Research Centre

The World Hair Council is committed to increasing treatment results for all patients suffering hair growth disorders or hair loss and ensuring they receive optimal therapy forms.

Therefore, following the clinical establishment of Proteoglycan Follicular Atrophy as being a major underlying negative contributor, the primary focus of the research presented is focussed on Proteoglycan Follicular Atrophy, Follicular Hypo-Glycania and clinically validated and proven Proteoglycan Replacement Therapy.

Find a selection of our clinical papers here

Integral Roles of Specific Proteoglycans in Hair Growth and Hair Loss: Mechanisms behind the Bioactivity of Proteoglycan Replacement Therapy in Pattern Hair Loss and Telogen Effluvium

Wadstein J, Thom E, Gadzhigoroeva A.
Dermatol Res Pract. 2020 Feb; 2020:8125081.

Conclusion: Female Pattern Hair Loss and Telogen Effluvium are the most common types of hair loss in women, yet their underlying causes are not convincingly explained. This milestone paper sheds light on a fundamental pathology that is behind several clinical presentations of hair growth disorders in women. Research shows that the ability of the affected follicular cells to synthesise proteoglycans declines considerably. This leads to a proteoglycan deficient state called Follicular Hypo-Glycania. This pathological state negatively affects multiple key metabolic pathways such as Wnt/β-catenin; thereby shortening the Anagen phase and inducing hair follicles to enter a dormant Telogen phase. Long-lasting, untreated Follicular Hypo-Glycania causes follicular miniaturisation and atrophy, a condition called Proteoglycan Follicular Atrophy. This recently recognised condition responds to Proteoglycan Replacement Therapy (using Nourkrin® with Marilex®). The authors suggest that this therapy delivers bioactive proteoglycans that can force hair follicles to enter Anagen and prolong hair growth by promoting cell proliferation. The clinical efficacy of Proteoglycan Replacement Therapy was proven through several human trials where it not only increased hair density of women with FPHL but also improved their self-esteem, psychosocial wellbeing, and overall quality of life.

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Proteoglycan Replacement Therapy: Objective and Subjective Effects and Tolerability in Persons with Hair Loss

Thom E
J Int Med Res. 2006;34(5):514-9.

Conclusion: Controlled evaluation of monotherapy (using Nourkrin® with Marilex®) evidenced a significant improvement in both hair density and treatment satisfaction compared to both baseline values and the placebo group. It is important to consider that the observed increase in scalp hair count was time-dependent and reached statistical significance after 6 months of treatment. It continued to improve throughout the 12-months follow up period of this trial.

These findings indicate that long-term Proteoglycan Replacement Therapy (6 months or more) is preferable for satisfactory results. No significant adverse effects were detected and none of the participants withdrew from the study because of side effects.

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Cosmetic Hair Treatments Improve Quality of Life in Woman with Female Pattern Hair Loss

Kingsley DH, Thom E
J Appl Cosmetol. 2012;30:49-59

Conclusion: This trial highlights, a critically important but widely neglected aspect, the effects of hair loss on psychological well-being and quality of life. In women with Ludwig type-I to type-III hair loss, treatment with Proteoglycan Replacement Therapy (using Nourkrin® with Marilex®) for 6 months improved all indices of quality of life. This psychological improvement did occur with an improvement in the cosmetic status of participants. Clinicians should also take this effect of Proteoglycan Replacement Therapy into account when considering the cost-benefit evaluation of the treatment.

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Treatment of Hair Thinning and Hair Ageing with specific Lectican and Leucine Proteoglycans

Thom E, Wadstein J, Thom EW, Kingsley DH
J Appl Cosmetol. 2014;32:105-15.

Conclusion: This review provides a focused overview of the function of specific proteoglycans in the hair follicle and their relevance in the pathophysiology of common hair growth disorders. With reference to the close involvement of proteoglycans in the biology of the hair follicle and considering their improving effects on hair pathologies, the authors proposed using specific bioavailable mixtures of proteoglycans (Marilex® in Nourkrin®) for the prevention and treatment of common types of hair loss.

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Pregnancy and the hair growth cycle: anagen induction against hair growth disruption using Nourkrin® with Marilex®, a proteoglycan replacement therapy

Thom E
J Cosmet Dermatol. 2017;16(3):421-7.

Conclusion: This review sheds light on the underlying mechanisms of Postpartum Telogen Effluvium and explains why the depletion of follicular proteoglycans is a potential underlying aetiology. The author argues that, based on the available evidence, dramatic fluctuations in the level of sex hormones and cortisol, during and shortly after pregnancy, can influence the homeostasis of follicular proteoglycans, which in turn leads to significant Anagen shortening and cycling disruption. Hence, Proteoglycan Replacement Therapy (using Nourkrin® with Marilex®) is proposed to treat Postpartum Telogen Effluvium.

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Stress and the Hair Growth Cycle: Cortisol-Induced Hair Growth Disruption

Thom E
J Drugs Dermatol. 2016;15(8):1001-4.

Conclusion: This review explores different factors involved in hair cycle disruption following acute or chronic stress, i.e., in Telogen Effluvium, highlighting a less-studied relationship between the stress hormone, cortisol, and follicular proteoglycans. There is evidence to show that the enhanced rate of degradation proteoglycans (Proteoglycan Follicular Atrophy), secondary to high concentrations of circulating cortisol, explains the association between stress and hair loss in Acute and Chronic Telogen Effluvium. A Proteoglycan Replacement Therapy (Nourkrin® with Marilex® from Pharma Medico), featuring versican and decorin specifically, can play a pivotal role in the induction and prolongation of the Anagen phase of the Hair Growth Cycle during stress-induced Acute and Chronic Telogen Effluvium.

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Lifestyle Diseases and the Hair Growth Cycle: A multidisciplinary approach using Nourkrin® with Marilex®, a proteoglycan replacement therapy, for anagen induction and maintenance

Thom E, Thom EW
Ann Dermatol Res. 2017;1:6-11.

Conclusion: This paper describes the common aetiological aspects and shared risk factors of hair loss and chronic lifestyle disorders e.g. insulin resistance syndromes. It appears that Androgenetic Alopecia is an independent risk factor for metabolic syndrome and coronary artery disease, given the fact that insulin resistance and inflammation can negatively affect the normal homeostasis of the hair follicle. Being aware of such an association justifies the importance of implementing a multidisciplinary approach towards diagnosis and treatment of hair loss. With its unique anti-inflammatory and hair regrowth properties, Proteoglycan Replacement Therapy (using Nourkrin® with Marilex®) provides an additional dimension to the management of hair loss accompanied by insulin resistance syndromes. Effective treatment of hair loss by Proteoglycan Replacement Therapy also contributes to alleviating psychological stress, which can aggravate both associated conditions.

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Metabolic Syndrome, Cardiovascular Disease and the Hair Growth Cycle: Addressing hair growth disruption using Nourkrin® with Marilex® as a proteoglycan replacement therapy: A concise review

Thom E, Wadstein J, Kingsley DH, Thom EW
Ann Dermatol Res. 2018;2:1-7.

Conclusion: This is an update to the former review published in 2017 that further elaborates on the underlying mechanisms behind a close association between hair loss and insulin resistance syndromes based on the latest published literature. In this paper, the authors explain how hyperinsulinemia may contribute to the pathogenesis of hair loss and that this association is stronger in women with Female Pattern Hair Loss than in men. Special prominence has been put on the role of proteoglycans in reversing the pathological changes that metabolic disturbances and hormonal dysregulations can cause to the hair follicles.

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Treating Female Diffuse Hair Loss using Proteoglycan Replacement Therapy (Nourkrin® with Marilex®) - An Open-label, Subjective, Outcome Study on Hair Growth and Appearance, Self-Confidence and Treatment Satisfaction

Wadstein J, Thom E.
J Clin Derm Ther. 2019, 5: 037

Conclusion: Most participants in this recently published, qualitative study expressed their satisfaction with Proteoglycan Replacement Therapy (using Nourkrin® with Marilex®). Treated individuals experienced a positive change in the quality and appearance of their hair as early as 3 months into the study. Patients’ satisfaction in both cosmetic and psychological aspects continued to rise with longer treatment durations. It can be concluded from this study that, in women with Female Pattern Hair Loss and Telogen Effluvium, high satisfaction rates are achieved by a 6-month or longer treatment period with Proteoglycan Replacement Therapy.

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Proteoglycan Replacement Therapy (using Nourkrin® with Marilex®) Enhances Hair Growth and Appearance and Improves Hair Confidence in Women with Diffuse Hair Loss from Brazil: An Investigator-initiated Clinical Study

Mattos Simoes M, Thom E, Wadstein J
J Clin Invs Dermatol. 2020;8(1): 4

Conclusion: In this long-term, subjective, clinical study, the therapeutic efficacy of Proteoglycan Replacement Therapy (using Nourkrin® with Marilex®) was evaluated in the Brazilian population. Along with hair growth and appearance, researchers also assessed psychological outcomes such as patients’ confidence and treatment satisfaction. Research findings clearly demonstrated that the condition of hair had improved in most participants after a course of monotherapy with specific proteoglycans. Observations also showed that the positive effects of Proteoglycan Replacement Therapy emerged just after 3 months, which demonstrates a shorter delay compared to conventional hair loss treatments. A high level of efficacy and short time of onset are the main factors that led to a high treatment satisfaction rate of 97%. More importantly, the enhanced hair confidence induced by Proteoglycan Replacement Therapy improves patients’ self-image and prevents psychosocial consequences of hair loss. This clinical study confirms that monotherapy with Proteoglycan Replacement Therapy is an effective approach towards treating hair loss.

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