishing. Reference Barnawi G, Lazarowitz R, Nukaly HY, Creighton R, Ridha Z, Aldein AS, Algaidi Y, Weiss E, Litvinov IV, Donovan J. Efficacy of upadacitinib for the treatment alopecia areata: a systematic review and meta-analysis. J Am Acad Dermatol. 2026 Jun 3. Source link

In the early stages of androgenetic alopecia (AGA), patients often present with increased hair shedding. As a result, many patients are quickly labeled as having telogen effluvium (TE) or chronic TE. While TE certainly causes shedding, early AGA can do the same. The key difference lies in what is happening to the follicles. As AGA develops, there is a progressive transformation of terminal hairs into finer, shorter, and eventually less pigmented hairs. This process, known as miniaturization, may be obvious in advanced disease but can be remarkably subtle in the early stages.. Another important clue is a gradual shift in follicular unit composition. Healthy scalp regions are rich in follicular units containing two, three and even four hairs. As AGA progresses, there is an increasing predominance of one-hair and two-hair follicular units (or completely empty follicles) as miniaturize and terminal hairs are lost. The accompanying image illustrates these challenges perfectly. This 23-year-old woman had experienced six years of persistent hair shedding and had repeatedly been told that she had telogen effluvium. However, close inspection reveals the hallmark features of androgenetic alopecia: increased numbers of single-hair follicular units, reduced numbers of robust multi-hair follicular units, and clear evidence of hair shaft miniaturization. This patient has androgenetic alopecia! An important principle is this: any individual with chronic hair shedding who has been told they have a diagnosis of telogen effluvium or chronic telogen effluvium should strongly consider a scalp biopsy and expert assessment if a) blood tests are fairly normal (or have normalized after correction of an apparent abnormality) and b) shedding has been going on more than 12 months despite improvement of lab results and c) density continues to decline year after year as captured by standard photos. Another diagnosis besides TE is highly likely in these situations! Source link

As many of you are aware, I direct the world’s largest and most comprehensive hair training program. The EBHF is an intensive two-year program that requires commitment, hours of study, and focus. Not everyone who applies gets accepted, and not everyone who gets accepted gets to the finish line and completes the program. EBH fellows attend lectures, complete assignments, take quizzes, and discuss cases. We do this non-stop for 2 years. But graduation from the EBHF signified something very special: “ A practitioner with commitment to hair loss at a high level who can take on some of the most challenging cases and clinical situations anywhere. In mid-June, our fellows took their very first formal examination of the 2026-2027 EBHF program. I would like to take the opportunity to congratulate our 120 EBHF fellows on completing the Block 1 Examination! This was a challenging exam in a demanding program. Passing it represents hard work, determination, and a genuine commitment to excellence in hair disorders. A tremendous accomplishment. Congratulations to all our fellow! On now to Block 2! Source link