Hair is a representation of personal style for many people. And if it’s been a part of your identity for the bulk of your life (or even if it hasn’t), suffering hair loss may be jarring, especially if the cause is a significant medical condition.
However, for others, a medical procedure known as platelet-rich plasma (PRP) injections may change the trajectory of your hair’s fate.
We contacted specialists Michele Green, MD, and Gary Goldenberg, MD, for additional information on the science behind PRP injections and how they work to restore hair follicle development.
GET TO KNOW THE EXPERT
- Michele Green, MD, is a New York City dermatologist.
- Gary Goldenberg, MD, is a medical and cosmetic dermatologist in Manhattan and the co-founder of Goldenberg Dermatology.
What Exactly Is PRP?
PRP is a non-invasive injectable procedure that employs a patient’s own blood, similar to “vampire facials.” In a dedicated tube, a little blood sample is collected from the patient (usually from the arm) and centrifuged for 10 minutes.
The tube is quickly spun while it is in there to separate the plasma from the red blood cells. The platelet-rich plasma is contained in the separated plasma, which is subsequently injected or micro-needled into the scalp.
In terms of hair loss, Goldenberg claims that the plasma feeds dormant hair follicles. “It maintains the existing hair follicles and then encourages development for the follicles in the scalp that are unable to grow due to a lack of nutrients,” he says.
“Androgenetic alopecia [ed. note: hair loss] operates through a process known as’miniaturization.'” During miniaturization, the follicle, which previously generated healthy (terminal) hairs, begins to produce thinner, more fragile hair that comes out readily, known as vellus hairs.
This causes a receding hairline, thin temples, a wider-than-usual part, or thinning or balding at the crown of the scalp.
When it comes to treating these dormant follicles, Green explains the science underlying PRP and why the centrifuge is required: “This process separates plasma, which includes growth factors, which are a combination of proteins and cytokines,” she explains. “Both are vital in activating the follicles to produce hair growth.”
PRP growth factors have been shown to have the following effects:
- Epidermal Growth Factor (EGF) regulates cell development by promoting the creation of keratin and fiber.
- Transforming Growth Factor: Encourages the formation of new blood vessels.
- Vascular Endothelial Growth Factor: Promotes the formation of new blood vessels from the existing vasculature.
- Fibroblast Growth Factor is a protein that promotes granulation during tissue regeneration.
- Platelet-Derived Growth Factor: Increases collagen and proteoglycan production while recruiting macrophages and fibroblasts to the treated region.
- Collagen Stimulating Development Factor: Promotes the growth of healthy tissue and blood cells by stimulating granulocyte and macrophage proliferation.
- Keratinocyte Growth Factor: Keratinocyte migration, differentiation, and proliferation may improve healing and skin regeneration conditions.
- Interleukins, macrophages, keratinocytes, endothelial cells, lymphocytes, fibroblasts, osteoblasts, basophils, and mast cells are all examples of immune cells. They activate fibroblast differentiation while also inducing collagen and proteoglycan synthesis for healthy cell formation and tissue repair.
What Is the Difference Between PRP and Traditional Hair Transplants?
While hair transplants have gained popularity due to their immediate effects, PRP is a less expensive upfront alternative that demands patience (PRP will typically cost $400 or more each session, whereas hair transplant surgery can range from $4000 to $15,000 for the whole treatment).
Green claims that PRP is a less painful procedure with no downtime.
Goldenberg further notes that hair stimulated by PRP seems more natural than hair transplanted from another section of the body.
What to Expect During a PRP Procedure?
On the day of your treatment, your blood will be extracted and centrifuged. The treatment region will be assessed and anesthetized at this time. PRP is then injected into the affected region.
Patients with undamaged hair follicles who are experiencing hair loss are usually ideal candidates for PRP. These people may shed excessively, but they aren’t fully bald, so the sooner a person comes in to manage their hair loss, the better the results.
Both men and women are good possibilities; nevertheless, Goldenberg believes that time is important.
In his experience, males seek treatment after balding has begun, but women seek treatment immediately since they consider hair loss an emergency.
Aside from severe baldness, people should be aware of a few additional issues before undergoing PRP.
“PRP is safe for the great majority of people,” Green says. “However, if you have any blood or platelet problems; active infections or viral outbreaks such as shingles; or are on a steroid therapy or blood thinners such as Coumadin, you should not have a PRP treatment.”
With many women experiencing hair loss and thinning during pregnancy, this may appear to be the ideal solution, but it is better to wait until after you have given birth before considering PRP treatment.
While the procedure does utilize your own blood, not enough study has been conducted to determine if it is safe to do while pregnant.
Finally, it all comes down to the degree of hair loss and the therapy combination. Three to four monthly sessions usually provide benefits, however, a significant alteration might take up to six months.
Both physicians agree that while there are no negative side effects and the technique is generally beneficial, there is no limit to the number of treatments a person can have.
However, because PRP is a therapy, not a cure, you will need to continue with it every year if you want your benefits to last.
Maintenance treatments can be performed quarterly to maintain results.
Fortunately, PRP does not have many recognized negative effects. Patients may suffer discomfort on the scalp following injections at most. A minor headache or pressure in the treated region may also be reported by some individuals. A simple pain reliever can alleviate this discomfort.
There have been allegations of PRP patients being exposed to or obtaining HIV at a medical spa3, raising questions about the procedure’s safety.
Green and Golden both believe that patients must have PRP delivered by a board-certified dermatologist.
Aside from this unusual case, they both feel that PRP is a highly safe procedure that produces more positive than unfavorable effects.
There is no downtime with PRP because it is a non-invasive procedure. Many people are able to resume their normal activities shortly after therapy. However, there are a few things you should avoid throughout your recovery:
- Avoid swimming and strenuous activity for the first 24 hours after therapy.
- For the next 24 hours, refrain from utilizing hair care products.
- For 48 hours, avoid exposing the treated area to the sun.
- 72 hours of no harsh chemicals, coloring, or perming
- Do not consume alcohol or smoke for 72 hours.
- If possible, avoid anti-inflammatory drugs for five days following your treatment.
- No blood-thinning medications for at least one week following your therapy.
The Bottom Line
Green claims that the effects of PRP treatments may be sustained by using oral prescription drugs meant to cure hair loss.
She also suggests using over-the-counter vitamins in combination with a targeted topical treatment and scalp stimulators. The following vitamins and therapies may be beneficial:
An over-the-counter vitamin supplement made with vital vitamins such as biotin, vitamin C, and vitamin B, as well as additional proprietary vitamins, to promote hair growth and thickness.
A proprietary over-the-counter vitamin combination that claims to restore hair growth. It is available as an oral supplement or as a topical application. Saw palmetto is included in the nutritional formulation to inhibit the conversion of male androgen hormones into DHT (dihydrotestosterone), a cause of baldness.
A drug prescribed for androgenetic alopecia. It treats DHT-induced hair follicle shrinking and decreases DHT levels in the scalp to encourage new hair growth.
A prescription drug that cures androgenetic alopecia in women by reducing male sex hormone production (androgens). It is used when there is a hormonal imbalance causing hair loss or thinning.
A topical therapy that comes in a solution or foam basis that can be administered to the scalp before going to bed. Long-term usage aids in the maintenance of benefits and the reduction of hair loss.
An FDA-approved at-home gadget that stimulates hair follicles using low-light treatment. It can be worn three times each week for 30 minutes.
It’s also worth noting that PRP doesn’t work on body hair. “More research is needed to assess the effectiveness of PRP treatments in these additional regions,” Green adds.
In contrast, Goldenberg has had patients want PRP for their brows. It’s a far more challenging procedure that isn’t as visible as it is on the scalp, but he’s had some success.
Finally, if you want to splurge, Goldenberg says he has seen women save umbilical cords after birth as well as liposuctioned fat as a stem cell source in the hopes of improving the PRP therapy.