21 years old, severe hair thinning had 3 PRP treatments done. Had best results which went away in a month. What's next? (Photo)

Thank you for your question. I understand that you had some fungal infections in your scalp and that you lost some hair. After undergoing platelet-rich plasma treatment, you observed some improvement. In more recent history, you were placed on a 100mg Fluconazole to take weekly, and finasteride, and you say that your hair has fallen out because of those drugs.Just a bit about my background — I’m a Board-certified cosmetic surgeon and a Fellowship-trained oculofacial plastic surgeon, practicing in Manhattan and Long Island for over 20 years. I’m also a hair specialist and the founder of Trichostem™ Hair Regeneration Centers, which offers a non-surgical alternative hair loss treatment using platelet-rich plasma (PRP) and extracellular matrix.Fungal infections can be quite difficult to manage as they require both topical and systemic treatment. These infections also have been known to cause some degree of hair loss. It’s important to point however that it appears that you also have genetic male pattern hair loss or androgenetic alopecia. Now, you had PRP injections which appeared to help you, but then you still had some hair fall, so you may be making the error of correlating the initiation of finasteride and fluconazole with causation of hair loss. With finasteride, what it does is inhibit an enzyme called 5-alpha reductase, which is responsible for converting testosterone to dihydrotestosterone. Hair follicles that are sensitive to dihydrotestosterone will thin out, so when you address the levels of dihydrotestosterone with finasteride, the drug will actually slow down the thinning process. It does not, however, stop hair loss and is beneficial for only about 60% of men, meaning 40% will not respond. In addition to this, a lot of patients in general prefer not to take finasteride because of concerns of long-term sexual side effects.It is certainly important that you address your fungal issues, but there is also a good opportunity for you to try a treatment that is slightly different from PRP injections. Now, PRP is a wonderful treatment that we use for a number of concerns: fine lines, wrinkles, acne scars, scar revision, complexion improvement. Having PRP injections for hair loss, I think, has only a short-term benefit. This is reflected by my observations of patients who come to us after they had platelet-rich plasma injections elsewhere, and say that while they did see some improvement, they weren’t sure if they could keep up with the injections every month for about 4 months.This has led us to develop Hair Regeneration, which uses a combination of platelet-rich plasma and extracellular matrix to provide a long-term solution for male pattern or female pattern hair loss. With over five years’ worth of clinical data gathered, we’ve been able to stop the progression, initiate or reactivate growth of existing hairs, and thicken thinning hairs for the majority of our patients in a single session. In some cases, we will do a second treatment in the second year.If you’re still quite young and you have aggressive hair loss, that means you have limited window to do something to treat the hair loss. Keep in mind that you may also be making an error in the way you interpret the cause of your hair loss, as it might be due to the wearing off of the effects of platelet-rich plasma and the concurrent presence of a fungal infection. Taking finasteride is a reasonable step, but at the same time, you may want to learn more about a treatment like Hair Regeneration to get you to a place where you can maximize your results.I hope that was helpful and I wish you the best of luck!This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.

If you still have a fungal infection of your scalp you need to treat this. PRP will not help with fungal infections.  You need to follow up with your doctor.