Friday, November 13, 2015

PRP and Hair Regrowth

Platelet-rich plasma (PRP) has been shown to be an effective treatment for hair loss.  I have only performed this procedure on one patient thus far, using PRP injections in conjunction with micro-needling.  This patient had some success after two treatments, and will be returning for a third session in the future.

Androgenic alopecia , or male pattern hair loss, can affect up to 80% of white men and even up to 40% of women.  There are multiple treatments available for this type of hair loss, although some of them will offer no benefit to many people.  Minoxidil and finasteride are two of the more common drug therapies approved by the FDA. In general, finasteride will help you keep the hair you have while minoxidil has some potential to grow new hair. Laser light therapy is another option, although it appears this may help keep the hair you have but will not actually grow new hair; it also seems to be the least effective of the therapies. One of the more successful therapies is hair transplant surgery, although the success rates vary widely and this can often necessitate more than one treatment.

A recent article published in the November 2015 journal Stem Cells Translational Medicine focused on the use of PRP injections in the realm of androgenic alopecia.  The research by Gentile, et al., titled "The Effect of Platelet-Rich Plasma in Hair Regrowth: A Randomized Placebo-Controlled Trial", studied the effect of PRP after 3 treatment cycles that were 30 days apart.  There were 23 study participants.

The procedure used in this study was simply PRP injected into an area of the scalp containing hair follicles, along with placebo injections in order to truly evaluate the effects. No local anesthesia was used during these treatments. The results were evaluated in 6 separate stages: at the beginning of the study, then at 2 months, 6 months, 12 months, 16 months, and 24 months.  These evaluations were made via photography, physician and patient assessments, and biopsies.

The results were very promising across the board. There was a significant increase in the overall hair count in the PRP treatment area after 3 months; the PRP area had 33.6 more hairs on average while the placebo region had 3.2 less hairs on average.The average density on hairs increased in the PRP treatment region by 45.9 hairs per square cm, with a 3.8 hair per square cm loss in the control area.  Biopsies showed an increase in epidermal skin thickness and an increase in the overall number of hair follicles in those areas treated with PRP.  Those are all very promising results from a procedure with low relative risk.

At 16 months, 4 of the 23 study patients showed some degree of progressive hair loss again.  These patients were re-treated with a series of 3 PRP treatments; the results after those injections were not evaluated in this study.

This is yet another in a series of small trials studying the efficacy of PRP for treatment of hair loss. Other studies have shown similar promising results.

Figure 5.

Here is a photo from the article referenced.  This is a 29 year-old male 2 weeks after the final treatment, with both increased hair density and total hair count.

The method I have used has 2 potential ways to stimulate hair growth.  The first is the injection of PRP as proposed in this research study and others like it.  The other mode to potentially promote hair growth is the use of microneedling.  This is a technique whereby a number of fine surgical grade microneedles are used to stimulate dermal stem cells and activate growth factors in the scalp. There have been studies also showing the effectiveness of microneedling for hair loss, and I will look at some of those results in the future.