Platelet-Rich Plasma therapy is a non-surgical procedure used to promote tissue regeneration and healing in many areas of the body, including the hair follicles. The platelet-rich plasma is a layer of blood containing several proteins and growth-accelerating nutrients thought to facilitate the healing of musculoskeletal injuries, post-surgery wounds, and still at infancy, hair regeneration.
This technique has been used by doctors to treat injuries since the 1980s, and as of the past decade, it’s been used progressively in the hair regeneration sphere. While it has never been clinically proven to treat hair loss caused by androgenic alopecia, relevant studies and reviews in academic circles are heating up again, with a considerable number of them reporting quite positively.
However, evidence is still not sufficient and most review papers still end with “more research is needed”. The treatment has also remained unapproved by the FDA for regenerating hair follicles, and because there are claims of success from both clinics and patients, it’s simply been termed ‘controversial’.
“One major misconception about Platelet-Rich Plasma Therapy is that it only works for Androgenic Alopecia,” says Joe Tillman, international hair transplant specialist and the founder of Hair Transplant Mentor. Tillman, an AA sufferer since his teenage years, had undergone a series of PRP sessions in 2016 at the Cooley Hair Center in North Carolina and noticed some remarkable changes in his hairline after some months. “It can also work for stress-related telogen effluvium. I’ll say that it appears to work better in cases where the hair isn’t completely gone and the blood supply to the follicle is still intact. Forms of hair loss that are more aggressive, such as alopecia areata, might not benefit because the body is actively working to destroy the hair, so the PRP process simply isn’t strong enough to combat the immune system.”
According to a 2019 academic review of 132 papers published in Aesthetic Plastic Surgery, 262 androgenic alopecia patients were pulled from 11 articles matching PRP experiment criteria.
“Through a meta-analysis, we found a significantly locally increased hair number per cm2 after PRP injections in the treatment group versus the control group. Similarly, a significantly increased terminal hair density was found in the PRP group compared with the control group,” the researchers reported.
However, they advise caution in interpreting the results as the sample size is extremely small.
How does PRP therapy for hair loss work?
PRP is a relatively simple yet careful process that begins with the extraction of a small amount of blood from a patient. For hair loss, it’s usually 60ml. The blood is then processed in a sterile centrifuge and separated into three layers: platelet-rich plasma, platelet-poor plasma, and red blood cells.
The platelet-rich plasma is isolated as it contains a high concentration of platelets, red blood cells fortified with growth factors and proteins that contribute to cell regeneration. The PRP is then activated and re-injected into the patient’s scalp.
The concept behind PRP therapy centers on the reaction following the injection phase. The syringe is thought to cause a small injury that triggers the PRP to respond to inflammation. Nutrients are activated to soothe cells around the site and the same process is said to revitalize the hair follicles.
According to Dr. Gupta Rawal, a board-certified otolaryngologist/head and neck surgeon, PRP for hair loss cannot reverse total baldness. This option only stands a chance if a patient still has some surviving hair follicles.
“PRP cannot generate new follicles in areas that have shiny baldness; however, when used in conjunction with hair transplant in these areas, can work synergistically to promote optimal and faster growth of the transplanted follicles, says Rawal, director of The Rawal Institute for Hair Restoration and Aesthetic Medicine.
According to Tillman, PRP therapy is not a “cure” for hair loss, and tagging it as a perfect remedy would be overreaching. “Clinics should never promote PRP as a stand-alone “cure” as it is contrary to the facts,” says Tillman, co-host of The Bald Truth, a hair loss radio show anchored by Spencer Kobren. “A ‘cure’ would be a one-time treatment, whereas PRP, which is highly variable as there is no standard protocol, is needed once, maybe twice a year at a minimum. Some clinics may encourage four or more visits in a year but this is usually due to having a poor quality protocol, or worse yet, poor ethics.”
Pricing, preparation for the procedure, and possible side effects
Most clinics that offer PRP services for hair loss may set prices according to the number of treatments required by each patient. Patients would typically require 3 or 4 procedures spaced out by 4-6 weeks, but in the more severe cases, a higher number of sessions would be advised. Since PRP for hair loss is still an uncharted area, the price range could be anywhere from $1500 to $3500, depending on your region and location. Many clinics would charge about $5000, even without hair transplantation options.
Preparing for scalp-targeted PRP:
PRP is not a treatment to be received at the local pharmacy or a random laboratory. You must consult with a board-certified physician at a licensed dermatological or aesthetic clinic. Ensure to tell your doctor about any underlying medical conditions and medications currently in use or within the past year.
Patients who have medical conditions including cancer, low platelet counts, metabolic disorders, sepsis, skin diseases, and thyroid conditions may be advised against opting for PRP. If you’re currently using blood-thinning medications, you may also be rejected for the procedure.
Possible side effects:
PRP is a simple, non-surgical procedure with minimal pain and is considered reasonably safe. Since the procedure is autologous, – involving your own blood and platelets – there’s said to be minimal risks of transmitting infections. However, a few unwanted reactions may be of note:
- Infections from poor sterilization and after-care
- Pain from the injections
- Possible nerve and tissue damage beneath and around the follicles
Any sign of an abnormal reaction or excessive pain, especially after the first session, should be reported to the doctor immediately.
Patients may opt for mild anesthetics before the injection. It’s recommended to avoid tedious activities in the first 24 hours after each session. Washing or shampooing should also be delayed by a day or two to avoid upsetting the injected fluid. Swelling is said to be normal in the first couple of days as fluids and blood drain out of facial channels.
Recovery
PRP is a mild procedure and with all factors considered, there should be little to no downtime. However, patients must avoid stressful activities in the following couple of days after each session and obey the doctor’s instructions.
On average, most people start seeing results after two to three months, and for others, it may take up to five months for a glimmer of hope to appear. If PRP does not work for you, recall that the only clinically proven treatments for hair loss, approved by the FDA, are Minoxidil and Finasteride. Transplant surgery is also an option, but should always be considered last.“PRP, or any treatment that is non-surgical, will take three to five months to see the first signs of life since this is the typical time it takes for a follicle to transition from the telogen (resting) state of growth back into the anagen (active) state of growth,” says Tillman, who was named Manager of Medical Media for Global Hair Loss Summit 2020, the world’s largest hair loss conference. “The same applies to PRP but it can take six to eight months to see enough length to the new growth to make a visible difference, depending on the length of the patient’s hair.
