Acell + PRP for Hairloss?

Thank you for your question. I understand you’ve had thin hair ever since you were young, and that you experience hair loss that is associated particularly with dieting. You’ve also described some possible therapeutic options which included topical minoxidil and ACell with PRP, in the absence of having a hair transplant. You’ve also expressed concern about FDA approval.I can certainly help you with your concerns, as I do specialize in treatment of hair loss and have performed hair transplant surgery for over 20 years. I am the founder of TrichoStem® Hair Regeneration centers, which offer a non-surgical hair loss treatment alternative using ACell and PRP in a very specific method which I developed. I’m also a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon.Let’s begin with the FDA’s role in medical practice. The United States FDA regulates drugs and devices, and, through rigorous proof and testing of safety and other things, allows the use of certain drugs and devices. The FDA, however, does not regulate medical practice, nor does it interfere with the physician’s authority to give their patients the best treatment. In fact, in the FDA Modernization Act of 1997, the FDA is actually prohibited from interfering with a physician’s ability to treat their patients.I think the confusion lies in the term “off-label use”, which people often misinterpret to mean “experimental”. This is an incorrect assumption. What it actually means is that once a drug or device is approved for use on people in the United States, doctors have the flexibility to use the said drug without having to disclose to patients what the drug or device is FDA-approved for. For example, Botox is FDA-approved specifically for use on the glabella or the number 11 lines. However, we use Botox everywhere: for crow’s feet, smile lines, and even underarm sweating. We use it for a number of indications, because as physicians we have the authority to use a drug or device to help our patients, and it isn’t considered experimental. In addition to this, the practicalities of getting FDA approval for every single indication is just not possible considering the number of applications of any given drug or device. FDA approval gives certain permission to a level, but in no way does it affect how a doctor uses a drug or device. For example, ACell is a wound-healing material that has been FDA-approved for human use since 2008. It is used commonly in general surgery and gynecologic surgery. In my practice, I use it for cosmetic and reconstructive procedures. As you can see, there are a lot of different ways to use this material, so it is completely within reason for a physician to use ACell for hair loss treatment. There are some ignorant physicians and plastic surgeons who often irresponsibly misuse the term FDA approval, regardless of whether it’s for ACell or PRP, and it is our duty as doctors to properly inform patients and not use terms inappropriately. If you are considering ACell plus PRP, don’t let the absence of a specific FDA approval for hair loss get in your way. In my practice, we have been using ACell and PRP in a treatment we call Hair Regeneration for our company TrichoStem® Hair Regeneration. We use this to treat pattern hair loss in both men and women and it has been very effective. We usually do a single treatment, but for those with more advanced hair loss, we can do a second treatment based on that particular individual’s response. We’ve had to really work hard to develop an algorithm based on experience of hundreds to thousands of patients over several years, to a point where we can say that we have enough data and volume to show that the results are sustainable for at least three to five years. The Hair Regeneration treatment is considerably more sustainable than a hair transplant because no surgery is involved. In addition, hair transplants do not stop the progression of hair loss and the donor area itself is limited. We are currently using Hair Regeneration has a long-term solution for hair loss.The key here is proper diagnosis. It is very important that what you are experiencing is pattern hair loss. Though we have used this treatment for other medical conditions, we’ve had consistently great results in pattern hair loss patients, with more than 99% of male patients and more than 90% of female patients responding very well. The bottom line is, as long as your hair is thinning, it’s a genetic pattern-based issue, and hair is still present, we can treat pattern hair loss with ACell and PRP, or what we call Hair Regeneration in our practice.I recommend that you look for doctors who perform this treatment and learn more. I hope that was helpful and I wish you the best of luck!

Platelet-rich plasma has been utilized for years in wound healing and orthopedic conditions, but more recently it has gained traction in aesthetic medicine, especially with respect to hair loss. Several clinicians have had some success in treating alopecia of various etiologies (lichen planopilaris, alopecia areata, etc), but most of the limited data have been focused on PRP use for male- and female-pattern hair loss.
The mechanism of action involves platelets’ ability to aggregate together, activate, and release alpha-granules containing various growth factors, such as platelet derived growth factor, transforming growth factor beta, vascular endothelial growth factor, epidermal growth factor, fibroblast growth factor, and insulin like growth factor-1 (IGF-1). Their release increases angiogenesis and vascularization, providing resting telogen hairs the signal that they need to enter the anagen phase. This increased vascularization and mix of growth factors also fosters the proliferation of dermal papilla cells and inhibits apoptosis, helping to prolong the anagen phase.More specific to androgenetic alopecia, PRP may help to counteract certain effects of dihydrotestosterone (DHT). In a mouse model of androgenetic alopecia, DHT was shown to block IGF-1 contributing to hair loss and PRP is a known source of IGF-1.
Platelet-rich plasma is fully autologous and thus provides patients a more “natural” treatment, with side effects limited to procedural discomfort and bruising.
There is no standard system, quantity, or interval of treatment regarding PRP for hair loss, which is why we currently utilize a proprietary hyperconcentrated platelet rich plasma concentration and treat patients monthly 4 times, then reevaluate after 8 to 12 months. If a patient has a response, then retreatment at follow-up may result in continued efficacy if performed at a 6- to 12-month basis.

Although there are those who feel the combination of A Cell with their PRP injections adds to their patient's hair restoration results, I have not seen any clinical studies that prove that there truly is a benefit.  I have seen significatn results using PRP treatments alone which are backed by some clinical studies.  A Cell is very expensive and I don't see the value of the added cost to the patient.  If some studies come out proving A Cell's  added benefit vs. PRP alone I would consider adding this to my PRP treatments especially if it can enhance and prolong the PRP results- requiring less treatments over a long period time = cost savings.