Platelet Rich Plasma (PRP) for Hair Loss

prpPlatelet Rich Plasma (PRP) Hair Loss Therapy

Platelet rich plasma (PRP) has been well established in fields like dentistry and orthopedic surgery for its role in providing growth factors to areas of healing. It involves drawing one’s blood, spinning it down with a centrifuge, and then extracting off a the platelet rich portion for use in medical therapy. Platelets were once thought to only help with blood clotting, but we now understand that they secrete valuable cytokines and growth factors, including but not limited to the following:

-Platelet-derived growth factor (PDGF)
-Transforming growth factor (TGF)
-Vascular endothelial growth factor (VEGF)
-Insulin-like growth factor (IGF)
-Epidermal growth factor (EGF)
-Interleukin-1 (IL-1)

 PRP for Hair Growth

A newer application is the use of PRP for hair growth. It was first described in 2006 by Dr. Uebel of Brazil to enhance growth with hair transplant surgery.1 Since then, basic science studies have demonstrated that activated PRP can increase the proliferation of dermal papilla cells and can stimulate extracellular signaling via fibroblast growth factor (FGF-7) and beta-catenin.2 One pilot study demonstrated clinically important differences seen in 40% and 54.7% of patients, according to the 2 evaluators, respectively.3

Who is a Candidate?

PRP can be a great choice for patients who have already maximized other medical therapies.4. It can also be used in conjunction with hair transplantation, starting the first week after surgery and extending for 4-6 months after surgery.

Advantages of PRP:

-This procedure is very safe. PRP is completely autologous (derived from your own body) and does not introduce any foreign drugs or chemicals to your body.
-There are no drug interactions
-It does not require any lab testing
-No allergies have been reported
-The procedure requires just 30 minutes and can be done in the office

Disadvantages of PRP:

-Although this is safe, PRP has not been FDA approved as a medical therapy for male or female pattern hair loss. Various PRP devices have 510-K approval as medical devices only.
-We do not yet have large, multi-center, double-blind, placebo-controlled trials demonstrating the efficacy of platelet rich plasma for male or female pattern hair loss.
-Most of our data is based on in vivo, anecdotal studies and case reports
-There is still a wide array of protocols, none of which have been formalized
-It is unclear at this time whether PRP represent a single treatment course or requires ongoing therapy

Role of Microneedling

-There is evidence that skin wounding alone can contribute to hair regrowth. This is based on mouse studies showing hair follicle regeneration after wounding. Clinical studies have also shown successful hair regrowth using micro needling in men who failed to respond to other therapies. While the scalp is anesthetized, we recommend also making use of this additional method of hair regrowth.

Reference:

1 Uebel CO, da Silva JB, Cantarelli D, Martins P. The role of platelet plasma growth factors in male pattern baldness surgery. Plast Reconstr Surg. 2006;118;1458-66.

2 Li ZJ, Choi H-I, et al. Autologous platelet-rich plasma: A potential therapeutic tool for promoting hair growth. Derm Surg. 2012;38:1040-46.

3 Schiavone G, Raskovic D, Greco J, Abeni D. Platelet-rich plasma for androgenetic alopecia: Pilot study. Derm Surg. 2014;40:1010-19.

4 Rogers, Nicole. Commentary on autologous platelet-rich plasma: A potential therapeutic tool for promoting hair growth. Dermatologic Surgery. 2012;38:1047-48.

5 Ito M, Yang Z, Andl T, Cui C, Kim N, Millar SE, Cotsarelis G. Wnt-dependent de novo hair follicle regeneration in adult mouse skin after wounding. Nature 2007;447:317-20.

6 Dhurat R, Mathapati S. Response to microneedling treatment in men who failed to respond to conventional therapy. Indian J Dermatol. 2015;60:260-63.

7 Dhurat R, Sukesh MS, Avhad G, Dandale A, Pal A, Pund P. A randomized evaluator blinded study of effect of micro needling in androgenetic alopecia: A pilot study. Int J Trichology 2013;5:6-11.

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