
In my journey as a trichology prescriber, I have delved deeply into the fascinating mechanisms behind hair growth. One area that stands out for its transformative potential is the role of follicular proteoglycans. These bioactive and functional components are far more than structural molecules—they are key regulators that adapt their expression in response to the hair growth cycle. Here is what I have learned and why I believe proteoglycan therapies could be the missing piece for many struggling with hair loss.
What Are Follicular Proteoglycans?
Proteoglycans are complex molecules composed of a protein core attached to glycosaminoglycan (GAG) chains. In hair follicles, these molecules do more than provide structural integrity; they are actively involved in cellular signalling, regulating growth phases, and maintaining follicular health. Their bioactivity lies in their ability to modulate the extracellular matrix (ECM), which is crucial for hair follicle cycling.
What makes proteoglycans unique is their dynamic expression. During different phases of the hair growth cycle—anagen (growth), catagen (regression), and telogen (resting)—specific proteoglycans upregulate or downregulate to support follicular needs. This adaptability is why they play such a pivotal role in maintaining healthy hair growth.
Key Proteoglycans
and Their Roles in Hair Growth
Proteoglycans for Hair Growth Restoration
Proteoglycan | Expression by Growth Phase | Role in Hair Growth | Consequences of Dysfunction | Visual Impact on Hair if Deficient |
Versican | High in anagen, low in catagen and telogen | Promotes cell adhesion and proliferation within the dermal papilla. Supports keratinocyte activity for robust hair shaft formation. | Reduced keratinocyte activity leads to thinner, weaker hair. | Diffuse thinning and miniaturised hair shafts. |
Decorin | Peaks in early anagen, declines in telogen | Modulates follicle cycling by binding to TGF-β, preventing premature catagen entry. | Premature catagen entry shortens the growth phase, leading to excessive shedding. | Patchy thinning and reduced hair density. |
Aggrecan | High in anagen, decreases in catagen and telogen | Stabilises ECM integrity and enhances follicular anchoring. | ECM instability leads to follicular miniaturisation. | Sparse hair and fragile strands. |
Perlecan | Consistently present but peaks during anagen | Facilitates angiogenesis, ensuring nutrient and oxygen supply to growing follicles. | Poor vascularisation results in sluggish regrowth and hair breakage. | Hair appears dull and brittle, with slowed regrowth. |
Proteoglycans in Androgenetic Alopecia and Telogen Effluvium
Androgenetic Alopecia (AGA)
In AGA, the progressive miniaturisation of hair follicles is accompanied by disruptions in proteoglycan levels. Reduced decorin and versican contribute to a shortened anagen phase and increased susceptibility to dihydrotestosterone (DHT). Supplementing these proteoglycans through targeted therapies may counteract follicular miniaturisation and prolong anagen activity.
Telogen Effluvium (TE)
TE is often triggered by acute stressors that disrupt proteoglycan synthesis. Stress-induced cortisol spikes accelerate the degradation of key proteoglycans like decorin and hyaluronan, pushing follicles into a premature telogen phase. Restoring these molecules can stabilise the follicular environment and support regrowth.
Kickstarting the Anagen Phase with Proteoglycans
One of the most promising applications of proteoglycans is their ability to reinitiate the anagen phase in dormant follicles. For patients experiencing stress-related alopecia or those whose hair growth treatments have plateaued, proteoglycan replacement can provide the essential "kickstart" their follicles need.
In my practice, I have witnessed remarkable results when combining proteoglycan therapies with personalised hair serums. Patients with recent telogen effluvium or long-standing AGA have reported faster regrowth, improved hair density, and enhanced hair quality. The synergistic effect of proteoglycans and targeted treatments underscores the importance of a multi-modal approach.
Supplementing for Anagen Phase Maintenance
Supplementing with proteoglycans helps sustain the anagen phase by restoring the balance of critical extracellular matrix components. Proteoglycan supplementation supports cell proliferation, ECM stability, and vascularisation within the follicle. This ensures that hair remains in the growth phase for an optimal duration, reducing shedding and promoting thicker, healthier strands. For individuals recovering from stress-related hair loss or those struggling with ineffective treatments, supplementing proteoglycans can revitalise dormant follicles and lay the foundation for long-term follicular health.
Evidence Supporting Proteoglycan Therapies
Research has consistently highlighted the role of proteoglycans in follicular health:
Nourkrin with Marilex®: Clinical studies have demonstrated its efficacy in improving hair growth and quality, particularly in women with diffuse hair loss. The active proteoglycans in this therapy support the anagen phase and restore follicular balance.
Decorin’s Role in ECM Modulation: Studies show that decorin’s TGF-β modulation prevents premature catagen entry, prolonging the growth phase (Thom et al., 2020).
Stress and Proteoglycan Degradation: Elevated cortisol levels have been linked to reduced proteoglycan synthesis, highlighting the need for therapeutic replenishment (Thom et al., 2020).
Why This Matters
Hair loss can be a deeply personal and distressing experience. Proteoglycan therapies offer a scientifically grounded, evidence-based solution that addresses the root causes of follicular dysfunction. For patients who feel like they have tried everything, this approach could be the breakthrough they have been waiting for.
I have seen these therapies work wonders in my practice, particularly when personalised to the individual’s needs. By restoring proteoglycan levels, we can not only kickstart dormant follicles but also pave the way for healthier, stronger hair growth.
References
Thom, E., & Vindholmen, S. (2020). Integral Roles of Specific Proteoglycans in Hair Growth and Hair Loss. Journal of Hair Science.
Erling Thom et al. (2020). Stress and the Hair Growth Cycle: Cortisol-Induced Hair Growth Disruption. ResearchGate.
Clinical data on Nourkrin with Marilex®. Journal of Clinical Hair Loss Research.
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