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For many, hair is a manifestation of personal style. And if it's served as part of your identity for the majority of your life (or even if it hasn't), experiencing hair loss can really throw you for a loop, especially if the root of the issue is a serious medical issue. For some, however, a medical treatment called platelet-rich plasma (PRP) injections could change the course of your hair's fate.
We asked experts Michele Green, MD, and Gary Goldenberg, MD to share more information on the science behind PRP injections and how they work to restore growth to inactive hair follicles.
Meet the Expert
What Is PRP?
Much like "vampire facials," PRP is a non-invasive injectable treatment that uses a patient’s own blood. A small blood sample is drawn from the patient (typically from the arm) in a specialized tube and is then placed in a centrifuge for 10 minutes. While it’s in there, the tube is rapidly spun to separate the plasma from red blood cells. The separated plasma contains the platelet-rich plasma, which is then injected or micro-needled into the scalp.
Benefits of PRP
In terms of hair loss, Goldenberg says that the plasma serves as sustenance for dormant hair follicles. "[It] supports the current hair follicles and then it promotes growth for the follicles that are in the scalp that aren’t able to grow because they don’t have enough nutrition,” he explains. “The way that androgenetic alopecia [ed. note: hair loss] works is with something that’s called ‘miniaturization,’ and that miniaturization for the hair follicles is a lot like purgatory on the scalp. They are not growing and they’re kind of just sitting there."
When it comes to actually treating these dormant follicles, Green offers a breakdown of the science behind PRP and why the centrifuge is necessary: “The plasma that is separated during this process contains growth factors, which are a mixture of proteins and cytokines,” she explains. “Both play an important role in stimulating the follicles to generate hair growth.”
The growth factors found in PRP are known to produce the following effects:
- Epidermal Growth Factor: Regulates cell growth by stimulating keratin and fiber production.
- Transforming Growth Factor: Promotes the growth of new blood vessels.
- Vascular Endothelial Growth Factor: Stimulates the growth of blood vessels from the existing vasculature.
- Fibroblast Growth Factor: Promotes granulation during tissue repair.
- Platelet-Derived Growth Factor: Promotes collagen growth and proteoglycan synthesis while also attracting macrophages and fibroblasts to the treated area.
- Collagen Stimulating Growth Factor: Stimulates granulocyte and macrophage proliferation for the growth of healthy tissue and blood cells.
- Keratinocyte Growth Factor: Keratinocyte migration, differentiation and proliferations may optimize conditions for healing and generation of new skin.
- Interleukins, Macrophages, Keratinocytes, Endothelial Cells, Lymphocytes, Fibroblasts, Osteoblasts, Basophils, and Mast Cells: Activate fibroblast differentiation and also induces collagen and proteoglycan synthesis for healthy cell production and repair of damaged tissues.
How Does PRP Differ from Traditional Hair Transplants?
While hair transplants have gained popularity for their instant results, PRP is less expensive upfront and is a non-surgical option that requires patience (PRP will, on average, cost around $400 or more per session, whereas hair transplant surgery can run anywhere from $4000 to $15,000 for the full procedure). Green notes that PRP is a less painful process and that downtime isn’t necessary.
Goldenberg also points out that hair stimulated by PRP tends to look more natural than hair that was transplanted from another part of the body.
What to Expect During PRP
On the day of your treatment, your blood will be drawn and then placed in a centrifuge. During this time, the area of treatment will be evaluated and anesthetized. The PRP is then injected into the area.
Patients who are experiencing hair loss with intact hair follicles are typically good candidates for PRP. These patients may have excessive shedding, but they aren’t completely bald, so the sooner a person comes in to address their hair loss, the better their results will be.
Both men and women are also good candidates; however, the timing factor usually plays a role according to Goldenberg. In his experience, men seek treatment when balding has begun to set in while women seek treatment right away because they tend to consider hair loss an emergency.
Aside from severe baldness, there are few other conditions patients should be aware of before getting PRP done. According to Green, “PRP is safe for the vast majority, however, if you have any blood or platelet disorders; active infections or viral outbreaks such as shingles, or are on a steroid treatment or blood thinners such as Coumadin, you should not have a PRP treatment.”
With hair loss and thinning affecting many women during pregnancy, this may sound like the ideal treatment, but it is best to wait until after you give birth to consider a PRP treatment. While the process does use your own blood, there has not been enough research done to determine if it is safe to do while pregnant.
Ultimately, it all depends on the severity of hair loss and treatment combination. Three to four sessions on a monthly basis tend to yield results, though it can take up to six months to see a serious transformation.
Both doctors acknowledge that with a lack of negative drawbacks and the procedure’s overall proven effectiveness, there is no limit to the number of treatments a person can have. However, in order for your results to last for the long term, you’ll have to continue with PRP every year because it's a treatment, not a cure.
To sustain results, maintenance treatments can be done quarterly.
Fortunately, there aren’t many known side effects of PRP. At most, patients may experience tenderness on the scalp after injections. Some patients may also report having a slight headache or pressure in the treated area. This discomfort can be relieved with a basic pain killer.
With reports of PRP recipients getting exposed to or contracting HIV at a medical spa, there are concerns about the procedure's safety. Green and Golden both agree that it is imperative for patients to get PRP administered by a board-certified dermatologist.
Aside from this rare instance, they both maintain that PRP is a very safe treatment that provides more good results than it does bad.
Since PRP is a non-invasive treatment, there is no downtime. Many are even able to go about their daily activities immediately following treatment. However, there’s a list of factors that you should steer clear of during recovery:
- Avoid water and heavy exercise for the first 24 hours following treatment
- Refrain from using hair care products for 24 hours
- Limit sun exposure to the treated area for 48 hours
- No harsh chemicals, hair coloring, or perming 72 hours
- Do not drink alcohol and/or smoke for 72 hours
- Avoid anti-inflammatory medications for five days after your procedure, if possible
- No blood-thinning agents for at least one week after your treatment
The Final Takeaway
According to Green, results from PRP treatments can be maintained by taking oral prescription medications designed to address hair loss. Additionally, she recommends taking over-the-counter vitamins in conjunction with a targeted topical cream and scalp-stimulating devices. Below are some supplements and treatments that may help:
- Viviscal: An over-the-counter vitamin supplement formulated with essential vitamins such as Biotin, Vitamin C and B in addition to other propriety vitamins for improved hair growth and thickness.
- Nutrafol: A propriety over-the-counter blend of vitamins that promises to restore hair growth. It comes as an oral supplement or a topical solution. The nutrient formulation has saw palmetto, which is meant to prevent the conversion of the male androgen hormones into DHT (dihydrotestosterone), a cause of baldness.
- Finasteride: A prescription medication used for androgenetic alopecia. It addresses hair follicle shrinkage caused by DHT and lowers those levels in the scalp to promote new hair growth.
- Spironolactone: A prescription medication that treats androgenetic alopecia in women by slowing down the production of male sex hormones (androgens). It is used when hair loss or thinning is caused by a hormonal imbalance.
- Minoxidil: A topical treatment that comes in either a solution or foam base and can be applied to the scalp at bedtime. Long-term use helps to sustain results and minimize hair loss.
- LaserCap: An at-home FDA approved device that uses low-light therapy to stimulate hair follicles. It can be worn for 30 minutes, three times per week.
It's also important to note that PRP does not work on body hair. “More studies are needed on the efficacy of PRP treatments for these other areas as they’ve not been determined,” says Green.
Goldenberg, on the other hand, has had patients request PRP for their eyebrows. It’s a much more difficult process and not as visibly effective as it is on the scalp, but he has seen some success.
Lastly, If you want to splurge, Goldenberg says he has seen women saving umbilical cords after birth along with liposuctioned fat as a stem cell source—all of which is done in hopes of enhancing the PRP treatment. Interesting.
Everts P, Onishi K, Jayaram P, Lana JF, Mautner K. Platelet-rich plasma: new performance understandings and therapeutic considerations in 2020. Int J Mol Sci. 2020;21(20):7794. doi:10.3390/ijms21207794
Goddard NV, Waterhouse N. Regenerative medicine, stem cell therapies, and platelet-rich plasma: where is the evidence? Aesthet Surg J. 2020;40(4):460-465. doi:10.1093/asj/sjz317