What is PRP?
Platelet rich plasma (PRP) is concentrated blood plasma which contains approximately three to five times the number of platelets found in normal circulating blood. Platelets contain components such as platelet derived growth factor (PDGF), vascular endothelial growth factor (VEGF), transforming growth factor (TGF) and other bioactive proteins that aid in wound healing and possibly hair growth.
Growth factors in platelet rich plasma (PRP) have been used to facilitate wound healing. It has been used in orthopedics to speed recovery 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. Recently, studies have suggested that PRP may also serve as a safe and effective treatment option for male and female pattern hair loss.
Platelets are a constituent of human blood, which is primarily composed of red blood cells (RBC). Other components include white blood cells (WBC), platelets, and plasma. Platelets are involved in coagulation and are integral 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 for both the medical treatment of hair loss and as an adjuvant in hair transplantation.
PRP for Treating Hair Loss
Platelet rich plasma is obtained from the patient’s own blood- it is considered ‘autologous’= from the patient (just like fat transfer is considered autologous as we use the patient’s own fat). Blood is centrifuged which separates it into layers; red blood cells, white blood cells, platelets and plasma. PRP is separated from the other components and carefully injected into the treatment areas- thinning hair on the scalp or into the face to rejuvenate the skin – the vampire facial – made famous by Kim Kardashian. Sometimes components are added to activate the platelet, other times, the platelets are activated during the injection process. PRP be can also be applied onto a recipient area during and after a hair transplant or injected directly into a balding scalp.
Prior to injecting PRP, local anesthesia is injected around the area to make the process as painless as possible. Treatments are scheduled about 1-2 months apart and 3- 4 treatments are recommended with follow up treatments at 6m to 1 year apart. Some improvement (in reversing miniaturization) can be expected in the first 2-3 months. The treatments must be continued periodically to maintain any improvement.
During the procedure, Dr. Madnani does microneedling of the scalp to further improve the results. The microneedling causes micro injuries to the scalp, which creates inflammation and increases blood flow to the hair follicles. This combined with the growth factors in the PRP, further enhances the results.
Mechanism of Action
For the medical treatment of hair loss, PRP is used to stimulate the growth of follicles, thereby reversing the hair miniaturization seen in androgenetic alopecia (common baldness). The introduction of platelets and white blood cells through platelet rich plasma (PRP) can amplify the body’s naturally-occurring wound healing mechanism. It is also proposed that PRP can stimulate the stem cells (dermal papilla) of the newly transplanted hair follicles when done in conjunction with a hair transplant.
What are the Indications for PRP?
In the medical treatment of male and female pattern baldness (androgenetic alopecia), 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 number of scientific studies showing its efficacy. The long-term benefits of PRP treatments for hair loss are not yet known.