Platelet Rich Plasma (PRP)
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. In addition, it contains 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. Recently, studies have suggested that PRP may also serve as a safe and effective treatment option for male and female pattern hair loss.
Human blood is comprised primarily of red blood cells (RBC), as well as white blood cells (WBC), platelets, and plasma. By initiating the first step of coagulation, platelets are the key 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 as both an adjuvant in hair transplantation and for the medical treatment of hair loss.
PRP for Treating Hair Loss
The Platelet Rich Plasma (PRP) commonly used in hair restoration is “autologous,” meaning that it is derived from the patient’s own blood. To obtain PRP, a patient’s blood is spun in a centrifuge to separate the solid from liquid components and platelet activators, such as thrombin, calcium chloride and sometimes collagen, are added. The separated “solid” portion of the blood is PRP (platelet rich plasma).
There are commercially available systems for PRP treatment. These include: Cydomedix, Emcyte Pure PRP, Angel system, and Harvest system. PRP is sometimes combined with A-Cell, although the benefit of this combination is speculative.
PRP is then placed into a syringe and reintroduced into the treatment site i.e., either the surgical site or an area of hair loss. PRP be can sprayed onto a recipient area during and after a hair transplant, laid into the donor incision, or injected directly into a balding scalp. Prior to injecting PRP, doctors often create a ring-block of local anesthesia with 1% lidocaine.
When used to stimulate hair growth most doctors schedule injections at intervals of 1 to 9 months. Some improvement (in reversing miniaturization) can be expected in the first 2-6 months. The treatments must be continued periodically to maintain any improvement.
PRP Treatments at Bernstein Medical
If PRP therapy is appropriate, we generally begin treatments at three month intervals and modify the treatment schedule based on the patient’s individual response. Patients are monitored to assess the benefits of therapy. We use the Emcyte Pure PRP systems – a double centrifuge technique – that allows the active biologic factors to be administered at the most effective concentration.
The treatments are administered by a Bernstein Medical physician and take about a half hour.
Mechanism of Action
For the medical treatment of hair loss, practitioners use PRP to stimulate the growth of follicles, thereby reversing the hair miniaturization seen in androgenetic alopecia (common baldness).
It is conjectured that 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 actually stimulate the stem cells (dermal papilla) of the newly transplanted hair follicles. Other doctors feel that during a hair transplant procedure, the body’s normal production of bioactive growth factors are optimal for healing and subsequent growth and that PRP gives no additional benefit.
What are the Indications for PRP?
PRP is used in many areas of medicine, including the acceleration of healing 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.
In hair transplantation, PRP can be injected into or sprayed on the recipient site area to, theoretically, stimulate the healing of the transplanted grafts and into the donor area to facilitate healing of the donor incision and potentially minimize scar formation.
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 limited number of scientific studies to show its efficacy. The long-term benefits of PRP treatments for hair loss are not yet known. All patients receiving PRP treatments at Bernstein Medical are followed closely to determine effectiveness and if other therapeutic modalities may be needed.
- Miao, Y., et al. Promotional effect of PRP on hair follicle reconstitution in vivo. Derm Surg. 2013; 39:1869-1876.
- Greco, J., and R. Brandt. Preliminary experience and extended applications for the use of autologous platelet rich plasma in hair transplantation surgery. Hair Transplant Forum Int’l. 2007; 17:131-132.
- Greco, J., and R. Brandt. The effects of autologous platelet rich plasma and various growth factors on non-transplanted miniaturized hair. Hair Transplant Forum Int’l. 2009; 19:49-50.
- V. Cervelli, S. Garcovich, A. Bielli, G. Cervelli, et al. “The effect of autologous activated platelet rich plasma (AA-PRP) injection on pattern hair loss: clinical and histomorphometric evaluation,” BioMed Research International. Volume 2014.