Walking into a cosmetic consultation can feel like entering a foreign country for the first time—you’re wholly unsure of your surroundings and don’t know a lick of the language. Which is why we’re launching Beauty Speak, where, every month, leading experts help us break down popular procedures into 10 key terms with easy-to-understand definitions. Consider it the Google Translate of aesthetics.
Kim Kardashian. Vampires. HIV.
Word-association games are no friend to platelet-rich plasma (PRP), the in-office treatment that made blood a next-level beautifier. Still, despite the sometimes sensational buzz surrounding PRP, aesthetics doctors routinely promote it as “liquid gold”—an all-natural, self-made solution for everything from lackluster skin to thinning hair and lagging libido.
In its every iteration, PRP therapy relies on plasma—the liquid portion of blood that carries red and white cells, platelets, and nutrients throughout the body. The fraction of plasma with an abundance of platelets is referred to, aptly so, as PRP. These platelets aren’t just blood-clotting agents but a rich source of reparative growth factors.
The earliest descriptions of PRP come from hematology (no surprise), where doctors counted on it to transfuse patients with platelet-impoverished blood. It was later used in maxillofacial and orthopedic surgery, to quell inflammation and speed wound healing. Only within the last decade or so have dermatologists and plastic surgeons begun seriously exploring the myriad ways PRP may improve the health and appearance of our skin and hair.
The small studies, systematic reviews, and case reports that exist in the literature paint PRP as a promising treatment for certain types of hair loss, post-procedure wound healing, select scars, skin rejuvenation, and, most recently, sexual-health issues across genders. Yet they almost always come with a caveat: more randomized, controlled studies are needed.
With the PRP conversation evolving daily, we asked board-eligible Nashville plastic surgeon Dr. Amaka Nwubah to update our lexicon with 10 terms that capture the procedure, hold the hype.
Alopecia
The primary type of hair loss that PRP treats, androgenic alopecia is hormonally driven and affects both men and women. “In males, this pattern of baldness is characterized by a receding hairline that forms an M shape; in women, thinning typically occurs along the part, on the crown, or in some cases, all over the head,” explains Dr. Nwubah. She’s also had success treating postpartum alopecia with PRP, along with three types of stress alopecia when caught early—trauma-induced telogen effluvium, trichotillomania (aka hair-pulling disorder), and the autoimmune disease alopecia areata. “By stimulating the stem cells around the hair follicle, accelerating tissue healing, and promoting new cellular growth, PRP causes new hairs to sprout and thickens existing strands,” she says. But it doesn’t work for total or advanced balding. “There must be mature hairs and functioning hair follicles in the area that the PRP can signal, to trigger dormant and baby follicles to blossom.”
Anti-inflammation
“PRP has been shown in many studies to reduce inflammation by blocking the production of certain prostaglandins, or cell-signaling substances, and other proteins that incite inflammation,” says Dr. Nwubah. PRP’s potent anti-inflammatory properties are especially influential when treating thinning hair, “because, oftentimes, hair loss is a direct result of scalp inflammation—and by reducing it, PRP is addressing the root cause of the problem.”
Related: The Best Shampoos to Use After Your PRP Scalp Treatment, According to Dermatologists
Centrifugation
This is the process of spinning down blood to separate its components. After blood is drawn from your arm, “it’s centrifuged at a certain speed for 10 minutes,” says Dr. Nwubah. “The red blood cells concentrate at the bottom [of the vial], and the platelets [defined below] and plasma, which are less dense, accumulate at the top. At the very top is the platelet-poor plasma—this is discarded. I then gently flip the tube over a few times, to make sure all of the valuable platelets are in the suspension, before drawing it up into my needle for injection.”
Collagen building
Engineered by cells called fibroblasts, collagen is a protein that makes skin plump and taut. Its production begins to wane in our 20s, but there are proven ways to rev it up—and PRP is a powerful one. “There are several growth factors [defined below] in the alpha granules of platelets, which stimulate the process of collagen synthesis,” says Dr. Nwubah. “Resurfacing treatments, such as microneedling and fractional lasers, which are frequently paired with PRP, are also well established collagen-induction therapies, as they directly spur collagen formation and wound healing by causing [a deliberate and controlled] injury in the dermis.” By drilling tiny portals in the skin with heat, these devices allow topically applied PRP to penetrate deep, for “a double benefit and overall enhanced results.”
Growth factors
These proteins stimulate cell growth and healing “in areas that are not performing like they should,” says Dr. Nwubah. Platelets, once injected, release various kinds of growth factors, which spark the construction of new hair and skin cells, collagen and elastin proteins, blood vessels (to boost circulation), and more.
O-Shot (Orgasm Shot)
When PRP is injected into the clitoris and front wall of the vagina, “it regenerates cells that have been affected by childbirth, menopause, or chemotherapy, making them more sensitive and responsive so women can have more intense and more frequent orgasms,” Dr. Nwubah says. In a pilot study of the procedure, researchers note that “in addition to increased blood flow, collagen and sensory nerve regrowth might relieve coital discomfort as well as enhance vaginal sensitivity. Also, increased blood flow in the clitoris … could lead to improved arousal and orgasm.” PRP can also increase vaginal lubrication, Dr. Nwubah adds, and combat urinary incontinence. “The bladder sits right under the part of the vagina that we’re injecting. By building collagen in the area, we get some tightening and increased tissue strength that helps with incontinence.”
Platelets
Made in our bone marrow, platelets are fragments of cells that form clots and “initiate the process of wound healing and repair,” says Dr. Nwubah. They also manufacture a number of growth factors, including PDGF, or platelet-derived growth factor; it plays a role in the formation and development of blood vessels, which are pivotal to healing.
PRP results
“For hair growth, it generally takes three treatments, spaced one month apart, before people see noticeable results—which is why I strongly advise patients against doing just one or two rounds,” says Dr. Nwubah. After the initial series, people generally come back every six months for maintenance. For the O-Shot, most women notice a difference after a few weeks, and Dr. Nwubah typically recommends a repeat treatment after six months. “With microneedling and PRP, you’ll see some awesome effects immediately—and continue to see positive changes in your skin for six months to a year, since collagen production and remodeling can take that long.” For best results, plan on two to four treatments, every six weeks, and a touch-up every year.
Related: The 5 Treatments RealSelf Editors Can’t Wait to Try in 2020
PRP safety
When performed by a board-certified physician with the proper training and experience, “PRP is very safe,” says Dr. Nwubah. Doctors should take care to label vials with the patient’s initials immediately after the blood draw, while the patient is watching. They should treat only one PRP patient at a time, using sterile equipment and new vials and needles, “discarding all products from each patient once treatment is complete, and never reusing microneedling pens.” The most common side effects of PRP injections are short-term swelling and discomfort.
Regenerative medicine
PRP is a form of regenerative medicine—the process of replacing or renewing damaged cells or tissues by stimulating the body’s own repair mechanisms to help establish normal functioning, says Dr. Nwubah. “Regenerative medicine is so exciting because it allows us to wake up parts of ourselves that we thought were gone for good and make them grow anew.”
