Alternatives to failed PRP at age 20?

Question

I'm 20. Started thinning around 16. I have lost a considerable amount of hair and now look 40. While although I don't have "bald spots" the top of my head is quite thin and my hair line is running away. I have had 3 PRP treatments spaced 6 weeks and have had a laser hat used for 30 min 3 times a week. I don't think it's changed a thing. Money is no issue but not having hair is. I am in need of a solution as I can't really afford to go bald.

Jason Emer, MD · Answer

Prp is effective, but I have a very specific protocol, every 3-4 weeks for 6 months with prp therapy.  I also add in progesterone to speed the healing process.  After that the injections are tailored down.  You should also be on viviscal and other growth promoting ingredients. See an expert for a formal evaluation. Best, Dr. Emer

Emrah Cinik, MD · Answer

There are alternatives for PRP treatment like supplements. You can use finasteride and minoxidil as an alternative for PRP

Jacqueline T. Cheng, MD · Answer

Hello, and thank you for question regarding PRP. PRP should help promote greater hair thickness and density especially in young, healthy patients. Your board-certified facial plastic surgeon should follow a protocol of about once a month for the first four months followed by treatments every three to six months afterwards. Depending on where you are in your treatment cycle, you may need more time to see results. Genetic factors also play a part. If PRP does not produce the results you want, schedule an in-person consultation with board-certified plastic surgeon to discuss other options including Finasteride and Minoxidil. These drugs may also work alongside PRP treatments if your board-certified facial plastic surgeon recommends continuing PRP. Good luck with your treatments!
- Jacqueline T. Cheng, MD

Kenneth Hughes, MD · Answer

The research performed and the anecdotal evidence would suggest that thickness of hair and density can improve with PRP injections.  The number of sessions as well as the quality of PRP obtained will vary considerably physician to physician.

Kevin Ende, MD · Answer

Although the PRP hasn't worked for you yet, consider either continuing it with the current doctor or trying a new doctor.  Also, you didn't mention minoxidil or finasteride.

Jeff Rapaport, MD · Answer

In my opinion, PRP should work well for young individuals. A visit to a hair expert would confirm the diagnosis of androgenic alopecia. Should you have androgenic alopecia, It is possible that the growth factors and cytokines in PRP cannot overcome the effects of DHT due to your genetics. Adding finasteride and minoxidil to your program of PRP may correct the imbalance. Find a PRP expert. Ask to see photos.PRP hair md.com

Kriston Kent, MD, MPH · Answer

Thank you for your question.
Hair
loss at your age is certainly undesirable, and so far it appears that attempts
to slow down, or
arrest, the process have been unsuccessful. In my experience, PRP treatments,
with high growth factor counts, will be successful 70-80% of the time.
Hopefully, you have undergone a medical workup for reversible causes of hair
loss. If no metabolic or other causes can be found, we are now using a new
technology that allows us to use a combination of adult regenerative stem cells
and PRP to repair and reactivate dormant and ailing hair follicles.

Karl Hekimian, MD · Answer

Responses to PRP can vary but it would be worth continuing the treatments, and the laser.  You should also consider adding minoxidil (Rogaine) and discussing use of finasteride (PRP) with a hair loss physician.  20 is young to consider hair transplantation for a number of reasons, but a visit to a hair restoration center that does weaves and hair systems may be worth your while as well.

Joyce Davis, MD · Answer

Although PRP treatments work for most types of hair loss, you may need medical therapy as well.  Hair loss/thinning on the top of the head is often androgenic.  See a dermatologist for a medical visit to be evaluated for Propecia or Avodart prescriptions.  There is also Minoxidil foam 5% available for over the counter purchase.

Amiya Prasad, MD - Account Suspended · Answer

Thank you for your question. You are 20-years-old, and started losing hair at 16. Although you don't have any bald spots, you have very thin hair, and your hairline is receding, so you say you look 40. You are describe the treatment strategies you’ve employed so far which are 3 PRP injections spaced about 6 weeks apart, and laser therapy for 30 minutes, 3 times a week. You feel like you’ve not gotten any improvement, and you’re looking for some potential options to help deal with your hair loss.
I can share with you my impression of your situation in the absence of a physical examination, and more detail about your family and medical history. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. I am also the founder of TrichoStem™ Hair Regeneration Centers, a system we developed that evolved out of hair transplant surgery using PRP and Acellular matrix to help men and women with genetic pattern hair loss non-surgically. We have treated patients from all over the world, and have extensive experience as we’re among the first, and at this point, probably the most experienced with this regenerative medicine technology which you have been trying to apply for yourself. With the knowledge gained from 7-8 years of experience, I can give you some guidance on what your clinical picture is. 
The measure of success in your situation is probably looking at things from a very short-term perspective. If you’ve had an injection done every 6 weeks of PRP, your doctor should have given you some guidance on what to expect after these treatments. 
When we were first using platelet-rich plasma and Acellular matrix (extracellular matrix) which is a wound healing material, we were using this for patients during hair transplant surgery. What we learned over time was thinning hair actually became thicker, in addition to the grafts and the donor area healing better. However, the results we saw came a year after the injections.
Over the course of several years since, I have looked at examples of patients over different protocols we ultimately developed for men and women of different ages and clinical profiles. What we have learned over time is to develop a classification system of the relative aggressiveness of a person’s hair loss. 
PRP has been established after many years of my colleagues dismissing it as a viable way to help treat hair loss. The challenge I feel with PRP is the longevity of its effect. When somebody has aggressive pattern of hair loss, the stimulatory effect of the PRP may be overwhelmed by the genetics, and this is important. 
When we look at a patient again with the experience, we first developed protocols, systems, and processes to customize the treatments for every patient. I would assert that PRP alone is not going to be as effective as PRP with Acellular matrix, but even that may not be effective enough in your case.
When we look at our patients, and we benefited from consistent high rates of success of a wide range of patients of different ages, different degrees of hair loss, and different rates of progression, but there would be patients who didn't respond. Patients who may have had an initial response, then they started to lose hair. I looked at these patients from a viewpoint of what else could have I done to help them in addition to this significant treatment of using platelet-rich plasma and Acellular matrix, which essentially created a new category of regenerative medicine technology. Looking at certain groups, and the group I think applies to you is a young person with early age of onset with rapid progression. In my practice when I meet someone like yourself, one of the things I strongly recommend is a DHT-blocker like the drug finasteride. With the benefit of experience, we’ve learned that even with patients who can do well with the stimulatory effect of Hair Regeneration, helping a patient who has relatively high DHT-sensitivity by diminishing the amount of DHT with finasteride has a potential value. 
The hard lesson to recognize and acknowledge is that no treatment is a cure. Whether you are using minoxidil,finasteride, Hair Regeneration, or hair transplant, none of these are cures - these are all management strategies to help people maximize coverage. 
I also recommend finasteride in a situation where somebody has such aggressive progression, because there is a value in finasteride slowing down that progression, and there’s the synergy of a treatment like Hair Regeneration which can stimulate the growth. You combine a prolongation with the stimulation of hair growth, and you get better coverage. However, there is going to be a certain expiration of all of these modalities where you will eventually lose the rest of your hair. What my strategy is with my patients is to delay that as long as possible, and delay the need for transplantation as long as possible. 
If you are very committed to dealing with this genetic situation, discuss with your doctor the use of a DHT-blocker. Discuss with your doctor this strategy where is the horizon when it comes to these PRP injections. A lot of people are coming to us after undergoing multiple PRP injections, and feeling like they’re not getting benefit similar to yourself. I think why a lot of my colleagues are not quite there in terms of experience is they don't know how to recognize the effectiveness, as well as how to space the treatments in an optimal way. We have already done that to this point with our systems for different patients of different classifications. As I said, we have a classification system based on gender, age, onset of hair loss, rate of progression, degree of progression, previous medical treatments, relative success of those treatments, and other medical variables. 
There are a lot of moving parts, but ultimately there is a common characteristic which defines and distinguishes someone like yourself with a young onset, and rapid progression. Contrast that with someone in their 40s who started losing hair in their late 30s who only have a moderate amount of hair loss because they have a different level of DHT-sensitivity, and a different genetic program. These are important variables. It’s important to discuss this with the doctor doing the treatments for you, or another hair loss specialist about a strategy to help maximize the coverage for as long as possible. I hope that was helpful, I wish you the best of luck, and thank you for your question.

Alternatives to failed PRP at age 20?

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