Platelet Rich Plasma for Hair Loss

This section is for the "Follically Challenged".  There are so many conversations and articles on the topic and I want make sure you are getting good information. ​

This month's article is:

 Platelet Rich Plasma for Hair Loss
PRP is an all-natural, minimally invasive treatment option for men and women with hair loss.

Androgenetic alopecia, or AGA, is the most common cause of hair loss among both men and women, affecting up to 40% of women and 70% of men. Visually, it's characterized by decreased hair density, diameter and length as thick, terminal hairs transition into thin, vellus hairs.

These changes often occur in a characteristic, gender-specific pattern. AGA has been associated with negative social implications and psychological conditions affecting quality of life. Current Food and Drug Administration-approved treatment options include oral finasteride for men and minoxidil for men and women, which are associated with potentially irreversible side effects, and linked with low patient compliance and suboptimal results. Due to limited effective therapies for AGA, platelet rich plasma – or PRP – has become an effective alternative treatment. PRP is an all-natural, minimally invasive treatment option for men and women with hair loss.

PRP is an autologous concentration of platelets in plasma with numerous growth factors that contribute to hair regeneration. The growth factors contained within platelets act on stem cells in the hair follicles and stimulate development of new follicles along with growth of new blood vessels. Since the early 2000s, PRP has been used across medical specialties such as neurosurgery, orthopedics and maxillofacial surgery for its wound-healing properties. Orthopedics has had success using PRP in joints after surgery and injuries, where they found there was less pain and faster healing due to its regenerative properties.

PRP is a volume of blood plasma that's concentrated (more than 1 million platelets/μL) with platelets. It's rich in growth factors contained in platelet granules. These growth factors bind to their receptors in the hair follicle, in turn helping to activate the growth phase of the hair follicle. Platelet-rich plasma has multiple actions at the hair follicle, leading to alterations in the hair cycle and improvement in hair growth.

Most of the literature and research supporting PRP for hair loss is with male or female pattern hair loss, or AGA. At the initial consultation, a doctor will discuss personal and family history of hair loss, along with dietary and lifestyle habits. It's important to discuss expectations and expected treatment outcomes with your provider, too.

Ultimately, PRP works best in combination with other therapies, both topical and oral, in order to address all the factors that can cause hair loss. It's also recommended to avoid NSAIDs, blood thinners and herbal supplements (such as garlic, ginko, vitamin E and St John's wort) for two weeks prior to treatment in order to decrease the risk of bruising and ensure the platelets are not affected. And it's advised to not color or dye the hair 48 hours before and after treatment. Hydration is also essential for 24 hours prior to injection, in order to ensure the maximum amount of plasma will be collected for each treatment. The procedure involves drawing blood, spinning it in a centrifuge for 10 to 15 minutes and then separating and preparing the PRP. Once it's prepared, it's injected into the thinning areas of the scalp through numerous injections.

From clinical experience, I recommend the use of PRP as a co-adjuvant treatment for AGA and encourage patients to continue topical and/or oral therapies (such as minoxidil, spironolactone and finasteride), as PRP does not suppress the hormonal component of AGA.
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Overall, our male and female patients have had positive results from PRP injections in AGA in terms of regrowth, increased hair density and improved quality of life. One are athat requires more research is how effective PRP is beyond one year of treatment. While many prospective and randomized controlled trials show benefit at three to six months of treatment, it's unclear when peak hair density is reached, how long treatment effects last and how often treatment must be continued after the short term. Longer-term, controlled studies examining these questions could eventually assist clinicians in establishing standardized treatment protocols.

From USNews and World Report