1. PRP, medication or Transplant, which one. (photos)

2. What qualification/degree i look for while consulting a doctor or dermatologist. I have been suffering from hair loss for about 3-4 years. I am very confused about it. Whatever hair I have on my scalp are gray. That's another issue, but I am more worried about hair loss. I have no clue where to start from or should I even see a dermatologist. Hair treatments are expensive and that's one of the reasons I never opted for a dermatologist. Now, situation is worsening and I feel if I don't do it now, then it's going to be very late.

Doctor Answers 7

Hair Restoration

Thank you for the question. All 3 treatments that you have mentioned are something we offer here in my practice and can all be used in conjunction with each other proving excellent results.  It is important at this point to maintain what you have, and to slow down the rate at which you are losing your hair. Medication may be key in that aspect.  A combination of PRP and Neograft Hair transplant surgery may be the next step in restoring what you have lost, by encouraging new growth with PRP in the Crown area and following with a transplant procedure to rebuild your front hair line filling in your temporal area and so on.

New York General Surgeon

You should stabilize your aggressive hair loss first before considering a transplant - you do have options to stabilize it

Thank you for your question. You’re asking about platelet-rich plasma (PRP) versus transplants and hair loss treatments, and you submitted several photos. Your question expresses very well the frustration you and many people have when it comes to trying to find,, as you describe, the most qualified doctor to help you with your hair loss. You also state in your question that treatments for hair loss, especially with dermatologists, are expensive. You’re in a situation where you say you started losing hair 3-4 years ago,  and the hair you have is gray as a separate issue. Your primary concern is the most cost-effective approach for treating hair loss.

I can help you understand from a general perspective on how hair loss is treated. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I’ve 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 from hair transplant surgery, but is now a non-surgical approach to hair loss for many people like yourself who come to us from around the world. Hair Regeneration uses stem cell-based wound healing technology to treat men and women with thinning hair.

For the challenge of finding the right doctor for this problem with hair loss, the first issue is the correct diagnosis. Fortunately, common things happen commonly, so 95% of hair loss is genetic pattern inherited hair loss, referred to as androgenetic alopecia in both men and women.

Treatment options are relatively small in number, so if you were to start your journey with finding a physician such as a dermatologist, you would at least get the important information you need to establish the diagnosis. Understand that treatment for hair loss, or any aesthetic treatment,  is going to be expensive. There is no getting around the cost. Seeking opinions from doctors, you are not going to necessarily land on the right doctor for you on day one with the first appointment. There is a challenge in finding the right fit for you, and the right doctor, and it’s not necessarily specialty specific. Every doctor comes to hair loss from a perspective that works for them, so if you were to reach out to a hair transplant doctor, there is a very good chance the doctor, not necessarily being 100% biased, but their solutions are predominantly surgical. They will likely discuss the options of transplant surgery and options for hair loss stabilization.

I counsel my patients by saying there are medical treatments, surgical treatments, and then there is the treatment we developed called Hair Regeneration. This is not intended to sell you on the idea of just one solution or option. Understand that what you are dealing with, from the photos you submitted, is a fairly aggressive pattern of hair loss that looks like androgenetic alopecia, or male pattern hair loss, especially if it only started 3-4 years ago. You are losing hair at a very rapid pace. My approach to someone like yourself would be inform you about the options of medical therapies such as the topical application of minoxidil, and finasteride which is a DHT (dihydrotestosterone) blocker which can help up to 60% of men with slowing the progression, but it’s not used for women.

That said, unfortunately a lot of men who come to our practice are reluctant to choose to take finasteride because they are afraid of the potential long-term sexual side effects. Clinically speaking, I disagree with the perception of it being common since in my practice, and among many of my colleagues who I speak to, it is very rare to have these side effects. No one I know can actually remember any patient who had suffered long-term side effects. In my experience, if someone were to have a side-effect from finasteride such as decreased libido, we stop the drug, and they’re back to their normal baseline soon after.

We’ve done hair transplants for many years, and used to average of 3-5 transplants per week. We were trying to develop a solution to help the transplants heal better using a material called Acellular matrix. This is a wound healing material that uses adult stem cells from your own body to help improve healing of grafts and the donor area, or the strip at the back of the scalp where we harvest the grafts. Thinning hairs started to get thicker in certain patients as side effect, so we developed over the course of several years a predictable, consistent way to use an injection treatment, which became known as Hair Regeneration.  Hair Regeneration is basically a combination of  Acellular matrix and platelet-rich plasma (PRP) put together in a very specific way, which I inject at different levels of the skin to actually stop the progression of hair loss, reactivate hair that is not growing, and induce the shed of thinning hair so that thicker hair grow in its place. People say this sounds much too good to be true, and I can understand their skepticism, but we have over 5-7 years of data showing stability and effectiveness, and these results we’ve been able to establish occurred from just one injection session.

I always customize these treatments, so patients who have more moderate to severe hair loss may get a second injection treatment. The second injection is for  strengthening fine hairs that were literally rescued from near death by the first treatment, and those hairs get thicker when I treat people somewhere around 15-18 months so they get more coverage. It’s been such a successful solution as an alternative to hair transplant surgery that patients are coming to us from all over the world, and my patient coordinator has become kind of an air traffic controller. Timing for you is critical, so in your situation, I would want you to do medical therapy and Hair Regeneration treatment before considering hair transplant surgery.

Going back to your question about what you should look for,  I think doing a lot of research to find the solution or the physician you feel you can trust in terms of discussing your concerns, budget, and what options are available. Unfortunately, time is not on your side - with this much advanced hair loss, once the hair is gone,  the limitation of Hair Regeneration treatment is the inventory of salvageable follicles. The earlier we treat someone, the better it is. Our youngest male patient to date is 17,and our youngest female patient is 16, so genetic pattern loss can affect people at a very young age.

For cost-effectiveness and cost in general, , I developed it in a way so it would be as accessible as possible. I think Hair Regeneration has been a significant cost savings for many patients who would otherwise have considered a hair transplant. People who go for a hair transplant not only get one done, but generally need multiple transplants because they continue to lose hair, especially if they’re not on any medical therapy to stabilize hair loss- that’s an important factor to include when calculating cost. Don’t be afraid to spend some money to meet with doctors. You are dealing with professionals who can help you, and if hair is important to you, you have to put in time and money to find the right resources. I don’t think anyone would say there is only one solution for everybody, and everyone should go to the same place.

Consider what I’ve discussed with regards to your question and then move forward on your journey to take the first step before you lose more hair. I hope that was helpful, I wish you the best of luck, and thank you for your question.

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Amiya Prasad, MD
New York Oculoplastic Surgeon
4.3 out of 5 stars 70 reviews

Hair transplant Plus a non surgical treatment will do

Hello, Rahul. For what I can see in the pictures you provided, your priority is to slow down the rate of your hair falling. To restore the hairline and density you will need a hair transplant. We usually combine treatments on order to achieve better results. PRP has great results and can give your newly transplanted hair and extra push to grow successfully.Through a consultation a Hair Doctor will be able to determine the number of grafts needed to achieve your goals.Best of lucks

William Yates, MD
Chicago Hair Restoration Surgeon
4.8 out of 5 stars 23 reviews

Hair Loss Treatment Options

Thanks for your question!  You could benefit from all three therapies you listed - medication, PRP and hair transplantation.  When I perform hair transplants I like to also include PRP in this treatment.  I do both scalp injections of PRP preoperatively and I like to soak the harvested grafts in PRP before transplanting.  This in combination with rogaine can give you an excellent result.  Be sure to do research before choosing your surgeon and feel free to get several opinions from hair experts.  Best of luck to you!

K. Roxanne Grawe, MD
Columbus Plastic Surgeon
4.9 out of 5 stars 137 reviews

PRP vs transplant

From the looks of your hair, you would most benefit from a hair transplant. This assumes you have a good donor site. I think you are past the point of benefit from PRP alone.  To find a great local hair physician, look at reviews, certifications, before/after pics, and the website. Meet with the doctor, and trust your gut.
Best of luck with your hair restoration journey.

Benjamin C. Paul, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 35 reviews

Hair transplants or PRP

You need to be evaluated to make sure you are a candidate for hair transplantation. If so, this is a far superior option for you than PRP

Jeff Donovan, MD, PhD
Vancouver Dermatologist

Hair Restoration with both medical therapy and surgical treatment

Most patients in your position with your pattern of hair loss are eligible for hair transplant, injections with PRP and medical therapy such as Propecia and Rogaine.  You could potentially benefit from all 3, but the hair transplant is likely to make the most difference. 

Kevin Ende, MD
Manhattan Facial Plastic Surgeon
4.6 out of 5 stars 10 reviews

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