What is the difference between PRP and ACEL for hair restoration?

Thank you for your question. You’re asking about the difference between PRP and ACell for hair restoration treatment.
I can help you understand how I explain our treatment and a lot of the nuance in the substance of your question. 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 derived from the use and experience in using PRP and Acellular matrix going on for over 7 years helping patients from around the world and arguably amongst the first physicians to use this material. We have developed systems based on individual clinical profiles to customize the treatment.
I want to first give you a little historic perspective. Acellular matrix was first being employed for hair transplant surgery. Hair transplant surgery has always been fraught with two significant challenges: maximizing the survival of hair grafts, and  improving the healing of the donor area. A serendipitous consequence, like many medical discoveries, was thinning hairs in some patients appeared to get thicker.
After seeing that possibility, I started to offer the treatment as a standalone procedure for different types of hair loss, including male pattern loss, female pattern hair loss, alopecia areata, scarring alopecia such as lichen planopilaris, central centrifugal cicatricial alopecia, frontal fibrosing alopecia, and alopecia totalis. We were trying to help as many patients as we could with what was in the beginning a significant impact in the treatment of hair loss.
I have determined over the course of time, and an evolution especially in the early years where very few people were doing this, and there were no clear answers on the best way to formulate the PRP, dose the Acellular matrix, to dose it in individual injections, and the best way to deliver the material. We were dealing with a lot of unknowns, so to help develop predictability and consistency, we had to look at our results very critically, document the responses, and look at the dosing very specifically, which took many years - I think it’s always a work in progress.
At this point, we have algorithms based on what I call clinical profiles. What we do to help our patients is determine the relative value of our system based on gender, age, age of onset of hair loss, rate of progression of hair loss, degree of hair loss, other previous treatments, the responsiveness, and other medical variables important in managing hair loss. What we’re doing essentially is managing hair loss.
Many of our more vocal colleagues were very dismissive and continue to be dismissive. Thankfully, in dermatology literature, PRP’s role in hair loss is now well established through the publication of peer reviewed articles. It took time, but eventually they started to catch up.
A challenge you’re facing now as a prospective patient is doctors are embracing this as a potential benefit with helping people with hair loss without having a clear plan. PRP can stimulate hair growth, and Acellular matrix can stimulate hair growth, so what’s the difference? We have to think about it as a scientific point of view.  Acellular matrix exists not just for hair loss, as its original purpose was for wound healing, and continues to be. I use this material extensively in my other cosmetic procedures from face lifting surgery, skin grafts, tissue grafts, for any kind of incision when I want to expedite healing, and challenging situations like reconstructive procedures. I leverage the benefit of Acellular matrix for its ability to stimulate adult stem cells and to enhance wound healing. I find the combination is greater than each element on its own. However, the dosing and delivery methods is what challenged us continuously to optimize the results for our patients.
There is no clear understanding on the mechanism of how these modalities help people stimulate hair growth. But in our practice, we have developed are algorithms to help different patients with different clinical profiles. I look at the feasibility,the practical longevity, and effectiveness in every given patient’s clinical profile. For example, a young male with aggressive hair loss progression and advanced hair loss is going to be treated very differently than a middle aged male with slow progression, later onset and moderate hair loss; or a female with later onset and moderate hair loss. Each patient comes with their own clinical profile.
It’s very important to meet with a doctor and ask what their plan is. Is the plan simply to come to the office every month for an injection? Or come to the office every 3 months for an injection with no clear sense of the expected outcome? And what is the commitment to long-term management? I think a lot of my colleagues are getting an awakening about this one-size-fits-all approach, the distinction of who has the best PRP machine, or my PRP is better than the guy next door which is not relevant, and whether the shotgun approach using the same formulation of PRP and Acellular matrix for every patient that doesn’t yield the same results they would expect with consistency, and is already starting to become the case. Patients are reaching out to us after they’ve had treatments done elsewhere for a more experienced perspective.
It’s ultimately in your best interest to interview the doctors, and see what their level of experience is, whether or not you can get some sense of predictability, and what kind of role does this technology play in your overall hair loss management. I emphasize to all our patients that 95% of patients with hair loss have androgenetic alopecia, or genetic pattern loss, and it is progressive. There is no cure, but there are strategies to manage hair loss: pharmaceuticals, non-surgical treatment, as well as surgical. The art is in maximizing the effectiveness to get the most coverage for the longest period of time, and managing this hardwiring in the DNA. I hope that was helpful, I wish you the best of luck, and thank you for your question.

Thank you for your question about PRP hair restoration. In our office we only use platelet rich plasma,PRP for hair restoration.  PRP is your own blood product so there is no risk of an adverse reaction occuring.  Orthopedic providers have been injecting PRP into joints to treat arthritis and other degenerative diseases for many years.  PRP is full of growth factors, proteins and other nutrients that stimulate hair growth.  PRP offers a much higher percentage of nutrients needed for restoration than synthetic growth factors do.
ACELL is a synthetic product used for similar purposes.  
To be sure, see two or more experienced, licensed and board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment. I hope this helps.

Good question.  ACELL is made of pig bladder and can be combined with PRP therapy.  However, it adds to the cost significantly and there really is no strong literature to support its efficacy.  However, there is evidence that PRP can improve hair thickness and density. Thus, we don't like to use ACEL but do perform PRP routinely along with microneedling to the scalp.