What is Platelet Rich Plasma (PRP) Therapy?
Platelet rich plasma (PRP) is concentrated blood plasma, which contains approximately three to five times the number of platelets found in normal circulating blood. In addition, it contains platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), transforming growth factor (TGF) and other bioactive proteins that aid in wound healing and hair growth.
Growth factors in platelet rich plasma (PRP) have been used to facilitate wound healing. Recently, studies have suggested that PRP may also serve as a safe and effective treatment option for male and female pattern hair loss.
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Human blood is comprised primarily of red blood cells (RBC), as well as white blood cells (WBC), platelets, and plasma. By initiating the first step of coagulation, platelets are the key to the body’s ability to heal wounds. It is thought that by increasing the platelet count in a wounded area, the body’s healing to that area would be accelerated – explaining the use of PRP in wound healing. Its possible effects on promoting hair growth make it potentially useful as both an adjuvant in hair transplantation and for the medical treatment of hair loss.
PRP for Treating Hair Loss
The Platelet Rich Plasma (PRP) commonly used in hair restoration is “autologous,” meaning that it is derived from the patient’s own blood. To obtain PRP, a patient’s blood is spun in a centrifuge to separate the solid from liquid components and platelet activators, such as thrombin, calcium chloride and sometimes collagen, are added. The separated “solid” portion of the blood is PRP (platelet rich plasma). PRP is then placed into a syringe and injected into the area of hair loss. Prior to injecting PRP, doctors may create a ring-block of local anesthesia with 1% lidocaine. When used to stimulate hair growth, multiple treatment sessions are required. Some improvement (in reversing miniaturization) can be expected in the first 2-6 months. The treatments must be continued periodically to maintain any improvement.
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If PRP therapy is appropriate, we can begin your PRP treatment at the time of your consultation. After the initial treatment session, we will administer the next two subsequent treatments at 4 week intervals. Additional treatments are given at three-month intervals depending on the response.
The treatments are administered by a physician and take about an hour. Patients are monitored photographically to assess the benefits of therapy. We will modify your treatment schedule based on your individual response to therapy.
Mechanism of Action
For the medical treatment of hair loss, practitioners use PRP to stimulate the growth of follicles, thereby reversing the hair miniaturization seen in female pattern hair loss and in male pattern hair loss.
It is conjectured that the introduction of platelets and white blood cells through PRP can amplify the body’s naturally occurring wound-healing mechanism. It is also proposed that PRP can actually stimulate the stem cells (dermal papilla) of the newly transplanted hair follicles.
What are the Indications for PRP?
PRP is used in many areas of medicine, including the acceleration of healing of tendon injuries, the treatment of osteoarthritis, in some aspects of dental work (i.e. jaw reconstruction), and in cardiovascular medicine. The concentrated form of plasma has been shown to accelerate wound healing and tissue repair and, thus, could potentially benefit hair restoration procedures.
In hair transplantation, PRP can be injected into or sprayed on the recipient site area to, theoretically, stimulate the healing of the transplanted grafts and into the donor area to facilitate healing of the donor incision and potentially minimize scar formation.
In the medical treatment of male and female pattern baldness, PRP can be injected into the balding scalp to potentially stimulate thin (miniaturized) hair to grow into thicker (terminal) hairs. Patients with thinning, but not totally bald, areas would be the best candidates.
PRP is a relatively new treatment for hair loss with a limited number of scientific studies to show its efficacy. The long-term benefits of PRP treatments for hair loss are not yet known. All patients receiving PRP treatments are followed closely to determine effectiveness and if other therapeutic modalities may be needed.
FAQ’s – Frequently Asked Questions about PRP for Hair Growth
PRP is being more commonly used for combating hair loss in women. Here are some answers to frequently asked questions.
What Causes Hair Loss in women?
Hair thinning in women, which affects nearly 40 million American women, is mainly due to heredity and can start any time after puberty. However, we also know that female pattern hair loss can be strongly influenced by age, nutrition, stress, surgery, medications, illness, social/lifestyle factors, hair care and more. As hair follicles weaken and stop producing hair, hair loss occurs.
How Is A Hair Loss Diagnosis Obtained?
The first step for anyone with a hair or scalp problem is to visit a full-time, credentialed hair restoration physician with experience and expertise in accurate diagnosis, successful treatment and long-term follow-up required in the medical management of hair loss patients. A medical hair loss “work up” starts with a detailed medical history, including family history, history of medical illness, poor nutrition, current medications, hair care regimen, recent surgeries and a detailed history of the hair loss situation.A hair dermoscopic analysis, scalp biopsy, and blood tests or other testing may be performed if indicated by the history and physical symptoms. Physical exam would include evaluation of the scalp for signs and symptoms of hair loss and any concurrent problems, such as inflammation. Hair Dermoscopy with the High Defintion FotoFinder System is essential to determine if there is decreased numbers of follicles in the affected areas, a decreased caliber of follicles in the affected areas, or inflammatory signs on the scalp that will guide the diagnosis.
What are PRP hair regrowth treatments and how do they work?
PRP or Platelet Rich Plasma for hair regrowth is an in-office, non-surgical, treatment derived from the patient’s own blood that can be performed in about an hour. After the area of concern is identified, evaluated and measured, standardized medical photos are taken in the photo suite. Special gentle and sterile techniques and equipment are used to separate and concentrate the platelets and plasma from a small sample of peripheral blood. PRP contains growth factors and cytokines that have been shown to be responsible for stimulating and enhancing hair follicle function. The scalp is prepared with antiseptic solution and anesthetic (a “ring block,” not simply local anesthetic gel) is used to completely numb the scalp. Small injections of the PRP deliver the powerful platelet-derived growth factors into the skin at the level of the weak follicles. Electronic, mechanical microneedling is performed.
Who is the ideal candidate for PRP treatments for hair loss?
At the Silicon Valley Hair Institute, Dr. Canales focuses on two types of hair loss patients when it comes to PRP treatments: patients with areas of “weak quality” hair growth on the scalp, where functioning hair follicles can still be observed, and patients with small areas of alopecia areata. In our experience, these are the patients who appear to have the greatest success with PRP hair regrowth treatments.
When can you expect results from PRP and how long do they last?
It takes six to twelve months to judge the results of PRP “visually” in the mirror or with standardized photos. Photographic assessment is performed every three months, so the plateau phase of improvement can be tracked.
What are the risks and benefits of PRP treatments?
PRP is a comfortable, in-office, non-surgical procedure that takes about an hour start-to-finish. Most patients notice a brief period of inflammation during which their scalp remains somewhat pink and numb for a few hours. Hair growth improvements can typically be measured in about three months, but it takes six to twelve months to visually “see” the difference in photos and in the mirror. Patients with certain blood disorders or on certain medications are not candidates for PRP treatments. PRP is immunologically neutral and poses little risk of allergy, hypersensitivity or foreign-body reactions.
Is there a recovery period or downtime after PRP treatments?
There is no activity restriction after a PRP treatment. Patients may shower/shampoo/condition their hair normally just several hours after the treatment and resume normal daily and athletic activities. As mentioned previously, some brief mild inflammation noticeable as redness/pinkness and numbness of the scalp may be present for several hours. No harsh chemical coloring or perming treatments should be performed for at least 72 hours. Use of topical hair growth treatments like Rogaine or similar can resume the next day. Laser therapy treatments can also be resumed the next day.
Are there any contraindications or other factors that would make someone ineligible for PRP?
Patients should be educated by their Hair Restoration Physician as to what results they could expect from PRP in various areas of the scalp. Different areas of the scalp may respond differently to PRP depending on the amount of weak hair follicles present in each zone. Generally, with the exception of small round areas of alopecia areata, locations where severe depletion of follicles has occurred should not be treated. The vast majority of healthy individuals can easily undergo PRP treatments. Certain conditions like blood and platelet disorders, chronic liver disease, presence of an active severe infection, cardiovascular or hemodynamic instability and/or the presence of anti-coagulation therapy (e.g. warfarin) would make PRP contraindicated.