Is my hair suitable for PRP? (Photo)

Question

Hi, I'm in my early 30's and are starting to loosing hair (runs in my genes). I want to use a hair transplat as a last option/solution and are considering gettting 4-5 PRP treatments with 1-1,5 month in between and an yearly follow up. Is it suitable for my hair or do you recommend me to get the hair transplant? Thanks in advance

Jeff Rapaport, MD · Answer

It's hard to answer without  a complete consultation. A history  including family and personal history is needed. Duration of hair loss is essential. A phototricogram to evaluate your state of miniaturization would be important.  A discussion of your acceptance of monotherapy vs combination is necessary to determine your success. Much more information is needed. In a PRP expert hands, a 4 month trial with an assessment using an AI hair camera (Hair Metrix) will determine if PRP is a viable alternative vs a transplant. You may also want to think about adding Amniotic Fluid to your Progen brand PRP. 
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Rene Garcia, MD · Answer

As an aesthetic doctor I will recommend to start a conservative treatment for at least 8-12 months. Starting with good habits, less stress, 7-8 hr of sleep, oral nutraceuticals, oral or topical meds scubas finasteride or minoxidil, LED therapy and PRP at least 4 session. Then do an assessment and consider a hair transplant once you try all these alternatives.

Elizabeth Wick, MD · Answer

PRP is a great option for younger patients (under 35) looking to improve their hair and/or delay the need for hair transplantation. It works best when performed as a series of 3 - 4 treatments separated by 1 month each. After this, maintenance treatments are suggested every 4 - 6 months to maintain the effect for around 2 years. Results from PRP can be variable, however, because the concentration of growth factors in the blood vary between people and the time of the day based on individual stress levels. 
The results of PRP also depend on the presence of remaining hair follicles. Hereditary balding can lead to complete loss of follicles (shiny balding), after which PRP does not offer improvement. In this situation, the only option to restore hair is hair transplantation which has the advantage of being a permanent treatment. 
The last thing I will add regarding hair loss prevention, and delaying hair transplantation, is that you should really consider starting a combination of topical minoxidil (Rogaine) and some form of finasteride (Propecia) or dutasteride. Oral Propecia is FDA approved to treat hair loss, but has a small (~2.5%) associated risk of temporary sexual side effects. While the oral form is the most effective form, topical forms have also been shown to be effective in slowing or stopping hair loss without the sexual side effects. I have patients that love this option, but it’s a personal decision since the oral form is slightly more effective. 
These medications should be prescribed by a physician that specialize in hair loss treatment such as a facial plastic surgeon, dermatologist, or plastic surgeon. Best wishes!

Patrick Yam, MD · Answer

There are many patients with moderate to severe androgenetic hair loss who wonder whether it's worth it to do PRP or go straight to a hair transplant procedure. Each situation is different and likely depends on several factors. Consider your goals and where you are starting. PRP might improve hair density and quality, but results would depend on concentration and dose of platelets in the PRP, age and overall health, type of PRP system used, and whether you are combining with other treatmetns at home such as microneedling, topical growth factors or medications (e.g. minoxidil, finasteride), low-level laser therapy (LLLT), Vit D, massage, etc. In general when considering moderate to severe hair loss, transplantation will have better results, however there are important considerations and even transplanted hair will not last forever.
For a hair transplant procedure to work well, you need enough healthy donor hair to transplant to the balding area. PRP used before, during and after the transplant procedure can improve results as more donor hairs will survive the transplant process. Like PRP, the other supporting treatments could help to improve the blood flow to the scalp and thus the hair itself. Without support, the donor hairs will eventually suffer the same fate as the hairs that were in those areas in the first place (miniturization, shortened growing phase and eventually hair loss). 
As for the interval of PRP treatments, a recent meta-analysis by Georgescu et al in the Journal of Personalized Medicine showed that closer intervals are associated with better outcomes, so you might be advised to have the treatments every 2 weeks instead of every month. You could also consider other adjuvant treatments with PRP such as Acellular matrix (Acell), or at the very least microneedling. 
In summary, PRP and other regenerative treatments can help whether or not you are going to do hair transplant. It's important to support your hair growth at home using other treatments as well. Transplanted hair also needs to be supported for long-term survival.

Is my hair suitable for PRP? (Photo)

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