Q: Dr. Bernstein, I am experiencing side effects on Propecia, are there alternative treatments? — J.D. ~ Roslyn, N.Y.
A: Yes, minoxidil (Rogaine), low level laser therapy (LLLT), and Platelet Rich Plasma (PRP). Unfortunately, none of these will be as effective as finasteride.
Posted byQ: I am a 65 year old female who has recently experienced thinning hair and I’ve heard of PRP treatments. Is PRP safe and does it work for older people? — R.E., Upper East Side, NY
A: PRP (Platelet Rich Plasma) is safe for persons of any age, although we don’t administer it to pregnant women and those under 18. It can be helpful as long as the person has enough miniaturized hair for it to work on. It will not work on a totally bald area of the scalp.
Posted byAn article in the September/October 2015 issue of Hair Transplant Forum International highlighted results of a 6-month study of platelet rich plasma (PRP) treatment in a 23-year-old male diagnosed with androgenetic alopecia (common male pattern baldness) ((Kahen, John (ISHRS 2015). “The Use of Platelet Rich Plasma in Treating Hair Loss.” Hair Transplant Forum International. 25 (5): 189)). The study showed a significant increase in hair density and decrease in miniaturized follicles, as well as an apparent darkening of hair pigmentation.
The patient, who was instructed not to use hair loss medications such as Propecia (finasteride) or Rogaine (minoxidil), was given several treatments of PRP solution in a single session. At six months after the treatment, digital densitometry was used to assess any changes to the scalp compared to pre-treatment. He noted fewer follicles in a miniaturized state and an increase in hair density.
Another clinical observation was a change in the patient’s hair color from light brown to dark brown. The author hypothesized that this change in pigmentation may be due to significant numbers of hairs rapidly transitioning to the anagen (growth) phase of the hair cycle. As a result of this shift, there was an increase in hair shaft diameter and an apparent darkening of the patient’s hair color.
This study has several limitations: it is not a peer-reviewed, controlled study; it is an assessment of only one patient; and no empirical data on the hair growth was recorded. However, this research joins a number of other studies which appear to show that PRP therapy may be an effective, and safe, treatment for androgenetic alopecia.
Read more about Platelet Rich Plasma (PRP) Treatment for Hair Loss
Posted byResearch published in the online edition of the journal STEM CELLS: Translational Medicine has found that Platelet-Rich Plasma therapy (PRP) may boost hair regrowth in people with androgenetic alopecia (common hair loss). Previous studies have shown that PRP has the potential to reverse hair loss, but these were limited by a short duration of study. This is the first published research showing the long-term efficacy of PRP therapy for hair loss.
Background/About the Study
PRP has long been thought of as a potential treatment for hair loss, and it has been successfully employed in other areas of regenerative medicine. The researchers of this study, from the University of Rome Tor Vergata and the Catholic University of the Sacred Heart, devised a randomized, evaluator-blinded, placebo-controlled study to test the efficacy of the treatment over a two-year span.
Twenty-three men between the ages of 19–63 with varying degrees of hair loss were enrolled. Twenty of these were given three injections of “activated” Platelet-Rich Plasma (PRP) at 30 day intervals. The activation of platelets with calcium molecules initiates the secretion of growth factors that are critical to the development of new hair follicles and the growth of new blood vessels.
“It is proposed that growth-factors released from platelets may act on stem cells in the bulge area of the follicles, stimulating the development of new follicles, and promoting vascularization.” ((Gentile P, Garcovich S, Bielli A et al. The Effect of Platelet-Rich Plasma in Hair Regrowth: A Randomized Placebo-Controlled Trial. Stem Cells Transl Med. 2015 Sep 23.))
Once derived and activated, the PRP treatment was applied to one side of each patient’s head, while the other side was injected with a placebo. Patients were evaluated in six stages over a span of 24 months. Three of the subjects were excluded from the study due to a predisposition to develop keloids.
Findings
After the third treatment, the researchers found that subjects experienced an average growth of 33.6 hairs per cm2 and an increase in total hair density of almost 46 hairs per cm2 in the areas treated with PRP. The control side (injected with placebo instead of PRP) continued to lose hair at a rate of 3.2 hairs per cm2.
The density of terminal hairs rose significantly, by a mean of 40.1 hairs per cm2 in the treated area, while falling by 5.6 terminal hairs per cm2 in the untreated/placebo area.
Researchers observed a thicker epidermis (outer layer of skin) within two weeks of PRP treatment, and an increase in the number of hair follicles. Within three months, new hair was seen growing in the treated area at a mean of 33.6 hairs per cm2.
At one year after the last treatment, researchers noted signs of hair loss relapse. Progressive hair loss was observed in four of the patients at that time, with the hair loss more evident 16 months after the last treatment.
There were no major side effects from PRP treatment in the course of the study.
Conclusion/Summary
This study confirms prior studies which have suggested that there is a positive therapeutic effect of Platelet-Rich Plasma injections on male hair loss. Equally as important, this is the first study to measure the ability of PRP to induce hair regrowth over the long-term. The evaluation of PRP as a hair loss treatment is particularly important because there is increasing demand for alternative options to hair transplantation or medications. As the popularity of hair restoration continues to increase, so too will the population seeking alternative treatments, since not everyone experiencing hair loss is indicated for existing medical and surgical treatments. Platelet-Rich Plasma may become an important treatment option for this population of patients. While the results of this study are significant, more research is needed to better understand the mechanism of PRP and to design ways to improve the treatment.
For more on this topic:
Bernstein Medical’s PRP section
PRP FAQ
Q: It was recommended by the doctor that I have a hair transplant. Can I do platelet rich plasma (PRP) instead? — W.D., Denver, CO
A: PRP will generally be inadequate for patients who are candidates for a hair transplant. PRP works to reverse miniaturization (thinning hair) as do other medical treatments (Propecia, Rogaine, LLLT). Unfortunately, medical treatments do not grow hair back once it has been lost.
Platelet Rich Plasma (PRP) FAQ
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