PRP Hair Restoration

PRP Hair Restoration services offered in Roslyn Heights, NY

What is PRP Therapy?

PRP (platelet-rich plasma) is a growth factor-based treatment for hair loss that falls under the regenerative medicine umbrella that also includes stem cell therapy. There are three potential sources for growth factors:

Synthetic, which is currently a proprietary product administered with an ultrasound device.
Exogenous, generally as exosomes, which are intercellular communication structures that are obtained from bone marrow or placenta, but exogenous also includes plant-based growth factors and other types of exogenous growth factors.
Endogenous, which is obtained from the patient’s own blood. It is the endogenous source that is most well-known as PRP, which is the subject of this page.

Platelets are blood-cell fragments that are critical to normal blood clotting function and that also contain several different growth factors. Growth factors are proteins that signal the body to generate specific tissues, such as blood vessels and skin, after an injury, as well as many other functions. With PRP, blood from a patient is centrifuged into separate layers, including red blood cells, plasma, and a buffy coat layer where all the platelets are concentrated. This layer is separated from the others along with a small quantity of plasma and is thus termed platelet-rich plasma, in which the growth factors reside.

Since there is a wide range for normal platelet levels (from 150 to 450 per mcl), some PRP samples will have much higher levels of growth factors than others, and this may account for the inconsistent results often seen with this therapy.

The PRP is injected very superficially into the skin of the scalp in areas of hair loss with the expectation that the growth factors will produce thicker, darker, healthier, and more cosmetically effective hair growth.

FDA Approval

Importantly, while several PRP preparation systems are FDA-cleared for orthopedic indications, their use for hair growth is “off-label“, as no data has been submitted to the FDA sufficient to grant clearance for this indication. Off-label treatments allow physicians to legally perform the procedure with adequate patient counseling about the nature of the procedure along with the pros, cons, and limitations associated with that kind of therapy.

An ongoing and possibly perpetual problem is a lack of standardization in terms of blood collection, preparation, and administration. There are literally dozens of permutations, and no attempts at standardization have achieved acceptance amongst practitioners.

How Does PRP Work for Hair Loss?

The exact mechanism of action for how PRP promotes hair growth is unknown. PRP contains at least six different growth factors, and the individual and synergistic effects of these proteins on hair growth cannot easily be identified. In addition, PRP contains at least 30 other substances, including chemokines, clotting factors, and immune mediators, all or some of which may influence hair growth as well. Growth factors in PRP that are most involved in hair growth include Fibroblast Growth Factor (FGF), Vascular Endothelial Growth Factor (VEGF), and Epidermal Growth Factor (EGF). Growth factors can increase the duration of the anagen, the growth phase of the hair, and may increase the thickness of the hair shaft.

Who’s a Good Candidate for PRP?

The best candidates are those with thinning hair rather than complete baldness and for those who have experienced more recent hair loss. Thinning hair is more common in younger individuals, but anyone with thinning hair loss may benefit from the treatment. As noted earlier, individuals with naturally high platelet levels have an advantage over those with lower platelet levels, as the quantity of growth factors administered will be greater in the former group.

PRP Treatment Process

A PRP visit begins with a clear explanation of the procedure and the signing of an informed consent form. This signifies that the patient understands the risks, benefits, limitations, and alternatives to the procedure.
Next, a quantity of blood will be drawn, the exact amount being dependent on the system used by the office. While the PRP is prepared, the patient will generally be moved to a treatment room, where local anesthesia will be administered if appropriate.
The blood sample will be processed according to the protocol specific to the system used, which may involve a single or double spin, and transferred to test tubes or separation containers. When concluded, there will be three products: packed red blood cells, platelet-poor plasma (PPP), and platelet-rich plasma (PRP).
Sometimes, but not always, a small sample will be tested to determine the exact concentration of platelets. The goal is to concentrate the platelet level 2–6 times higher than the starting level. There is no consensus on the ideal concentration.

PRP is often administered along with microneedling, another method of stimulating growth factor release. If so, an anesthetic ring block may be administered, or nitrous oxide gas may be administered, to reduce any pain. The PRP is injected in small quantities of as little as 0.05 ml, allowing as many as 120 injection sites per procedure. Microneedling will generally follow the PRP injections, if they are administered.

Required Number of Sessions

PRP treatments will always need to be repeated to be effective. However, there is no standard treatment interval. A common program is one treatment session each month for three months, followed by a booster session every six months. Your practitioner will discuss your recommended treatment program and its rationale.

Post Treatment Care

Avoid using scalp products prior to the procedure. Patients should avoid anti-inflammatory agents such as NSAIDs and aspirin for up to 14 days after the procedure, as they may interfere with the beneficial effects of PRP.

Benefits and Effectiveness of PRP for Hair Loss

PRP, along with all non-surgical hair loss treatments, may decrease shedding or result in thicker-looking hair. Thicker-looking hair can be seen with either an increase in the actual number of hairs present, by an increase in the hair-shaft diameter, or by a combination of both. Not all patients will benefit from growth factor treatments, so some patients experience no benefit. As mentioned above, any benefits noted will only be maintained if ongoing treatments are maintained.

Multiple studies have been published on the effectiveness of PRP. While some have demonstrated benefits, others have not. This is not surprising due to the wide variability of protocols and patient characteristics.

Potential Risks and Side Effects

PRP injections are considered to be very safe. The substance injected is autologous, meaning it was obtained from the patient’s own body, eliminating the risk of blood or tissue borne pathogens. Assuming the procedure is carried out in an aseptic manner, there is little risk of infection from the injections themselves, although it is not possible to sterilize the surface of the scalp. Thus, local and temporary pain at the injection sites is the principal risk.